HYPOTHYROIDISM A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Hypothyroidism: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83987-5 1. Hypothyroidism-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 hypothyroidism. 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 HYPOTHYROIDISM .................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Hypothyroidism ............................................................................ 4 E-Journals: PubMed Central ....................................................................................................... 40 The National Library of Medicine: PubMed ................................................................................ 42 CHAPTER 2. NUTRITION AND HYPOTHYROIDISM .......................................................................... 87 Overview...................................................................................................................................... 87 Finding Nutrition Studies on Hypothyroidism ........................................................................... 87 Federal Resources on Nutrition ................................................................................................... 92 Additional Web Resources ........................................................................................................... 92 CHAPTER 3. ALTERNATIVE MEDICINE AND HYPOTHYROIDISM .................................................... 95 Overview...................................................................................................................................... 95 National Center for Complementary and Alternative Medicine.................................................. 95 Additional Web Resources ......................................................................................................... 103 General References ..................................................................................................................... 106 CHAPTER 4. DISSERTATIONS ON HYPOTHYROIDISM .................................................................... 107 Overview.................................................................................................................................... 107 Dissertations on Hypothyroidism .............................................................................................. 107 Keeping Current ........................................................................................................................ 108 CHAPTER 5. CLINICAL TRIALS AND HYPOTHYROIDISM............................................................... 109 Overview.................................................................................................................................... 109 Recent Trials on Hypothyroidism .............................................................................................. 109 Keeping Current on Clinical Trials ........................................................................................... 110 CHAPTER 6. PATENTS ON HYPOTHYROIDISM ............................................................................... 113 Overview.................................................................................................................................... 113 Patents on Hypothyroidism ....................................................................................................... 113 Patent Applications on Hypothyroidism ................................................................................... 118 Keeping Current ........................................................................................................................ 122 CHAPTER 7. BOOKS ON HYPOTHYROIDISM .................................................................................. 123 Overview.................................................................................................................................... 123 Book Summaries: Federal Agencies............................................................................................ 123 Book Summaries: Online Booksellers......................................................................................... 124 The National Library of Medicine Book Index ........................................................................... 125 Chapters on Hypothyroidism ..................................................................................................... 126 CHAPTER 8. MULTIMEDIA ON HYPOTHYROIDISM........................................................................ 135 Overview.................................................................................................................................... 135 Bibliography: Multimedia on Hypothyroidism.......................................................................... 135 CHAPTER 9. PERIODICALS AND NEWS ON HYPOTHYROIDISM ..................................................... 137 Overview.................................................................................................................................... 137 News Services and Press Releases.............................................................................................. 137 Newsletter Articles .................................................................................................................... 140 Academic Periodicals covering Hypothyroidism ....................................................................... 142 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 143 Overview.................................................................................................................................... 143 U.S. Pharmacopeia..................................................................................................................... 143 Commercial Databases ............................................................................................................... 145 Researching Orphan Drugs ....................................................................................................... 145 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 149 Overview.................................................................................................................................... 149
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NIH Guidelines.......................................................................................................................... 149 NIH Databases........................................................................................................................... 151 Other Commercial Databases..................................................................................................... 154 The Genome Project and Hypothyroidism ................................................................................. 154 APPENDIX B. PATIENT RESOURCES ............................................................................................... 159 Overview.................................................................................................................................... 159 Patient Guideline Sources.......................................................................................................... 159 Finding Associations.................................................................................................................. 166 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 169 Overview.................................................................................................................................... 169 Preparation................................................................................................................................. 169 Finding a Local Medical Library................................................................................................ 169 Medical Libraries in the U.S. and Canada ................................................................................. 169 ONLINE GLOSSARIES................................................................................................................ 175 Online Dictionary Directories ................................................................................................... 181 HYPOTHYROIDISM DICTIONARY ........................................................................................ 183 INDEX .............................................................................................................................................. 259
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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 hypothyroidism 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 hypothyroidism, 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 hypothyroidism, 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 hypothyroidism. 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 hypothyroidism, 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 hypothyroidism. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON HYPOTHYROIDISM Overview In this chapter, we will show you how to locate peer-reviewed references and studies on hypothyroidism.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and hypothyroidism, 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 “hypothyroidism” (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: •
Hypothyroidism, Hyperthyroidism, Hyperparathyroidism Source: Patient Care. 33(14): 186-188, 191, 195-200, 202-203, 206. September 15, 1999. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: This article discusses the diagnosis and treatment of thyroid illnesses. These types of illnesses are among the most prevalent of the hormonal diseases that afflict people in the United States. Although hypothyroidism and hyperthyroidism are the most widespread, hyperparathyroidism (HPT) occurs in a large number of Americans as well. Diagnosis can be complicated because numerous patients present with nonspecific signs and symptoms that closely resemble other physical and mental conditions. Primary hypothyroidism occurs from failure of the thyroid gland itself, whereas
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Hypothyroidism
secondary hypothyroidism results from a deficiency of pituitary thyroid-stimulating hormone. The most common cause of hypothyroidism among adult patients is Hashimoto's thyroiditis. Other causes include drug side effects, congenital hypothyroidism, iodine excess, previous thyroidectomy, neck irradiation, and pituitary or hypothalamic disorders. Women who have type 1 diabetes are at greater risk for a temporary disorder known as postpartum thyroiditis. Signs and symptoms can be overt, subtle, or nonexistent. Diagnosis involves performing a physical examination and conducting laboratory tests. The treatment of choice for managing hypothyroidism is daily oral administration of levothyroxine. Some patients may benefit from referral to an endocrinologist. Hyperthyroidism, which is not as prevalent as hypothyroidism, is caused by Graves' disease or diffuse toxic goiter. Other causes include pituitary tumors, pituitary resistance to thyroid hormones, neonatal hyperthyroidism, and malignancies. Signs and symptoms can be overt, subtle, or nonexistent. Diagnosis involves performing a physical examination and conducting laboratory tests. Patient referral to an endocrinologist is indicated following a positive diagnosis or when hyperthyroidism is suspected. Treatment options include radioactive iodine therapy, antithyroid drugs, and surgery. HPT, another fairly common endocrine disorder, is the most common cause of hypercalcemia. Although about 75 percent of patients have no signs or symptoms attributable to this disease, it may affect the skeletal system, kidneys, and gastrointestinal tract. The only successful treatment is surgical removal of one or more parathyroid glands. Patients who have primary HPT should be referred to an endocrinologist. 1 figure. 4 tables. 5 references. •
Hypothyroidism: Often Overlooked, Easy to Treat Source: Access. 17(5): 30,32,34,36-37. May-June 2003. Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Chicago, IL 60611. (312) 440-8900. E-mail:
[email protected]. Website: www.adha.org. Summary: This article for dental hygienists reviews hypothyroidism, a condition in which the thyroid gland fails to produce sufficient quantities of thyroid hormones. The author discusses the healthy thyroid, the effects of low thyroid hormones, the causes of hypothyroidism, hypothyroidism at different stages of life, diagnosis and treatment of hypothyroidism, and implications for oral health care professionals. Gingivitis and dental caries (cavities) may occur in patients with untreated hypothyroidism because of mouth-breathing due to the enlarged tongues, as well as scalloping around the margins and chronic mucocutaneous candidiasis. Patients with untreated hypothyroidism should be treated only by the dentist and only emergency care should be delivered until the thyroid condition is corrected. The author also cautions readers to remember that untreated hypothyroid patients may be very sensitive to medications, thus care should be used when administering both over the counter and prescription analgesics, as well as hypnotics, and general and local anesthetics. 1 figure. 2 tables. 14 references.
Federally Funded Research on Hypothyroidism The U.S. Government supports a variety of research studies relating to hypothyroidism. These studies are tracked by the Office of Extramural Research at the National Institutes of
Studies
5
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 hypothyroidism. 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 hypothyroidism. The following is typical of the type of information found when searching the CRISP database for hypothyroidism: •
Project Title: A PANHYPOPITUITARY MOUSE MUTATION Principal Investigator & Institution: Camper, Sally A.; Professor; Human Genetics; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-APR-1993; Project End 31-MAR-2002 Summary: (Adapted from the Investigator's Abstract): This is a renewal application requesting five years of funding to continue Dr. Camper s research program to positionally clone and functionally characterize the mouse Ames dwarf (df) gene. The df mutation arose in descendants of an X-irradiated male mouse at Iowa State University in Ames, Iowa. Df is a recessive mutation that produces severe proportional dwarfism, hypothyroidism and infertility. The growth insufficiency results from a lack of thyroid stimulating hormone (TSH) and growth hormone (GH), and a lack of prolactin (PRL) contributes to the infertility of females. The Ames dwarf mice, like the Snell (Pitdw) dwarf mice, exhibit severe hypocellularity due to a deficiency in the three pituitary cells that produce PRL, GH, and TSH: lactotropes, somatotropes, and thyrotropes, respectively. The simultaneous loss of these three cell types suggest that they derive from a common precursor cell, and the similarity of the phenotypes of the non-allelic df and dw mutants suggests that the two mutated genes are involved in the proliferation and/or differentiation of this precursor cell. The dw mutation has been shown to result from defects in the Pit-1 transcription factor gene. In Specific Aim 1 Camper proposes to clone the df gene. The df critical region will be physically mapped and the 3.5 Mb YAC and P1 contig encompassing the 635 kb df critical region will be completed. Exon trapping and cDNA selection will be applied to identify transcripts within the df critical region. Full length cDNA clones will be generated for the identified transcripts and these clones will be used in Northern analyses, and if necessary RNase protection and RT-PCR assays, to determine the tissue distribution of the cloned transcripts. These studies will allow Camper to prioritize transcripts as products of possible candidate df genes. Candidate gene sequences will then be compared in normal and df mutant mice to detect mutations in the putative df gene. In Specific Aim 2, Camper will characterize the intron/exon structure and 5 end of the candidate df gene. In addition, df gene expression gene will be characterized by immunostaining of tissue sections, RT-PCR, RNase protection, in situ hybridization, and Northern analysis of pituitary cell lines. Confirmation that a mutation in a candidate gene is responsible for the df phenotype
2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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will be obtained in Specific Aim 3 by transgene correction, the generation of gain of function alleles, and the production of loss of function mutations. These studies will also begin to probe df gene function. Camper proposes in Specific Aim 4 to clone and chromosomally map the human df gene and to assess the association of df with human pituitary tumors and families of short stature. Specific Aim 5 will establish the role of the df gene within the hierarchy of genes regulating pituitary development by comparing the expression of early pituitary markers in df and dw and by examining df gene expression in other mouse mutants with pituitary defects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: A THYROID RECEPTOR CO-ACTIVATOR HYPOTHESIS FOR PSYCHOSIS Principal Investigator & Institution: Philibert, Robert A.; Psychiatry; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 01-JAN-2002; Project End 31-DEC-2005 Summary: (provided by applicant) Schizophrenia is a neurodevelopmental syndrome that affects approximately 1 percent of the U.S. population and is characterized by the presence of hallucinations and delusions. Genetic factors are thought to account for the majority of the vulnerability to illness for this syndrome. These genetic factors are thought to be composed of major, moderate ant mild effect loci. The identification and characterization of genetic factors of even mild effect loci is a critical step in the process of understanding the pathogenesis of this group of disorders. In prior moleular studies, the candidate has identified an exonic polymorphism (HOPA12bP) in a critical portion of a gene for a thyroid receptor co-activator named HOPAthat is associated with a behavioral endophenotype that include schizophrenia and hypothyroidism. In this five year training grant, the candidate proposes to focus on the behavioral syndrome that is associated with the polymorphism and 1) demonstrate segregation of the polymorphism with illness. 2 refine the phenotype associated with the polymorphism, and 3) identify other mutations that may be related to illness. Scientific Aims of this grant are 1). Peform case control analyses on schizophrenic probands with the HOPA12bp polymorphism. Schizophrenic HOPA probands will be identified and compared to matched case controls for cognitive/behavioral, endocrinological and medical differences. 2. Conduct a focused linkage study of the families of HOPA12bp probands. Structured interviews will be used to assess the presence of cognitive/behavioral and medical co-morbidity in the first-degree relatives of control and HOPA12bP probands. These results will be correlated with genetic status. 3). Conduct SSCP analysis across the HOPA Gene to detect other potentially pathogenic mutations. Mutation analysis will be performed using DNA from other schizophrenic patients to detect other mutations in theHOPA gene that can result in result in this syndrome or related phenotypes. Training Aims of this grant are to 1) develop clinical skills in the diagnosis and standardized measurement of complex behavior and endocrinological disorders, and 2) learn medical and psychiatric epidemiology, ethics, and biostatistical approaches to complex disorders. The net effect will be to produce an independent investigator capable of functional and translational research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ANTERIOR PITUITARY ALPHA SUBUNIT GENE ACTIVATION Principal Investigator & Institution: Ridgway, E Chester.; Professor of Medicine; Medicine; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508
Studies
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Timing: Fiscal Year 2001; Project Start 06-DEC-1993; Project End 30-NOV-2003 Summary: The alpha-subunit of the glycoprotein hormones is normally expressed in pituitary thyrotropes and gonadotropes, and in placental cells. A major advance in the understanding of alpha- subunit expression in pituitary cells resulted from recent studies in transgenic mice that revealed the presence of a powerful enhancer region about 4,000 base pairs upstream of the transcriptional start-site. Of considerable interest, this upstream regulatory area plays an important role in targeting alpha-subunit gene expression to the correct pituitary cell lineages, and exhibits a dual role as stimulatory in alpha- expressing cells and inhibitory in non-alpha-expressing cells, such as GH3 somatolactotropes. Most importantly, these investigations document strong interactions between the distal enhancer and specific areas on the proximal promoter, suggesting not only protein-DNA but also novel protein-protein interactions. The major focus of this competing renewal is to extend these investigations and systematically study the pivotal roles of this upstream regulatory area, leading to the identification of the key cellular proteins that functionally interact with that area. In addition, the studies will demonstrate the physiological consequences of disrupting the function of this area in transgenic mice. These approaches will utilize the most modern techniques of molecular and cell biology incorporated into cell culture and transgenic technology. These studies will provide new fundamental knowledge that will impact our understanding of physiological and pathological pituitary alpha-subunit expression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: APOPTOSIS IN THYROIDITIS Principal Investigator & Institution: Baker, James R.; Chief, Division of Allergy; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-JAN-1995; Project End 29-FEB-2004 Summary: The basis of autoimmune thyroid disease remains unclear. Most investigations into the pathogenesis of these disorders have focused on immune abnormalities that might lead to an autoimmune response. However, no unique genetic basis has been identified for the immune response to thyroid autoantigens, and many individuals who demonstrate autoimmune responses to thyroid antigens do not develop autoimmune disease. Apoptosis, the process most likely responsible for thyroid cell death in thyroiditis, is closely regulated. Work from our laboratory indicates that apoptosis is specifically regulated in thyroid follicular cells in several unique ways, and that the induction of immune-mediated apoptosis can be blocked or facilitated in a manner that could alter the induction of cytotoxicity. These finding have led to the hypothesis that the regulation of programmed cell death pathways in the thyroid has a significant role in the development of thyroiditis. Altered apoptosis could contribute to the pathogenesis of thyroiditis either by facilitating initial cellular damage that leads to an immune response or by accelerating immune-mediated apoptosis of thyrocytes that results in hypothyroidism. This proposal seeks to examine this hypothesis with four specific aims. The first specific aim will document the expression and function of proteins that are involved in specific cell-death pathways in thyroid follicular cells. These molecules include receptors and ligands involved in at least four distinct cell death signaling pathways. The second specific aim will examine the regulation of the apoptotic pathways present in thyroid cells, particularly the signaling pathways that potentially mediate immune damage to thyroid cells. The third specific aim involves an examination of regulation of the common apoptotic pathway in thyroid follicular cells, which mediates cell death through CASPASE activation, mitochondrial damage and
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cleavage of death substrates. The expression and regulation of molecules, such as members of the Bcl-2 family, that modulate this process will be clarified and the role that Vitamin D, estrogen, other steroid hormones, and iodine-induced oxidative stress play in modifying the apoptotic potential of thyroid cells will also be addressed. The fourth specific aim will confirm that the identified alterations in apoptosis can alter the susceptibility of thyroid cells to immune mediated cell death in vivo, first by an examination in thyroid slices and by analyzing the expression of death pathway molecules in thyroid cells derived from normal glands vs. thyroiditis. Animal studies involving treatment with specific hormones that alter apoptosis in the thyroid or transgenic animals will also confirm that alterations in death pathways can change the physiology of normal thyroid cells or alter the pathophysiology of thyroiditis. These studies will help to clarify how thyroid cells can be damaged by autoimmune responses and could provide insights into the physiologic regulation of thyroid cell turnover. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BLOOD BRAIN BARRIER LARGE NEUTRAL AMINO ACID TRANSPORTER Principal Investigator & Institution: Boado, Ruben J.; Medicine; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2004 Summary: (adapted from applicant's abstract): The availability of large neutral amino acids in brain cells is crucial to the regulation of both cerebral protein metabolism and neurotransmitter synthesis. The transport of circulating amino acids from blood to brain involves transport through two membranes in series: (i) the brain capillary endothelial wall, which makes up the blood-brain barrier (BBB) in vivo, and (ii) the brain cell (neuron, glial) plasma membrane. Since the surface area of the brain cell membrane is log orders greater than the surface area of the blood-brain barrier, the rate limiting step in amino acid movement from plasma to brain intracellular space is the BBB transport step. This work will study the pathophysiological expression of the large neutral amino acid transporter (LAT) at the blood-brain barrier. The preliminary data show that the full length LAT-cDNA encodes a protein that expresses LAT activity in frog oocytes. Antisera will be produced with synthetic peptides encoding either the carboxyl terminus or predicted extracellular domains of the bovine BBB LAT. The abundance and cellular localization of this transporter will be studied by Western blotting, ELISA, in situ hybridization, immunocytochemistry, and confocal and immunogold electron microscopy, respectively. The modulation of gene expression of BBB LAT will be studied under different pathophysiologic conditions known to modify the transporter activity, i.e. brain tumors, development, hypothyroidism and hypoxia. The mechanisms of gene regulation of BBB LAT will be investigated in brain endothelial cultured cells measuring the abundance of its protein and transcript, and the transcriptional rate and decay of the BBB LAT mRNA. The cloning of cDNAs encoding the rabbit BBB LAT will also be performed. Because the in vivo Km for the BBB LAT markedly differs among species (i.e. human BBB < rat BBB < rabbit BBB), comparison of the predicted amino acid sequence of BBB LAT from these 3 species will provide insight into the amino acids comprising the active site of the LAT protein, which will be confirmed by site-directed mutagenesis studies. These studies will provide new molecular biological information on a crucial transporter at the blood-brain barrier that regulates the supply in the brain of essential amino acids. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
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Project Title: CARDIAC CONTRACTILE KINETICS Principal Investigator & Institution: Regnier, Michael; Bioengineering; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 15-DEC-1998; Project End 30-NOV-2002 Summary: Many diseases such as diabetes, hypertrophic cardiomyopathy, hypothyroidism and heart failure involve alterations in the contractile and regulatory proteins of the myocardium. Changes in protein isoforms due to disease or mutation could impair cardiac function during normal activation of the heart or during strenuous activity. The long term objective of our research is to understand the complex molecular interactions between actomyosin cross-bridges (CBs) and thin filament (TF) proteins that regulate cardiac contractile function. In skeletal muscle the CB transition rates that control force development and fiber shortening have been studied using caged compound techniques and by varying substrate and hydrolysis product conditions. The CB processes that are rate limiting for force development and shortening in myocardium are less well understood than in skeletal muscle, and may be different. Additionally, the regulation of cardiac contractions appears to be dependent on a complex interaction between TF proteins and CBs. Using transient kinetics of isolated proteins in solution and glycerinated cardiac muscle we will study the rates of CB steps that govern actomyosin interaction and the influence of TnC Ca/2+ binding kinetics, comparing these with skeletal muscle. To test this we will independently alter the kinetics of TF activation and CB transition rates to determine how each affects steady state force and stiffness, the rate of force development and the velocity of shortening. We will also study the influence of protein phosphorylation and contractile filament lattice spacing on these measurements. The information gained from these studies will be used to modify and extend existing models of CB chemomechanical transduction and the regulation of CBs by TF proteins. These models will be useful in describing the important differences between cardiac and skeletal muscle in the control of force and shortening and the changes that occur in cardiac myopathies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DYSFUNCTION
CARDIOVASCULAR
CONSEQUENCES
OF
THYROID
Principal Investigator & Institution: Pearce, Elizabeth N.; Medicine; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Although it is known that thyroid disease and cardiovascular health are closely linked, the cardiovascular consequences of thyroid dysfunction remain imperfectly understood. Current evidence suggests that overt and subclinical thyroid dysfunction may cause alterations in lipid levels, in left ventricular size and function, and in endothelial reactivity. These changes may predispose patients to atherosclerosis and to congestive heart failure. The overall hypothesis of this proposal is that abnormal thyroid function is associated with alterations in lipid particle size, in endothelial reactivity, and in cardiac contractility, which result in increased risk for adverse clinical cardiovascular outcomes. In Specific Aim 1, cross-sectional data from the Framingham Heart Study Offspring cohort will be analyzed to determine whether lipid particle size correlates with thyroid function. Additionally, lipid particle subfractions will be measured prospectively in patients who are initially hypothyroid and then become euthyroid after treatment with L-thyroxine to determine whether lipid particle size is altered in overt hypothyroidism. In Specific Aim 2, data from the
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Hypothyroidism
Framingham original and offspring cohorts will be analyzed longitudinally to determine whether baseline thyroid status predicts cardiovascular disease over follow-up of up to 18 years. In Specific Aim 3, cross-sectional data from the original Framingham cohort will be analyzed to determine whether thyroid function correlates with left ventricular size and function. Data will also be analyzed longitudinally to determine whether baseline thyroid status is an independent predictor of incident congestive heart failure over 16 years of follow-up. Finally, in Specific Aim 4, a clinical study will assess whether L-thyroxine treatment of subclinical hypothyroidism (mild thyroid failure) in patients with congestive heart failure improves echocardiographic markers for left ventricular remodeling and endothelial reactivity. These research projects are designed to provide training in techniques for the cross-sectional and longitudinal analyses of large databases as well as techniques for the design and implementation of clinical studies in an outpatient setting. The pursuit of these projects, in conjunction with formal coursework in biostatistical and epidemiological methods, is intended to foster Dr. Pearce's career as an independent academic clinical investigator with a focus on thyroid disease and epidemiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CNS DEVELOPMENT UNDER HYPERGRAVITY : MODULATION BY TH? Principal Investigator & Institution: Sajdel-Sulkowska, Elizabeth M.; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-MAY-2005 Summary: (provided by applicant): To evaluate the potential risks associated with space exploration, the proposed studies will assess the impact of altered gravity on the developing CNS. Specifically, these studies will probe the hypothesis that changes in gravity affect cerebellar development and that this effect is mediated by altered thyroid status. This hypothesis is based on the following: (1) both the CNS and thyroid status are inhibited in astronauts and in adult animals exposed to micro- and hypergravity; (2) thyroid hormone (TH) is critical for normal CNS development; and (3) motor coordination, controlled by the cerebellum, is affected in both astronauts and animals under altered gravity. The experiments designed to test this hypothesis will utilize the hypergravity paradigm of a 24-ft centrifuge, since it provides the most adaptable system for studying the effect of altered gravity on developing mammals. Based on preliminary findings suggesting that exposure to centrifugation from gestation through weaning results in changes in the developing cerebellum and altered thyroid status in rat neonates, we predict that: (1) changes in cerebellar size and structure observed at 15G will become more pronounced at higher gravitational loading; (2) the mild hypothyroidism observed at 1.5 G will become more severe at higher gravitational loading. The effect of hypergravity on neonatal cerebellum will be evaluated primarily in terms of the celebellar size and number of Purkinje and granule cells; the thyroid status of dams and neonates will be assessed primarily in terms of plasma thyroid stimulating hormone (TSH), free T3 and T4, and neonatal cerebellar T3 and T4 at P6 to P21. These parameters will be compared between stationary controls (SC), rotational controls (RC) and hypergravity-exposed (HG, 1.5G. 1.65G. and 1.75G) dams and/or pups during one of the three developmental periods: (1) the second part of embryonic development through the neonatal period (Gil to P21); (2) the second part of embryonic development only (Gil-P 1); and (3) the neonatal period only (P1 to P21). To examine the possible contribution of other factors such as malnutrition, pair-fed controls will be included to evaluate the contribution of maternal-offspring interactions, HG neonates
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will be cross-fostered to SC dams. The status of the hypothalamic-pituitary-thyroid (HPT) axis will be examined by measuring neonatal serum thyroid-binding proteins (TBG, TTR) and thyroid size. Should these studies support the direct involvement of THin the neonatal response to hypergravity, a TI! supplement will be given to dams or pups to attempt to prevent the adverse effects of altered gravity. Additional molecular studies, including immuno-chemical immunohistological, and gene expression analyses (northern blots, RPA, and rat-specific cDNA arrays, focusing on TH-regulated genes) will probe the molecular mechanism(s) involved in gravity response. These studies will aid in developing an understanding of how altered gravity affects CNS development, what role the thyroid hormone plays in that response, and whether this response can be modulated by hormonal therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CNS PRECURSOR CELL DYSFUNCTION IN DEVELOPMENTAL MALADIES Principal Investigator & Institution: Noble, Mark D.; Professor; Genetics; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2006 Summary: Many different physiological insults to the developing child result in longlasting neurological impairment associated with a failure of myelination and/or destruction of existing myelin and a subsequent inability to repair this damage. Such impairment is associated, for example, with deficiencies in thyroid hormone, iron with inadequate nutrition, with fetal exposure to alcohol or cocaine, as a result of hypoxic episodes or in association with radiotherapy or chemotherapy. We propose that the underlying cellular basis for many childhood disorders of neurological development is disruption of specific steps in the development of the precursor cells that give rise to the differentiated cell types of the central nervous system (CNS). Consistent with this hypothesis, we have discovered that specific steps in development of the myelinforming oligodendrocytes of the CNS are disrupted in the two specific instances of thyroid hormone and iron deficiency. Initially, we will carry out in vitro and in vivo studies on hypothyroidism, as a well-defined model of hormonal and nutritional deficiency disorders. These studies will provide a detailed map of the stages of precursor cell development vulnerable to deficiency of thyroid hormone. To determine why hormonal replacement therapy applied at too late a stage does not promote repair of CNS damage, we next will transplant defined stem cell and precursor cell populations into the CNS of animals that have been hypothyroid throughout development and examine the ability of these cells to contribute to tissue repair. These experiments will provide insight into whether the failure to reconstitute normal development is due solely to an absence of appropriate precursor cells, or also is due to the CNS becoming refractory to repair. Complementary to this cellular biological analysis, we also will determine whether intracellular redox modulation is a critical component of the mechanism by which thyroid hormone exerts its effects on all the CNS precursor cells regulated by this hormone. In addition, we will extend preliminary observations indicating that the very different disorder of iron deficiency may also work in part through alteration of intracellular redox state. By asking whether different syndromes exert their effect through overlapping mechanisms, these studies may provide important clues to potential new therapeutic approaches to the treatment of hormonal and nutritional deficiency disorders. In sum, this research program will identify both cellular and biochemical mechanisms that explain the biology of critical
12
Hypothyroidism
developmental periods and may lead to the identification of therapeutic approaches that can enhance repair in multiple deficiency syndromes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONGENITAL HYPOTHYROIDISM IN GIANT SCHNAUZERS Principal Investigator & Institution: Patterson, Donald F.; Professor; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001 Summary: There is no text on file for this abstract. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COREPRESSOR REGULATION OF THYROID HORMONE ACTION Principal Investigator & Institution: Hollenberg, Anthony N.; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 15-AUG-2000; Project End 31-JUL-2005 Summary: (Adapted from the applicant's abstract) The thyroid hormone receptor (TR) isoforms are members of nuclear receptor superfamily. They regulate target genes both positively and negatively in the presence and absence of their ligand T3, which is essential for normal mammalian development and function. Ligand-independent function of the TR is mediated by two large proteins, NCoR and SMRT, termed nuclear corepressors, which in turn recruit a multiprotein complex which mediates gene silencing on positive thyroid hormone response elements (TREs). The addition of ligand causes the TR binding complex to release the corepressor and recruit coactivators to mediate further gene activation. NCoR and SMRT have significant homology at the amino acid level but differ substantially in sequence and structure in key regions important for TR interaction and repressing function. These differences, despite the similar distinct biological roles. It is unclear which corepressor is important in thyroid hormone action but it is likely that one or both play critical roles in hypothyroidism and Resistance to Thyroid Hormone (RTH). Thus, an understanding of the mechanisms by which the nuclear corepressors interact with thyroid hormone signaling pathways will shade new light on basic mechanisms by which the TRs regulate gene expression and on the role of the ligand-independent activity of the TR in human disease. The first aim of this proposal will focus on the nuclear receptor interacting domains of NCoR and SMRT in order to support the hypothesis that corepressor specificity exists and that the TR prefers to interact with NCoR. The second aim will allow for the direct testing of corepressor specificity in mammalian cells. The third aim will employ mouse models that lack functional NCoR to explore the role of the corepressors in hypothyroidism and RTH as well as to further address the role of NCoR directly in thyroid hormone action. Together, completion of these aims will lend significant insight into the role of the nuclear receptor proteins on thyroid hormone action and establish a role for these proteins in thyroid disease. Furthermore, given the growing importance of corepressor interactions in other signaling systems, the proposed studies will also shed insight into other areas of human biology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COREPRESSORS AND NEGATIVE REGULATION BY THYROID HORMONE Principal Investigator & Institution: Cohen, Ronald N.; Medicine; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2001; Project Start 05-AUG-1998; Project End 30-JUN-2003 Summary: (Taken from the applicant's Abstract): Thyroid hormone receptors (TRs) bind to thyroid hormone response elements (TREs) in the regulatory regions of genes to stimulate or inhibit gene transcription. TRs bind in the presence or absence of ligand, triiodothyronine (T3). In the absence of ligand, TRs repress transcription of genes that are positively regulated by T3. Ligand-independent repression is mediated by a class of proteins termed co-repressors, including NCoR and SMRT, which bind TR in the absence of T3. TRs also exhibit ligand-independent effects on genes negatively regulated by a thyroid hormone. One these negative TREs, TRs enhance transcription in the absence of ligand. These effects are less well defined, but appear to be mediated by members of the co-repressor families, as well. The goals of these studies are (1) to characterize the effects of co-repressors on genes negatively regulated by thyroid hormone; (2) to identify and characterize NCoR isoforms; and (3) to determine how corepressors interact with specific TR complexes. In these studies, we will focus on the interactions between co-repressors and TR-beta-2, a TR isoform that may play a distinct role in negative regulation. In addition, mutant TRs, found clinically in patients with syndromes of resistance to thyroid hormone (RTH) will be used to characterize interactions between TRs and co-repressor isoforms. This information will allow us to define further mechanisms underlying thyroid hormone resistance and thyroid hormone action, which will shed light on the basis of human hypothyroidism and hyperthyroidism. Moreover, an understanding of how TRs regulate gene transcription in the absence of ligand will provide further insight into the mechanisms of gene regulation in general. This project will be performed by Dr. Ronald Cohen under the guidance of Dr. Fredric Wondisford, in the Thyroid Unit and Endocrine Division of the Beth Israel Deaconess Medical Center. Dr. Wondisford has made major contributions to the understanding of the molecular mechanisms governing negative regulation of the TSH and TRH genes. There are also numerous investigators in the Endocrine Division and the surrounding Harvard Medical School community with interests in transcriptional regulation. This will provide an ideal environment to complete this project, and will provide a basis for Dr. Cohen's transition to an independent investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ENVIRONMENTAL NEURODEVELOPMENT
LEAD,
THYROID
FUNCTION
&
Principal Investigator & Institution: Factor-Litvak, Pam R.; Associate Professor; Epidemiology; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2004 Summary: Severe deficiency of thyroid hormone during the prenatal and neonatal periods is associated with adverse neurodevelopmental outcomes in infancy and childhood. Maternal iodine deficiency during pregnancy leads to a lowered production of activated (i.e., iodinated) thyroid hormone (T3) and an increased risk of cretinism (with associated severe mental retardation) in the child. Congenital hypothyroidism and transient hypothyroidism of prematurity are associated with deficits in cognition during early life. In light of these observations, it is appropriate to ask whether sub-
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Hypothyroidism
optimal maternal thyroid function, particularly during the first half of pregnancy when maternal contribution to fetal thyroid hormone is maximal, is associated with neurodevelopment of the child. Recent data suggest that children of mothers with 'lownormal' thyroid function are at risk for small deficits in cognition and increased reports of behavior problems. The overall goal of this project is to assess whether mild deficiencies in maternal thyroid function are associated with adverse neurodevelopment in the child, and, if so, to elucidate possible biologic mechanism. One possible mechanism is through damage to the choroid plexus, the site of production of the brainspecific transport protein for thyroid hormone. Animal studies suggest that the choroid plexus is damaged by exposure to environmental lead, raising the possibility that associations between lead exposure and cognition in the child arise through an effect of lead on transport of thyroid hormone to the brain. The proposed study draws on data from a prospective study designed to examine the associations between pre- and postnatal lead exposure and childhood development. The cohort comprises approximately 300 children, born in 1984-1985 in two towns in Kosovo, Yugoslavia who were followed through age 12. Sera are available to measure thyroid function in the mothers at midpregnancy and in the children at ages 4, 7 and 12. Outcomes, including cognition, motor function, behavior problems and anthropometric measurements, were measured repeatedly during infancy and childhood. This project will expand the findings of the Yugoslavia study to examine first, whether maternal thyroid function in the first half of pregnancy is associated with cognitive, behavioral and growth outcomes and second, whether the associations between Pb and these outcomes are mediated by exposure to thyroid hormone. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EPIDEMIOLOGY OF NEURODEVELOPMENT IN MULTIPLE BIRTHS Principal Investigator & Institution: Kuhn, Louise; Assistant Professor of Epidemiology; Gertrude H Sergievsky Center; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2001; Project Start 01-AUG-1997; Project End 30-APR-2003 Summary: The study aims to elucidate biological mechanisms in the aetiology of adverse neurodevelopmental outcomes in the offspring of multiple births of very low birth weight. First, risk factors for neonatal white matter damage and transient hypothyroxinemia of prematurity (two neonatal predictors of later severe motor and cognitive disability) will be investigated in a cohort of 443 twins and triplets, weighing less than 1500 grams at birth (155 complete sets of 334 infants). These infants were systematically evaluated for evidence of white matter damage according to standardized cranial ultrasound scan protocols during the neonatal period. Second, a sample of these multiple births (227 surviving children of 116 sets) will be evaluated at 7 years of age for cerebral palsy, cognitive functioning, other severe motor, hearing and vision impairments, and behavioral problems. All children will be examined by a pediatric neurologist and will undergo neuropsychological testing. Their mothers (or primary care-givers) will be asked to assess behavior and functioning. The effects on neurodevelopmental outcomes of pregnancy-specific and child-specific risk factors (including white matter damage and hypothyroxinemia), and the role of zygosity, will be investigated. Since twin-pairs are matched by nature on many maternal, perinatal and environmental variables, the effects of exposures can be investigated with strong control for known and unknown confounders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ESTROGEN AND SELECTIVE MODULATOR ON THYROID FUNCTION
ESTROGEN
15
RECEPTOR
Principal Investigator & Institution: Braverman, Lewis E.; Chief, Section of Endocrinology,; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001 Summary: To evaluate the effect of estrogen and selective estrogen receptor modulator, both of which increase thyroxine binding globulin concentration, on thyroid in menopausal women who are at risk to develop hypothyroidism and hypothyroid menopausal women on L-T4 replacement therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EXPERIMENTAL AUTOIMMUNE GRAVES' DISEASE Principal Investigator & Institution: Prabhakar, Bellur S.; Professor and Head; Microbiology and Immunology; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2001; Project Start 01-JUN-1995; Project End 30-NOV-2003 Summary: Autoantibodies to the thyrotropin receptor can either activate thyroid gland causing hyperthyroidism or block TSH mediated activation of thyroid and cause hypothyroidism. Until several years ago, it was not possible to develop an animal mode due to the unavailability of large quantities of purified TSHR. Subsequent to cloning of human TSHR, several laboratories, including our own, have used human recombinant proteins to induce the disease in mice. These studies have provided new insights on the requirements for an optimal immune response to TSHR, resulting in thyroid perturbation. Earlier, we expressed the ectodomain of mouse TSHR (mTSHR) and showed that it is antigenically distinct from human TSHR. Recently, we expressed mTSHR on M12 cells (H-2D) and used them to immunize BALB/c mice. These mice showed significant TBII activity with concomitant raise in T4 levels. In the present study, we propose to use a soluble ectodomain of mTSHR and various cell lines expressing mTSHR, Class-II and Co-stimulatory molecules to define optimal conditions required to induce autoimmunity to TSHR. Sera will be tested for antibody production and hormonal perturbations, and thyroids will be evaluated for pathology and radioiodine uptake. We will carryout studies to evaluate the importance of CD4+ vs. CD8+ and Th1 vs. Th2 T cells. To do this, we will use selective depletion and adoptive transfer experiments, determine the relevance of cytokines, and test the ability of the protein to induce disease in Class-I and II, IFNgamma, and IL4 knockout mice available on BALB/c background. To define TSHR epitopes to which pathogenic antibodies bind, we will carryout epitope mapping studies. For this, we will employ recombinant fragments of TSHR, ectodomains of TSHR-LH/CGR chimeric proteins and cells expressing these chimeras. These proteins or their fragments will be tested in a number of different serological and bioassays. Together these studies are expected to allow establishment of an appropriate animal model to study autoimmunity to TSHR. Such a model would facilitate a thorough understanding of the regulation of the immune response to TSHR with implications for the development of novel therapeutics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FETAL ALCOHOL, THYROID HORMONE AFFECTED GENES & BEHAVIOR Principal Investigator & Institution: Slone, Jennifer; Psychiatry and Behavioral Scis; Northwestern University Office of Sponsored Programs Chicago, Il 60611
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Hypothyroidism
Timing: Fiscal Year 2001; Project Start 01-MAR-2001 Summary: Fetal alcohol exposure (FAE) in humans leads to hyperactivity, learning deficits, response inhibition and higher prevalence of depression. I would like to find the mechanism(s) responsible for these outcomes in an animal model, in order to facilitate the prevention or treatment of FAE- related behavioral deficits in humans. In our animal model of FAE, we found a hypothyroid state in both the mother and fetus at gestation day 22. Since congenital hypothyroidism results in learning impairments and hyperactivity in children, one of the mechanisms by which the FAE behavioral impairments could be related to the congenital hypothyroidism of the FAE fetus. Preliminary data show increased depressive behavior in both male and female adult FAE offspring in the forced swim test (FST) compared to their pair-fed controls. Thyroid hormone receptor beta (TRbeta) knockout mice show decreased immobility in the FST compared to controls. In addition, using cDNA microarray technology, we have found altered expression in the FAE male amygdala/hypothalamic region on E19 of 80 genes, several of which are thyroid hormone regulated. In order to elucidate the role of thyroid abnormalities in the FAE-induced behavior, first I plan to confirm the results found from the microarray data using real-time quantitative RT-PCR and in situ hybridization. Then I will treat these animals with thyroid hormones prenatally, to correct for the fetal hypothyroid state, to alleviate hyperactivity, learning deficit and increased depressive behavior and changes in thyroid hormone-related gene expression found in these FAE offspring. Finally, I will treat these animals by early postnatal thyroid replacement to determine if this reverses any of the behavioral deficits and/or alterations in gene expression. If any of these thyroid hormone administration paradigms lead to attenuation of behavioral deficits in the FAE offspring, the could become treatments for FAE children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FUNCTIONAL RESPONSES OF EXTRAOCULAR EYE MUSCLES TO T3 Principal Investigator & Institution: Rubinstein, Neal A.; Associate Professor; Anatomy; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 01-DEC-1997; Project End 31-MAR-2003 Summary: Thyroid dysfunction affects some 10 million Americans; and although the extraocular muscles (EOMs) are often involved in thyroid disease, little is known about the effects of T3 on the properties or development of EOM fibers. The effects of dysthyroidisms on the function of appendicular muscle fibers suggest that altered T3 levels should have profound influences on the performance of EOM fibers; however, there unique developmental origin, structural and functional properties and singular reactions to diseases suggest that EOMs have unique rules governing gene expression. T3 regulates the contractile properties of muscle fibers by differentially activating or repressing isoforms of the myosin heavy chains (MyHCs). The transcriptional control is mediated by the thyroid receptors (TRs) and the retinoid X receptors (RXRs) which themselves exist as multiple isoforms. Preliminary data, as well as susceptibilities to disease, suggest that the response of genes to T3 in EOMs will differ from that in other muscles. We hypothesize this differential response will be related to unusual distributions of TR and RXR isoforms among fibers; altered T3 levels will lead to the expression of inappropriate MyHC isoforms, abnormal contractile characteristics and impaired vision. Proving this hypothesis requires (a) determining which MyHC genes are expressed in each EOM fiber type during development and in the adult, (b) correlating the MyHC complement of each fiber to the contractile properties of that
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fiber, (c) determining whether hypo-and hyperthyroidism after the expression of MyHC genes and contractile properties, (d) discriminating the TR and RXR isoforms synthesized in euthyroid and pathological conditions. Studies will isoform-specific cRNA probes and antibodies will be combined with contractile measurements of individual skinned EOM fibers to accomplish these aims. To understand how the eye performs its repertoire of motions under both normal and pathological circumstances, one must understand the synthetic capacity of each fiber and how it defines the functional properties of each fiber. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENETICS OF AUTOIMMUNE POLYENDOCRINE SYNDROME II Principal Investigator & Institution: Spritz, Richard A.; Professor and Director; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001 Summary: Autoimmune polyendocrine syndrome type II (APS-II) is characterized by the co-occurrence of two or more of various autoimmune disorders in individuals, and often also in their family members, most typically Addison's disease, autoimmune thyroid disease (Graves' disease and hypothyroidism), type I diabetes mellitus celiac disease, hypogonadism, vitiligo, alopecia, pernicious anemia, and myasthenia gravis, but in some families may also include lupus erythematosis, juvenile rheumatoid arthritis, multiple sclerosis, and other disorders. Our analyses strong indicate that autoimmunity in APS-II is controlled by a non-MHC gene in the context of a susceptible HLA genotype. We propose to map this non- MHC APS-II gene, determine its role in different clinical subtypes of APS-II, determine which autoimmune manifestations of APS-II are accounted for by this 2-locus model, and ultimately to identify the non- MHC APS-II gene. Our approach is to identify and analyze large APS-II pedigrees to define clerical heterogeneity that may reflect underlying genetic heterogeneity. We have carried out a series of large preliminary clinical surveys identifying three distinct groups of APS-II families in whom specific autoimmune disorders appear to occur as autosomal dominant traits; families with multiple cases of Addison's disease and other autoimmune disorders, families with multiple cases of vitiligo and other autoimmune disorders, and families with adult-onset type 1diabetes mellitus and other autoimmune disorders. In the multiplex Addison's disease families, we have identified specific HLA genotypes that appear to be necessary but not sufficient for the occurrence of disease. Given a susceptible HLA genotype, the occurrence of Addison's disease in these families appears to be determined by an autosomal dominantly inherited locus outside the MHC. We will map this non-MHC APS-II locus by an initial 10-cM genome screen to identify a candidate region of linkage, we will then refine this localization using additional families and additional markers, to the point of constructing a physical map of the region, and we will eventually identify the non-MHC APS-II susceptibility gene. We also plan to collect samples from vitiligo/APS-II and diabetes/APS-II families and to determine which of the various autoimmune manifestations in these families are accounted for by this gene. Definition of genes that predispose to various forms of APSII will greatly enhance our understanding of the genetics and causation of autoimmunity in general. The occurrence of lupus erythematosis, juvenile rheumatoid arthritis, and multiple sclerosis in some families with APS-II suggests that the identification of APS-II genes may also shed light on the pathogenesis of these autoimmune disorders. In the long run, identification of genes and corresponding gene
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Hypothyroidism
products that are involved in these autoimmune disorders will undoubtedly open up new avenues of approach to their treatment and even prevention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPOTHALAMIC GNRH PULSE GENERATOR Principal Investigator & Institution: Mann, David R.; Professor; Morehouse School of Medicine Atlanta, Ga 30310 Timing: Fiscal Year 2001; Project Start 26-SEP-2001; Project End 31-JUL-2006 Description (provided by applicant): The objective of this proposal is to establish whether thyroid hormone is required for the neurobiological processes that dictate the ontogeny of pulsatile hypothalamic GnRH release from birth until puberty in the male rhesus monkey (Macaca mulatta). The applicant?s Specific Aims will be to: 1) determine the effect of juvenile thyroidectomy in the male rhesus monkey on the timing and progression of the pubertal reaugmentation of hypothalamic GnRH pulse generator activity, and if pubertal reinitiation of pulsatile GnRH release is delayed or prevented; 2) determine whether thyroid hormone replacement restores a pubertal pattern of GnRH pulse generator activity, or if reaugmentation of the GnRH pulse generator is unaffected, then examine whether the thyroid hormone deficit has subtle effects on the GnRH pulse frequency; 3) confirm that neonatal thyroidectomy fails to influence the turn off of pulsatile GnRH release during the transition from infancy to the juvenile period; and 4) assess the effect of hypothyroidism during infancy (birth to 8 months of age) on the timing and progression of the pubertal reinitiation of pulsatile GnRH release. The agonadal monkey will be employed as the experimental paradigm to facilitate the tracking of the ontogeny of GnRH pulse generator activity, and to eliminate the confounding influence of thyroid hormone action on the testis. Circulating LH concentration will be used as an indirect index of changes in GnRH secretion. If necessary, monkeys will be implanted with venous catheters and housed in remote sampling cages to determine the pattern of GnRH release during the peripubertal period. Thyroid hormone status will be manipulated by thyroidectomy and thyroid hormone replacement. Studies of sexual development of the monkey are particularly relevant to the human situation because the control systems regulating the timing of puberty exhibit marked species differences. Most notable, the prepubertal brake that holds the hypothalamic-pituitary- gonadal axis in check throughout prepubertal development in man and other higher primates is not observed in rodents. Thus, the present proposal will lead to a better understanding of the mystery of human puberty and disorders of sexual development in boys and girls. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IDENTIFYING GENES LINKED TO AUTOIMMUNE THYROID DISEASES Principal Investigator & Institution: Tomer, Yaron; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant) The autoimmune thyroid diseases (AITD) are very common with a prevalence of - 5 percent. They include Hashimoto's thyroiditis (HT), which manifests by hypothyroidism, and Graves disease (GD), which causes hyperthyroidism. The mechanisms initiating the AITD are not completely understood. Abundant data point to a genetic susceptibility to AITD, and the applicant, has identified linkages for several AITD susceptibility loci. In the past four years we have
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performed genome scans on two data sets of multiplex families (102 families, 540 individuals), and mapped 8 loci showing evidence for linkage with AITD. In two of the loci we identified and investigated putative AITD susceptibility genes (CTLA-4 and CD4O}. The focus of the current proposal is four of the eight loci which showed the strongest evidence for linkage with AITD. The goals of our study are to identify and characterize the AITD susceptibility genes in these four loci. The specific aims of the proposed study are: 1) To resolve the genetic heterogeneity in our families at the 4 linked loci which are the focus of our studies. At all 4 loci the linkage analysis showed evidence of heterogeneity and resolving it will facilitate identification of the AITD susceptibility genes. We will subdivide the families according to various parameters (e.g. age of onset of disease), analyze these subsets separately for linkage with the four loci, and apply the Predivided-Sample Test. Resolving heterogeneity and identifying subsets of families that are uniformly linked with these loci will amplify the power of the subsequent single nucleotide polymorphism (SNP) and fine mapping analyses (Specific Aims 2 & 3); 2) To analyze two important genes (thyroglobulin and TGFBeta3 which are located at 2 of the linked loci, and are themselves linked and associated with AITD. We will analyze the sequences of the thyroglobulin and TGF-Beta3 genes in order to identify disease-specific SNP's; 3) To fine map two additional linked loci and narrow the linked regions in order to determine appropriate candidate genes for future analyses. We have the capacity and experience to perform these studies. Our flexible relational database (lngresTM) facilitates complex linkage and association analyses. We use two ABI-310 sequencers for genotyping and sequencing, and we have experience at SNPing genes and fine mapping linked regions. We expect that these studies will lead to the identification of gene sequence variations contributing to the expression of AITD. This will allow us to understand the mechanisms initiating these diseases, and hopefully will lead to the development of new therapies targeted at the mechanisms initiating AITD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IGFI UNDERNUTRITION IN BRAIN DEVELOPMENT Principal Investigator & Institution: Calikoglu, Ali S.; Pediatrics; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2001; Project Start 01-SEP-1997; Project End 31-AUG-2003 Summary: I now propose to study the interaction of undernutrition, TH, and IGF-I in brain development. Focusing on early postnatal brain development in the mouse, the time when brain IGF-I expression, b) determine the influence of undernutrition on the expression of the type I IGF and related receptors and on IGF binding proteins, and finally, c) using transgenic mouse models of IGF-I availability, determine whether IGF-I can alter brain pathophysiology resulting from undernutrition. This research will extend my skills to a wide range of experimental approaches and to the techniques of molecular and cell biology. These experiences, together with a broadening of my basic science knowledge, should provide me with the tools to become an independent investigator and academician. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THERAPY
LEVOTHYROXINE:
TRIIODOTHYRONINE
COMBINATION
Principal Investigator & Institution: Jonklaas, Jacqueliine; Medicine; Georgetown University Washington, Dc 20057
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Hypothyroidism
Timing: Fiscal Year 2002; Project Start 15-MAY-2002; Project End 30-APR-2007 Summary: (provided by applicant): The objective of this project is to determine what combination of thyroid hormones provides optimum replacement therapy for hypothyroidism. There are two circulating thyroid hormones, thyroxine and triiodothyronine, and standard thyroid hormone replacement consists of synthetic thyroxine (levothyroxine) alone. Although levothyroxine is converted into triiodothyronine in the circulation, triiodothyronine levels achieved may not be equal to those seen with intact thyroid function. Therefore, the overall hypothesis of this project is that levothyroxine replacement results in a subtle deficiency of triiodothyronine and provides incomplete treatment for hypothyroidism. The initial hypothesis to be tested in this project is whether, within individual patients, standard replacement with levothyroxine results in lower serum levels of triiodothyronine than those seen while the thyroid gland is functioning. Participants will be euthyroid individuals scheduled for thyroidectomy for benign nodular disease or thyroid cancer. Serum triiodothyronine levels prior to thyroid surgery will be compared with those after thyroidectomy, to determine if levothyroxine replacement results in lower, sub-physiologic triiodothyronine levels. Another hypothesis of this project is that a panel of genes can be identified whose expression level is reflective of thyroid status. Complimentary (c) DNA array technology will be used to develop a gene panel whose expression is regulated by thyroid hormone. This gene panel will be included in the biochemical markers used to assess thyroid status. The third hypothesis is that levothyroxinetriiodothyronine combination will provide superior treatment of hypothyroidism. Biochemical, physiologic and psychologic indices of thyroid status will be compared during combination therapy with several ratios of levothyroxine and triiodothyronine to indices during treatment with levothyroxine alone. The regimens will be compared to determine if the one that most closely reproduces the triiodothyronine levels seen with intact thyroid function, also has the most favorable impact on thyroid status. The final hypothesis of this project is that sustained release triiodothyronine is superior to commercially available triiodothyronine. Because of its short half-life, replacement with triiodothyronine leads to fluctuating serum levels. A new sustained release product, which results in steady triiodothyronine levels, will furnish more physiologic replacement. This will be tested against treatment with levothyroxine, and levothyroxine and triiodothyronine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MATERNAL ANTITHYROID ANTIBODIES AND CONGENITAL HYPOTHYROIDISM IN NATIVE AMERICANS Principal Investigator & Institution: Selva, Karin A.; University of New Mexico Albuquerque Controller's Office Albuquerque, Nm 87131 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHANISM OF ACTION OF THYROID HORMONE RECEPTORS Principal Investigator & Institution: Koenig, Ronald J.; Professor; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-JUL-1991; Project End 30-JUN-2004
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Summary: The overall goal is to increase our understanding of how thyroid hormone (T3) regulates gene expression. T3 binds to receptors (TRs), which bind to T3 response elements (TREs) in specific target genes. TREs generally consist of two (or more) binding sites (half sites) arranged as a direct repeat, inverted repeat, or everted repeat. TRs can bind to TREs as homodimers or as heterodimers with retinoid X receptors (RXRs); the relative biological importance of each of these dimer forms is uncertain. TRs regulate transcription via two domains, AF-1 and AF-2. The function of AF-1 is poorly understood. AF-2 functions by interacting with other proteins, generally known as coactivators and corepressors. T3 alters the conformation of the TR, thereby affecting which proteins interact with this receptor. Our data suggest that certain genes are regulated by TR homodimers and others by RXR-TR heterodimers, and that this is determined by the sequence of the TRE. In addition, our data suggest that TR homodimers and RXR-TR heterodimers have different coactivator requirements, and that half site orientation further influences coactivator requirements. These issues will be studied in yeast and in mammalian cells. Yeast are uniquely valuable because they lack the above proteins. Hence, TR, RXR, and various coactivators can be added back in defined ways to determine their effects on gene expression. Additionally, yeast are amenable to genetic manipulations that are essentially impossible in mammalian cells. However, confirmation of the findings in yeast must be made in mammalian cells, to demonstrate biological relevance. Three specific aims will be addressed: 1) Assess the mechanism of coactivator-independent (AF-1) TR function in yeast; 2) Assess the role of TRE structure and homodimers versus heterodimers in defining coactivator requirements in yeast; 3) Determine whether the key findings in the above aims apply to mammalian cells. The results should further our understanding of how T3 affects a broad range of metabolic processes in health and disease states such as hyperthyroidism and hypothyroidism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEFICIENCY
MOLECULAR
BASIS
OF
CONGENITAL
THYROTROPIN
Principal Investigator & Institution: Fyfe, John C.; Microbiology and Public Health; Michigan State University 301 Administration Bldg East Lansing, Mi 48824 Timing: Fiscal Year 2001; Project Start 06-JUL-2000; Project End 30-JUN-2002 Summary: (Adapted from applicant's description): Congenital hypothyroidism (CH) is one of the most common causes of preventable mental and growth retardation, with a collective incidence of 1:3-4,000 births. Early diagnosis and treatment is critical to the prevention of life-long debility because there is an inverse relationship between the age at which treatment is initiated and eventual psychometric outcomes. Thyroid hormone acts globally to activate metabolism and is required for normal growth and neonatal development of the brain and immune system. Thyroid hormone secretion is a finely regulated process that depends on a hormone cascade of the hypothalamus, pituitary gland, and thyroid gland. Though less common, CH due to pituitary defects present a particular diagnostic challenge to neonatal screening programs, resulting in delay of treatment. There has been no animal model of pituitary CH from which one might gain insight into such issues as the loss of thyrotropin-releasing hormone (TRH)-mediated functions in organs other than the pituitary gland. An inherited form of CH resulting in disproportionate growth delay, male hypofertility, and behavioral abnormalities was identified in a canine family. TRH-stimulation testing and hormone analysis demonstrated that the disorder is caused by failure of the pituitary gland to increase thyrotropin (TSH) secretion appropriately in affected dogs in spite of low thyroid
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Hypothyroidism
hormone concentrations. The longterm goals of this investigation are to characterize and use this unique animal model of human CH to better understand normal pituitary function, non-thyroid gland-mediated functions of thyrotropin, and the pathogenesis of deficient TRH signaling. Immediately the investigators proposed to determine the molecular basis of the disorder in order to give added significance to future studies of pathogenesis. The specific aims of this proposal are: 1) to maintain a breeding colony of CH dogs and to perform matings which extend the CH family in a way that is most informative for candidate gene linkage studies, 2) to examine the TRH-mediated signal transduction pathway of TSH secretion by measuring TRHstimulated calcium ion currents in affected and normal dog cells in order to generate candidate gene hypotheses, and 3) to investigate the molecular basis of canine CH by examining candidate disease genes. Initial emphasis will be analysis of the candidate gene encoding the TRH receptor. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MURINE MODELS OF HYPOTHYROIDISM AND CONGENITAL DEAFNESS Principal Investigator & Institution: Walsh, Edward J.; Professor; Director; Boys Town National Research Hospital 555 N 30Th St Omaha, Ne 68131 Timing: Fiscal Year 2001; Project Start 24-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): The overall, long-term goal of the research proposed in this application is to determine the anatomical and physiological basis of peripheral auditory anomalies associated with congenital hypothyroidism and to initiate an investigation into the molecular nature of associated deficits. In doing so, we hope to expand our understanding of thyroid hormone's role in the normal development of the inner ear and extend our understanding of the auditory consequences of hypothyroidism by considering the relative contribution that discrete inner ear tissues and structures make in the pathogenesis of the disease. The Tshrhyt mutant mouse is ideally suited to meet the needs of the proposed research and will serve as the primary model of hypothyroidism in the proposed study. We also propose to study normal BALB/c mice rendered hypothyroid through the actions of the anti-thyroid drugs, propylthiouracil (PTU) and methimazole (MMI), in an effort to establish a model of hypothyroidism-induced otopathology that will allow us to clarify differences reported in the literature regarding the effects of thyroid hormone deficiency on the auditory periphery, as well as the capacity of thyroid hormone to restore function in diseased animals. The chief hypothesis being tested in this proposal is that abnormal cochlear amplification represents an enduring defect of hypothyroidism-induced otopathology and that normal passive transduction is acquired developmentally over a protracted time course. In that context, in addition to experiments designed to address the primary question directly using in vivo recordings (ABR, CM and DPOAE), as well as in vitro recordings from outer hair cells, we plan to study the morphological and the functional properties of the tectorial membrane, along with its chemical composition, to determine its role in the pathogenesis of the disease. The role of other passive aspects of transduction (e.g., endocochlear potential) will be assessed directly. We also plan to take the first step in a study aimed at determining the molecular and genetic basis of hypothyroidism, using RT-PCR and in situ hybridization to study the expression of transcripts that may affect the expression of cochlear amplification. Finally, we propose to explore the intriguing possibility that the efferent OC system may influence the development of peripheral auditory function. If the main hypotheses proposed here are
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affirmed, the existing model of auditory system pathology induced by hypothyroidism will be fundamentally revised. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISEASE
NEUROCOGNITIVE EFFECTS OF
SUBCLINICAL THYROID
Principal Investigator & Institution: Samuels, Mary H.; Associate Professor of Medicine; Medicine; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): This Pilot and Feasibility Program (R-21) application represents a new research direction for the investigator, Dr. Mary Samuels, in the field of cognitive effects of mild (or "subclinical") thyroid disease in the adult human. 5% of the general population has subclinical thyroid disease, as defined by isolated TSH abnormalities, and 20% of older women have mild hypothyroidism (isolated TSH elevations). Therefore, the question of whether subclinical thyroid disease alters cognition has important public health implications. If subclinical thyroid disease were associated with cognitive deficits, this would be an important treatment indication. This is especially relevant to the older population, which has high rates of incipient dementia that could be worsened by the addition of cognitive deficits due to mild thyroid disease. In order to investigate this question, the investigator has designed a new model of experimentally-induced subclinical thyroid disease, and proposes a series of experiments to test and refine this model. Subjects who are currently taking L-thyroxine (L-T4) for chronic replacement therapy will be randomized to their usual doses of L-T4, vs. slightly lower doses (to induce mild subclinical hypothyroidism), or slightly higher doses (to induce mild subclinical hyperthyroidism). Treatment assignment is randomized, placebo-controlled, and double-blinded. Each treatment arm is designed to last 3 months. At the beginning and end of each arm, a battery of cognitive tests is administered. The specific cognitive outcome measures have been chosen to target cognitive domains most likely to be affected by mild thyroid disease. Throughout the studies, subjects are also monitored for safety, quality of life, mood, and other effects of altered thyroid function. The broad specific aims of this application are: 1) To develop and refine a model of experimentally-induced subclinical thyroid disease by testing dose increments of L-T4 in subjects receiving L-T4 replacement therapy; 2) To utilize the model to obtain pilot data on cognitive effects induced by subclinical hypothyroidism in younger and older human subjects; and 3) To utilize the model to obtain pilot data on cognitive deficits induced by subclinical hyperthyroidism in older subjects. Based on these pilot studies, it is the long-term goal of the investigator to investigate specific cognitive effects of altered thyroid status in the adult human. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEWBORN RELATIONSHIPS
SCREENING
AND
THE
PARENT-INFANT
Principal Investigator & Institution: Tluczek, Audrey; Psychiatry; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: The candidate is submitting a proposal for a K23 Award from the NICHD with a short-term career development goal of enhancing her research skills and a longterm goal of developing a program of research that includes clinical trials designed to evaluate the efficacy of psychosocial interventions for children with chronic illness and
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Hypothyroidism
their families. To meet these goals, she proposes a career development plan that includes participation in the Clinical Investigator Preparatory Program (CIPP) offered through the University of Wisconsin Medical School. The proposed research project will evaluate the impact of newborn screening and diagnosis on the parent-infant relationship; examine the interactional mechanism that may contribute to a parentinfant relational disturbance; and identify parent, infant, and parent-infant dyadic variables that may serve as mediating factors in the quality of the parent-infant relationship. Four groups will be compared: a) families with infants who have CF diagnosed through newborn screening (CF-D), b) families with infants who are heterozygote CF mutation carriers identified through newborn screening (CF-C), c), families with infants who have congenital hypothyroidism (CH) diagnosed through newborn screening (CH), and d) families who have healthy infants (H) with normal screening results. The design will consist of multi-modal methods including empirically validated self- report measures, observational measures, and chart review. Data will be collected on parent, infant, and parent-infant interactional variables. Independent variables will consist of parents' level of task-oriented behaviors and emotional responsiveness in interactions with their infants as measured by an observational method. The primary dependent variable will be the quality of the parent-infant attachment relationship as measured by parental self-report and an observational method. Mediating factors will include parental psychological symptoms, stress, and coping style, as well as infant temperament, developmental status, and illness severity. Families will be followed and data collected over one year to document parent-child relationship changes over the infant's first year. Demographic variables will be controlled statistically. This study will provide important data for development of an intervention study for this genetically at risk population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOCTURNAL TSH SURGE IN CENTRAL HYPOTHYROIDISM Principal Investigator & Institution: Rose, Susan R.; University of Tennessee Health Sci Ctr Health Science Center Memphis, Tn 38163 Timing: Fiscal Year 2001 Summary: In this study, 60 children with idiopathic short stature undergo overnight study of their pattern TSH. In addition, 60 children who have undergone treatment of CNS tumor/oncology and 60 children who have survived significant head injury will be studied. Those who are identified as having blunted TSH secretion at night will be eligible to participate in a subsequent placebo-controlled treatment phase." Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: OSTEOCALCIN SYNTHESIS AND CATABOLISM Principal Investigator & Institution: Gundberg, Caren M.; Associate Professor; Orthopedics and Rehabilitation; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 01-JUL-1986; Project End 31-AUG-2003 Summary: (Adapted from the Applicant's Abstract): The use of bone markers in clinical studies has provided both important insights into physiological processes, and information on therapy for the treatment of metabolic bone disease. Osteocalcin is one of the most extensively studied biological markers of bone turnover, and it is generally regarded as an index of osteoblastic activity. However, the clinical interpretation of an osteocalcin measurement in individual patients is often ambiguous and does not always
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correlate with other markers, or with clinical findings. These difficulties arise because of differences in assay specificity, uncertainties regarding the origin of the circulating forms of the protein, and lack of a clear understanding of its function in bone. Studies in the applicant laboratory demonstrate that in addition to the intact protein, fragments of osteocalcin are found in the circulation. They have identified several of these fragments by the use of antibodies with specific epitopes. These individual fragments of osteocalcin may be produced by osteoblasts and/or osteoclasts, and may reflect distinct cellular processes related to the function of osteocalcin in bone. In light of this, the proposed experiments are designed to answer the following questions: (1) what are the forms of osteocalcin in the circulation? Efforts are proposed to further identify the circulating forms of osteocalcin by using specific immunoassays coupled with HPLC and mass spectral analysis. The planned experimentation will identify and quantitate these forms (a) in serum from normal adults and children, with respect to age, race, and sex, and (b) in patients with metabolic bone disease. The resultant values will be compared to standard clinical measures, including calcitropic hormones, minerals, markers of bone resorption, and bone density; (2) what is the source of circulating osteocalcin? The applicants will study (a) osteocalcin biosynthesis, using primary cultures of osteoblasts, (b) the catabolism of osteocalcin, using rabbit-derived osteoclasts in a bone resorbing system, and c) metabolic clearance of the major fragments; and (3) what is the function of osteocalcin in bone? Here, the potential role of osteocalcin in bone turnover and calcium homeostasis will be examined by studying the response of osteocalcin-deplete mice to acute and chronic mineral and hormonal alterations. Responsiveness will be determined by standard measures of calcium homeostasis, including calcitropic hormones, minerals, markers of bone resorption, alternative measures of bone formation, bone density, histomorphometry, and mineral quality and content in bone. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PATHOLOGIC ALTERATIONS OF THYROID FUNCTION Principal Investigator & Institution: Foley, Thomas P.; Children's Pittsburgh/Upmc Hlth Sys of Upmc Health Systems Pittsburgh, Pa 15213
Hosp
Timing: Fiscal Year 2001 Summary: Determine etiology and pathogenesis of abnormal thyroid hormone metabolism or secretion in Grave's Disease, Hashimoto's Disease, and congenital hypothyroidism. Hormonal homeostasis is assessed during hypo and hyper- thyroidism to determine the role of altered thyroid hormone secretion in metabolic homeostasis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PCB NEUROTOXICITY: EFFECTS ON CEREBELLAR DEVELOPMENT Principal Investigator & Institution: Opanashuk, Lisa A.; Environmental Medicine; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2002; Project Start 08-MAR-2002; Project End 31-DEC-2004 Summary: (Taken from the Investigator's Abstract) Polychlorinated biphenyls (PCBS) are widespread and persistent environmental contaminants. Perinatal PCB exposure is related to developmental cognitive and motor abnormalities in humans. Therefore, exposure to these toxicants is recognized as a significant human health-related concern. Corroborative animal studies have identified neurobehavioral changes in perinatal PCB exposed rats which include defective locomotor activity, altered eyeblink conditioning, and impaired delayed spatial alternation and reversal learning. The nature of these
26
Hypothyroidism
alterations likely reflects PCB-induced disruption of cerebellar output. Based on these considerations it is hypothesized that gestational PCB exposure disrupts neuronal maturation during a critical period of cerebellar development. Exposure hinders neuronal differentiation, thereby leading to abnormal formation of cytoarchitecture and dysregulation of neurochemical function. These structural and functional perturbations ultimately interfere with cerebellar output. This hypothesis will be addressed by the following specific aims: Specific aim 1: Does gestational exposure to Aroclor 1254 influence cell acquisition or synaptogenesis during rat cerebellar development? Specific aim 2: Is gestational exposure to Aroclor 1254 related to alterations in the molecular differentiation state of neurons in the developing cerebellum? Specific aim 3: Does gestational exposure to Aroclor 1254 alter cerebellar amino acid neurotransmitter levels, turnover, and neurochemical output? The actions of PCBs on the developing cerebellum have been largely unexplored despite clear indications of regional vulnerability. The proposed project will provide a foundation for identifying cellular sites of PCB action in cerebellum and corresponding molecular mechanisms. Such studies will lead to a better understanding of pathophysiology which can be used as a rational basis for reducing exposure risks and developing efficacious pharmacotherapies. Since there is evidence that PCBs induce a state of hypothyroidism in developing brain, future research will explore the role of thyroid hormone in PCB neurotoxicity and the possibility of thyroid replacement therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHASE I STUDY OF THYROID HORMONE IN PREMATURES Principal Investigator & Institution: Lagamma, Edmund F.; Pediatrics; New York Medical College Valhalla, Ny 10595 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2005 Summary: (provided by the applicant): We propose a Phase 1 pilot study to set the stage for a Phase 3 study of thyroid supplementation in infants born prior to 28 weeks of gestation to assess whether such treatment improves long-term outcomes, specifically IQ and risk of disabling cerebral palsy. The purpose of the pilot study is to establish the dosing schedules needed to achieve the optimum plasma hormone targets in the neonatal period, without increasing measures of neonatal morbidity, mortality or physiological dysfunction. A particular goal is to avoid suppression of thyroid stimulating hormone from administration of thyroid hormone. We also aim to demonstrate cooperation among an international consortium of five participating institutions before initiating a trial to involve about 20 study sites. Six groups of 24 infants each will receive saline control, iodine supplementation, or any of four combinations of thyroid hormone, varying in type (thyroxine combined with triiodothyronine), dosage (4 or 8 pg./kg./day) and route of administration (bolus or continuous). Enrollment will take place in three sites: Westchester Medical Center-New York Medical College, Valhalla, NY; Emma Children's Hospital-Academic Medical Center, Amsterdam, the Netherlands; and Hospital La Paz-Autonomous University of Madrid, Spain. Measures of thyroid hormone and iodine status will be obtained at specific times on study subjects and their mothers, and cortisol levels in infants. Experienced laboratories in California and Spain will be employed for assessing hormones and iodine levels respectively. Several thyroid-related physiological measures will be prospectively recorded from medical records. A patient safety-monitoring plan has been developed. Data will be entered using a web-based system and analyzed at the data coordination center of Michigan State University. As soon as clarity is obtained on the optimum mode of achieving euthyroidemia in the study population, the research
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team will apply for a subsequent Planning Grant to develop the protocols and instruments for the eventual full-scale multicenter trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHYSIOLOGY OF THYROID HORMONE DEPENDENT GENE EXPRESSION Principal Investigator & Institution: Larsen, Philip R.; Professor; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 15-JAN-1992; Project End 31-MAR-2006 Summary: (Scanned from the applicant's abstract) Our laboratory has focused on the mechanisms regulating triiodothyronine (T3) homeostasis for over 25 years. Critical to this process are the actions of the iodothyronine deiodinases which function in concert to regulate thyroxine (T4) activation and the inactivation of T4 and T3. This proposal continues this theme. In the first Specific Aim we will continue our investigations of a cell type specific negative thyroid hormone response element (nTRE) in the promoter of the human Type 1 deiodinase (Dl) gene. This thyroid receptor (TR) binding sequence also binds a novel JEG cell transcription factor (JTF) with high affinity and specificity. JTF increases expression of genes containing this sequence and this effect is enhanced by APO-TRs. T3 eliminates this effect. Using DNA affinity matrix techniques we will isolate and identify this newly discovered protein and determine how TR cooperates with it as an example of a specific mechanism for negative regulation of gene expression by thyroid hormone. Uncontrolled, rapid inactivation of thyroid hormone causes hypothyroidism in a syndrome which we recently identified in infants with large hemangiomas. Infantile hemangiomas express Type 3 iodothyronine deiodinase (D3), the major physiological inactivator of 13 and 14, at levels up to 8-fold that in placenta. Large tumors can deiodinate T4 and T3 more rapidly than the infant's thyroid can secrete them. Specific Aim 2 will elucidate the mechanism for ectopic expression of D3 in these tumors. We will compare hemangioma-derived and normal human capillary endothelial cells to discover pathways which could activate D3 expression analogous to those in placenta. Specific Aim III is to define the mechanism for the myocardial response of the euthyroid heart to the thyrotoxic state such as occurs in patients with hyperthyroidism. We have developed a novel method for inducing chronic myocardial thyrotoxicosis in mice by use of a transgene in which Type 2 iodothyronine deiodinase (D2) is driven by the alpha-MHC promoter. We will first define the mechanism for the two-fold increase in the cAMP response to forskolin in myocardial membranes from these transgenic mice. We will also document the differences n gene expression profiles between euthyroid and thyrotoxic myocardium from both young and old mice. Only a few genes have been identified which increase their expression significantly between the euthyroid and hyperthyroid state. Identifying such genes in the myocardium will be especially critical to the understanding of the effects of T3 excess on the heart in human hyperthyroidism. These studies will provide new information relevant to both basic and clinical thyroid physiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PILOT & FEASIBILITY STUDIES Principal Investigator & Institution: Nissanov, Jonathan; Carnegie-Mellon University 5000 Forbes Ave Pittsburgh, Pa 15213 Timing: Fiscal Year 2001
28
Hypothyroidism
Summary: Decreased thyroid function often occurs in critically ill patients and is of prognostic significance. However, it is unknown if hypothyroidism is a cause of organ dysfunction or just an epi-phenomena of acute sepsis. The objective of this study is to determine the ability of exogenous thyroid hormone to improve hepatic bioenergetics in a septic rat model. Bioenergetic function will be assessed by measuring the high energy phosphate levels in the liver using 31P NMR spectroscopy. The experimental animals in the study will be given thyroid treatment immediately following septic induction. The comparison of the high energy phosphate levels between the treatment and nontreatment groups will demonstrate the influence of thyroid function on hepatic bioenergetics Preliminary data show that an injured but unchallenged liver exhibits apparently stable bioenergetic function as assessed by ATP and inorganic phosphate (Pi) concentrations. Subsequently, when the liver is subjected to a metabolic challenge (glucagon), there is an increase in the Pi/ATP ratio. This ratio increase demonstrates the severity to which the liver is dysfunctional from an energetics perspective. Our preliminary data (without the glucagon challenge) have not demonstrated the livers of the septic animals to be bioenergetically unstabIe~therefore, we tested the liver with a glucagon challenge. The preliminary results from these data demonstrate hepatic bioenergetic failure in septic animals, whereas non-septic animals do not. Accordingly, we now propose to study the effects of triiodothyronine (T3) replacement on modifying this hepatic dysfunction. : Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PRENATAL ALCOHOL; HORMONE-REGULATED GENES & BEHAVIOR Principal Investigator & Institution: Redei, Eva E.; Professor; Psychiatry and Behavioral Scis; Northwestern University Office of Sponsored Programs Chicago, Il 60611 Timing: Fiscal Year 2002; Project Start 01-MAR-2002; Project End 28-FEB-2005 Summary: (provided by applicant): Children exposed to alcohol in utero frequently exhibit behavioral problems including hyperactivity, learning deficits, response inhibition and increased prevalence of depression. Many of these behavioral deficits are also observed in animal models of fetal alcohol exposure. Similar behavioral deficits occur after prenatal stress and in children born to mothers with subclinical hypothyroidism. This information formed the main hypothesis of this proposal: fetal glucocorticoid and thyroid hormone milieu may contribute significantly to the deleterious consequences of prenatal alcohol exposure. Specific Aim 1 will investigate the sub-hypotheses that relative hypothyroidism found in the alcohol-consuming dam and its fetuses is due, at least in part, to elevated maternal corticosterone suppressing the thyroid function. Subsequently, this prenatal hypothyroid state of the fetal alcoholexposed (FAE) offspring can cause the activity and cognitive behavioral deficits in the adult offspring. Specifically, we aim to determine 1) whether eliminating the alcoholinduced increase in maternal corticosterone would normalize the FAE offspring hypothalamic-pituitary-adrenal (HPA) and thyroid (HPT) function and behavior; 2) if prenatal or neonatal thyroid hormone supplementation would correct HPT function abnormalities and behavioral deficits of FAE offspring. Specific Aim 2 will establish a murine model of prenatal alcohol exposure so that with the aid of transgenic mice prenatal alcohol-induced changes in thyroid hormone responsive genes can be found in a temporal, spatial and cell specific fashion. To achieve that, we will 1) characterize the effects of fetal alcohol exposure on HPA, HPT function and specific behavioral measures in C57BL/6J mice; 2) develop transgenic mouse line which ubiquitously expresses the reporter LacZ gene driven by thyroid-responsive DNA promoter (pTRELacZ); 3) expose
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pTRE-LacZ transgenic mice to alcohol in utero and determine the developmental profile and specific brain region(s) of the most profound changes in thyroid hormone responsive genes; 4) carry out a microarray-based differential expression analysis on the specific brain region(s) identified with the help of the pTRE-LacZ transgenic mice. The long-term goal of these studies is to determine if thyroid hormone supplementation preor postnatally can ameliorate the effects of ethanol on the developing brain. Furthermore, the proposed experiments will identify known or novel genes that are specifically responsive to thyroid hormones and show altered expression in the developing fetal brain during ethanol exposure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROTON LEAK, OXIDATIVE STRESS, AND ENERGY RESTRICTION Principal Investigator & Institution: Ramsey, Jon J.; Assistant Professor; Vet Molecular Biosciences; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 95616 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2004 Summary: (adapted from Investigator's abstract): The mechanism by which CR works to extend lifespan in multiple rodent species is of high relevance and significance to research into aging. Mitochondria do not seamlessly convert the mitochondrial membrane potential to chemical energy, i.e. ATP. Rather there are several possibilities for proton "leak" through the mitochondrial inner membrane that do not require passage through the ATPase and synthesis of ATP. The investigator formulates the hypothesis that it is really the rate and extent of these leak reactions that are both 1) major contributors to resting mitochondrial O2 consumption, and 2) major contributors to the production of reactive oxygen species (ROS). Caloric Restriction has been demonstrated consistently to increase lifespan, and to decrease several biochemical endpoints of mitochondrial and oxidative stress specifically in postmitotic tissues. The premise is that Caloric Restriction (CR), hypothyroidism, and modulation of dietary fat will decrease mitochondrial permeability (i.e. proton leak), therefore decreasing molecular Oxygen consumption, and presumably oxidative stress. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: QUALITY CONTROL TOOL FOR NEWBORN SCREENING BLOOD SAMPLES Principal Investigator & Institution: Craine, Brian L.; Western Research Company, Inc. 2127 E Speedway, Ste 209 Tucson, Az 85719 Timing: Fiscal Year 2002; Project Start 01-MAR-1999; Project End 31-AUG-2004 Summary: (provided by applicant): Essentially all newborns in the United States (about 4 million per year) and at least 30 other countries have blood samples obtained on filter paper cards for the purpose of screening for a number of metabolic and genetic diseases. To prevent morbidity, such as brain damage, from metabolic diseases such as phenylketonuria or congenital hypothyroidism, it is critical that the screening results be obtained in a timely fashion. A persistent and well-documented problem for the newborn screening programs has been the arrival of inadequate blood card samples at the testing laboratories. These result in expensive recall testing and introduce a dangerous delay in the diagnosis of disease. This project will develop an imaging based system for the evaluation of blood cards to determine if they are adequate. Use of such a system at a birthing center will allow for the immediate correction of the problem,
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Hypothyroidism
saving health care dollars and preventing any unnecessary delay in the diagnosis of important metabolic diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF LIPOPROTEIN LIPASE IN ADIPOCYTES Principal Investigator & Institution: Kern, Phillip A.; Professor; Internal Medicine; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, Ar 72205 Timing: Fiscal Year 2001; Project Start 01-SEP-1988; Project End 30-JUN-2006 Summary: (Scanned from the Applicant's Description): Lipoprotein lipase (LPL) is a central enzyme in lipid metabolism and adipocyte biology. Although the changes in LPL activity with diabetes and other conditions have been well described, the mechanism of LPL regulation is complex. We have described regulation of LPL translation in response to catecholamines, thyroid hormone, and in diabetes. Our recent studies have described an RNA binding protein that inhibited translation through binding to the 3'UTR of the LPL mRNA. We have now identified a member of the RNA binding complex as the alpha catalytic subunit of cAMP dependent protein kinase (PKA). In addition, we have produced transgenic mice that express an LPL gene (LPLt) that lacks the RNA binding motif on the 3'UTR. Our future aims are to better characterize the role of PKA in LPL regulation, and to better understand the role of translation in the physiologic regulation of LPL. Hypothesis 1. Protein kinase A (PKA) is involved in the translational regulation of LPL. Aim 1. Characterize the binding of the PKA C subunit to LPL mRNA: tissue specificity and involvement of other proteins. Aim 2. Determine the sequence and kinase activity of the C subunit involved in translational regulation. Aim 3. Characterize the motif on the 3'UTR of LPL that is involved in C binding. Aim 4. Determine whether LPL translation is altered in PKA knockout mice. Hypothesis 2. Regulation of LPL translation is important physiologically. Aim 1. Examine the translational regulation of both LPLt and wild type LPL (LPLwt) in response to epinephrine, thyroid hormone, and phorbol ester in isolated adipocytes from transgenic mice. Aim 2. Examine the regulation of LPLt and LPLwt in adipose tissue of transgenic mice following the induction of streptozotocin-diabetes or hypothyroidism, and the in vivo administration of epinephrine. Aim 3. Examine the mechanism by which the expression of LPLt in transgenic mice is accompanied by a down regulation of wild type LPL. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: REGULATION OF PROTEIN TRAFFIC IN NEUROENDOCRINE CELLS Principal Investigator & Institution: Thomas, Gary; Scientist/Professor; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-DEC-1985; Project End 30-NOV-2005 Summary: Endocrine disease in the United States is increasing at an alarming rate. Approximately 40 million people are currently debilitated by diabetes, hypothyroidism, or infertility alone and the incidence of these and other endocrine diseases is expected to increase. Although this broad collection of diseases has many causes, these numbers nonetheless underscore the importance of endocrine and neuroendocrine homeostasis for our health. This homeostasis relies on the ability of stimulus-triggered secretory cells to correctly sort, package, and process numerous molecules either into or away from the maturing secretory granules. The cellular mechanisms that control the sorting of these molecules, however, are poorly understood. Both the trans-Golgi network and the immature granules are key sorting stations for the formation of dense-core, stimulus-
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triggered secretory granules. The immature granule functions as a "gatekeeper" that segregates a collection of seemingly unrelated "TGN/endosomal" membrane proteins from those destined for inclusion in mature granules. Retrieval of these non-granule membrane proteins requires an acidic cluster sorting signal that must be phosphorylated by casein kinase 2. Recently, my laboratory reported the identification of a novel cell sorting protein, named PACS-1, that binds to these phosphorylated acidic cluster signals and is required for the retrieval of the non- granule membrane proteins from the immature granule. Our identification of PACS-1 has provided new insights into secretory granule formation. The proposed studies will first determine the biochemical bases for the binding of PACS-1 to these phosphorylated acidic-cluster sorting motifs and how PACS-1 sorting activity itself is regulated by phosphorylation. Second, we will determine the subcellular localization of PACS-1 and the mechanism by which it is recruited to immature granules. Third, we will determine the importance of PACS-1 to neuroendocrine cell physiology. Together, these studies will improve our understanding of the regulation of protein sorting in neuroendocrine cells, as well as increase our knowledge of the cell biology underlying both endocrine and neuroendocrine homeostasis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ROLE OF INTERFERON GAMMA IN THYROIDITIS Principal Investigator & Institution: Caturegli, Patrizio P.; Pathology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 28-FEB-2004 Summary: Interferon gamma (IFNg) has been implicated with contradictory results in the pathogenesis of autoimmune thyroid diseases. To investigate this issue, we have made transgenic mice that express IFNg in the thyroid gland under control of the thyroglobulin promoter. The thyr-IFNg transgenic mice present signs of hypothyroidism, which results from a profound inhibition of the expression of the sodium iodide symporter gene. The thyroid pathology is characterized by extensive loss of follicular architecture, maturation delay in the remaining follicles, and a mild mononuclear cell infiltration. The thyr-IFNg transgenic mice provide a model to study how the local production of IFNg in thyroid autoimmunity affects thyroid structure and function. We have structured this application with three specific aims. Specific aim 1 tests, by crossing thyr-IFNg transgenic mice to RAG-2 knock out mice, whether the observed morphologic and functional thyroid changes are mediated lymphocytes or, instead, by a direct effect of IFNg on thyrocytes. Specific aim 2 defines, by genetic tools and transfection assays, the mechanisms through which IFNg causes suppression of the expression of the sodium iodide symporter gene, leading to hypothyroidism. Specific aim 3 compares, by serial analysis of gene expression, the thyroid transcriptome of normal and thyr-IFNg transgenic thyrocytes, with the goals to quantitatively measure the genes in the IFNg signaling and thyroid hormone synthetic pathways; and to discover new thyroid-specific genes. The long-term objectives of this proposal are to characterize the role of IFNg in relation to inflammation and cell damage in thyroiditis. The health-relatedness of the project stems from the high prevalence of autoimmune thyroid diseases in humans. Furthermore, the understanding of the pathogenesis can open new avenues for diagnosis, prognosis, and treatment of these and other organspecific autoimmune diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ROLE OF RETINOIDS AND RECEPTORS IN THYROTROPE FUNCTION Principal Investigator & Institution: Haugen, Bryan R.; Associate Professor; Medicine; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 15-AUG-2000; Project End 31-JUL-2005 Summary: (Adapted from the applicant's abstract) Vitamin A has a well recognized, but poorly understood effect on the pituitary-thyroid axis. Vitamin A excess causes central hypothyroidism with suppressed levels of serum TSH and T4. The effects of vitamin A are mediated through two nuclear hormone receptors, the retinoic acid receptors (RARs) and retinoid X receptors (RXRs). Many synthetic derivatives of vitamin A, or retinoids, have been developed, and these retinoids exhibit unique chemotherapeutic and chemopreventive properties in many different cancers. An RXR-selective retinoid (Targretin, LG 1069) caused a reversible central hypothyroidism in patients, suggesting that the vitamin A effect on this axis is mediated, at least in part, through an RXRliganded mechanism. The principal investigator's laboratory has utilized molecular techniques to show that retinoids directly suppress activity of thyrotrope-specific TSHbeta gene promoter. This mechanism appears to require the RXRgamma isoform, which has expression limited to the thyrotropes within the anterior pituitary gland. The goals of this proposal are to define the specific mechanisms governing the effect of retinoids on TSH regulation, to use the TSHbeta promotor as a model of negative gene regulation by retinoids, and to further define the role of RXR and the unique role of the RXR isoform. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SIGNALING CROSSTALK AND THYROID CELL SURVIVAL Principal Investigator & Institution: Meinkoth, Judith L.; Associate Professor; Pharmacology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-MAY-2000; Project End 30-APR-2004 Summary: Immune-mediated cell destruction is one of the central pathologic events in the development of autoimmune disease. In Hashimoto's thyroiditis (HT), a specific immune response to thyroid antigens leads to lymphocytic infiltration, follicular cell destruction and clinical hypothyroidism. It is now evident that apoptosis is one of the major pathologic mechanisms underlying HT and other forms of autoimmune disease. Proinflammatory cytokines are thought to play an initiating role in autoimmunity and apoptosis. Interferon-gamma (IFN-gamma) and interleukin 1-beta have been implicated in the pathogenesis of HT and other autoimmune disorders. Recently, these cytokines were shown to induce Fas receptor expression on normal human thyrocytes, cells that express FasL. Cross-linking of Fas resulted in massive apoptosis, leading to the speculation that following inflammation and cytokine release, thyroid cells are pruned to die by fratricidal mechanisms. Thyrotropin (TSH) regulates thyroid function, proliferation and possibly, survival. TSH stimulates the expression of thyroid-specific genes, effects that are opposed by (IFN-gamma). In turn, TSH has been reported to decrease IFN-gamma effects on Fas expression and apoptosis. Our aims are to elucidate the effects of proinflammatory cytokines in a continuous line of rat thyroid cells. We wish to explore the mechanisms of cytokine-induced cell death, and of survival promoted by TSH using a combination of biochemistry, cell biology and microinjection. Crosstalk between cytokines and hormones, given their opposing effects on Fas expression, may significantly alter the susceptibility of endocrine cells to apoptosis, a
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factor with profound implications for autoimmune diseases including thyroiditis, diabetes and rheumatoid arthritis. Ras activation, a frequent event in thyroid cancer, sensitizes many cells to cytokine-induced apoptosis, and numerous studies implicate a close linkage between signals activated by Ras and Fas. TSH appears to alter the balance in Ras-mediated signals from proliferation to apoptosis, a finding that may explain the infrequent occurrence of mutations in Ras and in Gs or the TSH receptor, mutations leading to the constitutive activity cAMP- mediated signaling pathways, in thyroid tumors. We will examine the acute effects of Ras on apoptosis, and the signaling pathways responsible for these effects. We will identify cellular factors that contribute to the ability of Ras-transformed cells to escape apoptosis. Taken together, these studies will provide new insight into the regulation of thyroid cell survival and transformation applicable to other endocrine cells. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SUBCUTANEOUS RHUIL4 IN PATIENTS WITH RA Principal Investigator & Institution: St Clair, Eugene W.; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001 Summary: Purpose: The purpose of the present study is to determine the safety and tolerability and potential clinical efficacy of subcutaneous doses of recombinant human IL-4 (rHuIL-4) in patients with rheumatoid arthritis (RA). RA is a chronic inflammatory disease of unknown etiology. It is characterized by synovial inflammation with frequent progression to articular cartilage and bone destruction. The synovial inflammatory response in RA consists predominately of T lymphocytes, mostly T helper cells (Th), with fewer numbers of macrophages and B lymphocytes. The Th cells can be divided into two overlapping subpopulations with important functional significance, Th1 and Th2 cells. Th1 cells secrete IL-2 and interferon- and regulate cell-mediated responses. Th2 cells secrete IL-4, IL-5, and IL-10, and mediate humoral responses. Most Th cells in the rheumatoid joint belong to the Th1 subpopulation. The synovial tissue in RA exhibits other features typical of a cell-mediated response, including hypervascularity, upregulation of cell adhesion molecules, and overexpression of pro-inflammatory cytokines such as IL-1 and tumor necrosis factor (TNF)-. IL-4, a cytokine produced by Th2 cells and macrophages, has primarily immunosuppressive and anti-inflammatory properties. The inhibitory effects of IL-4 have been observed in animal models of arthritis where it can ameliorate joint inflammation. Methods: The study is a multicenter, double-blind, placebo-controlled, escalating dose (0.5, 1.0, and 2.0 5g/kg) clinical trial with a dosing period of 6 weeks. The main outcomes for the study are the frequency and severity of adverse effects and the American College of Rheumatology Core Disease Measures. Results: The study has been completed. A total of four patients were enrolled at this site. The study population was predominantly female (3/1) and Caucasian. The study drug was well tolerated and did not cause any serious adverse event reactions. One patient, a Caucasian male, was seen during the reporting period. There were two serious adverse events that occurred during the course of the study. One patient with a past history of supraventricular tachycardia, hypertension, and hypothyroidism (managed with Levothyroxin) was admitted to the hospital for atrial fibrillation. Because of the cardiotoxicity profile of IL-4 in preclinical trials, the investigator considers the atrial fibrillation to be possibly related to the study drug. The second serious adverse event concerned a patient who was admitted for hip replacement surgery. This patient had long- standing disease and a past history of multiple joint replacements. IL-4 treatment did not improve disease measures.
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Significance: RA is widely believed to be a Th1-mediated disease, although the data to support this hypothesis is circumstantial. For example, Th1 cells are associated with cellular immune responses, which seems to fit with the characteristics of rheumatoid joint inflammation, and T cell clones isolated from synovial tissue of RA patients most often secrete Th1 cytokines. Additional insights into whether RA is a Th-driven response in RA may be obtained by examining the treatment and biological effects of cytokines that downregulate Th1 responses. Future plans: Since, interleukin-4 did not yield the expected effect in RA patients, there are no plans for future studies at this time. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TESTING OF PATIENTS WITH SUSPECTED DISORDERS OF TSH SECRETION Principal Investigator & Institution: Wondisford, Fredric E.; Professor; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TH-DEPENDENT, ACTIN-BASED VESICLE TRAFFICKING Principal Investigator & Institution: Leonard, Jack L.; Professor; Nuclear Medicine; Univ of Massachusetts Med Sch Worcester Office of Research Funding Worcester, Ma 01655 Timing: Fiscal Year 2001; Project Start 15-AUG-2001; Project End 30-JUN-2006 Summary: (provided by applicant): Thyroid hormone (TH) is essential for the normal growth and development of the brain, but the molecular events that mediate these actions are poorly understood. While TH-regulated gene expression is widely assumed to play a key role in this process, the recent revelation that both TH receptor genes (TRa and TRb) can be deleted without affecting brain development raises the possibility that other nongenomic TH-dependent processes contribute to the actions of TH in brain. One of the best-characterized, nongenomic actions of TH is the dynamic regulation of brain type 2 deiodinase (D2). Both thyroxine (T4) and the metabolically inert TH, reverse T3 (rT3), dynamically regulate brain D2 levels in vivo by modulating the rate of D2 removal from the plasma membrane through actin-based endocytosis. A key component of this regulatory cascade is a high affinity TH Initiator Protein (TIP) that facilitates the docking of the D2 containing endosome to the actin based molecular motor, Myosin 5a (Myo5a). We hypothesize the high affinity T4-binding protein(s) (TIP) that tethers the endocytotic vesicle to Myo5a is derived from the C-terminus of the TRa gene, known as TRAa. We will establish the role of TRAa(s) in TH-dependent vesicle trafficking using TH-displacement analysis, in vitro actin-binding assays, real time analysis of THinitiated vesicle trafficking and pull-down assays with the vesicle binding domain of Myo 5a (SA #1). We will also survey the cell lysate for additional TIP proteins using bait:prey with the C-terminus of Myo5a, expression cloning and TH-binding assays (SA#II). We will then develop targeted gene constructs designed to delete the TRAdeltaalphas using homologous recombination and the LoxP/Cre system. We will examine the consequences of this targeted TRa intron 7 deletion on TH-dependent :actin-based endocytosis in neurons and glial cells derived in vitro from TRAa-nul ES cells and create TRda-nul :mice (SA#III). The biology of T4-dependent actin-based endocytosis of p29 is a unique experimental model for understanding the nongenomic actions(s) of TH in brain and uses cellular machinery essential to normal synaptic function which may account for the neurological abnormalities of hypothyroidism.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THYROCYTE PROTEIN TRANSPORT TO THE CELL SURFACE Principal Investigator & Institution: Arvan, Peter R.; Professor; Medicine; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2001; Project Start 01-SEP-1988; Project End 31-AUG-2003 Summary: Even after action of thyrotropin (TSH) on its cell surface receptor, thyroid hormone synthesis requires the presence of multiple different molecules at the apical or basolateral plasma membranes of thyrocytes. These secretory and membrane proteins are delivered to the cell surface by intracellular transport through the secretory pathway. Successful/unsuccessful of several different proteins and cell types are proposed as models to investigate questions within this theme. Aim 1 of this grant will focus on molecular studies of thyroglobulin (Tg), a secretory protein that has been implicated as defective for transport in certain kindreds with congenital goitrous hypothyroidism. The investigators have obtained the first stable expression of fulllength non-mutant Tg in a heterologous cell type. Feasibility studies support a proposal to now produce and test site-specific mutations in the Tg backbone, based on naturallyoccurring Tg mutants, as well as mutations to identify functional domains in Tg folding and assembly. Aim 2 of this grant will examine aspects of quality control of protein export from the endoplasmic reticulum (ER). Studies in the Progress Report demonstrate new systems being developed to compare the fates of identical secretory proteins expressed in thyrocytes versus other cell types. Feasibility studies support a plan to test their hypothesis of cell-type specific differences in the rates and efficiency of protein export and ER- associated protein degradation. The last Aim of this grant will pursue the question of targeting signals for polarized traffic of thyroid proteins expressed in the MDCK cell line, which serves as the best system available for studies of protein sorting in polarized epithelial cells. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THYROID AXIS IN MAJOR DEPRESSION Principal Investigator & Institution: Ninan, Philip T.; Professor; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2001; Project Start 01-APR-1998; Project End 31-JAN-2003 Summary: The goals of this proposal are to examine the relationship between Major Depressive Disorder (MDD) and abnormalities of the hypothalamic pituitary thyroid (HPT) axis. HPT abnormalities, specially subclinical hypothyroidism, are present in a significant number of patients with MDD. Yet the most common HPT abnormality reported in MDD is a blunted TSH response to TRH challenge suggesting central hyperactivity of the HPT axis. Perturbation of the normal functioning of the HPT axis is postulated to reflect central abnormality of TRH secretion which contribute to the heterogeneity of MDD, and plays a role in the response to antidepressant treatment. This application proposes to systematically examine the value of supplemental triiodothyronine (T3, Cytomel) with sertraline, a selective serotonin reuptake inhibitor (SSRI) in the treatment of MDD. The focus will be on two overlapping populations: 1) those with evidence of HPT abnormalities, and 2) those who did not respond to a previous adequate SSRI trial. This application proposes to programmatically develop a large study population of patients with MDD, classified with respect to HPT abnormalities and previous response to antidepressant treatment. The HPT axis will be systematically assessed in 200 patients with MDD and the benefit of triiodothyronine or
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placebo supplementation of sertraline examined. Half the study patients will have documented failure to a previous SSRI trial. The assessment of the HPT axis will include repeated peripheral baseline measures of TSH, total and free T3 and T4, antibodies to thyroglobulin and thyroid peroxidase; and the TRH stimulation test. Assessments will be repeated again after treatment. The primary hypothesis is that triiodothyronine supplementation sertraline will result in a greater improvement in HAM-D scores compared to placebo. Additional hypotheses will examine the role of HPT abnormalities and previous treatment response in the improvement to concomitant triiodothyronine with sertraline. This proposal is designed to provide a definitive clinical study of triiodothyronine augmentation of SSRI. It has the potential to significantly alter clinical practice in the management of MDD, particularly in patients who are non-responsive to antidepressants. The proposal will shed light on the role of the HPT axis in the pathophysiology and heterogeneity of MDD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THYROID HORMONE ACTION IN NEUROGENESIS Principal Investigator & Institution: Maas, Richard L.; Associate Professor and Chief; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 15-SEP-1998; Project End 31-JUL-2002 Summary: Perinatal deficiency of thyroid hormone (TH) or hypothyroidism results in abnormal development of the central nervous system, typified by poor neurite growth and synaptogenesis in the cerebellum. Brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3), members of the neurotrophic factor family, may serve critical roles in this process since NT-3 and BDNF levels are stimulated by TH, and TH treatment, or replacement of NT-3 or BDNF in part, reverses the abnormal nerve growth and development in the cerebellum. Further, a mutant mouse, staggerer (sg), in which the orphan nuclear hormone receptor RORalpha gene is disrupted, exhibits morphological and neurological abnormalities of the cerebellum similar to those seen in hypothyroid animals. In this mouse, TH does not alter the abnormal phenotype. Cerebellar Purkinje cells in sg-wild type mouse chimeras lack aberrant morphologies suggesting that trophic factors secreted from wild type cells can rescue sg cells. These results indicate that RORalpha may be involved in the TH-regulated expression of neurotrophic factors and other genes. The main goal of this proposal is to determine the mechanisms by which TH regulates neurotrophin gene expression in the cerebellum, including the role of RORalpha. The specific aims are: (1) to determine the effect of thyroid status on the developmental changes in BDNF, NT-3, Pcp-2, calbindin and cytochrome c oxidase I gene expression in the cerebellum of normal and sg mice in vivo; (2) to examine the effects of TH on BDNF, NT-3 and RORalpha gene expression, and TH, BDNF and NT-3 on neuropil outgrowth and synaptogenesis in primary cultures of cerebellum of normal and sg mice in vitro; (3) to examine the direct involvement of TR and RORalpha in neurotrophin and RORalpha (for TR) gene expression and cerebellar Purkinje cell neurogenesis, using transgenic mice expressing dominant-negative TR and RORalpha in Purkinje cells, respectively; (4) to investigate the potential involvement of RORalpha in TR action on BDNF, NT-3 and other cerebellar genes that are directly regulated by TR, using promoter analyses, transfection studies and DNA binding assays; (5) to identify and characterize other cerebellar genes that play critical roles in cerebellar neurogenesis and are regulated by TH, using differential hybridization and PCR-based subtraction techniques. These studies will provide new insights into the role of TH in brain development, which may have clinical importance in cretinism and infantile hypothyroidism.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THYROID HORMONE AND OLIGODENDROCYTE DEVELOPMENT Principal Investigator & Institution: Schoonover, Chris M.; Medicine; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 22-JUL-2002; Project End 21-JUL-2005 Summary: (provided by applicant): The long-term objectives of this program are to determine the physiological, biochemical, and molecular mechanisms by which thyroid hormone (TH) is responsible for mammalian brain development. The studies proposed in this application will focus on the effects of thyroid hormone on oligodendrocyte survival and development. Specifically, I will determine whether oligodendrocyte deficits in hypothyroid rat brain white matter tracts are a result of increased apoptosis or aberrant oligodendrocyte proliferation. To differentiate between these two hypotheses I will quantitate the total number of oligodendrocytes undergoing apoptosis during discrete stages of development. In comparison we will also assess the effects of TH on oligodendrocyte proliferation. Additionally, I will determine how IGF- I is regulated in the hypothyroid rat brain, and evaluate its role as an effector molecule of oligodendrocyte apoptosis. I will evaluate both the mRNA and protein expression patterns of IGF- 1 in the hypothyroid rat brain. If these experiments indicate a role for TH's effects on the IGF-1 axis, I will then attempt to test this hypothesis by simulating IGF-l over expression in vivo. These studies will provide significant insight towards the pathophysiologic mechanisms of hypothyroidism on the developing central nervous system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THYROID HORMONE RECEPTOR FUNCTION IN CARDIAC HYPERTROPHY Principal Investigator & Institution: Ojamaa, Kaie M.; Associate Professor; North ShoreLong Island Jewish Res Inst Jewish Research Institute Manhasset, Ny 11030 Timing: Fiscal Year 2003; Project Start 28-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): Many aspects of cardiac contractile function are determined by the action of thyroid hormones, specifically triiodothyronine (T3), on myocyte-specific gene transcription that is mediated byT3 binding to one or more nuclear thyroid hormone receptors (TR). The precise role of the individual TRs (TR alpha I,TR beta 1) and their post-transcriptional modification in determining transcription of specific cardiomyocyte genes, including co-myosin heavy chain (alphaMHC), remains unknown. The myocardium in conditions of pathologic and physiologic hypertrophy exhibits altered expression of many T3-responsive genes, which can be partially normalized by T3 treatment. The present application will test the hypothesis that impaired T3 responsiveness in the hypertrophied heart is the result of altered expression and phosphorylation of TR isoforms which affect all aspects of nuclear receptor function including DNA binding, dimerization, interaction with co-regulators, ligand affinity and transcriptional activity. In the first two specific aims, we propose to test the hypothesis that the hypertrophic cardiac phenotype is a result of changes in nuclear, content of TR isoforms and that the individual TR alpha I and beta 1 isoforms are differentially phosphorylated as assessed by isolation of nuclear proteins from purified adult rat ventricular myocytes. Our preliminary data suggest that the non-T3 binding isoform, TR alpha 2,has the unique ability to repress T3-inducible transcription of cardiac alpha-MHC and SERCA2 genes. A recombinant adenovirus strategy will be
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used in specific aim 3 to overexpress TR alpha 2 protein in cultured cardiomyocytes,and the resulting changes in transcription of the endogenous alpha-MHC gene will be measured by a novel assay to quantify alpha-MHC heteronuclear RNA. Specific aim 4 will test will the hypothesis that protein kinase C signaling pathways that are activated in the hypertrophic myocardium result in phosphorylation of specific TR isoforms, which in turn mediate changes in cardiac phenotype remarkably similar to that of the hypothyroid heart. We will study the effects of adenoviral-mediated overexpression of individual PKC delta, epsilon, and zeta isoenzymes on specific TR isoform phosphorylation and alpha-MHC gene transcription. Completion of these studies will provide novel mechanistic information regarding the role of TRs in mediating the hypertrophic phenotype, and provide the rationale for the potential therapeutic utility of T3 in the setting of congestive heart failure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THYROID HORMONE REGULATION OF NEURAL DEVELOPMENT Principal Investigator & Institution: Burd, Gail D.; Professor & Interim Head; Anatomy; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2001; Project Start 27-SEP-1999; Project End 31-AUG-2003 Summary: (Adapted from applicant's abstract) Thyroid hormone plays a crucial role in the development of the nervous system by inducing a variety of anatomical, physiological, biochemical, and molecular events during critical periods. One in every 40000 newborns have congenital hypothyroidism that will lead to growth deficiencies and irreversible mental retardation unless thyroid hormone treatment begins within the first four weeks of life. In addition hypothyroidism results in several neurological disorders in adults, including reduction or loss of olfactory abilities. The thrust of this proposal is to determine the influence of thyroid hormone on the development of the olfactory system using a model system-the olfactory epithelium of the clawed frog, Xenopus laevis. Adult Xenopus have a tripartite olfactory system that consists of olfactory epithelium in the principal and middle cavities and vomeronasal epithelium in the vomeronasal organ. Different classes of odorant receptor genes have been isolated from the adult principal cavity and middle cavity that resemble mammalian and fish odorant receptor genes respectively. The adult olfactory structures are formed at metamorphosis when the middle cavity develops de novo and the principal cavity undergoes radical cellular and biochemical transformations. The specific aims of the current proposal are to: (1) determine whether thyroid hormone is required for development of the middle cavity, (2)determine whether all the receptor cells in the principal cavity die and are replaced at metamorphosis, (3) determine the temporal and spatial expression patterns of mammalian-like and fish-like odorant receptor genes, and (4) determine whether thyroid hormone levels influence the cellular changes and odorant receptor gene expression patterns in the developing olfactory epithelium. These goals will be accomplished with hormonal manipulations, immunocytochemistry, electron microscopy, neuronal tract tracing, RT-PCR, and in situ hybridization. The goal of this research is to provide insight into thyroid hormone regulation of olfactory system development using an experimentally-favorable model system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TRANSTHYRETIN AND DEPRESSION Principal Investigator & Institution: Gorman, Jack M.; Professor; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 10032
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Timing: Fiscal Year 2001; Project Start 01-APR-1999; Project End 31-MAR-2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRH REGULATION/BIOSYNTHESIS AND PARAVENTRICULAR NUCLEUS Principal Investigator & Institution: Lechan, Ronald M.; Professor of Medicine; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2001; Project Start 01-FEB-1986; Project End 31-JAN-2002 Summary: The long term goals of this program are to elucidate the mechanisms of control of the biosynthesis of thyrotropin-releasing hormone (TRH) in a discrete population of neurons in the hypothalamic paraventricular nucleus (PVN) that is critical for the regulation of anterior pituitary TSH secretion and determine how this regulatory system is perturbed in disease states characterized by low circulating thyroid hormone and inappropriately low TSH (sick euthyroid syndrome) and by adverse physiologic conditions. The importance of type 2 thyroxine deiodinase (D2) production by ependymal tanycytes, the transport of T4 across the blood-CSF barrier through the choroid plexus and the concentration of thyroid hormones in the CSF on feedback regulation by thyroid hormone on TRH gene expression in the PVN will be determined by interfering with these processes experimentally or depleting thyroid hormone in the CSF and identifying the amount of systemically administered thyroid hormone required to return proTRH mRNA in the PVN in hypothyroid animals to normal. Using an adenovirus shuttle system to reduce the concentration of specific thyroid hormone receptor (TR) isoforms in TRH neurons in the PVN or increase the expression of TRalpha2, we will identify the TR subtype(s) necessary for neuron-specific repression of the TRH gene by thyroid hormone. On the basis that leptin, a fat-derived circulating protein, can restore proTRH mRNA levels to normal in the PVN of fasting animals, we will study the importance of this protein in resetting the set point for feedback regulation by thyroid hormone on hypophysiotropic TRH and determine whether leptin exerts its central actions to modulate proTRH gene expression by direct effects on TRH secretion, indirectly through neuropeptide Y (NPY) or glucocorticoid secretion, or by regulating the amount of T4 transported through the choroid plexus into the CSF. In addition, by ablating brainstem catecholamine projection pathways to one side of the PVN, we will determine whether these pathways also contribute to resetting the sensitivity of TRH in the PVN to feedback regulation by thyroid hormone and mediate altered responses of proTRH mRNA to cold exposure. The importance of pituitary adenylate cyclase-activating polypeptide (PACAP) alone, or in conjunction with catecholamines in the regulation of hypophysiotropic TRH will be studied in vitro and by determining whether microinjection of these substances in vivo into the PVN will induce the phosphorylation of CREB in TRH neurons. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TYPE HEMANGIOMAS
3
IODOTHYRONINE
DEIODINASE
IN
INFANTILE
Principal Investigator & Institution: Huang, Stephen A.; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2002; Project Start 15-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): Hemangiomas are the most common tumor of infancy, with a prevalence of 5-10% at one year of age. We recently discovered a
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previously unrecognized association between hypothyroidism and infantile hemangiomas, due to the expression of type 3 iodothyronine deiodinase (D3) in these tumors. This research grew out of our clinical observations of an infant seen in the first year of my endocrinology fellowship. D3 is a selenoenzyme normally present in the brain and placenta as the physiologic inactivator of thyroxine and triiodothyronine. Extremely high levels of D3 activity are present in proliferative hemangioma tissue, causing the rapid inactivation of thyroid hormone. In the case of children with high tumor burden, severe hypothyroidism can develop due to the inability of the infant's thyroid to secrete hormone faster than it is inactivated by the tumor. Since the publication of these findings, several additional children have been diagnosed and three other institutions have published reports of infants with hepatic hemangiomas and acquired hypothyroidism. We have termed this condition "consumptive hypothyroidism." The goals of this proposal are to determine the clinical consequences of D3 expression in hemangiomas and characterize the molecular mechanism(s) for its expression. The large population of hemangioma patients seen by the Vascular Anomalies Center of Children's Hospital Boston will be studied prospectively to determine the incidence of this endocrinopathy and the optimal means of treating their thyroid dysfunction. Patient specimens will be analyzed by immunohistochemistry using two newly generated D3 antibodies. Human endothelial cells have been successfully cultured from surgical specimens and will be used as a model to study the transcription regulation of D3. Under the mentorship of Dr. P. Reed Larsen, the candidate will receive training in molecular biology and clinical thyroidology with the goal of becoming an independent investigator and an expert in the management of pediatric thyroid disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “hypothyroidism” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for hypothyroidism in the PubMed Central database: •
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A single amino acid change in the acetylcholinesterase-like domain of thyroglobulin causes congenital goiter with hypothyroidism in the cog /cog mouse: A model of human endoplasmic reticulum storage diseases. by Kim PS, Hossain SA, Park YN, Lee I, Yoo SE, Arvan P.; 1998 Aug 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=21435
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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Changes in the Sialylation and Sulfation of Secreted Thyrotropin in Congenital Hypothyroidism. by Gyves PW, Gesundheit N, Thotakura NR, Stannard BS, DeCnerney GS, Weintraub BD.; 1990 May 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=53989
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Choreoathetosis, hypothyroidism, and pulmonary alterations due to human NKX2-1 haploinsufficiency. by Krude H, Schutz B, Biebermann H, von Moers A, Schnabel D, Neitzel H, Tonnies H, Weise D, Lafferty A, Schwarz S, DeFelice M, von Deimling A, van Landeghem F, DiLauro R, Gruters A.; 2002 Feb 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=150790
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Deletion of the thyroid hormone receptor [alpha]1 prevents the structural alterations of the cerebellum induced by hypothyroidism. by Morte B, Manzano J, Scanlan T, Vennstrom B, Bernal J.; 2002 Mar 19; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=122635
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Drug-induced and postnatal hypothyroidism impairs the accumulation of diacylglycerol in liver and liver cell plasma membranes. by Krasilnikova OA, Kavok NS, Babenko NA.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=126221
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Hypothyroidism in transgenic mice expressing IFN-[gamma] in the thyroid. by Caturegli P, Hejazi M, Suzuki K, Dohan O, Carrasco N, Kohn LD, Rose NR.; 2000 Feb 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=26502
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Lithium side-effects and predictors of hypothyroidism in patients with bipolar disorder: sex differences. by Henry C.; 2002 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=161639
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Reversible Alterations in Myocardial Gene Expression in a Young Man with Dilated Cardiomyopathy and Hypothyroidism. by Ladenson PW, Sherman SI, Baughman KL, Ray PE, Feldman AM.; 1992 Jun 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=49269
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Serum thyroid stimulating hormone in assessment of severity of tissue hypothyroidism in patients with overt primary thyroid failure: cross sectional survey. by Meier C, Trittibach P, Guglielmetti M, Staub JJ, Muller B.; 2003 Feb 8; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=143526
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Tertiary hypothyroidism and hyperglycemia in mice with targeted disruption of the thyrotropin-releasing hormone gene. by Yamada M, Saga Y, Shibusawa N, Hirato J, Murakami M, Iwasaki T, Hashimoto K, Satoh T, Wakabayashi K, Taketo MM, Mori M.; 1997 Sep 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=23510
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Thyroxine treatment in patients with symptoms of hypothyroidism but thyroid function tests within the reference range: randomised double blind placebo controlled crossover trial. by Pollock MA, Sturrock A, Marshall K, Davidson KM, Kelly CJ, McMahon AD, McLaren EH.; 2001 Oct 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=58535
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The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with hypothyroidism, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “hypothyroidism” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for hypothyroidism (hyperlinks lead to article summaries): •
A 21-year-old woman with consumptive hypothyroidism due to a vascular tumor expressing type 3 iodothyronine deiodinase. Author(s): Huang SA, Fish SA, Dorfman DM, Salvatore D, Kozakewich HP, Mandel SJ, Larsen PR. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 October; 87(10): 4457-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364418&dopt=Abstract
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A 6-month randomized trial of thyroxine treatment in women with mild subclinical hypothyroidism. Author(s): Kong WM, Sheikh MH, Lumb PJ, Naoumova RP, Freedman DB, Crook M, Dore CJ, Finer N, Naoumova P. Source: The American Journal of Medicine. 2002 April 1; 112(5): 348-54. Erratum In: Am J Med 2002 August 15; 113(3): 264. Am J Med 2002 October 1; 113(5): 442. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11904108&dopt=Abstract
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A case of refractory hypothyroidism requiring daily intravenous thyroxine. Author(s): Nagaoka T, Miyakoshi H, Takamura T, Nagai Y, Matsushita S, Kaneko S, Kobayashi K. Source: J Int Med Res. 2002 July-August; 30(4): 463-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12235934&dopt=Abstract
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A case of Turner syndrome with congenital hypothyroidism untreated until age 38 years. Author(s): Ishikawa N, Tanaka T, Hashimoto K, Wada M. Source: Hormone Research. 2003; 59(1): 50-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566737&dopt=Abstract
6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A new C-terminal located mutation (V272ter) in the PIT-1 gene manifesting with severe congenital hypothyroidism. Possible functionality of the PIT-1 C-terminus. Author(s): Blankenstein O, Muhlenberg R, Kim C, Wuller S, Pfaffle R, Heimann G. Source: Hormone Research. 2001; 56(3-4): 81-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11847467&dopt=Abstract
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A new heterozygous mutation (L338N) in the human Gsalpha (GNAS1) gene as a cause for congenital hypothyroidism in Albright's hereditary osteodystrophy. Author(s): Pohlenz J, Ahrens W, Hiort O. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2003 April; 148(4): 463-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12656668&dopt=Abstract
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A novel loss-of-function mutation in TTF-2 is associated with congenital hypothyroidism, thyroid agenesis and cleft palate. Author(s): Castanet M, Park SM, Smith A, Bost M, Leger J, Lyonnet S, Pelet A, Czernichow P, Chatterjee K, Polak M. Source: Human Molecular Genetics. 2002 August 15; 11(17): 2051-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12165566&dopt=Abstract
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A plurihormonal TSH-producing pituitary tumor of monoclonal origin in a patient with hypothyroidism. Author(s): Ma W, Ikeda H, Watabe N, Kanno M, Yoshimoto T. Source: Hormone Research. 2003; 59(5): 257-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12714791&dopt=Abstract
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A population-based study on the frequency of additional congenital malformations in infants with congenital hypothyroidism: data from the Italian Registry for Congenital Hypothyroidism (1991-1998). Author(s): Olivieri A, Stazi MA, Mastroiacovo P, Fazzini C, Medda E, Spagnolo A, De Angelis S, Grandolfo ME, Taruscio D, Cordeddu V, Sorcini M; Study Group for Congenital Hypothyroidism. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 February; 87(2): 557-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11836285&dopt=Abstract
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A prospective, nonrandomized study of the impact of amifostine on subsequent hypothyroidism in irradiated patients with head and neck cancers. Author(s): Zoberi I, Wasserman TH, Chao KS. Source: Seminars in Radiation Oncology. 2002 January; 12(1 Suppl 1): 14-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11917278&dopt=Abstract
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A rare form of hypothyroidism. Author(s): Basaria S, Braga M. Source: Southern Medical Journal. 2002 May; 95(5): 549-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12005016&dopt=Abstract
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A report of hypothyroidism induced by an over-the-counter fat loss supplement (Tiratricol). Author(s): Scally MC, Hodge A. Source: International Journal of Sport Nutrition and Exercise Metabolism. 2003 March; 13(1): 112-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660410&dopt=Abstract
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A retrospective hospital-based study on congenital hypothyroidism in the Sultanate of Oman. Author(s): Al Shaikh HA, Bappal B, Nair R, Al Khusaiby S. Source: Journal of Tropical Pediatrics. 2003 August; 49(4): 245-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12929888&dopt=Abstract
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Accuracy of ultrasonography to establish the diagnosis and aetiology of permanent primary congenital hypothyroidism. Author(s): Kreisner E, Camargo-Neto E, Maia CR, Gross JL. Source: Clinical Endocrinology. 2003 September; 59(3): 361-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919160&dopt=Abstract
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Additional phenotypic abnormalities with presence of cysts within the empty thyroid area in patients with congenital hypothyroidism with thyroid dysgenesis. Author(s): Marinovic D, Garel C, Czernichow P, Leger J. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 March; 88(3): 12126. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629108&dopt=Abstract
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Adult height in congenital hypothyroidism: prognostic factors and the importance of compliance with treatment. Author(s): Bain P, Toublanc JE. Source: Hormone Research. 2002; 58(3): 136-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218379&dopt=Abstract
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Alcohol withdrawal in severe hypothyroidism. Author(s): Lambert MT. Source: Psychosomatics. 2003 January-February; 44(1): 79-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12515842&dopt=Abstract
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Alphafetoprotein in screening for congenital hypothyroidism. Author(s): Shawky RM, Abd el-Fattah S, el-din Azzam ME, Rafik MM, Osman A. Source: East Mediterr Health J. 2001 January-March; 7(1-2): 171-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12596967&dopt=Abstract
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Alteration of serum enzymes in primary hypothyroidism. Author(s): Saha B, Maity C. Source: Clinical Chemistry and Laboratory Medicine : Cclm / Fescc. 2002 June; 40(6): 609-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211657&dopt=Abstract
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An interim report of the pilot study of screening for congenital hypothyroidism in Tehran and Damavand using cord blood spot samples. Author(s): Ordookhani A, Mirmiran P, Hedayati M, Hajipour R, Azizi F. Source: European Journal of Pediatrics. 2003 March; 162(3): 202-3. Epub 2003 January 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12655430&dopt=Abstract
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Antenatal diagnosis and treatment of a case of fetal goitrous hypothyroidism associated with high-output cardiac failure. Author(s): Morine M, Takeda T, Minekawa R, Sugiyama T, Wasada K, Mizutani T, Suehara N. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2002 May; 19(5): 506-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11982987&dopt=Abstract
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Aortic valve fibroelastoma presenting with anginal symptoms in a patient with hypothyroidism. Author(s): Mahadevan VS, Ali N, Campalani G, Dalzell GW. Source: International Journal of Cardiology. 2002 July; 84(1): 95-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12104072&dopt=Abstract
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Assessment of left ventricular diastolic function by radionuclide ventriculography at rest and exercise in subclinical hypothyroidism, and its response to L-thyroxine therapy. Author(s): Brenta G, Mutti LA, Schnitman M, Fretes O, Perrone A, Matute ML. Source: The American Journal of Cardiology. 2003 June 1; 91(11): 1327-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12767425&dopt=Abstract
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Asymmetric crying facies and congenital hypothyroidism: report of two patients. Author(s): Kurtoglu S, Caksen H, Per H, Narin N, Uzum K. Source: J Pediatr Endocrinol Metab. 2001 September-October; 14(8): 1177-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11592580&dopt=Abstract
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Attention problems in adolescents with congenital hypothyroidism: a multicomponential analysis. Author(s): Rovet JF, Hepworth S. Source: Journal of the International Neuropsychological Society : Jins. 2001 September; 7(6): 734-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11575595&dopt=Abstract
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Audit of investigation of subclinical hypothyroidism in Scottish laboratories. Author(s): Armston A, Bulusu S. Source: Annals of Clinical Biochemistry. 2002 September; 39(Pt 5): 535-6; Author Reply 536. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296308&dopt=Abstract
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Audit of investigation of subclinical hypothyroidism in Scottish laboratories. Author(s): Berry P. Source: Annals of Clinical Biochemistry. 2002 January; 39(Pt 1): 26-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11853186&dopt=Abstract
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Auditory brainstem evoked potentials in early-treated congenital hypothyroidism. Author(s): Chou YH, Wang PJ. Source: Journal of Child Neurology. 2002 July; 17(7): 510-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12269730&dopt=Abstract
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Autoimmune hypothyroidism and retinoic acid. Author(s): Spedini P, Tajana M. Source: Haematologica. 2002 April; 87(4): Elt20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11940505&dopt=Abstract
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Autoimmune hypothyroidism coexisting with a pituitary adenoma secreting thyroidstimulating hormone, prolactin and alpha-subunit. Author(s): Idiculla JM, Beckett G, Statham PF, Ironside JW, Atkin SL, Patrick AW. Source: Annals of Clinical Biochemistry. 2001 September; 38(Pt 5): 566-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11587139&dopt=Abstract
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Behavioural correlates of early-treated congenital hypothyroidism. Author(s): Kooistra L, Stemerdink N, van der Meere J, Vulsma T, Kalverboer AF. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 October; 90(10): 1141-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11697425&dopt=Abstract
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Bilateral non-specific orbital inflammation (orbital “pseudotumour”), posterior scleritis, and anterior uveitis associated with hypothyroidism in a child. Author(s): Uddin JM, Rennie CA, Moore AT. Source: The British Journal of Ophthalmology. 2002 August; 86(8): 936. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12140225&dopt=Abstract
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Blood coagulation and fibrinolytic activity in hypothyroidism. Author(s): Erem C, Kavgaci H, Ersoz HO, Hacihasanoglu A, Ukinc K, Karti SS, Deger O, Telatari M. Source: Int J Clin Pract. 2003 March; 57(2): 78-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12661786&dopt=Abstract
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Borderline congenital hypothyroidism in the neonatal period. Author(s): Siklar Z, Tezer H, Dallar Y, Tanyer G. Source: J Pediatr Endocrinol Metab. 2002 June; 15(6): 817-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12099392&dopt=Abstract
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By the way, doctor. For years, I've been taking the same dose of Synthroid for hypothyroidism, and recent tests place me in the normal range. However, I still have several symptoms of low thyroid--fatigue, difficulty losing weight, sensitivity to cold, and constipation. My doctor doesn't seem concerned with the symptoms, as long as my blood tests are normal. But I'm frustrated. Is there anything I can do? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 2001 January; 8(5): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11137975&dopt=Abstract
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Cardiovascular and medical ramifications of treatment of subclinical hypothyroidism. Author(s): Glueck CJ, Streicher P. Source: Current Atherosclerosis Reports. 2003 January; 5(1): 73-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562546&dopt=Abstract
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Central hypothyroidism: consequences in adult life. Author(s): Asteria C, Persani L, Beck-Peccoz P. Source: J Pediatr Endocrinol Metab. 2001; 14 Suppl 5: 1263-9; Discussion 1297-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11964021&dopt=Abstract
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Cerebral blood flow and glucose metabolism in hypothyroidism: a positron emission tomography study. Author(s): Constant EL, de Volder AG, Ivanoiu A, Bol A, Labar D, Seghers A, Cosnard G, Melin J, Daumerie C. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 August; 86(8): 3864-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11502825&dopt=Abstract
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Changes in brain size with treatment in patients with hyper- or hypothyroidism. Author(s): Oatridge A, Barnard ML, Puri BK, Taylor-Robinson SD, Hajnal JV, Saeed N, Bydder GM. Source: Ajnr. American Journal of Neuroradiology. 2002 October; 23(9): 1539-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12372744&dopt=Abstract
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Changes in lipoprotein(a) levels in overt and subclinical hypothyroidism before and during treatment. Author(s): Tzotzas T, Krassas GE, Konstantinidis T, Bougoulia M. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 September; 10(9): 803-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11041458&dopt=Abstract
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Changes in thyroxine requirements in patients with hypothyroidism undergoing renal transplantation. Author(s): Thomas MC, Mathew TH, Russ GR. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 February; 39(2): 354-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840377&dopt=Abstract
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Changes of event related potential and cognitive processes in patients with subclinical hypothyroidism after thyroxine treatment. Author(s): Jensovsky J, Ruzicka E, Spackova N, Hejdukova B. Source: Endocrine Regulations. 2002 September; 36(3): 115-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12463967&dopt=Abstract
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Children with irreversible brain damage associated with hypothyroidism and multiple intracranial calcifications. Author(s): Arii J, Tanabe Y, Makino M, Sato H, Kohno Y. Source: Journal of Child Neurology. 2002 April; 17(4): 309-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12088091&dopt=Abstract
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Choreoathetosis, hypothyroidism, and pulmonary alterations due to human NKX2-1 haploinsufficiency. Author(s): Krude H, Schutz B, Biebermann H, von Moers A, Schnabel D, Neitzel H, Tonnies H, Weise D, Lafferty A, Schwarz S, DeFelice M, von Deimling A, van Landeghem F, DiLauro R, Gruters A. Source: The Journal of Clinical Investigation. 2002 February; 109(4): 475-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11854319&dopt=Abstract
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Circulating levels of oxidized low-density lipoprotein in overt and mild hypothyroidism. Author(s): Duntas LH, Mantzou E, Koutras DA. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 November; 12(11): 1003-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490078&dopt=Abstract
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Clinical features versus laboratory values. An infant with transient neonatal hypothyroidism. Author(s): Manzar S. Source: Saudi Med J. 2000 January; 21(1): 103. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11533762&dopt=Abstract
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Clinical presentation of hypothyroidism: a case control analysis. Author(s): Khurram IM, Choudhry KS, Muhammad K, Islam N. Source: J Ayub Med Coll Abbottabad. 2003 January-March; 15(1): 45-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870318&dopt=Abstract
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Clinical utility of thyroid ultrasonography in the diagnosis of congenital hypothyroidism. Author(s): Ohnishi H, Inomata H, Watanabe T, Wataki K, Sato H, Sanayama K, Noda H, Yasuda T, Niimi H. Source: Endocrine Journal. 2002 June; 49(3): 293-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12201211&dopt=Abstract
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Color Doppler sonography in hypothyroidism. Author(s): Schulz SL, Seeberger U, Hengstmann JH. Source: European Journal of Ultrasound : Official Journal of the European Federation of Societies for Ultrasound in Medicine and Biology. 2003 February; 16(3): 183-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12573787&dopt=Abstract
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Combined thyroxine/liothyronine treatment does not improve well-being, quality of life, or cognitive function compared to thyroxine alone: a randomized controlled trial in patients with primary hypothyroidism. Author(s): Walsh JP, Shiels L, Lim EM, Bhagat CI, Ward LC, Stuckey BG, Dhaliwal SS, Chew GT, Bhagat MC, Cussons AJ. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 October; 88(10): 4543-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14557419&dopt=Abstract
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Confirming congenital hypothyroidism identified from neonatal screening. Author(s): Foo A, Leslie H, Carson DJ. Source: Ulster Med J. 2002 May; 71(1): 38-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12137163&dopt=Abstract
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Congenital central hypothyroidism due to homozygous thyrotropin beta 313 Delta T mutation is caused by a Founder effect. Author(s): Brumm H, Pfeufer A, Biebermann H, Schnabel D, Deiss D, Gruters A. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 October; 87(10): 4811-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364478&dopt=Abstract
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Congenital hypothyroidism and early severe hyperbilirubinemia. Author(s): Tiker F, Gurakan B, Tarcan A, Kinik S. Source: Clinical Pediatrics. 2003 May; 42(4): 365-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800733&dopt=Abstract
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Congenital hypothyroidism associated with Rubinstein-Taybi syndrome. Author(s): Kurtoglu S, Akcakus M, Gunes T, Cetin N, Topaloglu N. Source: J Pediatr Endocrinol Metab. 2003 March; 16(3): 457-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705373&dopt=Abstract
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Congenital hypothyroidism in a child with unsuspected familial dysalbuminemic hyperthyroxinemia caused by a mutation (R218H) in the human albumin gene. Author(s): Pohlenz J, Sadow PM, Koffler T, Schonberger W, Weiss RE, Refetoff S. Source: The Journal of Pediatrics. 2001 December; 139(6): 887-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11743520&dopt=Abstract
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Congenital hypothyroidism in Iran. Author(s): Ordookhani A, Mirmiran P, Najafi R, Hedayati M, Azizi F. Source: Indian J Pediatr. 2003 August; 70(8): 625-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14510082&dopt=Abstract
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Congenital hypothyroidism in Saudi children. Author(s): Tamimi W, Abokhashab M, Alhazmi Z, Alsadhan A, Al-Mutair A, Al-Alwan I, Al-Saif S, Hajeer AH. Source: British Journal of Biomedical Science. 2003; 60(1): 37-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12680633&dopt=Abstract
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Congenital hypothyroidism in Western Australia 1981-1998. Author(s): Kurinczuk JJ, Bower C, Lewis B, Byrne G. Source: Journal of Paediatrics and Child Health. 2002 April; 38(2): 187-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12031004&dopt=Abstract
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Congenital hypothyroidism with Prader-Willi syndrome. Author(s): Sher C, Bistritzer T, Reisler G, Reish O. Source: J Pediatr Endocrinol Metab. 2002 January; 15(1): 105-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11822575&dopt=Abstract
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Congenital hypothyroidism: a review of current diagnostic and treatment practices in relation to neuropsychologic outcome. Author(s): Rovet J, Daneman D. Source: Paediatric Drugs. 2003; 5(3): 141-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608879&dopt=Abstract
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Congenital hypothyroidism: an analysis of persisting deficits and associated factors. Author(s): Rovet JF. Source: Neuropsychology, Development, and Cognition. Section C, Child Neuropsychology : a Journal on Normal and Abnormal Development in Childhood and Adolescence. 2002 September; 8(3): 150-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759831&dopt=Abstract
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Congenital hypothyroidism: influence of disease severity and L-thyroxine treatment on intellectual, motor, and school-associated outcomes in young adults. Author(s): Oerbeck B, Sundet K, Kase BF, Heyerdahl S. Source: Pediatrics. 2003 October; 112(4): 923-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14523187&dopt=Abstract
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Congenital isolated central hypothyroidism caused by a “hot spot” mutation in the thyrotropin-beta gene. Author(s): McDermott MT, Haugen BR, Black JN, Wood WM, Gordon DF, Ridgway EC. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 December; 12(12): 1141-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12593729&dopt=Abstract
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Congenital secondary hypothyroidism caused by exon skipping due to a homozygous donor splice site mutation in the TSHbeta-subunit gene. Author(s): Pohlenz J, Dumitrescu A, Aumann U, Koch G, Melchior R, Prawitt D, Refetoff S. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 January; 87(1): 3369. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11788671&dopt=Abstract
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Cushing's syndrome manifesting as pseudo-central hypothyroidism and hyperosmolar diabetic coma. Author(s): Gooch BR. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2002 March-April; 8(2): 11923. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11942777&dopt=Abstract
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Deletion of NKX2.1 gene encoding thyroid transcription factor-1 in two siblings with hypothyroidism and respiratory failure. Author(s): Iwatani N, Mabe H, Devriendt K, Kodama M, Miike T. Source: The Journal of Pediatrics. 2000 August; 137(2): 272-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10931427&dopt=Abstract
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Determinants of changes in plasma homocysteine in hyperthyroidism and hypothyroidism. Author(s): Diekman MJ, van der Put NM, Blom HJ, Tijssen JG, Wiersinga WM. Source: Clinical Endocrinology. 2001 February; 54(2): 197-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11207634&dopt=Abstract
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Determination of IgG subclasses and avidity of antithyroid peroxidase antibodies in patients with subclinical hypothyroidism - a comparison with patients with overt hypothyroidism. Author(s): Silva LM, Chavez J, Canalli MH, Zanetti CR. Source: Hormone Research. 2003; 59(3): 118-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12637791&dopt=Abstract
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Diagnosis of congenital hypothyroidism from human anagen scalp hair by infrared microspectroscopy. Author(s): Lin SY, Niu DM, Tu CP, Lin HL, Li MJ, Cheng YD. Source: Ultrastructural Pathology. 2001 September-October; 25(5): 357-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11758716&dopt=Abstract
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Different renal pathologies associated with hypothyroidism. Author(s): Paydas S, Gokel Y. Source: Renal Failure. 2002 September; 24(5): 595-600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12380904&dopt=Abstract
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Dissociating attention deficits in children with ADHD and congenital hypothyroidism using multiple CPTs. Author(s): Rovet JF, Hepworth SL. Source: Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2001 November; 42(8): 1049-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11806687&dopt=Abstract
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Diurnal thyrotropin secretion in short-term profound primary hypothyroidism: does it ever persist? Author(s): Hirshberg B, Veldhuis JD, Sarlis NJ. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 December; 10(12): 1101-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11201856&dopt=Abstract
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Does a combination regimen of thyroxine (T4) and 3,5,3'-triiodothyronine improve depressive symptoms better than T4 alone in patients with hypothyroidism? Results of a double-blind, randomized, controlled trial. Author(s): Sawka AM, Gerstein HC, Marriott MJ, MacQueen GM, Joffe RT. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 October; 88(10): 4551-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14557420&dopt=Abstract
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Dynamics of the plasma concentrations of TSH, FT4 and T3 following thyroxine supplementation in congenital hypothyroidism. Author(s): Bakker B, Kempers MJ, De Vijlder JJ, Van Tijn DA, Wiedijk BM, Van Bruggen M, Vulsma T. Source: Clinical Endocrinology. 2002 October; 57(4): 529-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12354136&dopt=Abstract
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Dysarthria as the leading symptom of hypothyroidism. Author(s): Stollberger C, Finsterer J, Brand E, Tschabitscher D. Source: American Journal of Otolaryngology. 2001 January-February; 22(1): 70-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11172218&dopt=Abstract
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Dyshormonogenic hypothyroidism with normal neurological development, unexplained short stature and facial anomalies in three siblings. Author(s): Vakili R, Mazlouman SJ. Source: Clinical Dysmorphology. 2003 January; 12(1): 21-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12514361&dopt=Abstract
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Early changes in parameters of bone and mineral metabolism during therapy for hyper- and hypothyroidism. Author(s): Sabuncu T, Aksoy N, Arikan E, Ugur B, Tasan E, Hatemi H. Source: Endocrine Research. 2001 February-May; 27(1-2): 203-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11428712&dopt=Abstract
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Early development of transient hypothyroidism after I131 therapy for thyrotoxicosis. Author(s): Khanna CM, Sankar R, Magdum M, Gera A. Source: J Assoc Physicians India. 1998 March; 46(3): 268-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11273344&dopt=Abstract
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Effect of combined treatment with calcitonin on bone densitometry of patients with treated hypothyroidism. Author(s): Stamato FJ, Amarante EC, Furlanetto RP. Source: Revista Da Associacao Medica Brasileira (1992). 2000 April-June; 46(2): 177-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11022359&dopt=Abstract
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Effect of different starting doses of levothyroxine on growth and intellectual outcome at four years of age in congenital hypothyroidism. Author(s): Salerno M, Militerni R, Bravaccio C, Micillo M, Capalbo D, Di MS, Tenore A. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 January; 12(1): 45-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11838730&dopt=Abstract
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Effect of hypothyroidism and its treatment on the IGF system in infants and children. Author(s): Purandare A, Co Ng L, Godil M, Ahnn SH, Wilson TA. Source: J Pediatr Endocrinol Metab. 2003 January; 16(1): 35-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585338&dopt=Abstract
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Effect of levothyroxine on cardiac function and structure in subclinical hypothyroidism: a double blind, placebo-controlled study. Author(s): Monzani F, Di Bello V, Caraccio N, Bertini A, Giorgi D, Giusti C, Ferrannini E. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 March; 86(3): 11105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11238494&dopt=Abstract
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Effect of subclinical hypothyroidism and obesity on whole-body and regional bone mineral content. Author(s): Bertoli A, Fusco A, Andreoli A, Magnani A, Tulli A, Lauro D, De Lorenzo A. Source: Hormone Research. 2002; 57(3-4): 79-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12006702&dopt=Abstract
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Effect of subclinical hypothyroidism on body fluid compartments. Author(s): De Lorenzo A, Andreoli A, Fusco A, Magnani A, D'Orazio N, Bertoli A. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 2000 September; 32(9): 359-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11014384&dopt=Abstract
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Effect of treatment of hypothyroidism on the plasma concentrations of neuroactive steroids and homocysteine. Author(s): Bicikova M, Tallova J, Hill M, Vanuga A, Putz Z, Tomandl J. Source: Clinical Chemistry and Laboratory Medicine : Cclm / Fescc. 2001 August; 39(8): 753-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11592446&dopt=Abstract
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Effects of subclinical hypothyroidism and its treatment on serum lipids. Author(s): Ineck BA, Ng TM. Source: The Annals of Pharmacotherapy. 2003 May; 37(5): 725-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708952&dopt=Abstract
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Effects of thyroid replacement therapy on arterial blood pressure in patients with hypertension and hypothyroidism. Author(s): Dernellis J, Panaretou M. Source: American Heart Journal. 2002 April; 143(4): 718-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11923811&dopt=Abstract
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Elevated C-reactive protein and homocysteine values: cardiovascular risk factors in hypothyroidism? A cross-sectional and a double-blind, placebo-controlled trial. Author(s): Christ-Crain M, Meier C, Guglielmetti M, Huber PR, Riesen W, Staub JJ, Muller B. Source: Atherosclerosis. 2003 February; 166(2): 379-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12535752&dopt=Abstract
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Elevated serum creatinine levels in infants with congenital hypothyroidism: reflection of decreased renal function? Author(s): Asami T, Uchiyama M. Source: Acta Paediatrica (Oslo, Norway : 1992). 2000 December; 89(12): 1431-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11195231&dopt=Abstract
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EMG myokymia as a cause of ptosis in hypothyroidism. Author(s): Lo YL, Ho SC, Koh LK, Khoo DH. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2003 January; 10(1): 87-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12535001&dopt=Abstract
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Epidemiology and prevention of clinical and subclinical hypothyroidism. Author(s): Vanderpump MP, Tunbridge WM. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 October; 12(10): 839-47. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487765&dopt=Abstract
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Excess coronary artery bypass graft mortality among women with hypothyroidism. Author(s): Zindrou D, Taylor KM, Bagger JP. Source: The Annals of Thoracic Surgery. 2002 December; 74(6): 2121-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643405&dopt=Abstract
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Familial forms of thyroid dysgenesis among infants with congenital hypothyroidism. Author(s): Castanet M, Lyonnet S, Bonaiti-Pellie C, Polak M, Czernichow P, Leger J. Source: The New England Journal of Medicine. 2000 August 10; 343(6): 441-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10939901&dopt=Abstract
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Fatal thyroid crisis years after two thyroidectomies for graves' disease: is thyroid tissue autotransplantation for postthyroidectomy hypothyroidism worthwhile? Author(s): Leow MK, Loh KC. Source: Journal of the American College of Surgeons. 2002 September; 195(3): 434-5; Author Reply 435-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12229955&dopt=Abstract
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Final height and pubertal growth in Japanese patients with congenital hypothyroidism detected by neonatal screening. Author(s): Adachi M, Asakura Y, Tachibana K. Source: Acta Paediatrica (Oslo, Norway : 1992). 2003 June; 92(6): 698-703. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856981&dopt=Abstract
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Finding and treating subclinical hypothyroidism. Author(s): Mazzaferri EL. Source: Hosp Pract (Off Ed). 2001 June 15; 36(6): 9-10, 16. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11419537&dopt=Abstract
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Fractures in patients with hyperthyroidism and hypothyroidism: a nationwide follow-up study in 16,249 patients. Author(s): Vestergaard P, Mosekilde L. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 May; 12(5): 411-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12097203&dopt=Abstract
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Genetics of specific phenotypes of congenital hypothyroidism: a population-based approach. Author(s): Calaciura F, Miscio G, Coco A, Leonardi D, Cisternino C, Regalbuto C, Bozzali M, Maiorana R, Ranieri A, Carta A, Buscema M, Trischitta V, Sava L, Tassi V. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 November; 12(11): 945-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490071&dopt=Abstract
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Germline mutations of TSH receptor gene as cause of nonautoimmune subclinical hypothyroidism. Author(s): Alberti L, Proverbio MC, Costagliola S, Romoli R, Boldrighini B, Vigone MC, Weber G, Chiumello G, Beck-Peccoz P, Persani L. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 June; 87(6): 2549-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12050212&dopt=Abstract
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Goiter and hypothyroidism in two siblings due to impaired Ca(+2)/NAD(P)Hdependent H(2)O(2)-generating activity. Author(s): Figueiredo MD, Cardoso LC, Ferreira AC, Campos DV, da Cruz Domingos M, Corbo R, Nasciutti LE, Vaisman M, Carvalho DP. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 October; 86(10): 4843-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11600551&dopt=Abstract
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Growth of children with primary hypothyroidism on treatment with respect to different ages at diagnosis. Author(s): Darendeliler F, Yildirim M, Bundak R, Sukur M, Saka N, Gunoz H. Source: J Pediatr Endocrinol Metab. 2001 February; 14(2): 207-10. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11305800&dopt=Abstract
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Hashimoto's thyroiditis presenting as single hot nodule and hypothyroidism. Author(s): Mousavi Z, Zakavi SR, Farid NR. Source: J Endocrinol Invest. 2002 July-August; 25(7): 643-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12150342&dopt=Abstract
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Hearing loss in congenital hypothalamic hypothyroidism: a wide therapeutic window. Author(s): Wasniewska M, De Luca F, Siclari S, Salzano G, Messina MF, Lombardo F, Valenzise M, Ruggeri C, Arrigo T. Source: Hearing Research. 2002 October; 172(1-2): 87-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361870&dopt=Abstract
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Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism. Author(s): Faber J, Petersen L, Wiinberg N, Schifter S, Mehlsen J. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 April; 12(4): 319-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12034057&dopt=Abstract
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High occurrence of thyroid multinodularity and low occurrence of subclinical hypothyroidism among tobacco smokers in a large population study. Author(s): Knudsen N, Bulow I, Laurberg P, Perrild H, Ovesen L, Jorgensen T. Source: The Journal of Endocrinology. 2002 December; 175(3): 571-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12475368&dopt=Abstract
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Hoffman's syndrome: muscle stiffness, pseudohypertrophy and hypothyroidism. Author(s): Mastropasqua M, Spagna G, Baldini V, Tedesco I, Paggi A. Source: Hormone Research. 2003; 59(2): 105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12589116&dopt=Abstract
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Homocysteine: a risk factor for cardiovascular disease in subclinical hypothyroidism? Author(s): Deicher R, Vierhapper H. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 August; 12(8): 733-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12225643&dopt=Abstract
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HTLV-I associated myelopathy/tropical spastic paraparesis with pseudohypothyroidism. Author(s): Fritzen R, Dressel A. Source: Neurology. 2001 October 9; 57(7): 1349-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11591873&dopt=Abstract
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Hyperprolactinaemia in hypothyroidism: clinical significance and impact of TSH normalization. Author(s): Raber W, Gessl A, Nowotny P, Vierhapper H. Source: Clinical Endocrinology. 2003 February; 58(2): 185-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12580934&dopt=Abstract
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Hyperthyrotropinemia during iodide administration in normal children and in children born with neonatal transient hypothyroidism. Author(s): Markou KB, Paraskevopoulou P, Karaiskos KS, Makri M, Georgopoulos NA, Iconomou G, Mengreli C, Vagenakis AG. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 February; 88(2): 617-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574190&dopt=Abstract
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Hypothyroidism and aging: the Rosses' survey. Author(s): Bonar BD, McColgan B, Smith DF, Darke C, Guttridge MG, Williams H, Smyth PP. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 September; 10(9): 821-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11041461&dopt=Abstract
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Hypothyroidism and atherosclerosis. Author(s): Cappola AR, Ladenson PW. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 June; 88(6): 2438-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12788839&dopt=Abstract
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Hypothyroidism and cognition: preliminary evidence for a specific defect in memory. Author(s): Burmeister LA, Ganguli M, Dodge HH, Toczek T, DeKosky ST, Nebes RD. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 December; 11(12): 1177-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186506&dopt=Abstract
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Hypothyroidism and depression: a therapeutic challenge. Author(s): Rack SK, Makela EH. Source: The Annals of Pharmacotherapy. 2000 October; 34(10): 1142-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054982&dopt=Abstract
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Hypothyroidism and hyperthyroidism in anxiety disorders revisited: new data and literature review. Author(s): Simon NM, Blacker D, Korbly NB, Sharma SG, Worthington JJ, Otto MW, Pollack MH. Source: Journal of Affective Disorders. 2002 May; 69(1-3): 209-17. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12103468&dopt=Abstract
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Hypothyroidism and muscular respiratory failure successfully treated with liothyronine. Author(s): Finsterer J, Prainer C, Stollberger C, Valentin A, Jarius C, Schreier R. Source: Southern Medical Journal. 2002 November; 95(11): 1347-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540007&dopt=Abstract
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Hypothyroidism and open-angle glaucoma: an accidental or an essential coexistence? Author(s): Tahat AA, al-Khawaldeh AM. Source: East Mediterr Health J. 2000 March-May; 6(2-3): 299-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11556016&dopt=Abstract
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Hypothyroidism and thyroiditis after therapy for Hodgkin's disease. Author(s): Illes A, Biro E, Miltenyi Z, Keresztes K, Varoczy L, Andras C, Sipka S, Bako G. Source: Acta Haematologica. 2003; 109(1): 11-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12486317&dopt=Abstract
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Hypothyroidism and women's health. Author(s): Redmond GP. Source: Int J Fertil Womens Med. 2002 May-June; 47(3): 123-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12081257&dopt=Abstract
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Hypothyroidism as a cause of resistance to erythropoietin. Author(s): Dilek M, Akpolat T, Cengiz K. Source: Nephron. 2002 September; 92(1): 248. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12187117&dopt=Abstract
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Hypothyroidism as a cause of rhabdomyolysis. Author(s): Barahona MJ, Mauri A, Sucunza N, Paredes R, Wagner AM. Source: Endocrine Journal. 2002 December; 49(6): 621-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625411&dopt=Abstract
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Hypothyroidism following struma ovarii tumor resection: a case report. Author(s): Carvalho JP, Carvalho FM, Lima de Oliveira FF, Asato de Camargo RY. Source: Revista Do Hospital Das Clinicas. 2002 May-June; 57(3): 112-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12118269&dopt=Abstract
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Hypothyroidism in children with medulloblastoma: a comparison of 3600 and 2340 cGy craniospinal radiotherapy. Author(s): Paulino AC. Source: International Journal of Radiation Oncology, Biology, Physics. 2002 July 1; 53(3): 543-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12062595&dopt=Abstract
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Hypothyroidism in house officers. Author(s): Worley G, Garges H, Valente AM, Kredich DW. Source: Lancet. 2002 September 14; 360(9336): 879. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12243955&dopt=Abstract
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Hypothyroidism in patients older than 55 years: an analysis of the etiology and assessment of the effectiveness of therapy. Author(s): Diez JJ. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2002 May; 57(5): M315-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11983726&dopt=Abstract
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Hypothyroidism in patients treated with total laryngectomy. A multivariate study. Author(s): Leon X, Gras JR, Perez A, Rodriguez J, de Andres L, Orus C, Quer M. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2002 April; 259(4): 193-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064507&dopt=Abstract
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Hypothyroidism incidence after multimodality treatment for stage III and IV squamous cell carcinomas of the head and neck. Author(s): Colevas AD, Read R, Thornhill J, Adak S, Tishler R, Busse P, Li Y, Posner M. Source: International Journal of Radiation Oncology, Biology, Physics. 2001 November 1; 51(3): 599-604. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11597798&dopt=Abstract
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Hypothyroidism presenting as sleep apnoea hypopnoea syndrome. Author(s): Jain AP, Gokhale K, Kapoor M. Source: J Assoc Physicians India. 2002 May; 50(5): 740-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186143&dopt=Abstract
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Hypothyroidism promotes survival. Author(s): Garfield D. Source: The Lancet Oncology. 2002 June; 3(6): 328. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107013&dopt=Abstract
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Hypothyroidism. Author(s): Tato L, Tonini G, Bernasconi S, Bona G, Bozzola M, Buzi F, De Sanctis C, De Sanctis V, Radetti G, Rigon F. Source: Minerva Pediatr. 2002 June; 54(3): 279-85. English, Italian. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12070489&dopt=Abstract
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Hypothyroidism: a frequent event after radiotherapy for patients with head and neck carcinoma. Author(s): Daniell HW. Source: Cancer. 2002 August 1; 95(3): 673-4; Author Reply 674. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12209766&dopt=Abstract
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Images in thyroidology. Onycholysis associated with hypothyroidism. Author(s): Schneider AE, Tomer Y. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 July; 11(7): 707. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11484901&dopt=Abstract
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Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: beneficial effect of levothyroxine therapy. Author(s): Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, Salvetti A, Ferrannini E, Monzani F. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 August; 88(8): 3731-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12915662&dopt=Abstract
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In congenital hypothyroidism bone maturation at birth may be a predictive factor of psychomotor development during the first Year of life irrespective of other variables related to treatment. Author(s): Wasniewska M, De Luca F, Cassio A, Oggiaro N, Gianino P, Delvecchio M, Aiazzi R, Stoppioni V, Lombardo F, Messina MF, Valenzise M, Arrigo T. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2003 July; 149(1): 1-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824859&dopt=Abstract
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Inactivating mutations in the gene for thyroid oxidase 2 (THOX2) and congenital hypothyroidism. Author(s): Moreno JC, Bikker H, Kempers MJ, van Trotsenburg AS, Baas F, de Vijlder JJ, Vulsma T, Ris-Stalpers C. Source: The New England Journal of Medicine. 2002 July 11; 347(2): 95-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12110737&dopt=Abstract
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Incidence of subclinical hypothyroidism and its influence on cognitive performance and on metabolic aspects in an hospitalized geriatric population. Author(s): Bossoni S, Cossi S, Marengoni A, De Martinis M, Calabrese P, Leonardi R, Giustina A, Romanelli G, Grassi V. Source: J Endocrinol Invest. 2002; 25(10 Suppl): 75-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12508926&dopt=Abstract
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Increased central arterial stiffness in hypothyroidism. Author(s): Obuobie K, Smith J, Evans LM, John R, Davies JS, Lazarus JH. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 October; 87(10): 4662-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364455&dopt=Abstract
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Increased need for thyroxine in women with hypothyroidism during estrogen therapy. Author(s): Arafah BM. Source: The New England Journal of Medicine. 2001 June 7; 344(23): 1743-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11396440&dopt=Abstract
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Increased prevalence of hypothyroidism among human immunodeficiency virusinfected patients: a need for screening. Author(s): Beltran S, Lescure FX, Desailloud R, Douadi Y, Smail A, El Esper I, Arlot S, Schmit JL; Thyroid and VIH Group. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 August 15; 37(4): 579-83. Epub 2003 July 28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12905143&dopt=Abstract
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Increased prevalence of peripheral arterial disease in older men and women with subclinical hypothyroidism. Author(s): Mya MM, Aronow WS. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2003 January; 58(1): 68-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12560414&dopt=Abstract
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Induction of autoimmune hypothyroidism and subsequent hyperthyroidism by TSH receptor antibodies following subacute thyroiditis: a case report. Author(s): Iitaka M, Kakinuma S, Yamanaka K, Fujimaki S, Oosuga I, Wada S, Katayama S. Source: Endocrine Journal. 2001 April; 48(2): 139-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11456259&dopt=Abstract
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Influence of severity of congenital hypothyroidism and adequacy of treatment on school achievement in young adolescents: a population-based cohort study. Author(s): Leger J, Larroque B, Norton J; Association Francaise pour le Depistage et la Prevetion des Handicaps de l'Enfant. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 November; 90(11): 1249-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11808894&dopt=Abstract
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Influence of short-time application of a low sodium diet on blood pressure in patients with hyperthyroidism or hypothyroidism during therapy. Author(s): Marcisz C, Jonderko G, Kucharz EJ. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2001 October; 14(10): 995-1002. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11710792&dopt=Abstract
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Initial treatment dose of L-thyroxine in congenital hypothyroidism. Author(s): Selva KA, Mandel SH, Rien L, Sesser D, Miyahira R, Skeels M, Nelson JC, Lafranchi SH. Source: The Journal of Pediatrics. 2002 December; 141(6): 786-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461494&dopt=Abstract
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Insidious hypothyroidism unmasked after operation. Author(s): Vretzakis G, Ferdi E, Papaziogas B. Source: European Journal of Anaesthesiology. 2002 July; 19(7): 532-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12113620&dopt=Abstract
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Insulin resistance syndrome (syndrome X) and hypothyroidism. Author(s): Singh SK. Source: J Assoc Physicians India. 2001 September; 49: 947. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11837779&dopt=Abstract
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Intellectual outcome of patients with congenital hypothyroidism detected by neonatal screening. Author(s): Hsiao PH, Chiu YN, Tsai WY, Su SC, Lee JS, Soong WT. Source: J Formos Med Assoc. 2001 January; 100(1): 40-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11265259&dopt=Abstract
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Interferon-alpha-induced transient severe hypothyroidism in a patient with Graves' disease. Author(s): Braga-Basaria M, Basaria S. Source: J Endocrinol Invest. 2003 March; 26(3): 261-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12809178&dopt=Abstract
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Intrauterine diagnosis and management of congenital goitrous hypothyroidism. Author(s): Agrawal P, Ogilvy-Stuart A, Lees C. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2002 May; 19(5): 501-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11982986&dopt=Abstract
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Intrauterine treatment of fetal goitrous hypothyroidism controlled by determination of thyroid-stimulating hormone in fetal serum. A case report and review of the literature. Author(s): Gruner C, Kollert A, Wildt L, Dorr HG, Beinder E, Lang N. Source: Fetal Diagnosis and Therapy. 2001 January-February; 16(1): 47-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11125252&dopt=Abstract
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Investigating the paradox of hypothyroidism and increased serum thyrotropin (TSH) levels in Sheehan's syndrome: characterization of TSH carbohydrate content and bioactivity. Author(s): Oliveira JH, Persani L, Beck-Peccoz P, Abucham J. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 April; 86(4): 1694-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11297605&dopt=Abstract
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Iodine sufficiency and measurements of thyroid function in maternal hypothyroidism. Author(s): Mitchell ML, Klein RZ, Sargent JD, Meter RA, Haddow JE, Waisbren SE, Faix JD. Source: Clinical Endocrinology. 2003 May; 58(5): 612-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699443&dopt=Abstract
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Iodine-induced hypothyroidism as a result of excessive intake of confectionery made with tangle weed, Kombu, used as a low calorie food during a bulimic period in a patient with anorexia nervosa. Author(s): Matsubayashi S, Mukuta T, Watanabe H, Fuchigami H, Taniguchi J, Chinen M, Ninomiya H, Sasaki H. Source: Eat Weight Disord. 1998 March; 3(1): 50-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11234256&dopt=Abstract
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Iodine-Induced hypothyroidism. Author(s): Markou K, Georgopoulos N, Kyriazopoulou V, Vagenakis AG. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 May; 11(5): 501-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11396709&dopt=Abstract
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Is bile flow reduced in patients with hypothyroidism? Author(s): Laukkarinen J, Sand J, Saaristo R, Salmi J, Turjanmaa V, Vehkalahti P, Nordback I. Source: Surgery. 2003 March; 133(3): 288-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660641&dopt=Abstract
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Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia? Author(s): Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 November; 85(11): 3975-87. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11095417&dopt=Abstract
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Is the birthdate a risk factor for congenital hypothyroidism? A statistical answer based on personal experience. Author(s): Rocchi MB, Perlini C, Ciatti R, Burroni M. Source: Minerva Pediatr. 2001 December; 53(6): 531-6. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11740434&dopt=Abstract
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Isolated menarche and multicystic ovaries in a 7 1/2 year girl with hypothyroidism. Author(s): Dhanwal D, Tandon N. Source: Indian Pediatrics. 2001 April; 38(4): 432-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11313523&dopt=Abstract
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Isolated menarche and multicystic ovaries in a 7(1/2)-year- girl with hypothyroidism. Author(s): Singh SK, Singh R, Maurya VK. Source: Indian Pediatrics. 2001 December; 38(12): 1431-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11752750&dopt=Abstract
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Juvenile dermatomyositis associated with subclinical hypothyroidism due to autoimmune thyroiditis. Author(s): Go T, Mitsuyoshi I. Source: European Journal of Pediatrics. 2002 June; 161(6): 358-9. Epub 2002 April 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12029461&dopt=Abstract
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Kocher-Debre-Semelaigne syndrome: hypothyroidism with muscle pseudohypertrophy. Author(s): Tullu MS, Udgirkar VS, Muranjan MN, Sathe SA, Kamat JR. Source: Indian J Pediatr. 2003 August; 70(8): 671-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14510090&dopt=Abstract
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Large differences in incidences of overt hyper- and hypothyroidism associated with a small difference in iodine intake: a prospective comparative register-based population survey. Author(s): Bulow Pedersen I, Knudsen N, Jorgensen T, Perrild H, Ovesen L, Laurberg P. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 October; 87(10): 4462-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364419&dopt=Abstract
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Left ventricular myocardial impairment in subclinical hypothyroidism assessed by a new ultrasound tool: pulsed tissue Doppler. Author(s): Vitale G, Galderisi M, Lupoli GA, Celentano A, Pietropaolo I, Parenti N, De Divitiis O, Lupoli G. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 September; 87(9): 4350-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213897&dopt=Abstract
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Lesson of the week: Hypothyroidism mimicking intra-abdominal malignancy. Author(s): Krishnan ST, Philipose Z, Rayman G. Source: Bmj (Clinical Research Ed.). 2002 October 26; 325(7370): 946-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399347&dopt=Abstract
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Lessons to be learned: a case study approach: severe hyponatraemia induced by primary hypothyroidism and associated with possible increased hepatic sensitivity to thyroxine replacement. Author(s): Olukoga A, Horsman G, Stewart F. Source: J R Soc Health. 1999 June; 119(2): 117-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11043008&dopt=Abstract
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Levels of testosterone, allopregnanolone and homocysteine in severe hypothyroidism. Author(s): Bicikova M, Tallova J, Stanicka S, Hill M, Vondra K, Hampl R. Source: Clinical Chemistry and Laboratory Medicine : Cclm / Fescc. 2002 October; 40(10): 1024-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12476942&dopt=Abstract
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Life-threatening hypothyroidism associated with administration of cyclosporine in a patient treated with reduced-intensity hematopoietic stem-cell transplantation for metastatic renal-cell carcinoma. Author(s): Imataki O, Kim SW, Kojima R, Hori A, Hamaki T, Sakiyama M, Murashige N, Satoh M, Kami M, Makimoto A, Takaue Y. Source: Transplantation. 2003 March 27; 75(6): 898-907. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660521&dopt=Abstract
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Linear growth in children with congenital hypothyroidism detected by neonatal screening and treated early: a longitudinal study. Author(s): Morin A, Guimarey L, Apezteguia M, Ansaldi M, Santucci Z. Source: J Pediatr Endocrinol Metab. 2002 July-August; 15(7): 973-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12199341&dopt=Abstract
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Linkage analysis identifies the thyroglobulin gene region as a major locus for familial congenital hypothyroidism. Author(s): Ahlbom BE, Yaqoob M, Gustavsson P, Abbas HG, Anneren G, Larsson A, Wadelius C. Source: Human Genetics. 2002 February; 110(2): 145-7. Epub 2002 January 29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11935320&dopt=Abstract
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Lipid profile changes in young children treated for hypothyroidism. Author(s): DiNicola AF, Mahabadi V, Afridi B, Gelyana D. Source: Pediatric Annals. 2000 November; 29(11): 667-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11098514&dopt=Abstract
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Lipid profile in subclinical hypothyroidism: is L-thyroxine substitution beneficial? Author(s): Efstathiadou Z, Bitsis S, Milionis HJ, Kukuvitis A, Bairaktari ET, Elisaf MS, Tsatsoulis A. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 December; 145(6): 705-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11720894&dopt=Abstract
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Lipoprotein profile in subclinical hypothyroidism: response to levothyroxine replacement, a randomized placebo-controlled study. Author(s): Caraccio N, Ferrannini E, Monzani F. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 April; 87(4): 1533-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11932277&dopt=Abstract
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Lithium side-effects and predictors of hypothyroidism in patients with bipolar disorder: sex differences. Author(s): Henry C. Source: Journal of Psychiatry & Neuroscience : Jpn. 2002 March; 27(2): 104-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11944505&dopt=Abstract
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Longitudinal growth, sexual maturation and final height in patients with congenital hypothyroidism detected by neonatal screening. Author(s): Salerno M, Micillo M, Di Maio S, Capalbo D, Ferri P, Lettiero T, Tenore A. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 October; 145(4): 377-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11580992&dopt=Abstract
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Long-term consequences of congenital hypothyroidism in the era of screening programmes. Author(s): Gruters A, Jenner A, Krude H. Source: Best Practice & Research. Clinical Endocrinology & Metabolism. 2002 June; 16(2): 369-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064898&dopt=Abstract
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Long-term follow-up of children born with sporadic congenital hypothyroidism. Author(s): Rovet J. Source: Annales D'endocrinologie. 2003 February; 64(1): 58-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707637&dopt=Abstract
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Longterm outcome in children with congenital hypothyroidism. Author(s): Heyerdahl S. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 November; 90(11): 1220-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11808888&dopt=Abstract
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Low cholesteryl ester transfer protein (CETP) concentration but normal CETP activity in serum from patients with short-term hypothyroidism Lack of relationship to lipoprotein abnormalities. Author(s): Dedecjus M, Masson D, Gautier T, de Barros JP, Gambert P, Lewinski A, Adamczewski Z, Moulin P, Lagrost L. Source: Clinical Endocrinology. 2003 May; 58(5): 581-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699439&dopt=Abstract
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Low TSH congenital hypothyroidism: identification of a novel mutation of the TSH beta-subunit gene in one sporadic case (C85R) and of mutation Q49stop in two siblings with congenital hypothyroidism. Author(s): Sertedaki A, Papadimitriou A, Voutetakis A, Dracopoulou M, ManiatiChristidi M, Dacou-Voutetakis C. Source: Pediatric Research. 2002 December; 52(6): 935-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12438673&dopt=Abstract
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Low-density lipoprotein cholesterol in subclinical hypothyroidism. Author(s): Vierhapper H, Nardi A, Grosser P, Raber W, Gessl A. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 November; 10(11): 981-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11128726&dopt=Abstract
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Lupus syndrome, hypothyroidism and bullous skin lesions after interferon alfa therapy for hepatitis C in a haemodialysis patient. Author(s): Pouthier D, Theissen F, Humbel RL. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002 January; 17(1): 174. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11773492&dopt=Abstract
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Management of hypothyroidism and hyperthyroidism in the intensive care unit. Author(s): Ringel MD. Source: Critical Care Clinics. 2001 January; 17(1): 59-74. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11219235&dopt=Abstract
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Management of overt and subclinical hypothyroidism. Factors influencing Lthyroxine dosage. Author(s): Rezzonico JN, Pusiol E, Saravi FD, Rezzonico M, Bossa N. Source: Medicina (B Aires). 1999; 59(6): 698-704. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10752211&dopt=Abstract
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Management of questionable hypothyroidism? Author(s): Haddad G. Source: Postgraduate Medicine. 2000 September 15; 108(4): 121. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11021265&dopt=Abstract
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Managing hypothyroidism during pregnancy. Author(s): Nikfar S, Koren G. Source: Can Fam Physician. 2001 August; 47: 1555-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11561329&dopt=Abstract
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Massive localized lymphedema: additional locations and association with hypothyroidism. Author(s): Wu D, Gibbs J, Corral D, Intengan M, Brooks JJ. Source: Human Pathology. 2000 September; 31(9): 1162-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11014586&dopt=Abstract
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Maternal hypothyroidism and cognitive development of the offspring. Author(s): Klein RZ, Mitchell ML. Source: Current Opinion in Pediatrics. 2002 August; 14(4): 443-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12130910&dopt=Abstract
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Maternal hypothyroidism in autoimmune thyroiditis and the prognosis of infants. Author(s): Wada K, Kazukawa I, Someya T, Watanabe T, Minamitani K, Minagawa M, Wataki K, Nishioka T, Yasuda T. Source: Endocrine Journal. 2000 March; 47 Suppl: S133-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10890202&dopt=Abstract
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Maternal hypothyroidism may affect fetal growth and neonatal thyroid function. Author(s): Blazer S, Moreh-Waterman Y, Miller-Lotan R, Tamir A, Hochberg Z. Source: Obstetrics and Gynecology. 2003 August; 102(2): 232-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12907094&dopt=Abstract
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Maternal hypothyroxinemia versus hypothyroidism and potential neurodevelopmental. Alterations of her offspring. Author(s): Morreale de Escobar G. Source: Annales D'endocrinologie. 2003 February; 64(1): 51-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707634&dopt=Abstract
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Maternal isodisomy for chromosome 2p causing severe congenital hypothyroidism. Author(s): Bakker B, Bikker H, Hennekam RC, Lommen EJ, Schipper MG, Vulsma T, de Vijlder JJ. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 March; 86(3): 11648. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11238503&dopt=Abstract
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Maternal thyrotoxicosis causing central hypothyroidism in infants. Author(s): Lee YS, Loke KY, Ng SC, Joseph R. Source: Journal of Paediatrics and Child Health. 2002 April; 38(2): 206-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12031010&dopt=Abstract
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Methodological problems in a study on the treatment of subclinical hypothyroidism. Author(s): Goichot B, Vinzio S, Schlienger JL. Source: The American Journal of Medicine. 2003 January; 114(1): 76-7; Author Reply 77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543297&dopt=Abstract
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Metrorrhagia and precocious puberty revealing primary hypothyroidism in a child with Down's syndrome. Author(s): Chemaitilly W, Thalassinos C, Emond S, Thibaud E. Source: Archives of Disease in Childhood. 2003 April; 88(4): 330-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12651760&dopt=Abstract
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Molecular characterization of myocardial fibrosis during hypothyroidism: evidence for negative regulation of the pro-alpha1(I) collagen gene expression by thyroid hormone receptor. Author(s): Chen WJ, Lin KH, Lee YS. Source: Molecular and Cellular Endocrinology. 2000 April 25; 162(1-2): 45-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10854697&dopt=Abstract
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Molecular pathogenesis of neonatal hypothyroidism. Author(s): Krude H, Biebermann H, Schnabel D, Ambrugger P, Gruters A. Source: Hormone Research. 2000; 53 Suppl 1: 12-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10895037&dopt=Abstract
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Myopathy as the sole manifestation of thyroprivic hypothyroidism of autoimmune etiology. Author(s): Wadhwa S. Source: J Assoc Physicians India. 2001 October; 49: 1031-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11848313&dopt=Abstract
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Myxedema associated with cardiac tamponade. Author(s): Lin CT, Liu CJ, Lin TK, Chen CW, Chen BC, Lin CL. Source: Japanese Heart Journal. 2003 May; 44(3): 447-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12825813&dopt=Abstract
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Myxedema psychosis with grade II hypothyroidism. Author(s): Lehrmann JA, Jain S. Source: General Hospital Psychiatry. 2002 July-August; 24(4): 275-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12100840&dopt=Abstract
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Neonatal congenital hypothyroidism screening in Addis Ababa, Ethiopia. Author(s): Feleke Y, Enquoselassie F, Deneke F, Abdulkadir J, Hawariat GW, Tilahun M, Mekbib T. Source: East Afr Med J. 2000 July; 77(7): 377-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12862157&dopt=Abstract
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Neonatal screening for congenital hypothyroidism and phenylketonuria at Siriraj Hospital, Mahidol University, Bangkok, Thailand--a pilot study. Author(s): Wasant P, Liammongkolkul S, Srisawat C. Source: Southeast Asian J Trop Med Public Health. 1999; 30 Suppl 2: 33-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11400774&dopt=Abstract
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Neonatal screening for hypothyroidism at a university hospital in Thailand. Author(s): Thaithumyanon P, Srivuthana S, Poshyachinda M. Source: Southeast Asian J Trop Med Public Health. 1999; 30 Suppl 2: 25-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11400772&dopt=Abstract
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Neonatal screening of phenylketonuria and congenital hypothyroidism in China. Author(s): Fan GX, Jun Y, Rui-guan C. Source: Southeast Asian J Trop Med Public Health. 1999; 30 Suppl 2: 17-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11400761&dopt=Abstract
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New autosomal recessive mutation of the TSH-beta subunit gene causing central isolated hypothyroidism. Author(s): Vuissoz JM, Deladoey J, Buyukgebiz A, Cemeroglu P, Gex G, Gallati S, Mullis PE. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 September; 86(9): 4468-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11549695&dopt=Abstract
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Newborn screening for congenital hypothyroidism, Victoria, Australia, 1977-1997. Part 1: The screening programme, demography, baseline perinatal data and diagnostic classification. Author(s): Connelly JF, Coakley JC, Gold H, Francis I, Mathur KS, Rickards AL, Price GJ, Halliday JL, Wolfe R. Source: J Pediatr Endocrinol Metab. 2001 November-December; 14(9): 1597-610. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11795652&dopt=Abstract
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Newborn screening for congenital hypothyroidism, Victoria, Australia, 1977-1997. Part 2: Treatment, progress and outcome. Author(s): Connelly JF, Rickards AL, Coakley JC, Price GJ, Francis I, Mathur KS, Wolfe R. Source: J Pediatr Endocrinol Metab. 2001 November-December; 14(9): 1611-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11795653&dopt=Abstract
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Newborn screening for PKU and congenital hypothyroidism in Latvia. Author(s): Lugovska R, Vevere P, Andrusaite R, Kornejeva A. Source: Southeast Asian J Trop Med Public Health. 1999; 30 Suppl 2: 52-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11400783&dopt=Abstract
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Nineteen years of national screening for congenital hypothyroidism: familial cases with thyroid dysgenesis suggest the involvement of genetic factors. Author(s): Castanet M, Polak M, Bonaiti-Pellie C, Lyonnet S, Czernichow P, Leger J; On behalf of AFDPHE (Association Francaise pour le Depistage et la Prevention des Handicaps de l'Enfant. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 May; 86(5): 2009-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11344199&dopt=Abstract
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Non-autoimmune primary hypothyroidism in diabetic and non-diabetic chronic renal dysfunction. Author(s): Bando Y, Ushiogi Y, Okafuji K, Toya D, Tanaka N, Miura S. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 2002 November; 110(8): 408-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12518252&dopt=Abstract
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Novel mutations of the thyroid peroxidase gene in patients with permanent congenital hypothyroidism. Author(s): Ambrugger P, Stoeva I, Biebermann H, Torresani T, Leitner C, Gruters A. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 July; 145(1): 19-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11415848&dopt=Abstract
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Objective estimates of the probability of developing hypothyroidism following radioactive iodine treatment of thyrotoxicosis. Author(s): Ahmad AM, Ahmad M, Young ET. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2002 June; 146(6): 767-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12039696&dopt=Abstract
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One-step quantitative thyrotropin assay for the detection of hypothyroidism in pointof-care conditions. Author(s): von Lode P, Hagren V, Palenius T, Lovgren T. Source: Clinical Biochemistry. 2003 March; 36(2): 121-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633761&dopt=Abstract
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Optimisation of thyroxine dose in congenital hypothyroidism. Author(s): Hindmarsh PC. Source: Archives of Disease in Childhood. 2002 February; 86(2): 73-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11827896&dopt=Abstract
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Overt and subclinical hypothyroidism complicating pregnancy. Author(s): Abalovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 January; 12(1): 63-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11838732&dopt=Abstract
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Pattern visual evoked potential (PVEP) evaluation in hypothyroidism. Author(s): Nazliel B, Akbay E, Irkec C, Yetkin I, Ersoy R, Toruner F. Source: J Endocrinol Invest. 2002 December; 25(11): 955-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12553554&dopt=Abstract
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Pericardial effusion with cardiac tamponade as a form of presentation of primary hypothyroidism. Author(s): Rachid A, Caum LC, Trentini AP, Fischer CA, Antonelli DA, Hagemann RP. Source: Arquivos Brasileiros De Cardiologia. 2002 June; 78(6): 580-5. English, Portuguese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12185857&dopt=Abstract
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Perspective: genetic defects in the etiology of congenital hypothyroidism. Author(s): Kopp P. Source: Endocrinology. 2002 June; 143(6): 2019-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12021164&dopt=Abstract
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Pictorial CME. Presentation of lethargy and pellagra lesions diagnosed as hypothyroidism. Author(s): Bajaj S, Bajaj AK. Source: J Assoc Physicians India. 1998 June; 46(6): 525. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11273251&dopt=Abstract
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Plasma viscosity in female patients with hypothyroidism: effects of oxidative stress and cholesterol. Author(s): Konukoglu D, Ercan M, Hatemi H. Source: Clinical Hemorheology and Microcirculation. 2002; 27(2): 107-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12237480&dopt=Abstract
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Polymorphism of the CTLA-4 gene is associated with autoimmune hypothyroidism in the United Kingdom. Author(s): Nithiyananthan R, Heward JM, Allahabadia A, Franklyn JA, Gough SC. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 January; 12(1): 3-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11842815&dopt=Abstract
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Polymyositis-like syndrome in hypothyroidism: review of cases reported over the past twenty-five years. Author(s): Madariaga MG. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 April; 12(4): 331-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12034059&dopt=Abstract
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Population-based association analyses of the HOPA12bp polymorphism for schizophrenia and hypothyroidism. Author(s): Philibert RA, Sandhu HK, Hutton AM, Wang Z, Arndt S, Andreasen NC, Crowe R, Wassink TH. Source: American Journal of Medical Genetics. 2001 January 8; 105(1): 130-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11424983&dopt=Abstract
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Potential consequences of maternal hypothyroidism on the offspring: evidence and implications. Author(s): Glinoer D. Source: Hormone Research. 2001; 55(3): 109-14. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11549871&dopt=Abstract
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Pre- and postnatal brain development in neonates with congenital hypothyroidism. Author(s): Bongers-Schokking JJ. Source: J Pediatr Endocrinol Metab. 2001; 14 Suppl 6: 1463-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11837500&dopt=Abstract
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Pretreatment prevalence of hypothyroidism in patients with head and neck carcinoma. Author(s): Mini S, Dori S, Horowitz Z, Bedrin L, Peleg M, Wolf M, Shoshani Y, Taicher S, Kronenberg J, Talmi YP. Source: Cancer. 2001 September 15; 92(6): 1512-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11745229&dopt=Abstract
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Prevalence of hypergastrinemia in patients with hyper- and hypothyroidism: impact for calcitonin? Author(s): Vierhapper H, Nowotny P, Bieglmayer Ch, Gessl A. Source: Hormone Research. 2002; 57(3-4): 85-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12006703&dopt=Abstract
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Prevalence of migraine in hypothyroidism. Author(s): Singh SK. Source: J Assoc Physicians India. 2002 November; 50: 1455-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12583488&dopt=Abstract
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Primary hypothyroidism and osteopenia associated with Neuhauser syndrome. Author(s): Sarkozy A, Mingarelli R, Brancati F, Dallapiccola B. Source: American Journal of Medical Genetics. 2002 September 1; 111(4): 412-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12210302&dopt=Abstract
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Primary hypothyroidism presenting as a pituitary gland enlargement with regression following thyroxine therapy. Author(s): Manocha SM, Moulick ND, Shah NS. Source: J Assoc Physicians India. 2000 June; 48(6): 651. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11273552&dopt=Abstract
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Primary hypothyroidism. Author(s): Kristensen L, Nygaard B. Source: Clin Evid. 2002 June; (7): 548-54. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12230680&dopt=Abstract
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Prolactin and interleukin 2 concentrations before and after i.v. TRH application in primary hypothyroidism and in controls. Author(s): Trejbal D, Petrasova D, Wagnerova H. Source: Bratisl Lek Listy. 2001; 102(9): 417-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763678&dopt=Abstract
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Propylthiouracil-induced chemical hypothyroidism with high-dose tamoxifen prolongs survival in recurrent high grade glioma: a phase I/II study. Author(s): Hercbergs AA, Goyal LK, Suh JH, Lee S, Reddy CA, Cohen BH, Stevens GH, Reddy SK, Peereboom DM, Elson PJ, Gupta MK, Barnett GH. Source: Anticancer Res. 2003 January-February; 23(1B): 617-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12680157&dopt=Abstract
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Prospective study of the spontaneous course of subclinical hypothyroidism: prognostic value of thyrotropin, thyroid reserve, and thyroid antibodies. Author(s): Huber G, Staub JJ, Meier C, Mitrache C, Guglielmetti M, Huber P, Braverman LE. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 July; 87(7): 3221-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107228&dopt=Abstract
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Pseudo-central hypothyroidism. Author(s): Basaria S, Altman K, Braga-Basaria M. Source: Southern Medical Journal. 2003 February; 96(2): 204-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630650&dopt=Abstract
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Re: “metabolic maladaptation: individual and social consequences of medical intervention in correcting endemic hypothyroidism”. Author(s): Thomson A. Source: Nutrition (Burbank, Los Angeles County, Calif.). 2000 April; 16(4): 318. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10896419&dopt=Abstract
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Recombinant human TSH testing is a valuable tool for differential diagnosis of congenital hypothyroidism during L-thyroxine replacement. Author(s): Fugazzola L, Persani L, Mannavola D, Reschini E, Vannucchi G, Weber G, Beck-Peccoz P. Source: Clinical Endocrinology. 2003 August; 59(2): 230-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864801&dopt=Abstract
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Regression of both pituitary and ovarian cysts after administration of thyroid hormone in a case of primary hypothyroidism. Author(s): Yamashita Y, Kawamura T, Fujikawa R, Mochizuki H, Okubo M, Arita K. Source: Intern Med. 2001 August; 40(8): 751-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11518117&dopt=Abstract
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Relation of severity of maternal hypothyroidism to cognitive development of offspring. Author(s): Klein RZ, Sargent JD, Larsen PR, Waisbren SE, Haddow JE, Mitchell ML. Source: Journal of Medical Screening. 2001; 8(1): 18-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11373843&dopt=Abstract
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Relationship of etiology to treatment in congenital hypothyroidism. Author(s): Hanukoglu A, Perlman K, Shamis I, Brnjac L, Rovet J, Daneman D. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 January; 86(1): 18691. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11231999&dopt=Abstract
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Residual pituitary enlargement in primary hypothyroidism despite 1 1/2 years of Lthyroxine therapy. Author(s): Goswami R, Tandon N, Sharma R, Kochupillai N. Source: Australasian Radiology. 1999 February; 43(1): 121-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10901888&dopt=Abstract
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Respiratory symptoms in patients with treated hypothyroidism and inflammatory bowel disease. Author(s): Birring SS, Morgan AJ, Prudon B, McKeever TM, Lewis SA, Falconer Smith JF, Robinson RJ, Britton JR, Pavord ID. Source: Thorax. 2003 June; 58(6): 533-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775870&dopt=Abstract
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Response of glucose disposal to hyperinsulinaemia in human hypothyroidism and hyperthyroidism. Author(s): Rochon C, Tauveron I, Dejax C, Benoit P, Capitan P, Fabricio A, Berry C, Champredon C, Thieblot P, Grizard J. Source: Clinical Science (London, England : 1979). 2003 January; 104(1): 7-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519082&dopt=Abstract
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Results of resting and ambulatory electrocardiograms in patients with hypothyroidism and after return to euthyroid status. Author(s): Osborn LA, Skipper B, Arellano I, MacKerrow SD, Crawford MH. Source: Heart Disease. 1999 March-April; 1(1): 8-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11720599&dopt=Abstract
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Risk factors associated with hypothyroidism after laryngectomy. Author(s): Gal RL, Gal TJ, Klotch DW, Cantor AB. Source: Otolaryngology and Head and Neck Surgery. 2000 September; 123(3): 211-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10964293&dopt=Abstract
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Risk factors for cardiovascular disease in women with subclinical hypothyroidism. Author(s): Luboshitzky R, Aviv A, Herer P, Lavie L. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 May; 12(5): 421-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12097204&dopt=Abstract
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Risk factors for congenital hypothyroidism: an investigation of infant's birth weight, ethnicity, and gender in California, 1990-1998. Author(s): Waller DK, Anderson JL, Lorey F, Cunningham GC. Source: Teratology. 2000 July; 62(1): 36-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10861631&dopt=Abstract
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Risk in cardiovascular disease. Subclinical hypothyroidism is risk factor for coronary heart disease. Author(s): Fowler PB. Source: Bmj (Clinical Research Ed.). 2000 July 15; 321(7254): 175. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10950543&dopt=Abstract
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Screening for congenital hypothyroidism. Author(s): Henry G, Sobki SH, Othman JM. Source: Saudi Med J. 2002 May; 23(5): 529-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12070574&dopt=Abstract
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Serum concentrations of tumour necrosis factor-alpha (TNF-alpha) and soluble TNFalpha receptor p55 in patients with hypothyroidism and hyperthyroidism before and after normalization of thyroid function. Author(s): Diez JJ, Hernanz A, Medina S, Bayon C, Iglesias P. Source: Clinical Endocrinology. 2002 October; 57(4): 515-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12354134&dopt=Abstract
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Serum level of the circulating angiogenesis inhibitor endostatin in patients with hyperthyroidism or hypothyroidism. Author(s): Kucharz EJ, Kotulska A, Kopec M, Stawiarska-Pieta B, Pieczyrak R. Source: Wiener Klinische Wochenschrift. 2003 March 31; 115(5-6): 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12741078&dopt=Abstract
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Serum thyroid stimulating hormone in assessment of severity of tissue hypothyroidism in patients with overt primary thyroid failure: cross sectional survey. Author(s): Meier C, Trittibach P, Guglielmetti M, Staub JJ, Muller B. Source: Bmj (Clinical Research Ed.). 2003 February 8; 326(7384): 311-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574044&dopt=Abstract
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Sex-specific impact of congenital hypothyroidism due to thyroid dysgenesis on skeletal maturation in term newborns. Author(s): Van Vliet G, Larroque B, Bubuteishvili L, Supernant K, Leger J; Association of Francaise pour le Depistage et la Prevention des Handicaps de l'Enfant. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 May; 88(5): 2009-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727946&dopt=Abstract
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Steroid responsive cutaneous Rosai-Dorfman disease associated with uveitis and hypothyroidism. Author(s): Salim A, Williamson M, Barker F, Hughes J. Source: Clinical and Experimental Dermatology. 2002 June; 27(4): 277-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12139669&dopt=Abstract
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Study of hypothyroidism in Indian females with idiopathic oedema. Author(s): Singh SK. Source: J Assoc Physicians India. 2001 June; 49: 677-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11584957&dopt=Abstract
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Subchemical hypothyroidism. Author(s): Wikland B, Sandberg PO, Wallinder H. Source: Lancet. 2003 April 12; 361(9365): 1305. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699993&dopt=Abstract
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Subclinical hypothyroidism and cardiac function. Author(s): Biondi B, Palmieri EA, Lombardi G, Fazio S. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 June; 12(6): 505-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12165114&dopt=Abstract
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Subclinical hypothyroidism and lipid abnormalities in older women attending a vascular disease prevention clinic: effect of thyroid replacement therapy. Author(s): Ganotakis ES, Mandalaki K, Tampakaki M, Malliaraki N, Mandalakis E, Vrentzos G, Melissas J, Castanas E. Source: Angiology. 2003 September-October; 54(5): 569-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14565632&dopt=Abstract
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Subclinical hypothyroidism in early childhood: a frequent outcome of transient neonatal hyperthyrotropinemia. Author(s): Calaciura F, Motta RM, Miscio G, Fichera G, Leonardi D, Carta A, Trischitta V, Tassi V, Sava L, Vigneri R. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 July; 87(7): 3209-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107226&dopt=Abstract
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Subclinical hypothyroidism in flight personnel: evaluation for suitability to fly. Author(s): Danese D. Source: Rev Int Serv Sante Forces Armees. 1997; 70(1-3): 32-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11540646&dopt=Abstract
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Subclinical hypothyroidism in HIV-infected patients receiving highly active antiretroviral therapy. Author(s): Calza L, Manfredi R, Chiodo F. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2002 November 1; 31(3): 361-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439214&dopt=Abstract
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Subclinical hypothyroidism in women: who to treat. Author(s): Morocco M, Kloss RT. Source: Disease-A-Month : Dm. 2002 October; 48(10): 659-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562053&dopt=Abstract
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Subclinical hypothyroidism is associated with coronary artery disease in older persons. Author(s): Mya MM, Aronow WS. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2002 October; 57(10): M658-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12242320&dopt=Abstract
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Subclinical hypothyroidism is mild thyroid failure and should be treated. Author(s): McDermott MT, Ridgway EC. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 October; 86(10): 4585-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11600507&dopt=Abstract
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Subhyoid ectopic thyroid with mediolateral location in a developmentally retarded child with hypothyroidism in an iodine deficiency region. Author(s): Demir H, Berk F, Isgoren S, Erdincler RO, Ciftci E, Aktolun C. Source: Ann Nucl Med. 2002 November; 16(7): 483-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12508839&dopt=Abstract
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Suppression of TSH in congenital hypothyroidism is significantly related to serum levels and dosage of thyroxine. Author(s): Brown JJ, Datta V, Sutton AJ, Swift PG. Source: Hormone Research. 2003; 59(2): 85-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12589112&dopt=Abstract
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Suprasellar tuberculoma presenting with diabetes insipidus and hypothyroidism--a case report. Author(s): Jain R, Kumar R. Source: Neurology India. 2001 September; 49(3): 314-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11593255&dopt=Abstract
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Surveyance of disease frequency in a population by linkage to diagnostic laboratory databases. A system for monitoring the incidences of hyper- and hypothyroidism as part of the Danish iodine supplementation program. Author(s): Pedersen IB, Laurberg P, Arnfred T, Knudsen N, Jorgensen T, Perrild H, Ovesen L. Source: Computer Methods and Programs in Biomedicine. 2002 March; 67(3): 209-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11853947&dopt=Abstract
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The effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto's thyroiditis. Author(s): Yoon SJ, Choi SR, Kim DM, Kim JU, Kim KW, Ahn CW, Cha BS, Lim SK, Kim KR, Lee HC, Huh KB. Source: Yonsei Medical Journal. 2003 April 30; 44(2): 227-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12728462&dopt=Abstract
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The incidence of Helicobacter pylori infection in Greek female patients with autoimmune hypothyroidism: is there a relationship? Author(s): Zervas A, Katopodi A, Protonotariou A, Tolis G, Zouridakis S. Source: Journal of Clinical Gastroenterology. 2002 November-December; 35(5): 413-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394235&dopt=Abstract
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The lifelong lurker. A clinical review of hypothyroidism. Author(s): Falsetti D. Source: Adv Nurse Pract. 2001 April; 9(4): 63-4, 67-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420438&dopt=Abstract
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Thyroid autoimmunity and hypothyroidism before and during pregnancy. Author(s): Poppe K, Glinoer D. Source: Human Reproduction Update. 2003 March-April; 9(2): 149-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12751777&dopt=Abstract
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Thyroid function tests and hypothyroidism. Author(s): Toft AD, Beckett GJ. Source: Bmj (Clinical Research Ed.). 2003 February 8; 326(7384): 295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574021&dopt=Abstract
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Thyroid function tests and hypothyroidism. Reducing concentrations further would be harmful. Author(s): Crilly M. Source: Bmj (Clinical Research Ed.). 2003 May 17; 326(7398): 1086; Author Reply 1087. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12750219&dopt=Abstract
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Thyroid function tests and hypothyroidism. Restoring serum TSH to reference range should be goal of replacement. Author(s): Vanderpump MP, Franklyn JA. Source: Bmj (Clinical Research Ed.). 2003 May 17; 326(7398): 1086-7; Author Reply 1087. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12750218&dopt=Abstract
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Thyroid-stimulating-hormone concentrations and risk of hypothyroidism. Author(s): Glasheen JJ, Zwillich C, Ridgway EC. Source: Lancet. 2002 December 21-28; 360(9350): 2082-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504443&dopt=Abstract
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Thyroid-stimulating-hormone concentrations and risk of hypothyroidism. Author(s): Haddow JE, Palomaki GE, Williams J. Source: Lancet. 2002 December 21-28; 360(9350): 2081-2; Author Reply 2082. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504442&dopt=Abstract
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Thyrotropin screening for congenital hypothyroidism in Queen Sirikit National Institute of Child Health, Thailand (during year 1995-2000). Author(s): Churesigaew S, Ratrisawasdi V, Thaeramanophab S. Source: J Med Assoc Thai. 2002 July; 85(7): 782-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296410&dopt=Abstract
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Thyrotropin suppression by thyroid hormone replacement is correlated with thyroxine level normalization in central hypothyroidism. Author(s): Shimon I, Cohen O, Lubetsky A, Olchovsky D. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 September; 12(9): 823-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12481949&dopt=Abstract
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Thyroxine hair content in congenital hypothyroidism and hyperthyroidism. Author(s): Zamboni G, Camilot M, Francia G, Lauriola S, Arslanoglu I, Isguven P, Tato L. Source: J Pediatr Endocrinol Metab. 2003 March; 16(3): 379-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705362&dopt=Abstract
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Thyroxine vs thyroxine plus triiodothyronine in treatment of hypothyroidism after thyroidectomy for Graves' disease. Author(s): Bunevicius R, Jakubonien N, Jurkevicius R, Cernicat J, Lasas L, Prange AJ Jr. Source: Endocrine. 2002 July; 18(2): 129-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12374459&dopt=Abstract
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Time course to hypothyroidism after fixed-dose radioablation therapy of Graves' disease in children. Author(s): Nebesio TD, Siddiqui AR, Pescovitz OH, Eugster EA. Source: The Journal of Pediatrics. 2002 July; 141(1): 99-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12091858&dopt=Abstract
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Transient neonatal hypothyroidism due to a maternal vegan diet. Author(s): Shaikh MG, Anderson JM, Hall SK, Jackson MA. Source: J Pediatr Endocrinol Metab. 2003 January; 16(1): 111-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585349&dopt=Abstract
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Treatment for congenital hypothyroidism: thyroxine alone or thyroxine plus triiodothyronine? Author(s): Cassio A, Cacciari E, Cicognani A, Damiani G, Missiroli G, Corbelli E, Balsamo A, Bal M, Gualandi S. Source: Pediatrics. 2003 May; 111(5 Pt 1): 1055-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12728088&dopt=Abstract
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Treatment of primary hypothyroidism during pregnancy: is there an increase in thyroxine dose requirement in pregnancy? Author(s): Chopra IJ, Baber K. Source: Metabolism: Clinical and Experimental. 2003 January; 52(1): 122-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12524672&dopt=Abstract
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Treatment of the infant with congenital hypothyroidism. Author(s): Hopwood NJ. Source: The Journal of Pediatrics. 2002 December; 141(6): 752-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461487&dopt=Abstract
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Turbulencies during hypothyroidism therapy. Author(s): Koch HJ, Szecsey A, Vogel M. Source: Cardiology. 2002; 98(1-2): 99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12373054&dopt=Abstract
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Two cases of sleep apnea syndrome caused by primary hypothyroidism. Author(s): Hattori H, Hattori C, Yonekura A, Nishimura T. Source: Acta Otolaryngol Suppl. 2003; (550): 59-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12737345&dopt=Abstract
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Ultrasonic myocardial textural analysis in subclinical hypothyroidism. Author(s): Di Bello V, Monzani F, Giorgi D, Bertini A, Caraccio N, Valenti G, Talini E, Paterni M, Ferrannini E, Giusti C. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2000 September; 13(9): 832-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10980086&dopt=Abstract
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Unmasking of childhood hypothyroidism by disseminated xanthomas. Author(s): Dotsch J, Zepf K, Schellmoser S, Rascher W, Dorr HG. Source: Pediatrics. 2001 November; 108(5): E96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11694680&dopt=Abstract
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Update on the management of hyperthyroidism and hypothyroidism. Author(s): Woeber KA. Source: Archives of Family Medicine. 2000 August; 9(8): 743-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10927715&dopt=Abstract
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Usefulness of thyroxine and free thyroxine filter paper measurements in neonatal screening for congenital hypothyroidism of preterm babies. Author(s): Gruneiro-Papendieck L, Prieto L, Chiesa A, Bengolea S, Bossi G, Bergada C. Source: Journal of Medical Screening. 2000; 7(2): 78-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11002447&dopt=Abstract
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Validity of self-reported hyperthyroidism and hypothyroidism: comparison of selfreported questionnaire data with medical record review. Author(s): Brix TH, Kyvik KO, Hegedus L. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 August; 11(8): 769-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11525270&dopt=Abstract
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Vascular variant of keratosis lichenoides chronica associated with hypothyroidism and response to tacalcitol and acitretin. Author(s): Nijsten T, Mentens G, Lambert J. Source: Acta Dermato-Venereologica. 2002; 82(2): 128-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12125942&dopt=Abstract
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Very low birth weight newborns do not need repeat screening for congenital hypothyroidism. Author(s): Vincent MA, Rodd C, Dussault JH, Van Vliet G. Source: The Journal of Pediatrics. 2002 March; 140(3): 311-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11953728&dopt=Abstract
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Vitamin D receptor genotype and bone mineral density in Caucasian children with congenital hypothyroidism. Author(s): Leger J, Tourrel C, Ruiz JC, Czernichow P, Garabedian M. Source: J Pediatr Endocrinol Metab. 2000 June; 13(6): 599-603. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10905383&dopt=Abstract
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What is the optimal treatment for hypothyroidism? Author(s): Walsh JP, Stuckey BG. Source: The Medical Journal of Australia. 2001 February 5; 174(3): 141-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11247618&dopt=Abstract
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What is the target TSH level in thyroid hormone replacement for primary hypothyroidism? Author(s): Zimmerman RS. Source: Cleve Clin J Med. 2003 April; 70(4): 329-30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701986&dopt=Abstract
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When to treat mild hypothyroidism. Author(s): Ayala AR, Danese MD, Ladenson PW. Source: Endocrinology and Metabolism Clinics of North America. 2000 June; 29(2): 399415. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10874537&dopt=Abstract
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Where and what visuospatial processing in adolescents with congenital hypothyroidism. Author(s): Leneman M, Buchanan L, Rovet J. Source: Journal of the International Neuropsychological Society : Jins. 2001 July; 7(5): 556-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11459107&dopt=Abstract
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Wolcott-Rallison syndrome in two siblings with isolated central hypothyroidism. Author(s): Bin-Abbas B, Al-Mulhim A, Al-Ashwal A. Source: American Journal of Medical Genetics. 2002 August 1; 111(2): 187-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12210348&dopt=Abstract
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CHAPTER 2. NUTRITION AND HYPOTHYROIDISM Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and hypothyroidism.
Finding Nutrition Studies on Hypothyroidism The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “hypothyroidism” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “hypothyroidism” (or a synonym): •
Antenatal diagnosis and treatment of a case of fetal goitrous hypothyroidism associated with high-output cardiac failure. Author(s): Department of Obstetrics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka University Graduate School of Medicine, Osaka, Japan. Source: Morine, M Takeda, T Minekawa, R Sugiyama, T Wasada, K Mizutani, T Suehara, N Ultrasound-Obstet-Gynecol. 2002 May; 19(5): 506-9 0960-7692
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Bone metabolism in children with congenital hypothyroidism--a longitudinal study. Author(s): Department of Pediatrics, University of Chieti, Italy. Source: Verrotti, A Greco, R Altobelli, E Morgese, G Chiarelli, F J-Pediatr-EndocrinolMetab. 1998 Nov-December; 11(6): 699-705
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Borderline congenital hypothyroidism in the neonatal period. Author(s): Department of Pediatrics, Ankara Hospital, Turkey.
[email protected] Source: Siklar, Z Tezer, H Dallar, Y Tanyer, G J-Pediatr-Endocrinol-Metab. 2002 June; 15(6): 817-21
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Changes in brain size with treatment in patients with hyper- or hypothyroidism. Author(s): Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, Faculty of Medicine, Imperial College, Hammersmith Hospital Campus, London W12 0HS, England, UK. Source: Oatridge, A Barnard, M L Puri, B K Taylor Robinson, S D Hajnal, J V Saeed, N Bydder, G M AJNR-Am-J-Neuroradiol. 2002 October; 23(9): 1539-44 0195-6108
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Congenital hypothyroidism with Prader-Willi syndrome. Author(s): Genetic Institute, Assaf-Harofeh Medical Center Zrifin, Israel.
[email protected] Source: Sher, Carron Bistritzer, Tzvi Reisler, Gad Reish, Orit J-Pediatr-EndocrinolMetab. 2002 January; 15(1): 105-7
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Effect of different starting doses of levothyroxine on growth and intellectual outcome at four years of age in congenital hypothyroidism. Author(s): Department of Pediatrics, University of Naples Federico II, Italy.
[email protected] Source: Salerno, Mariacarolina Militerni, Roberto Bravaccio, Carmela Micillo, Maria Capalbo, Donatella Di, Maio Salvatore Tenore, Alfred Thyroid. 2002 January; 12(1): 4552 1050-7256
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Four cases of aggression and hypothyroidism in dogs. Author(s): Departament de Biologia Cellular i Fisiologia, Facultat de Veterinaria, Universitat Autonoma de Barcelona, Bellaterra, Spain. Source: Fatjo, J Stub, C Manteca, X Vet-Rec. 2002 November 2; 151(18): 547-8 0042-4900
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Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism. Author(s): Department of Cardiology and Endocrinology E, Frederiksberg Hospital, Frederiksberg, Denmark.
[email protected] Source: Faber, J Petersen, L Wiinberg, N Schifter, S Mehlsen, J Thyroid. 2002 April; 12(4): 319-24 1050-7256
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Hypothyroidism and cognition: preliminary evidence for a specific defect in memory. Author(s): Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania, USA.
[email protected]
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Source: Burmeister, L A Ganguli, M Dodge, H H Toczek, T DeKosky, S T Nebes, R D Thyroid. 2001 December; 11(12): 1177-85 1050-7256 •
Hypothyroidism and myocardial failure in two Great Danes. Author(s): Department of Clinical Sciences, Kansas State University, 1800 Denison Avenue, Manhattan, Kansas 66506-5606, USA. Source: Phillips, D E Harkin, K R J-Am-Anim-Hosp-Assoc. 2003 Mar-April; 39(2): 133-7 0587-2871
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Hypothyroidism and nutritional status alter 3,5,3'-triiodothyronine (T3) receptors in isolated liver nuclei of Anabas testudineus (Bloch). Author(s): Department of Zoology, University of Kerala, Trivandrum, Kerala, India. Source: Shameena, B Renuka, T R Varghese, S Paulose, C S Oommen, O V Endocr-Res. 2001 August; 27(3): 329-36 0743-5800
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Hypothyroidism in elderly people. Author(s): Genesis ElderCare Physician Services, Maryland, USA. Source: Li, Tsui Ming Geriatr-Nurs. 2002 Mar-April; 23(2): 88-93 0197-4572
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Hypothyroidism in patients older than 55 years: an analysis of the etiology and assessment of the effectiveness of therapy. Author(s): Department of Endocrinology, Hospital La Paz, Madrid, Spain.
[email protected] Source: Diez, Juan J J-Gerontol-A-Biol-Sci-Med-Sci. 2002 May; 57(5): M315-20 1079-5006
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Increased sensitivity to thyroid hormone replacement therapy followed by hyponatremia and eosinophilia in a patient with long-standing young-onset primary hypothyroidism. Author(s): Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Fukuoka City, Japan. Source: Fujikawa, M Okamura, K Sato, K Mizokami, T Shiratsuchi, M Fujishima, M JEndocrinol-Invest. 1999 June; 22(6): 476-80 0391-4097
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Intrauterine diagnosis and management of congenital goitrous hypothyroidism. Author(s): University of Cambridge, School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK. Source: Agrawal, P Ogilvy Stuart, A Lees, C Ultrasound-Obstet-Gynecol. 2002 May; 19(5): 501-5 0960-7692
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Iodine-Induced hypothyroidism. Author(s): Department of Medicine, University of Patras Medical School, Greece. Source: Markou, K Georgopoulos, N Kyriazopoulou, V Vagenakis, A G Thyroid. 2001 May; 11(5): 501-10 1050-7256
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Long-term consequences of congenital hypothyroidism in the era of screening programmes. Author(s): Paediatric Endocrinology, University Children's Hospital Charite, Augustenburger Platz 1, 13353, Berlin, Germany. Source: Gruters, Annette Jenner, Anja Krude, Heiko Best-Pract-Res-Clin-EndocrinolMetab. 2002 June; 16(2): 369-82 1521-690X
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Overt and subclinical hypothyroidism complicating pregnancy. Author(s): Division Endocrinologia, Hospital C. Durand, Buenos Aires, Argentina.
[email protected] Source: Abalovich, M Gutierrez, S Alcaraz, G Maccallini, G Garcia, A Levalle, O Thyroid. 2002 January; 12(1): 63-8 1050-7256
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Pericardial effusion with cardiac tamponade as a form of presentation of primary hypothyroidism. Author(s): Hospital das Clinicas de Curitiba da Universidade Federal do Parana. Source: Rachid, A Caum, L C Trentini, A P Fischer, C A Antonelli, D A Hagemann, R P Arq-Bras-Cardiol. 2002 June; 78(6): 580-5 0066-782X
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Polymyositis-like syndrome in hypothyroidism: review of cases reported over the past twenty-five years. Author(s): Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
[email protected] Source: Madariaga, M G Thyroid. 2002 April; 12(4): 331-6 1050-7256
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Response of mitochondrial function to hypothyroidism in normal and regenerated rat skeletal muscle. Author(s): Unite de Bioenergetique et Environnement, Centre de Recherches du Service de Sante des Armies, La Tronche, France. Source: Zoll, J Ventura Clapier, R Serrurier, B Bigard, A X J-Muscle-Res-Cell-Motil. 2001; 22(2): 141-7 0142-4319
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Risk factors for cardiovascular disease in women with subclinical hypothyroidism. Author(s): Endocrine Institute, Haemek Medical Center, Afula, Israel.
[email protected] Source: Luboshitzky, R Aviv, A Herer, P Lavie, L Thyroid. 2002 May; 12(5): 421-5 10507256
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Scintigraphic evaluation of primary congenital hypothyroidism: results of the Greek screening program. Author(s): Department of Nuclear Medicine, Sotiria Hospital, 152 Mesogion Avenue, 11527 Athens, Greece.
[email protected] Source: Panoutsopoulos, G Mengreli, C Ilias, I Batsakis, C Christakopoulou, I Eur-JNucl-Med. 2001 April; 28(4): 529-33 0340-6997
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Serum thyrotropin in primary hypothyroidism: a reliable and accurate predictor of optimal daily levothyroxine dose. Author(s): VA Medical Center, Phoenix, Arizona, USA. Source: Kabadi, U M Kabadi, M M Endocr-Pract. 2001 Jan-February; 7(1): 16-8 1530-891X
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Serum vitamin E and lipid peroxides in malnutrition, hyper and hypothyroidism [Alpha tocopherol]. Source: Krishnamurthy, S. Prasanna, D. Acta-Vitaminol-Enzymol. Milano : Gruppo Lepetit. 1984. volume 6 (1) page 17-21. 0300-8924
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Severe hypothyroidism due to autoimmune atrophic thyroiditis--predicted target height and a plausible mechanism for sexual precocity. Author(s): Department of Paediatric Endocrinology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
[email protected] Source: Niedziela, M Korman, E J-Pediatr-Endocrinol-Metab. 2001 Jul-August; 14(7): 901-7
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Smoking as a risk factor for Graves' disease, toxic nodular goiter, and autoimmune hypothyroidism. Author(s): The Osteoporosis Clinic, Aarhus Amtssygehus, Aarhus University Hospital, Denmark.
[email protected] Source: Vestergaard, Peter Rejnmark, Lars Weeke, Jorgen Hoeck, Hans Christian Nielsen, Henning K Rungby, Jorgen Laurberg, Peter Mosekilde, Leif Thyroid. 2002 January; 12(1): 69-75 1050-7256
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Subclinical hypothyroidism and cardiac function. Author(s): Department of Clinical and Molecular Endocrinology and Oncology, University of Naples Federico II School of Medicine, Naples, Italy.
[email protected] Source: Biondi, B Palmieri, E A Lombardi, G Fazio, S Thyroid. 2002 June; 12(6): 505-10 1050-7256
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Surveyance of disease frequency in a population by linkage to diagnostic laboratory databases. A system for monitoring the incidences of hyper- and hypothyroidism as part of the Danish iodine supplementation program. Author(s): Department of Endocrinology and Medicine, Aalborg Hospital, Reberbansgade, DK-9000 Aalborg, Denmark.
[email protected] Source: Pedersen, Inge Bulow Laurberg, Peter Arnfred, Terkel Knudsen, Nils Jorgensen, Torben Perrild, Hans Ovesen, Lars Comput-Methods-Programs-Biomed. 2002 March; 67(3): 209-16 0169-2607
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The blood spot thyrotropin method is not adequate to screen for hypothyroidism in the elderly living in abundant-iodine intake areas: comparison to sensitive thyrotropin measurements. Author(s): 1st Department of Medicine, Haynal Imre University of Health Sciences, Budapest, Hungary. Source: Takats, I K Peter, F Rimanoczi, E Dohan, O Foldes, J Vadasz, J Feldkamp, J Szilagyi, G Goth, M Kovacs, L Radacsi, A Szabolcs, I Thyroid. 2000 January; 10(1): 79-85 1050-7256
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The effects of hypothyroidism on 5-HT1A and 5-HT2A receptors and the serotonin transporter protein in the rat brain. Author(s): Institute of Cytology and Genetics, Siberian Division, Russian Academy of Sciences, Novosibirsk. Source: Kulikov, A V Jeanningro, R Neurosci-Behav-Physiol. 2001 Jul-August; 31(4): 4459 0097-0549
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The influence of etiology and treatment factors on intellectual outcome in congenital hypothyroidism. Author(s): Brain and Behaviour Program, The Hospital for Sick Children, Toronto, Ontario, Canada. Source: Song, S I Daneman, D Rovet, J J-Dev-Behav-Pediatr. 2001 December; 22(6): 37684 0196-206X
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Treatment and therapeutic monitoring of canine hypothyroidism. Author(s): Axiom Veterinary Laboratory, Teignmouth, Devon. Source: Dixon, R M Reid, S W Mooney, C T J-Small-Anim-Pract. 2002 August; 43(8): 33440 0022-4510
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Xerosis in hypothyroidism: a potential role for the use of topical thyroid hormone in euthyroid patients. Author(s): Division of Dermatology, University of Medicine and Dentistry, Robert Wood Johnson Medical School at Camden, USA.
[email protected] Source: Heymann, W R Gans, E H Manders, S M Green, J J Haimowitz, J E MedHypotheses. 2001 December; 57(6): 736-9 0306-9877
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Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMD®Health: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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The following is a specific Web list relating to hypothyroidism; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Vitamin A Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B3 Source: Healthnotes, Inc.; www.healthnotes.com
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Minerals Iodine Source: Healthnotes, Inc.; www.healthnotes.com Iodine Source: Integrative Medicine Communications; www.drkoop.com Iodine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,888,00.html Iron Alternative names: Ferrous Sulfate Source: Integrative Medicine Communications; www.drkoop.com Selenium Source: Healthnotes, Inc.; www.healthnotes.com Zinc Source: Healthnotes, Inc.; www.healthnotes.com
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Food and Diet Beef Source: Healthnotes, Inc.; www.healthnotes.com Broccoli Source: Healthnotes, Inc.; www.healthnotes.com Brussels Sprouts Source: Healthnotes, Inc.; www.healthnotes.com Cabbage Source: Healthnotes, Inc.; www.healthnotes.com Cauliflower Source: Healthnotes, Inc.; www.healthnotes.com
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Ferrous Sulfate Source: Integrative Medicine Communications; www.drkoop.com Lima Beans Source: Healthnotes, Inc.; www.healthnotes.com Low-Salt Diet Source: Healthnotes, Inc.; www.healthnotes.com Soy Source: Healthnotes, Inc.; www.healthnotes.com Soy Source: Prima Communications, Inc.www.personalhealthzone.com Sweet Potatoes Source: Healthnotes, Inc.; www.healthnotes.com
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CHAPTER 3. ALTERNATIVE HYPOTHYROIDISM
MEDICINE
AND
Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to hypothyroidism. 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 hypothyroidism 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 “hypothyroidism” (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 hypothyroidism: •
A psychiatric study of hypothyroidism. Author(s): Jain VK. Source: Psychiatr Clin (Basel). 1972; 5(2): 121-30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5021364&dopt=Abstract
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A report of hypothyroidism induced by an over-the-counter fat loss supplement (Tiratricol). Author(s): Scally MC, Hodge A. Source: International Journal of Sport Nutrition and Exercise Metabolism. 2003 March; 13(1): 112-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660410&dopt=Abstract
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Abnormal thyroid function tests in infants with congenital hypothyroidism: the influence of soy-based formula. Author(s): Jabbar MA, Larrea J, Shaw RA. Source: Journal of the American College of Nutrition. 1997 June; 16(3): 280-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9176836&dopt=Abstract
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Adult-onset hypothyroidism and the cerebral metabolism of (1,2-13C2) acetate as detected by 13C nuclear magnetic resonance. Author(s): Chapa F, Kunnecke B, Calvo R, Escobar del Rey F, Morreale de Escobar G, Cerdan S. Source: Endocrinology. 1995 January; 136(1): 296-305. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7828544&dopt=Abstract
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Basal metabolic temperature vs. laboratory assessment in “posttraumatic hypothyroidism”. Author(s): Cassidy JD. Source: Journal of Manipulative and Physiological Therapeutics. 1996 July-August; 19(6): 425-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8864976&dopt=Abstract
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Basal metabolic temperature vs. laboratory assessment in “posttraumatic hypothyroidism”. Author(s): Sehnert KW, Croft AC. Source: Journal of Manipulative and Physiological Therapeutics. 1996 January; 19(1): 612. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8903695&dopt=Abstract
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Bone mass in children with congenital hypothyroidism treated with thyroxine since birth. Author(s): Kooh SW, Brnjac L, Ehrlich RM, Qureshi R, Krishnan S. Source: J Pediatr Endocrinol Metab. 1996 January-February; 9(1): 59-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8887134&dopt=Abstract
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Cerebral blood flow and glucose metabolism in hypothyroidism: a positron emission tomography study. Author(s): Constant EL, de Volder AG, Ivanoiu A, Bol A, Labar D, Seghers A, Cosnard G, Melin J, Daumerie C. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 August; 86(8): 3864-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11502825&dopt=Abstract
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Cerebral evoked responses in hypothyroidism. Author(s): Nishitani H, Kooi KA.
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Source: Electroencephalography and Clinical Neurophysiology. 1968 June; 24(6): 554-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4172739&dopt=Abstract •
Changes produced by experimental hypothyroidism in fibre type composition and mitochondrial properties of rat slow and fast twitch muscles. Author(s): Crespo-Armas A, Azavache V, Torres SH, Anchustegui B, Cordero Z. Source: Acta Cient Venez. 1994; 45(1): 42-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8525758&dopt=Abstract
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Cochlear action potentials in experimentally induced hypothyroidism in guinea pigs. Author(s): Rubenstein M, Perlstein TP, Hildesheimer M. Source: Acta Otolaryngol Suppl. 1975; 331: 1-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1060361&dopt=Abstract
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Complete iodide trapping defect in two cases with congenital hypothyroidism: adaptation of thyroid to huge iodide supplementation. Author(s): Leger FA, Doumith R, Courpotin C, Helal OB, Davous N, Aurengo A, Savoie JC. Source: European Journal of Clinical Investigation. 1987 June; 17(3): 249-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3040420&dopt=Abstract
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Congenital hypothyroidism. Vestibular and auditory damage in the pigmented rat. Author(s): Meza G, Acuna D, Penaloza Y, Poblano A. Source: Annals of the New York Academy of Sciences. 1991; 630: 274-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1952604&dopt=Abstract
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Congenital hypothyroidism: a review of current diagnostic and treatment practices in relation to neuropsychologic outcome. Author(s): Rovet J, Daneman D. Source: Paediatric Drugs. 2003; 5(3): 141-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608879&dopt=Abstract
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Control of breathing in patients with short-term primary hypothyroidism. Author(s): Gorini M, Spinelli A, Cangioli C, Gigliotti F, Duranti R, Arcangeli P, Scano G. Source: Lung. 1989; 167(1): 43-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2493534&dopt=Abstract
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Diagnosis and management of hypothyroidism in pregnancy. Author(s): Mooney CJ, James DA, Kessenich CR.
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Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1998 July-August; 27(4): 374-80. Review. Erratum In: J Obstet Gynecol Neonatal Nurs 1998 September-October; 27(5): 531. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9684200&dopt=Abstract •
Dietary maladvice as a cause of hypothyroidism and short stature. Author(s): Labib M, Gama R, Wright J, Marks V, Robins D. Source: Bmj (Clinical Research Ed.). 1989 January 28; 298(6668): 232-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2493871&dopt=Abstract
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Dynamics of the plasma concentrations of TSH, FT4 and T3 following thyroxine supplementation in congenital hypothyroidism. Author(s): Bakker B, Kempers MJ, De Vijlder JJ, Van Tijn DA, Wiedijk BM, Van Bruggen M, Vulsma T. Source: Clinical Endocrinology. 2002 October; 57(4): 529-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12354136&dopt=Abstract
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Effect of antioxidants (vitamin C, E and turmeric extract) on methimazole induced hypothyroidism in rats. Author(s): Deshpande UR, Joseph LJ, Patwardhan UN, Samuel AM. Source: Indian J Exp Biol. 2002 June; 40(6): 735-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587721&dopt=Abstract
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Effect of hypothyroidism on rat peripheral nervous system. Author(s): Quattrini A, Nemni R, Marchettini P, Fazio R, Iannaccone S, Corbo M, Canal N. Source: Neuroreport. 1993 May; 4(5): 499-502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8513126&dopt=Abstract
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Effect of hypothyroidism, diabetes and polyunsaturated fatty acids on heparinreleasable rat liver lipase. Author(s): Hulsmann WC, Oerlemans MC, Geelhoed-Mieras MM. Source: Biochemical and Biophysical Research Communications. 1977 December 7; 79(3): 784-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=597306&dopt=Abstract
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Effects of developmental hypothyroidism on auditory and motor function in the rat. Author(s): Goldey ES, Kehn LS, Rehnberg GL, Crofton KM. Source: Toxicology and Applied Pharmacology. 1995 November; 135(1): 67-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7482541&dopt=Abstract
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Electrocochleography in congenital hypothyroidism. Author(s): Mendel D, Robinson M.
Alternative Medicine 99
Source: Developmental Medicine and Child Neurology. 1978 October; 20(5): 664-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=729915&dopt=Abstract •
Expression of c-fos mRNA after audiogenic seizure in adult rats with neonatal hypothyroidism. Author(s): Kato N, Ishida N, Kanai H, Watanabe Y, Kuroda Y, McEwen BS. Source: Brain Research. Molecular Brain Research. 1996 May; 38(1): 85-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8737671&dopt=Abstract
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Free thyroxine as a supplement to thyrotropin in cord screening for hypothyroidism. Author(s): Joseph R, Aw TC, Tan KL. Source: Ann Acad Med Singapore. 1993 July; 22(4): 549-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8257056&dopt=Abstract
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Growth-hormone deficiency in iatrogenic hypothyroidism. Author(s): Wilkinson R, Anderson M, Smart GA. Source: British Medical Journal. 1972 April 8; 2(805): 87-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5018314&dopt=Abstract
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Hypothyroidism and hyperthyroidism in the elderly. Author(s): Mintzer MJ. Source: J Fla Med Assoc. 1992 April; 79(4): 231-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1588294&dopt=Abstract
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Hypothyroidism and nutritional status alter 3,5,3'-triiodothyronine (T3) receptors in isolated liver nuclei of Anabas testudineus (Bloch). Author(s): Shameena B, Renuka TR, Varghese S, Paulose CS, Oommen OV. Source: Endocrine Research. 2001 August; 27(3): 329-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11678580&dopt=Abstract
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Hypothyroidism in patients with thalassemia syndromes. Author(s): Magro S, Puzzonia P, Consarino C, Galati MC, Morgione S, Porcelli D, Grimaldi S, Tancre D, Arcuri V, De Santis V, et al. Source: Acta Haematologica. 1990; 84(2): 72-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2120889&dopt=Abstract
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Hypothyroidism reduces HDL binding to rat liver cells. Author(s): Fong BS, Greco AV, Angel A. Source: Atherosclerosis. 1989 September; 79(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2803342&dopt=Abstract
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Iodine-Induced hypothyroidism. Author(s): Markou K, Georgopoulos N, Kyriazopoulou V, Vagenakis AG. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 May; 11(5): 501-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11396709&dopt=Abstract
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Iodine-induced subclinical hypothyroidism in euthyroid subjects with a previous episode of amiodarone-induced thyrotoxicosis. Author(s): Roti E, Minelli R, Gardini E, Bianconi L, Gavaruzzi G, Ugolotti G, Neri TM, Braverman LE. Source: The Journal of Clinical Endocrinology and Metabolism. 1992 November; 75(5): 1273-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1331165&dopt=Abstract
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NMDA receptors in the inferior colliculus are critically involved in audiogenic seizures in the adult rats with neonatal hypothyroidism. Author(s): Higashiyama A, Ishida N, Nishimura T, Yasuda S, Kuroda Y, McEwen BS, Kato N. Source: Experimental Neurology. 1998 September; 153(1): 94-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9743570&dopt=Abstract
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Parathyroid function in patients with hyper- or hypothyroidism. Author(s): Bouillon R, De Moor P. Source: The Journal of Clinical Endocrinology and Metabolism. 1974 June; 38(6): 9991004. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4208808&dopt=Abstract
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Parathyroid function in spontaneous primary hypothyroidism. Author(s): Adams P, Chalmers TM, Riggs BL Jr, Jones JD. Source: The Journal of Endocrinology. 1968 April; 40(4): 467-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4966868&dopt=Abstract
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Parenteral selenium supplementation in extremely low birth weight infants: inadequate dosage but no correlation with hypothyroidism. Author(s): Klinger G, Shamir R, Singer P, Diamond EM, Josefsberg Z, Sirota L. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 1999 December; 19(8 Pt 1): 568-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10645521&dopt=Abstract
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Parkinson's disease presenting as hypothyroidism. Author(s): Strang RR.
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Source: Dis Nerv Syst. 1968 June; 29(6): 396-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5676814&dopt=Abstract •
Pathogenesis of autoimmune hypothyroidism induced by lymphokine-activated killer (LAK) cell therapy: in vitro inhibition of human thyroid function by interleukin-2 in the presence of autologous intrathyroidal lymphocytes. Author(s): Sato K, Yamazaki K, Shizume K, Yamakawa Y, Satoh T, Demura H, Kanaji Y, Obara T, Fujimoto Y, Aiba M, et al. Source: Thyroid : Official Journal of the American Thyroid Association. 1993 Fall; 3(3): 179-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8257856&dopt=Abstract
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Primary hypothyroidism associated with interleukin-2 and interferon alpha-2 therapy of melanoma and renal carcinoma. Author(s): Scalzo S, Gengaro A, Boccoli G, Masciulli R, Giannella G, Salvo G, Marolla P, Carlini P, Massimini G, Holdener EE, et al. Source: European Journal of Cancer (Oxford, England : 1990). 1990; 26(11-12): 1152-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2149997&dopt=Abstract
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Primary hypothyroidism-associated TSH-secreting pituitary adenoma/hyperplasia presenting as a bleeding nasal mass and extremely elevated TSH level. Author(s): Ghannam NN, Hammami MM, Muttair Z, Bakheet SM. Source: J Endocrinol Invest. 1999 June; 22(6): 419-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10435850&dopt=Abstract
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Reversible cerebral hypoperfusion observed with Tc-99m HMPAO SPECT in reversible dementia caused by hypothyroidism. Author(s): Kinuya S, Michigishi T, Tonami N, Aburano T, Tsuji S, Hashimoto T. Source: Clinical Nuclear Medicine. 1999 September; 24(9): 666-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10478741&dopt=Abstract
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Reversible hypothyroidism with EDTA chelation therapy in a patient with elevated lead burden and chronic renal insufficiency. Author(s): Lin JL, Shih FC. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1997 February; 12(2): 364-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9132667&dopt=Abstract
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Selenium decreases thyroglobulin concentrations but does not affect the increased thyroxine-to-triiodothyronine ratio in children with congenital hypothyroidism. Author(s): Chanoine JP, Neve J, Wu S, Vanderpas J, Bourdoux P.
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Source: The Journal of Clinical Endocrinology and Metabolism. 2001 March; 86(3): 11603. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11238502&dopt=Abstract •
Severe short-term hypothyroidism is not associated with an increased incidence of myocardial ischemia as assessed by thallium-201 stress/rest myocardial scintigraphy. Author(s): Prasch F, Wogritsch S, Hurtl I, Holm C, Najemnik C, Dudczak R. Source: Thyroid : Official Journal of the American Thyroid Association. 1999 February; 9(2): 155-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10090315&dopt=Abstract
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Silent myocardial ischemia in hypothyroidism. Author(s): Bernstein R, Muller C, Midtbo K, Smith G, Haug E, Hertzenberg L. Source: Thyroid : Official Journal of the American Thyroid Association. 1995 December; 5(6): 443-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8808093&dopt=Abstract
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Successful treatment of acute leukemia with t(4;11) in an infant with congenital hypothyroidism. Author(s): Tonouchi T, Mimaya J, Toyoda Y, Kaneko Y, Kawai S, Ueda R, Kondo M. Source: Am J Pediatr Hematol Oncol. 1990 Fall; 12(3): 325-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2240480&dopt=Abstract
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Surveyance of disease frequency in a population by linkage to diagnostic laboratory databases. A system for monitoring the incidences of hyper- and hypothyroidism as part of the Danish iodine supplementation program. Author(s): Pedersen IB, Laurberg P, Arnfred T, Knudsen N, Jorgensen T, Perrild H, Ovesen L. Source: Computer Methods and Programs in Biomedicine. 2002 March; 67(3): 209-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11853947&dopt=Abstract
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Taste thresholds in hyper- and hypothyroidism. Author(s): Pittman JA, Beschi RJ. Source: The Journal of Clinical Endocrinology and Metabolism. 1967 June; 27(6): 895-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6026367&dopt=Abstract
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Thyroxine supplementation. Method for the prevention of clinical hypothyroidism. Author(s): Tibaldi J, Barzel US. Source: The American Journal of Medicine. 1985 August; 79(2): 241-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3895910&dopt=Abstract
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Transient neonatal hypothyroidism due to a maternal vegan diet. Author(s): Shaikh MG, Anderson JM, Hall SK, Jackson MA.
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Source: J Pediatr Endocrinol Metab. 2003 January; 16(1): 111-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585349&dopt=Abstract •
Transient secondary hypothyroidism and thyroxine binding globulin deficiency in leukemic children during polychemotherapy: an effect of L-asparaginase. Author(s): Heidemann PH, Stubbe P, Beck W. Source: European Journal of Pediatrics. 1981 July; 136(3): 291-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6167443&dopt=Abstract
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Treatment of goitrous hypothyroidism with iodized oil supplementation in an area of iodine deficiency. Author(s): Azizi F, Kimiagar M, Ghazi A, Nafarabadi M, Behjati J, Esfahanian F. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 1996; 104(5): 387-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8957274&dopt=Abstract
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Treatment of primary hypothyroidism during pregnancy: is there an increase in thyroxine dose requirement in pregnancy? Author(s): Chopra IJ, Baber K. Source: Metabolism: Clinical and Experimental. 2003 January; 52(1): 122-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12524672&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
•
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/
•
HealthGate: http://www.tnp.com/
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WebMD®Health: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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•
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to hypothyroidism; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Cancer Prevention (Reducing the Risk) Source: Prima Communications, Inc.www.personalhealthzone.com Depression Source: Healthnotes, Inc.; www.healthnotes.com Depression (Mild to Moderate) Source: Prima Communications, Inc.www.personalhealthzone.com Erectile Dysfunction Source: Healthnotes, Inc.; www.healthnotes.com Female Infertility Source: Healthnotes, Inc.; www.healthnotes.com Glaucoma Source: Integrative Medicine Communications; www.drkoop.com High Homocysteine Source: Healthnotes, Inc.; www.healthnotes.com Hypothyroidism Source: Healthnotes, Inc.; www.healthnotes.com Hypothyroidism Source: Integrative Medicine Communications; www.drkoop.com Menopausal Symptoms (Other Than Osteoporosis) Source: Prima Communications, Inc.www.personalhealthzone.com Menopause Source: Integrative Medicine Communications; www.drkoop.com Miscarriage Source: Integrative Medicine Communications; www.drkoop.com Obesity Source: Integrative Medicine Communications; www.drkoop.com Osteoporosis Source: Prima Communications, Inc.www.personalhealthzone.com
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Spontaneous Abortion Source: Integrative Medicine Communications; www.drkoop.com Thyroid Inflammation Source: Integrative Medicine Communications; www.drkoop.com Thyroiditis Source: Integrative Medicine Communications; www.drkoop.com Vertigo Source: Healthnotes, Inc.; www.healthnotes.com •
Alternative Therapy Chelation Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,679,00.html Detoxification Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10119,00.html
•
Herbs and Supplements Beta-carotene Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10103,00.html Bugleweed Alternative names: Lycopus virginicus Source: Healthnotes, Inc.; www.healthnotes.com Forskolin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10025,00.html Horseradish Alternative names: Cochlearia armoracia Source: Healthnotes, Inc.; www.healthnotes.com Kelp Source: Healthnotes, Inc.; www.healthnotes.com Spirulina and Kelp Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10058,00.html
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St. John's Wort Source: Prima Communications, Inc.www.personalhealthzone.com Thyroid Extracts Source: Healthnotes, Inc.; www.healthnotes.com Thyroid Hormone Alternative names: Armour Thyroid, S-P-T, Thyrar Source: Prima Communications, Inc.www.personalhealthzone.com Thyroid Hormones Source: Healthnotes, Inc.; www.healthnotes.com
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON HYPOTHYROIDISM Overview In this chapter, we will give you a bibliography on recent dissertations relating to hypothyroidism. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “hypothyroidism” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on hypothyroidism, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Hypothyroidism ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to hypothyroidism. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
Heart Sarcolemmal Changes in Hypothyroidism by Daly, Michael J; PhD from the University of Manitoba (Canada), 1982 http://wwwlib.umi.com/dissertations/fullcit/NK54239
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The Effect of Hypothyroidism on Hepatic Adrenergic Receptors in the Rat by Preiksaitis, Harold G; PhD from McGill University (Canada), 1983 http://wwwlib.umi.com/dissertations/fullcit/NK64622
•
The Effects of Hypothyroidism, Colchicine and Adriamycin on the Dorsal Root Ganglia of Rats at Critical Periods of Postnatal Development an Ultrastructural Study by Eddy, Ertrice L; PhD from The University of Manitoba (Canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK43072
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Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND HYPOTHYROIDISM Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning hypothyroidism.
Recent Trials on Hypothyroidism The following is a list of recent trials dedicated to hypothyroidism.8 Further information on a trial is available at the Web site indicated. •
Evaluation of Patients with Thyroid Disorders Condition(s): Hyperthyroidism; Hypothyroidism; Pituitary Neoplasm Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Purpose - Excerpt: Participants in this study will be patients diagnosed with or suspected to have a thyroid function disorder. These conditions may include: hypothyroidism, hyperthyroidism, thyroid hormone resistance, Graves' Dermopathy, and thyroid-stimulating hormone (TSH) secreting pituitary adenomas. The main purpose of this study is to further understand the natural history, clinical presentation, and genetics of thyroid function disorders. Many of the tests performed are in the context of standard medical care that is offered to all patients with thyroid function disorders. In addition, blood and tissue samples may be taken for research and genetic studies. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001159
8
These are listed at www.ClinicalTrials.gov.
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Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “hypothyroidism” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
•
For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON HYPOTHYROIDISM Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “hypothyroidism” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on hypothyroidism, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Hypothyroidism By performing a patent search focusing on hypothyroidism, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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The following is an example of the type of information that you can expect to obtain from a patent search on hypothyroidism: •
Assay for fetal thyroid function Inventor(s): Wu; Sing-Yung (3114 Marna, Long Beach, CA 90808) Assignee(s): none reported Patent Number: 5,670,380 Date filed: July 8, 1994 Abstract: Disclosed is an assay for fetal thyroid function involving determining the amount of fetal thyroid function indicator that is present in the maternal blood and maternal urine and then comparing the determined value to a known standard for the gestation age of the fetus. It is defined as below one standard deviation of the normal values. Also disclosed is a method of treating a fetus having hypothyroidism involving determining that the fetus is hypothyroid using the assay of the present invention and thereafter, administering supplemental thyroid hormone (T.sub.4, 500 ug/wk) into the amniotic sac. Also disclosed is a method of identifying euthyroid state using the assay of the present invention in hypothyroid fetuses receiving T.sub.4 therapy. Excerpt(s): The present invention relates to methods of detecting inadequate fetal thyroid function and to treating a fetus having inadequate fetal thyroid function in order to prevent or lessen the associated sequelae. Prenatal hypothyroidism can result in a syndrome known as cretinism. This syndrome can be manifested at birth by jaundice, umbilical hernia, noisy respirations, hypotonia, depressed reflexes and lethargy, and after birth by the development of abnormal facial features, retarded bone development, enlarged tongue and constipation. Most significantly, inadequate thyroid function prior to birth can cause abnormal neurologic development including mental retardation, varying degrees of deafness and a combination of flexed posture with spasticity and rigidity of proximal limb musculature. These nervous system deficits can persist throughout life. Web site: http://www.delphion.com/details?pn=US05670380__
•
Method for treating hypercalcemia Inventor(s): Donovan; Stephen (Capistrano Beach, CA) Assignee(s): Allergan Sales, Inc. (Irvine, CA) Patent Number: 6,447,785 Date filed: November 2, 2000 Abstract: A method for treating hypothyroidism by local administration of a neurotoxin, such as a botulinum toxin, to a thyroid, thereby reducing an inhibitory effect upon thyroid hormone secretion. A method for treating hyperthyroidism by local administration of a neurotoxin, such as a botulinum toxin, to a sympathetic ganglion which innervates the thyroid, thereby reducing a stimulatory effect upon thyroid hormone secretion. Methods for treating calcium metabolism disorders by local administration of a neurotoxin to modulate calcitonin secretion are also disclosed. Excerpt(s): The present invention relates to methods for treating thyroid disorders. In particular the present invention relates to methods for treating thyroid disorders by
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administration of a neurotoxin to a patient. It has been estimated that at least about two hundred million people worldwide are afflicted with a thyroid disorder and women are affected disproportionaly, as compared to men, by a ratio of about ten to one. In the United States, about ten million persons, including ten percent of all women over age 45, have either overactive or underactive thyroid glands. Bayliss et al., Thyroid Disease The Facts, preface, Oxford University Press (1998). The thyroid is an endocrine gland comprised of follicle cells and non-follicular or C cells. The follicle cells are capable of making two hormones, triiodothyronine (T.sub.3) which contains three iodine atoms and thyroxine (T.sub.4) which contains four. The action of thyroid hormone is concerned principally with the regulation of metabolic rate by, for example, increasing energy production and oxygen consumption by most normal tissues. Synthesis and release of T.sub.3 and T.sub.4 by thyroid cells in influenced by thyroid stimulating hormone (TSH, also called thyrotrophin) made by the pituitary. The C cells can make calcitonin which appears to influence calcium metabolism. Significantly, calcitonin is a potent hypocalcemic agent. Disorders of the thyroid include autoimmune disorders (such as Graves' disease), thyroiditis (inflammation or infection of the thyroid), and cancer, all of which conditions can result in hypothyroidism (as can occur in Hashimoto's thyroiditis) or hyperthyroidism (thyroidtoxicosis, as can occur in Graves' disease). An enlarged thyroid (goiter) can by euthyroid, or a symptom of either hyperthyroidism (thyroidtoxicosis) or hypothyroidism. Web site: http://www.delphion.com/details?pn=US06447785__ •
Method of producing a 19P2 ligand Inventor(s): Masato; Suenaga (Hyogo, JP), Osamu; Nishimura (Hyogo, JP), Takeo; Moriya (Osaka, JP), Yoko; Tanaka (Kyoto, JP) Assignee(s): Takeda Chemical Industries, Ltd. (Osaka, JP) Patent Number: 6,103,882 Date filed: June 26, 1998 Abstract: The method of the present invention is suitable for the commercial high-level production of a protein or peptide which can be used as a prophylactic and therapeutic drug for various diseases such as senile dementia, cerebrovascular dementia (dementia arising from cerebrovascular disorders), dementia associated with genealogical retroplastic diseases (e.g. Alzheimer's disease, Parkinson's disease, Pick's disease, Huntington's disease, etc.), dementia associated with infectious diseases (e.g. Creutzfeldt-Jakob's and other virus diseases), dementia associated with endocrine or metabolic disease or toxicosis (e.g. hypothyroidism, vitamin B12 deficiency, alcoholism, intoxication by drugs, metals, and organic compounds), dementia associated with tumorigenic diseases (e.g. brain tumor), dementia associated with traumatic diseases (e.g. chronic subarachnoidal hemorrhage), and other types of dementia, depression, hyperactive child syndrome (microencephalopathy), and disturbance of consciousness. Additionally, the ligand polypeptide of the present invention has prolactin secretionstimulating and inhibiting activities. Excerpt(s): The present invention relates to a method of producing a 19P2 ligand (19P2L) or an amide thereof or a salt thereof which comprises preparing a fusion protein or peptide and subjecting said fusion protein or peptide to a peptide bond cleavage reaction. In the production of a protein or peptide by recombinant DNA technology, it is more or less common practice to have the protein or peptide expressed in the form of a fusion protein in view of the liability of the protein or peptide to be decomposed within
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living cells. For excision of the objective protein or peptide from the fusion protein, a chemical method for cleavage using cyanogen bromide (Itakura et al., Science, 198,1056, 1977) and an enzymatic method using factor Xa (Nagai et al., Methods in Enzymology, 153, 46, 1987) are known. Furthermore, as a method for cleavage of a peptide bond in a protein, cleavage of the acylcysteine bond with 2-nitro-5-thiocyanobenzoic acid is known [Seikagaku Jikken Koza 1, Tanpakushitsu-no-Kagaku II (Biochemical Experiment Series 1, Protein Chemistry II), Japanese Society of Biochemistry (ed.), Tokyo Kagaku Dojin, 247-250, 1976]. However, there is no disclosure on the excision of an objective protein or peptide from a protein. Web site: http://www.delphion.com/details?pn=US06103882__ •
Process for the production of thyroglobulin Inventor(s): Corkins; H. Glenn (Harriman, NY), Scarano; Louis (Harriman, NY) Assignee(s): Nepera, Inc. (Harriman, NY) Patent Number: 5,099,001 Date filed: December 28, 1989 Abstract: The invention relates to a process for the production of thyroglobulin, which is used in the treatment of hypothyroidism, from hog thyroid glands. Ground hog thyroid glands are subjected to saline digestion to produce a thyroglobulin extract. The extract is precipitated by pH adjustment and then heated to a denaturing temperature. The denatured precipitated thyroglobulin solution is subjected to a separation step to produce crude wet thyroglobulin solids. The crude thyroglobulin solids are defatted and dewatered by solvent extraction. The resultant defatted thyroglobulin product can then be further worked up, for example, by drying, milling, and screening, to produce a powdered product. In order to achieve a final product having a T.sub.4 /T.sub.3 ratio of 2.6-3.4 and upon proteolysis a minimum of 0.7.mu.g/mg of levothyronine and 2.1.mu.g/mg of liothyronine, the time periods for the precipitating, denaturing, and/or defatting steps are carefully controlled so that the T.sub.4 /T.sub.3 ratio is within this desired range. Excerpt(s): This invention relates to processes for the production of thyroglobulin. Thyroglobulin, a glycoprotein produced by the thyroid gland, functions as a source of the active hormones levothyroxine (C.sub.15 H.sub.11 I.sub.4 NO.sub.4, also referred to as thyroxine) and triiodothyronine (C.sub.15 H.sub.12 I.sub.3 NO.sub.4, also known as liothyronine and thyronine). These hormones are formed from the iodinated tryosine moieties of thyroglobulin and are released into blood by proteolysis of thyroglobulin. Thyroglobulin is utilized in the treatment of hypothyroidism, e.g., as an orally administered thyroid supplement. Specific diseases which can be treated with thyroglobulin include cretinism, myxedema, and ordinary, primary, secondary, and/or tertiary hypothyroidism. The components, structure, physical properties, and biological activity of thyroglobulin are known in the art. The product is available is prescription form. See, for example, Physicians Desk Reference 1989, p. 1593, "Proloid".RTM. brand of thyroglobulin; S. Lissitzky, Pharmacol. Ther. B 2, 219 (1976); and G. Levy et al., Am. J. Pharm. 133, 255 (1961). The source of commercially produced thyroglobulin is the thyroid glands of hogs. These glands are ground and digested in a saline solution. After separating the meat tissue, the resulting aqueous solution is further treated (e.g., precipitation, denaturing, defatting, and drying). Web site: http://www.delphion.com/details?pn=US05099001__
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•
Stabilized thyroxine compounds Inventor(s): LeClercq; Anne F. (Blacksburg, VA), Piccariello; Thomas (Blacksburg, VA) Assignee(s): New River Pharmaceuticals Inc. (Radford, VA) Patent Number: 6,627,660 Date filed: November 16, 1999 Abstract: Throxinyldimethylphosphinate was invented as a prodrug to stabilize thyroxine, a drug widely used to treat hypothyroidism. The presence of the dimethylphosphinate group at the phenolic hydroxyl of thyroxine is key to preventing thyroxine from decomposing through the proposed pathway. The prodrug will be hydrolyzed in the stomach or the gut into thyroxine and the biologically inert dimethylphosphinic acid. Related products may be stabilized with the same or similar protecting groups. Excerpt(s): This invention relates to the use of a phosphinate protecting group to stabilize thyroxine and related compounds, thus extending the shelf life of the drugs. Hypothyroidism is the most common disorder of the thyroid and is manifested through the thyroid gland's inability to produce sufficient thyroid hormone, primarily 3, 3', 5triiodothyronine (also known as T3). Symptoms associated with hypothyroidism include cold intolerance, lethargy, fatigue, chronic constipation and a variety of hair and skin changes. Although none of these conditions are life threatening, the disease, left untreated, could result in myxedema, coma, or death. The cause of hypothyroidism in the U.S. is brought about by either autoimmune destruction of the thyroid tissue (Hashimoto's disease),.sup.131 I therapy, or ablative surgery. It is estimated that 8 to 10 million people in the United States have low thyroid gland function, but only about 4 to 5 million hypothyroid cases have been diagnosed and treated. The prevalence of hypothyroidism increases with age, particularly within the female population. Web site: http://www.delphion.com/details?pn=US06627660__
•
Sustained release thyroactive composition Inventor(s): Hennemann; Georg (Rotterdam, NL), Krenning; Eric P. (Rotterdam, NL) Assignee(s): Akzo N.V. (Arnhem, NL) Patent Number: 5,324,522 Date filed: December 28, 1992 Abstract: Disclosed are sustained release dosage forms of liothyronine, in combination with normal or sustained release of thyroxine in a molar ratio of about 1 to 50:1, especially 5 to 20:1, useful in thyroid hormone replacement therapy. Surprisingly, it is found that by incorporating liothyronine and optionally thyroxine into a prolonged action dosage form in the described ratios, that the side effects associated with thyroid hormone replacement therapy are greatly reduced or eliminated. The preparation can be a dosage form containing salts of both thyroxine and liothyronine which release in a sustained manner. The preparations will typically contain 5 to 25.mu.g of liothryronine. Also disclosed are processes of manufacturing the pharmaceutical preparations. The compositions are useful in treating disease states such as hypothyroidism, hyperthyroidism (in combination with thyrostatic drugs), so-called "TSH" suppressive therapy, and depression.
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Excerpt(s): The invention relates to pharmaceutical preparations generally, and more specifically to a preparation useful in replacement therapy for thyroactive material normally supplied by the thyroid gland. The thyroid gland, among other things, modulates a body's energy metabolism. It does so by releasing various iodinated thyronines. Two of these iodinated thyronines are thyroxine (3,5,3',5'-tetraiodothyronine or "T-4") and liothyronine (3,5,3'-triiodothyronine or "T-3"). Various diseases affecting the thyroid or pituitary gland can result in hypothyroidism. Hypothyroidism can also result from thyroid surgery or treatment with radioactive iodine. In a "hypothyroid" state, the body's basal metabolic state drops, and growth and development may be impaired. Web site: http://www.delphion.com/details?pn=US05324522__
Patent Applications on Hypothyroidism As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to hypothyroidism: •
Botulinum toxin therapy for hashimoto's thyroiditis Inventor(s): Donovan, Stephen; (Capistrano Beach, CA), Voet, Martin A.; (San Juan Capistrano, CA) Correspondence: Stephen Donovan; Allergan, INC.; Legal Department, T2-7h; 2525 Dupont Drive; Irvine; CA; 92612; US Patent Application Number: 20020081319 Date filed: October 30, 2001 Abstract: Methods for treating the hypothyroidism of Hashimoto's thyroiditis by local administration of a neurotoxin, such as a botulinum toxin, to the thyroid gland of a patient. Excerpt(s): This application is a continuation in part of application Ser. No. 09/512,110, filed Feb. 24, 2000, which is a continuation in part of application Ser. No. 09/504,538, filed Feb. 15, 2000. The present invention relates to methods for treating Hashimoto's thyroiditis. In particular the present invention relates to methods for treating Hashimoto's thyroiditis by administration of a neurotoxin to a patient. Hashimoto's thyroiditis is a chronic condition and is the most common thyroid disorder, occurring in up to 2% of women and 0.2 % of men, with the incidence increasing with age. Typical symptoms of Hashimoto's thyroiditis are hypothyroidism, goiter and thyroid follicular hyperplasia. Patients with Hashimoto's thyroiditis frequently develop primary hypothyroidism as a result of the chronic autoimmune destruction of the thyroid and the presence of thyroid stimulating hormone (TSH) receptor blocking antibodies. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
10
This has been a common practice outside the United States prior to December 2000.
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HO-1 as a diagnostic and prognostic test for dementing diseases Inventor(s): Chertkow, Howard; (Westmount, CA), Schipper, Hyman M.; (Montreal, CA) Correspondence: Lorusso & Loud; 3137 Mount Vernon Avenue; Alexandria; VA; 22305; US Patent Application Number: 20020119453 Date filed: February 6, 2001 Abstract: The invention relates to a commercial package for determining the concentration of heme oxygenase-1 (HO-1) and/or a nucleotide sequence encoding HO1 in tissue obtained from a patient, wherein the commercial package is used to predict the onset of, diagnose, or prognosticate a dementing disease. The tissue is suitably plasma, lymphocytes, cerebrospinal fluid or fibroblasts. The commercial package is useful where the dementing disease is any of Alzheimer's Disease, Age-Associated Cognitive Decline, Progressive Supranuclear Palsy, Vascular (i.e. multi-infarct) Dementia, Lewy Body Dementia, Huntington's Disease, Down's syndrome, normal pressure hydrocephalus, corticobasal ganglionic degeneration, multisystem atrophy, head trauma, Creutzfeld-Jacob disease, viral encephalitis and hypothyroidism. Excerpt(s): This application is a division of U.S. application Ser. No. 09/323,248, filed Jun. 1, 1999, now allowed, which claims the benefit of U.S. Provisional Application No. 60/098,141, filed Aug. 27, 1998. This invention relates to a method for predicting, diagnosing, and prognosticating dementing diseases such as Alzheimer's Disease (AD) and Age-Associated Cognitive Decline (AACD). Alzheimer's Disease is a neurodegenerative disease which causes dementia. The period from first detection of AD to termination can range from a few years to 15 years, during which time the patient progressively suffers loss of both mental function and control of bodily functions. There is significant variability in the progress of the disease. While the majority of patients have a gradual, inexorable progression (losing on average 3 to 4 points on the 30 point Folstein mini-mental state score annually), approximately 30% of AD cases have a prolonged stable initial plateau phase lasting several years (Haxby et al., 1992). A subgroup of patients has a fulminant, rapidly progressive downhill course over several years (Mann et al., 1992). Other patients (about 10% of cohorts) remain slowly progressive, showing only gradual decline from year to year (Grossi et al., 1988). The pathological, chemical, and molecular bases of this heterogeneity remain undetermined. Recognition of the variability of AD progression represents an important clinical insight, and may explain the diagnostic difficulties presented by "atypical" cases. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Indole carboxylic acids as thyroid receptor ligands Inventor(s): Aspnes, Gary E.; (Rockville, RI), Chiang, Yuan-Ching P.; (East Lyme, CT) Correspondence: Pfizer INC.; Patent Department, Ms8260-1611; Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20030078289 Date filed: September 24, 2002 Abstract: A compound of the formula 1wherein W, R.sup.1, R.sup.2, R.sup.3, R.sup.4, R.sup.5, R.sup.6, R.sup.7, R.sup.8 and R.sup.13 are as defined herein, useful in the
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treatment of obesity, overweight condition, hyperlipidemia, glaucoma, cardiac arrhythmias, skin disorders, thyroid disease, hypothyroidism, thyroid cancer and related disorders and diseases such as diabetes mellitus, atherosclerosis, hypertension, coronary heart disease, congestive heart failure, hypercholesteremia, depression, osteoporosis and hair loss. Excerpt(s): This non-provisional application claims the benefit of U.S. provisional application No. 60/325,385, filed Sep. 26, 2001. The present invention relates to novel thyroid receptor ligands and, more preferably, relates to indole carboxylic acids, and derivatives thereof, which are useful in the treatment of obesity, overweight condition, hyperlipidemia, glaucoma, cardiac arrhythmias, skin disorders, thyroid disease, hypothyroidism, thyroid cancer and related disorders and diseases such as diabetes mellitus, atherosclerosis, hypertension, coronary heart disease, congestive heart failure, hypercholesteremia, depression, osteoporosis and hair loss. The present invention also provides methods, pharmaceutical compositions and kits for treating such diseases and disorders. Thyroid hormones are important in normal development and in maintaining metabolic homeostasis. For example, thyroid hormones stimulate the metabolism of cholesterol to bile acids and enhance the lipolytic responses of fat cells to other hormones. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Methods for diagnosing thyroid conditions and for monitoring thyroxine therapy Inventor(s): Hourihan, Joachim; (Dorchester, MA), Salhanick, Hilton A.; (Brookline, MA) Correspondence: Cooper & Dunham, Llp; 1185 Avenue OF The Americas; New York; NY; 10036; US Patent Application Number: 20020076827 Date filed: July 26, 2001 Abstract: This invention provides a method of diagnosing a thyroid condition in a subject which comprises: determining the concentration of thyroid stimulating hormone in a urine sample by a method which is not a radioimmunoassay; and comparing the concentration of thyroid stimulating hormone with a urinary concentration of thyroid stimulating hormone in a normal subject; wherein: i) a concentration of thyroid stimulating hormone which is higher than the urinary concentration of thyroid stimulating hormone in the normal subject diagnoses hypothyroidism in the subject; and ii) a concentration of thyroid stimulating hormone which is lower than the urinary concentration of thyroid stimulating hormone in the normal subject diagnoses hyperthyroidism in the subject. This invention also proves a method of monitoring thyroxine therapy. Excerpt(s): This application is a continuation-in-part of U.S. Provisional Application No. 60/220,894, filed Jul. 26, 2000, the contents of which are hereby incorpoated by reference into this application. Throughout this application, various publications are referenced by Arabic numerals. Full citations for these publications may be found at the end of the specification immediately preceding the claims. The disclosure of these publications is hereby incorporated by reference into this application to describe more fully the art to which this invention pertains. The subject invention relates to the development of urine tests for thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4), that will detect abnormal thyroid states and monitor therapy. The invention relates to the validation biochemically and clinically that urinary thyroid stimulating hormone
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(TSH) is a reliable screening procedure for hypothyroidism and is useful in monitoring therapy. The invention relates to the validation biochemically and clinically that urinary tri-iodothyronine (T3) and/or thyroxine (T4) are reliable screening procedure for hyperthyroidism. The invention relates to the development of methodology for urinary TSH, T3 and T4 tests that can be applied in the physician's office or clinic (i.e. point of care) to yield results within the time interval of a patient's visit. The invention relates to the development of methodologies which utilize application of TSH, T3 and T4 that are simple, inexpensive and conveniently rapid so that the tests can also be performed at home. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Oxamic acids and derivatives as thyroid receptor ligands Inventor(s): Chiang, Yuan-Ching Phoebe; (East Lyme, CT), Dow, Robert L.; (Waterford, CT) Correspondence: Gregg C. Benson; Pfizer INC.; Patent Department, MS 4159; Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20020049226 Date filed: September 27, 2001 Abstract: The present invention provides novel compounds of the Formula 1and prodrugs therefore, geometric and optical isomers thereof, and pharmaceutically acceptable salts of such compounds, prodrugs and isomers, wherein R.sup.1-R.sup.8 and W are as describe herein. Pharmaceutical compositions containing such compounds, prodrugs, isomers or pharmaceutically acceptable salts thereof, and methods, pharamaceutical compositions and kits for treating obesity, hyperlipidemia, glaucoma, cardiac arrhythmia, skin disorders, thyroid disease, hypothyroidism and related disorders and diseases such as diabetes mellitus, atherosclerosis, hypertension, coronary heart disease, hypercholesteremia, depression and osteoporsis are provided. Excerpt(s): This application claims priority from U.S. Provisional Patent Application No. 60/122,292 filed Mar. 1, 1999, the benefit of which is hereby claimed under 37 C.F.R.sctn.1.78(a)(3). The present invention relates to novel thyroid receptor ligands and, more particularly, relates to novel oxamic acids, and derivatives thereof, which are useful in the treatment of obesity, hyperlipidemia, glaucoma, cardiac arrhythmia, skin disorders, thyroid disease, hypothyroidism and related disorders and diseases such as diabetes mellitus, atherosclerosis, hypertension, coronary heart disease, hypercholesteremia, depression and osteoporosis. Also provided are methods, pharmaceutical compositions and kits for treating such diseases and disorders. It is generally accepted that thyroid hormones, specifically, biologically active iodothyronines, are critical to normal development and to maintaining metabolic homeostasis. Thyroid hormones stimulate the metabolism of cholesterol to bile acids and enhance the lipolytic responses of fat cells to other hormones. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Thyroid receptor ligands Inventor(s): Chiang, Yuan-Ching P.; (East Lyme, CT) Correspondence: Gregg C. Benson; Pfizer INC.; Patent Department; MS 4159, Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20010051645 Date filed: April 17, 2001 Abstract: The invention provides thiazolidinedione, oxadiazolidinedione, and triazolone compounds of Formula (I) which compounds are thyroid receptor ligands. 1The invention further provides pharmaceutical compositions and kits comprising such compounds and methods of treating obesity, overweight condition, hyperlipidemia, glaucoma, cardiac arrhythmias, skin disorders, thyroid disease, hypothyroidism, thyroid cancer, diabetes, atherosclerosis, hypertension, coronary heart disease, congestive heart failure, hypercholesterolemia, depression, and osteoporosis using such compounds. Excerpt(s): This application claims priority of U.S. provisional application No. 60/199,044, filed Apr. 21, 2000. The present invention relates to certain thiazolidinedione, oxadiazolidinedione, and triazolone compounds which are thyroid receptor ligands. The invention further relates to pharmaceutical compositions and kits comprising such thiazolidinedione, oxadiazolidinedione, and triazolone compounds and to methods of using such compounds in the treatment of obesity, overweight condition, hyperlipidemia, glaucoma, cardiac arrhythmias, skin disorders, thyroid disease, hypothyroidism, thyroid cancer, diabetes, atherosclerosis, hypertension, coronary heart disease, congestive heart failure, hypercholesterolemia, depression, and osteoporosis. 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 hypothyroidism, 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 “hypothyroidism” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on hypothyroidism. You can also use this procedure to view pending patent applications concerning hypothyroidism. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON HYPOTHYROIDISM Overview This chapter provides bibliographic book references relating to hypothyroidism. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on hypothyroidism include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “hypothyroidism” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on hypothyroidism: •
Genetic Disorders and Birth Defects: A Compendium of AAP Guidelines and Resources for the Primary Care Practitioner Source: Elk Grove Village, IL: American Academy of Pediatrics (AAP). 1997. 130 p. Contact: Available from American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (800) 433-9016 (members) or (888) 227-1773 (nonmembers). Fax (847) 434-8000. Website: www.aap.org. PRICE: $24.95 each (members); $29.95 each (nonmembers); plus shipping and handling. Order Number BMA0097. Summary: This volume provides a compendium of the American Academy of Pediatrics (AAP) guidelines and resources for health care providers who are working with patients who have genetic disorders and birth defects. The compendium serves as a diagnostic and management resource guide for pediatricians and primary care physicians.
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Although some of the disorders covered are relatively uncommon, it is likely that most pediatricians will encounter and care for a few such patients in their practice panel. The authors emphasize that early intervention services, multidisciplinary care, and developmental assessment and management form a major part of continuing care for many children with genetic conditions. The AAP Policy Statements are provided on folic acid for the prevention of neural tube defects, issues in newborn screening, maternal phenylketonuria, maternal serum alpha-fetoprotein screening, newborn screening for congenital hypothyroidism, newborn screening fact sheets, and prenatal genetic diagnosis for pediatricians. In addition, policy statements are provided for the health supervision of children born with the following conditions: achondroplasia, Down syndrome, fragile X syndrome, Marfan syndrome, neurofibromatosis, sickle cell disease, and Turner syndrome. Each Policy Statement includes references. The compendium includes extensive appendices, covering topics including fetal alcohol syndrome, general principles of care for children and adolescents with genetic and other chronic health conditions, hospital stays, medical homes, preventive pediatric health care, and transition of care provided for adolescents with special health care needs. The compendium also lists the references where the policy statements were first published, the contact information for national and regional genetic organizations, and the members of the AAP Section on Genetics and Birth Defects.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “hypothyroidism” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “hypothyroidism” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “hypothyroidism” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Congenital Hypothyroidism by Jean H. Dussault (Editor), Peter Walker (Editor); ISBN: 0824770064; http://www.amazon.com/exec/obidos/ASIN/0824770064/icongroupinterna
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How I Reversed My Hashimoto's Thyroiditis Hypothyroidism by Robert T. Dirgo (Compiler), Mary Dirgo (Editor) (2001); ISBN: 059516708X; http://www.amazon.com/exec/obidos/ASIN/059516708X/icongroupinterna
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Hypothyroidism & Goitre by Lazurus (1997); ISBN: 0702012955; http://www.amazon.com/exec/obidos/ASIN/0702012955/icongroupinterna
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Hypothyroidism : discussions in patient management by John F. Hennessy; ISBN: 0874888980; http://www.amazon.com/exec/obidos/ASIN/0874888980/icongroupinterna
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Hypothyroidism: How Do You Know by Michelle Fenton (2002); ISBN: 1591291968; http://www.amazon.com/exec/obidos/ASIN/1591291968/icongroupinterna
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Hypothyroidism: The Unsuspected Illness by Broda Barnes (Author) (1976); ISBN: 069001029X; http://www.amazon.com/exec/obidos/ASIN/069001029X/icongroupinterna
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Living Well with Hypothyroidism: What Your Doctor Doesn't Tell You. That You Need to Know by Mary J. Shomon (Author); ISBN: 0380808986; http://www.amazon.com/exec/obidos/ASIN/0380808986/icongroupinterna
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Research in Congenital Hypothyroidism (NATO Asi Series A, Life Sciences, Vol 161) by F. Delange, et al (1989); ISBN: 0306431416; http://www.amazon.com/exec/obidos/ASIN/0306431416/icongroupinterna
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The First Year - Hypothyroidism: An Essential Guide for the Newly Diagnosed by Maureen Pratt, Elliot G., Md. Levy (2003); ISBN: 1569244960; http://www.amazon.com/exec/obidos/ASIN/1569244960/icongroupinterna
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What Your Doctor May Not Tell You About Hypothyroidism: A Simple Plan for Extraordinary Results by Ph.D. Ken M.D. Blanchard (Author) (2004); ISBN: 0446690619; http://www.amazon.com/exec/obidos/ASIN/0446690619/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “hypothyroidism” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 •
AACE clinical practice guidelines for the evaluation and treatment of hyperthyroidism and hypothyroidism Author: American Association of Clinical Endocrinologists.; Year: 1996; [Jacksonville, Fla.?: The Association?, 1995?]
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Adrenergic receptor response in hypothyroidism; an in vitro study on human adipose tissue and rabbit aorta. Author: Rosenqvist, Urban.; Year: 1972; Orsa, 1972
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Cochlear action potentials in experimentally induced hypothyroidism in guinea pigs Author: Rubinstein, M.; Year: 1975; Uppsala; Stockholm: Distributed by Almqvist; Wiksell, 1975
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Current concepts in hypothyroidism. Author: Crispell, Kenneth Raymond,; Year: 1963; Oxford, Symposium Publications Division, Pergamon Press, 1963
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Hypothyroidism and goitre Author: Evered, David.; Year: 1960; London; Philadelphia: Saunders, 1979
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Infantile hypothyroidism then and now: the results of neonatal screening Author: Klein, Robert Z.; Year: 1964; Chicago: Year Book Medical Publishers, c1985
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Management of infants with congenital hypothyroidism Author: Mitchell, Marvin L.; Year: 1982; Rockville, Md.: U.S. Dept. of Health and Human Services, Public Health Service, Health Services Administration, Office for Maternal and Child Health, 1981
11
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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The influence of lithiumcarbonate on the hypothalamic-pituitary-thyroid axis: studies in patients with affective disorders, thyrotoxicosis and hypothyroidism Author: Bakker, Karel.; Year: 1995; [S.l.: s.n., 1977?]
Chapters on Hypothyroidism In order to find chapters that specifically relate to hypothyroidism, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and hypothyroidism using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “hypothyroidism” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on hypothyroidism: •
Metabolic Disorders Source: in Gerber, S.E. Etiology and Prevention of Communicative Disorders. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1998. p. 217-231. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $65.00 plus shipping and handling. ISBN: 1565939476. Summary: Metabolism is the total exchange of energy and chemical matter of any living cell. This chapter on metabolic disorders is from a textbook that focuses on the primary and secondary prevention of communicative disorders. The author considers three categories of metabolic disorders that have significance for communication: thyroid disorders, the mucopolysaccharidoses, and diabetes. There are more than three categories of metabolic disorders, but these are more common and more serious than others. All of them may have sequelae in the domains of speech, language, and hearing; in neuromotor and neurosensory function; and in cognitive development. Specific topics covered include congenital hypothyroidism, Pendred syndrome, mucopolysaccaridosis, Hurler syndrome, Hunter syndrome, childhood diabetes, and gestational diabetes. The chapter concludes with a glossary of terms and a reference list. 6 figures. 55 references.
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Systemic Disease: Oral Manifestations and Effects on Oral Health Source: in Wray, D., et al. Textbook of General and Oral Medicine. Edinburgh, Scotland: Churchill Livingstone. 1999. p. 307-328. Contact: Available from Harcourt Health Sciences. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 325-4177. Fax (800) 874-6418. Website: www.harcourthealth.com. PRICE: $50.00 plus shipping and handling. ISBN: 0443051895. Summary: Oral lesions and symptoms are usually the result of local disease, but can be the earliest indication of, or in some instances the main features in, patients with systemic disease. Indeed, oral manifestations can sometimes lead to the diagnosis of systemic disease. This chapter on the oral manifestations of systemic disease is from an undergraduate dentistry textbook that covers both general medicine and surgery, and oral medicine, emphasizing the overlap between them. The authors note that there are surprisingly few diseases, or their treatments, that are not capable of causing some oral
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signs or symptoms or affecting oral health care. Topics include blood disorders, including anemia, the thalassemias, lymphoreticular malignancy, myeloproliferative disorders, plasma cell tumors (myeloma), and porphyria; hemorrhagic diseases, including platelet disorders, Von Willebrand's disease, clotting disorders, and acquired clotting defects; cardiovascular disease, including patients with cardiac pacemakers, and oral reactions to drugs used for heart disease; endocrine (hormone) disorders, including acromegaly, adrenocortical insufficiency, corticosteroid treatment, diabetes mellitus, hyperthyroidism, hypothyroidism, hyperparathyroidism, and hypoparathyroidism; gastrointestinal disorders, including celiac disease (gluten sensitive enteropathy), Crohn's disease, Gardner's syndrome, and pyostomatitis vegetans; granulomatous diseases, including foreign body reactions, midline granuloma syndromes, orofacial granulomatosis, and sarcoidosis; immunological disorders, including allergy that may manifest as angioedema, aphthae, contact cheilitis, erythema multiforme, lichen planus, orofacial granulomatosis, and plasma cell gingivitis; nutritional deficiencies, including vitamin A, riboflavin (vitamin B2), nicotinamide, vitamin B12 and folic acid, vitamin C, and vitamin D; pregnancy; and renal disease. Clinical points to remember are highlighted in text boxes. 16 figures. 31 tables. •
Oral Medicine Source: in Sonis, S.T., ed. Dental Secrets: Questions You Will Be Asked On Rounds, In the Clinic, On Exams, On Boards. Philadelphia, PA: Hanley and Belfus, Inc. 1994. p. 1732. Contact: Available from Hanley and Belfus, Inc. Medical Publishers, 210 South 13th Street, Philadelphia, PA 19107. (800) 962-1892 or (215) 546-7293; Fax (215) 790-9330; http://www.hanleyandbelfus.com. PRICE: $36.95 plus shipping and handling. ISBN: 1560530634. Summary: Presented in a question and answer format, this book chapter on oral medicine is from a mini-textbook that can be used as a review for examinations, rounds, and clinical discussions. Topics covered include disorders of hemostasis, including patient indications for surgery, gingival bleeding, and the use of warfarin; indications for prophylactic antibiotics, including the specific antibiotics and dosages recommended by the American Heart Association; treatment of HIV-positive patients; cardiovascular disease, including the emergency management of a possible cardiovascular event; metabolic disorders, including diabetes mellitus, patients on corticosteroids, and hypothyroidism; allergic reactions, including the symptoms of anaphylaxis; hematology and oncology, including sickle cell anemia, leukemia, chemotherapy, and radiation therapy; kidney disease, including patients on dialysis and patients with kidney transplants; pulmonary disease; liver disease; and seizures. This book chapter provides specific management strategies, including the recommended drug administration and dosages. 3 tables. 16 references.
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Oral Signs of Systemic Disease Source: in Fenton, S.J.; Perlman, S.; Turner, H., eds. Oral Healthcare for People with Special Needs: Guidelines for Comprehensive Care. River Edge, NJ: Exceptional Parent, Psy-Ed Corp. 2003. p. 29-33. Contact: Available as part of a monograph from Exceptional Parent, Psy-Ed Corp. 65 East Route 4, River Edge, NJ 07661. (800) EPARENT or (800) 372-7368. E-mail:
[email protected]. Website: www.eparent.com. PRICE: Contact publisher.
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Summary: The mouth has often been called the barometer of a person's health. Serious illnesses, conditions or genetic disorders may first present with mouth conditions such as unusual bleeding or multiple lumps and bumps in the mouth, extra or missing teeth, or their premature loss. These mouth changes are frequently helpful in determining the underlying disease or its cause. This article on the oral signs of systemic disease is from a monograph that offers guidelines for the comprehensive oral health care for people with special needs. The monograph is designed to help oral health care providers embrace more fully all the members of their communities, while being respectful of a variety of special needs. In this article, the authors consider unusual bleeding in the mouth, infectious mononucleosis, measles, hemophilia, leukemia, vitamin C and K deficiencies, multiple lumps or bumps in the mouth, enlarged tongue, hypothyroidism, Beckwith-Widemann syndrome, the mucopolysaccharidoses, multiple neoplasia syndrome type 2B, neurofibromatosis, granulomatous diseases, and extra or missing teeth, or premature loss of teeth. •
Oral Manifestations of Endocrine Disorders Source: in Bork, K., et al. Diseases of the Oral Mucosa and the Lips. Orlando, FL: W.B. Saunders Company. 1993. p. 364-365. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522 (individuals) or (800) 782-4479 (schools); Fax (800) 874-6418 or (407) 352-3445; http://www.wbsaunders.com. PRICE: $99.00 plus shipping and handling. ISBN: 0721640397. Summary: This brief chapter, from a textbook on diseases of the oral mucosa and the lips, discusses the oral manifestations of endocrine disorders. Disorders covered are diabetes mellitus, hypothyroidism (congenital and acquired), and Addison's disease. For each disorder, the authors describe the clinical features and present brief diagnostic and therapeutic recommendations. For diabetes, only patients with poorly controlled disease are likely to have oral symptoms. All the different forms of hypothyroidism may have oral findings. In Addison's disease, the presence of oral mucosal involvement may be a valuable diagnostic sign. (AA-M).
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Endocrinology in the Rheumatic Diseases Source: in Maddison, P.J.; et al., Eds. Oxford Textbook of Rheumatology. Volume 1. New York, NY: Oxford University Press, Inc. 1993. p. 146-154. Contact: Available from Oxford University Press, Inc., New York, NY. Summary: This chapter for health professionals examines the involvement of the endocrine system in rheumatic diseases. The rheumatological manifestations of various thyroid diseases are described, including those of hypothyroidism, thyrotoxicosis, hyperparathyroidism, and hypoparathyroidism. The rheumatological manifestations of acromegalic arthropathy are highlighted. The musculoskeletal manifestations of diabetes mellitus are discussed, including the syndrome of limited joint mobility, articular syndromes, neuropathic joints, and soft-tissue rheumatological syndromes. In addition, polyglandular autoimmune syndromes are described. 58 references, 5 figures, and 3 tables.
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How Vocal Abilities Can Be Limited by Endocrine System Diseases and Disorders Source: in Thurman, L. and Welch, G., eds. Bodymind and Voice: Foundations of Voice Education, Volumes 1-3. 2nd ed. Collegeville, MN: VoiceCare Network. 2000. p. 556-563.
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Contact: Available from National Center for Voice and Speech (NCVS). Book Sales, 334 Speech and Hearing Center, University of Iowa, Iowa City, IA 52242. Website: www.ncvs.org. PRICE: $75.00 plus shipping and handling. ISBN: 0874141230. Summary: This chapter on endocrine system diseases and disorders is from a multivolume text that brings a biopsychosocial approach to the study of the voice. The authors use the phrase 'bodyminds' to describe the interrelationship of perception, memory, learning, behavior, and health, as they combine to affect all environmental interactions, adaptations, and learning. The books are written for teachers, voice professionals, people who use their voices on an avocational basis, and interested members of the general public. This chapter describes how the hormones produced by the endocrine system stimulate or inhibit the body's organs and systems during physical growth and development, and they participate in the metabolic ecology of the body. When abnormal fluctuations occur in the endocrine system, unfortunate consequences to human neuropsychobiological functioning are common. Topics include general endocrine imbalances, diabetes mellitus, thyroid gland disorders (hyperthyroidism, hypothyroidism), adrenal gland disorders, sexual hormones (processes, imbalances, and disorders), the menstrual cycle, pregnancy, and menopause. 54 references. •
Medical and Surgical Treatment of Cochlear Hearing Loss Source: in Valente, M.; Hosford-Dunn, H.; Roeser, R.J., eds. Audiology: Treatment. New York, NY: Thieme. 2000. p. 377-396. Contact: Available from Thieme. 333 Seventh Avenue, New York, NY 10001. (800) 7823488. Fax (212) 947-0108. E-mail:
[email protected]. PRICE: $69.00 plus shipping and handling. ISBN: 0865778590. Summary: This chapter on the medical and surgical management of cochlear hearing loss is from a textbook that provides a comprehensive overview of the numerous treatment options available to help patients relieve the clinical symptoms seen in an audiology practice. Cochlear hearing loss may be caused by a wide variety of medical problems; it is the responsibility of the practitioner to identify the cause of hearing loss and to evaluate the other potential associated medical ramifications to treat the patient as a whole. Topics covered include metabolic disorders, including Meniere's disease, diabetes mellitus, renal disease, hypothyroidism, and cochlear otosclerosis; immunologic disorders, including autoimmune inner ear disease, Cogan's syndrome, polyarteritis nodosa, Vogt Koyanagi Harada syndrome, Wegener's granulomatosis, sarcoidosis, and postapedectomy granuloma; ototoxicity, including that from aminoglycoside antibiotics, erythromycin, vancomycin, other antibiotics, loop diuretics, antineoplastic (chemotherapy) agents, antiinflammatory agents, and antimalarials; trauma, including temporal bone fractures, noise trauma, and barotrauma (from barometric pressure changes); infections, including cytomegalovirus, toxoplasmosis, congenital rubella, mumps, measles, Varicella Zoster virus, HIV, other viruses and Mycoplasma, meningitis, labyrinthitis, fungal infections, and syphilis; malignancy; presbycusis; sudden idiopathic sensorineural hearing loss; and hereditary or development causes. The authors stress that complete audiological assessments are crucial in the initial evaluation and subsequent therapeutic monitoring of sensorineural hearing losses. The chapter includes an outline of the topic covered, a list of references, a summary outline of the related preferred practice guidelines, and various 'pearls and pitfalls' offering practical advice to the reader. 11 figures. 1 table. 67 references.
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Tinnitus: For Whom the Bell Tolls-and Tolls, and Tolls Source: in Rosenfeld, I. Live Now, Age Later: Proven Ways to Slow Down the Clock. New York, NY: Warner Books. 1999. p. 311-321. Contact: Available from Warner Books. 1271 Avenue of the Americas, New York, NY 10020. (800) 759-0190. E-mail:
[email protected]. Website: www.twbookmark.com. PRICE: $7.99 plus shipping and handling. Summary: This chapter on tinnitus is from a book that offers practical strategies and healthy living advice for people who want to slow down their own aging process. The book is written in casual language with an emphasis on explaining medical and health issues for the general public. The chapter first defines tinnitus (ringing or other sounds in the ears) and describes how it can occur. The author describes two types of tinnitus, objective tinnitus (someone else can hear the sounds) and subjective tinnitus (only the patient can hear the sounds). Causes of tinnitus can include wax in the ear canal, high blood pressure, prolonged bouts of high blood glucose (sugar), arthritis, neurological processes, emotional stress, drug therapy, food allergies, alcohol use, marijuana, caffeine, nicotine, Meniere's disease, otosclerosis (a bone disease), repeated exposure to loud noise, hypothyroidism (underfunction of the thyroid gland), infections, tooth grinder, and high cholesterol. The author also reviews the treatment options for the tinnitus of aging. The chapter concludes with a brief summary of the points covered, focusing on the ways to reduce the negative impact of tinnitus.
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Vertigo of Peripheral Origin Source: in Canalis, R.F. and Lambert, P.R., eds. Ear: Comprehensive Otology. Philadelphia, PA: Lippincott Williams and Wilkins. 2000. p. 647-664. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030. Fax (301) 223-2300. Website: www.lww.com. PRICE: $179.00 plus shipping and handling. ISBN: 078171558X. Summary: This chapter on vertigo of peripheral origin is from a textbook that offers complete coverage of the field of clinical otology (study of the ear). The book is oriented to serve both the otolaryngology resident as a practical learning tool and the practicing otolaryngologist as an updated reference source of clinical and basic information. Topics include differentiating types of dizziness; the mechanisms of vertigo; features of peripheral vertigo, including time course, precipitating factors, associated symptoms, compensation, and predisposing factors; benign positional vertigo; infections of the inner ear, including bacterial infections, viral neurolabyrinthitis, syphilitic infections of the inner ear, and differential diagnosis of labyrinthitis; Meniere's disease; vascular diseases of the inner ear; tumors of the ear and temporal bone (malignant and benign); trauma, including temporal bone fractures, labyrinthine concussion, posttraumatic positional vertigo, perilymph fistula, and the differential diagnosis of posttraumatic inner ear disorders; metabolic disorders, including diabetes mellitus, uremia, hypothyroidism, otosclerosis, Paget's disease, and management of inner ear metabolic disorders; acute alcohol intoxication; ototoxins (medications that can damage the ear), including aminoglycosides, salicylates, and cisplatinum; and autoimmune inner ear disease. For each condition, the author covers clinical features, mechanisms, diagnosis, and treatment options. 2 figures. 5 tables. 75 references.
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Chapter 21-C: Vasculitides: Giant Cell Arteritis, Polymyalgia Rheumatica, and Takayasu's Arteritis Source: in Klippel, J.H., et al., eds. Primer on the Rheumatic Diseases. 12th ed. Atlanta, GA: Arthritis Foundation. 2001. p. 397-405. Contact: Available from Arthritis Foundation. P.O. Box 1616, Alpharetta, GA 300091616. (800) 207-8633. Fax (credit card orders only) (770) 442-9742. Website: www.arthritis.org. PRICE: $69.95 plus shipping and handling. ISBN: 0912423293. Summary: This chapter provides health professionals with information on the epidemiology, etiology, pathogenesis, clinical features, diagnosis, and treatment of giant cell arteritis (GCA), polymyalgia rheumatica (PMR), and Takayasu's arteritis (TA). GCA, also known as temporal arteritis, occurs more frequently in women than in men and is most likely to occur in people older than 50 years. The prevalence is highest in Scandinavian countries and in regions settled by people of northern European descent. This suggests an inherited risk. GCA presents with two major symptomatic complexes: signs of vascular insufficiency resulting from impaired blood flow and signs of systemic inflammation. The extracranial branches of the carotid arteries are most often affected. The predominant histologic feature of GCA is a mononuclear cell infiltrate dominated by T lymphocytes and macrophages that penetrate all layers of the wall of a mid sized artery. There is no pathognomonic laboratory test for GCA, and specific autoantibodies have not been identified. Diagnosis is based on clinical features and arterial biopsy results. Corticosteroids are effective in suppressing the symptoms. No other immunosuppressive agent used to manage other rheumatic diseases has proved useful in treating GCA. Vision loss, the most feared complication of GCA, can be prevented with early diagnosis and prompt treatment. PMR, a syndrome of muscle pain and stiffness in the neck, shoulders, and hips, can accompany, precede, or follow GCA, but it may also occur independently. The disease appears more frequently in women than in men and is more prevalent in Scandinavians and people of northern European descent. The cause of PMR is unknown. Most pathogenic abnormalities in people who have PMR are similar to those of GCA, supporting the emerging concept that PMR is a GCA variant characterized by dominance of the systemic inflammatory syndrome over the vascular component. The onset of PMR is abrupt and the myalgias are symmetrical and initially affect the shoulders. Malaise, weight loss, sweats, and low grade fever are common. The diagnosis of PMR is a clinical one. The differential diagnosis includes arthropathies, shoulder disorders, inflammatory myopathies, hypothyroidism, Parkinson's disease, malignancies, and infections. Although PMR is responsive to corticosteroid therapy, a critical issue in treating the disease is the dosage required for successful suppression of symptoms because the steroid requirements may differ markedly among patients. PMR is self limiting in most patients. TA is a rare granulomatous polyarteritis of the large elastic arteries, but it also may affect the coronary and pulmonary arteries. The disease affects primarily adolescent girls and young women. Incidence rates are highest in Asia. Although the etiology of TA is unknown, microbial infections have been implicated; however, no conclusive evidence for infectious organisms has been found. Clinical manifestations include fever, night sweats, malaise, anorexia, weight loss, diffuse myalgias, neurologic and ophthalmologic symptoms, and cardiac disease. Diagnosis is made by characteristic findings on vascular imaging. Corticosteroids are the therapy of choice for TA. Early diagnosis, immunosuppression, and aggressive surgical management have led to improved prognosis. 4 figures and 21 references.
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Nutritional Implications of Taste and Smell Disorders Source: in Doty, R.L., ed. Handbook of Olfaction and Gustation. New York, NY: Marcel Dekker, Inc. 1995. p. 731-744. Contact: Available from Marcel Dekker, Inc. 270 Madison Avenue, New York, NY 10016. (800) 228-1160 or (212) 696-9000; Fax (212) 685-4540. PRICE: $225.00 plus shipping and handling. ISBN: 0824792521. Summary: This chapter, from a medical text on olfaction and gustation, summarizes the chemosensory changes associated with cancer, hypertension, hypothyroidism, obesity, diabetes, renal disease, and liver diseases; these changes are then related to the dietary practices of these patient groups. The author notes that experience from chemosensory clinical research centers has provided insights for using dietary approaches to promote optimal nutrition and enhance the quality of life for patients with taste and/or smell abnormalities, but no approaches have been systemically evaluated. The author presents a consideration of the best available guidelines in this area. Finally, the author focuses on the effects of chemosensory disorders on diet and nutritional status. The effects of nutritional status on chemosensory function are not addressed. 101 references. (AA-M).
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Metabolic and Endocrine Disorders Source: in Grundy, M.C.; Shaw, L.; and Hamilton, D.V. Illustrated Guide to Dental Care for the Medically Compromised Patient. St. Louis, MO: Mosby-Year Book, Inc. 1993. p. 51-59. Contact: Available from Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-9934. (800) 426-4545 or (314) 872-8370; Fax (800) 535-9935 or (314) 4321380; E-mail:
[email protected]; http://www.mosby.com. PRICE: $24.95 plus shipping and handling. ISBN: 0815140223. Summary: This chapter, from an illustrated guide to dental care for medically compromised patients, discusses metabolic and endocrine disorders. The chapter's topics include diabetes mellitus (insulin-dependent and noninsulin-dependent), including hypoglycemia and hyperglycemia; phenylketonuria; adrenocortical diseases; Addison's disease, including secondary adrenal insufficiency and Cushing's syndrome; thyroid disorders, including hyperthyroidism and hypothyroidism; and parathyroid disorders. For each condition, the authors provide a brief description, the components of medical management, and suggestions for dental care. Illustrations, including photographs, are included. 5 figures.
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Endocrine Regulation of Calcium and Phosphate Metabolism Source: in Porterfield, S.P. Endocrine Physiology. 2nd ed. St. Louis, MO: Mosby, Inc. 2001. p. 107-129. Contact: Available from Harcourt Health Sciences. Foots Cray High Street, Sidcup, Kent DA14 5HP, United Kingdom. 020 8308 5700. Fax 020 8308 5702. E-mail:
[email protected]. PRICE: $32.95 plus shipping and handling. ISBN: 0323011284. Summary: This chapter, which is part of a textbook on endocrine physiology, focuses on endocrine regulation of serum calcium and phosphate. The chapter begins with an examination of the role of calcium and phosphate in the body. This is followed by a discussion of serum calcium and phosphate levels and serum calcium and phosphate balance. The chapter then describes the role of osteoblasts, osteocytes, and osteoclasts in bone metabolism and identifies major growth factors in bone such as insulin like growth
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factors. These components, which are mitogenic polypeptides that resemble insulin structure and function, are present in bone matrix. They stimulate bone and cartilage growth and increase osteoblast proliferation. Insulin and growth hormone control their production. The chapter next discusses parathyroid hormone, calcitonin, and vitamin D in terms of their structure, control of secretion, and actions on bone and kidney. The actions of other hormones are also highlighted, including estrogens, glucocorticoids, and thyroid hormones. In addition, the chapter describes pathologic disorders of calcium and phosphate balance, including hyperparathyroidism, hypercalcemia of malignancy, pseudohypoparathyroidism, hypothyroidism, vitamin D deficiency, Paget's disease, and bone problems of renal failure. The chapter includes a list of key words and concepts and presents self-study problems. 15 figures. 1 table. 11 references.
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CHAPTER 8. MULTIMEDIA ON HYPOTHYROIDISM Overview In this chapter, we show you how to keep current on multimedia sources of information on hypothyroidism. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Bibliography: Multimedia on Hypothyroidism The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in hypothyroidism (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on hypothyroidism: •
Congenital hypothyroidism [videorecording] Source: produced by UT/TV-Houston, the University of Texas Health Science Center at Houston; Year: 1990; Format: Videorecording; [Houston, Tex.: UT/TV], c1990
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Hypothyroidism: diagnosis in management [videorecording] Source: Department of Medicine, Emory University, School of Medicine; Year: 1980; Format: Videorecording; Atlanta: Emory Medical Television Network: [for loan or sale by A. W. Calhoun Medical Library], 1980
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Hypothyroidism [videorecording] Source: [presented by] Medical Video Library; coproduced by IMS, Faculty of Medicine, University of Toronto and Medical Productions and Associates; Year: 1989; Format: Videorecording; [Toronto, Ont.]: Burn-Shield, [1989]
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Hypothyroidism [videorecording]: new thoughts about an old disease Source: presented by the Department of Medicine, Emory University, School of Medicine; Year: 1986; Format: Videorecording; Atlanta, Ga.: The University, 1986
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CHAPTER 9. PERIODICALS HYPOTHYROIDISM
AND
NEWS
ON
Overview In this chapter, we suggest a number of news sources and present various periodicals that cover hypothyroidism.
News Services and Press Releases One of the simplest ways of tracking press releases on hypothyroidism is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “hypothyroidism” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to hypothyroidism. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “hypothyroidism” (or synonyms). The following was recently listed in this archive for hypothyroidism: •
Primary hypothyroidism linked to reduced incidence of breast cancer Source: Reuters Medical News Date: April 07, 2003
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Hypothyroidism a sequela of cranial irradiation of pediatric brain tumor Source: Reuters Medical News Date: February 21, 2003
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Thyroid oxidase gene mutations linked to congenital hypothyroidism Source: Reuters Medical News Date: July 12, 2002
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Estrogen therapy may necessitate increase in thyroxine dose for hypothyroidism Source: Reuters Industry Breifing Date: June 06, 2001
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Abbott Laboratories to file NDA for hypothyroidism drug Source: Reuters Industry Breifing Date: April 30, 2001
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Hypothyroidism linked to greater miscarriage risk Source: Reuters Medical News Date: November 22, 2000
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Watson to market Jerome Stevens' hypothyroidism therapy Source: Reuters Industry Breifing Date: October 17, 2000
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Hypothyroidism develops in 15% of patients treated for advanced head and neck cancer Source: Reuters Medical News Date: June 05, 2000
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Early, adequate treatment reduces consequences of congenital hypothyroidism Source: Reuters Medical News Date: April 07, 2000
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Subclinical hypothyroidism may be major risk factor for CVD in postmenopausal wome Source: Reuters Medical News Date: February 15, 2000
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Elevated homocysteine levels accompany hypothyroidism and stroke Source: Reuters Medical News Date: September 13, 1999
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Retinoid X receptor activation may lead to hypothyroidism Source: Reuters Medical News Date: April 12, 1999
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Migraine history linked with higher frequency of hypothyroidism headache Source: Reuters Medical News Date: April 08, 1999
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Combination therapy for hypothyroidism improves mood, cognitive performance Source: Reuters Medical News Date: February 11, 1999
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Four Hypothyroidism Drugs Bioequivalent And Interchangeable Source: Reuters Medical News Date: April 16, 1997
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Women With Hypothyroidism Require More Thyroxine During Pregnancy Source: Reuters Medical News Date: October 18, 1995
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Smoking Exacerbates Hypothyroidism Source: Reuters Medical News Date: October 12, 1995
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Hypothyroidism Common Finding In Dyslipidemic Individuals Source: Reuters Medical News Date: July 24, 1995
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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “hypothyroidism” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “hypothyroidism” (or synonyms). If you know the name of a company that is relevant to hypothyroidism, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.
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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “hypothyroidism” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “hypothyroidism” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on hypothyroidism: •
Early and Late Side Effects of Radiation Therapy for Head and Neck Cancers Source: News from SPOHNC. News from Support for People with Oral and Head and Neck Cancer, Inc. 10(4): 1-3. Winter 2000. Contact: Available from Support for People with Oral and Head and Neck Cancer, Inc. (SPOHNC). P.O. Box 53, Locust Valley, NY 11560-0053. (516) 759-5333. E-mail:
[email protected]. Website: www.spohnc.org. Summary: Radiation therapy plays an important role in the treatment of head and neck cancers. With the new imaging modalities and sophisticated treatment planning and delivery systems, it is possible today to deliver radiation more precisely, but still not without some side effects to the normal tissues in the vicinity of the tumor bearing area. This article briefly discusses the early and late side effects of curative irradiation for head and neck cancers. Early side effects discussed include fatigue, radiation dermatitis (skin changes in the area under treatment, something like sunburn), mucositis (inflammation of the mucous membranes lining the mouth and throat), loss of taste and smell, and impaired hearing. Late side effects (more than 3 months after radiation therapy) discussed include xerostomia (dry mouth), osteoradionecrosis (bone disease, notably necrosis or death of the jawbone), dry eyes, hair loss, laryngeal edema (swelling of the voice box), hypothyroidism, delayed wound healing, stiffness in the muscles that open and close the mouth, and risk of secondary cancers. The authors briefly describe each of these problems, how they may be treated, and what the patient can expect in terms of recovery.
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Maybe It's Your Thyroid. Source: Consumer Reports on Health. 13(5):8-10. May 2001. Contact: Consumers Union of United States, Inc., 101 Truman Avenue, Yonkers, NY 1073-1057. Summary: The thyroid gland adjusts the body's metabolism by secreting energyregulating hormones. Disease, viral infections, surgery, and other factors can cause the thyroid to secrete too few hormones, called hypothyroidism, or too many, termed hyperthyroidism. Each disease causes various symptoms and complications.
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Hypothyroidism can bring about modest weight gain, while hyperthyroidism can produce moderate-to-severe weight loss. The article reviews who should be screened for thyroid function, who should be treated for hypothyroidism, and how and when to treat hyperthyroidism. A sidebar discusses a screening test for thyroid disease. •
Musculoskeletal Manifestations of Thyroid Disease Source: Bulletin on the Rheumatic Diseases. 49(11): 1-4. 2001. Contact: Available from Arthritis Foundation. 1330 West Peachtree Street, Atlanta, GA 30309. (800) 268-6942 or (404) 872-7100. Fax (404) 872-9559. Website: www.arthritis.org. Summary: This newsletter article provides health professionals with information on evaluating and treating the musculoskeletal manifestations of thyroid disease. Thyroid disease can cause musculoskeletal symptoms that mimic known rheumatic syndromes. Hypothyroidism and thyrotoxicosis can affect the musculoskeletal system. The manifestations of congenital hypothyroidism and hypothyroidism occurring in childhood are usually dominated by cognitive deficiencies and developmental delays. In adults, hypothyroidism may result from autoimmune and postablative mechanisms, pituitary failure, or iodine deficiency. Hypothyroid adults usually have manifestations consistent with low basal metabolic rate. An arthropathy may occur, or hypothyroidism may be confused with fibromyalgia. Hypothyroidism is also associated with other musculoskeletal and rheumatic diseases, including polymyositis, carpal tunnel syndrome, avascular necrosis of the hip, polymyalgia rheumatica, giant cell arteritis, rheumatoid arthritis, and systemic lupus erythematosus. Thyrotoxicosis may also have musculoskeletal manifestations, including myopathy, osteoporosis, and shoulder pain. Graves' disease, an autoimmune disease caused by antibodies directed against the TSH receptor in the thyroid, is associated with pretibial myxedema and thyroid acropachy. 2 tables and 35 references.
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Less Well-Recognized Manifestations of Systemic Sclerosis (Scleroderma) Source: Scleroderma Foundation Newsline. 2(3): 3,26-27. Summer-Fall 1999. Contact: Available from Scleroderma Foundation. 12 Kent Way, Suite 101, Byfield, MA 01922. (800) 722-4673 or (978) 463-5843. Fax (978) 463-5809. E-mail:
[email protected]. Website: www.scleroderma.org. Summary: This newsletter article provides people who have scleroderma with the less well recognized manifestations of systemic sclerosis. Skin induration and fibrosis, as well as the manifestations of the CREST syndrome, are well known clinical manifestations of systemic sclerosis. However, there are several other clinical manifestations that are not as well recognized, including hypothyroidism, impotence, bladder fibrosis, testicular fibrosis, carpal tunnel syndrome, trigeminal nerve palsy, periodontal ligament resorption, and vocal cord infiltration. Hypothyroidism manifests as progressive weight gain, decreased tolerance to cold temperatures, sluggishness, slowing of mental functions, and, in later stages, cutaneous lesions in the lower extremities. Thyroid hormone replacement often improves these manifestations. Impotence may be the result of generalized fatigue, the effect the disease has on the body, or psychological factors. However, it may be directly caused by the pathologic alterations of the disease. Various therapeutic measures are needed to successfully overcome the difficulties associated with this manifestation of systemic sclerosis. Bladder manifestations include an urgent need to urinate and increased frequency of urination. Various tests may be used to determine whether systemic sclerosis or other problems are responsible for symptoms. Testicular fibrosis manifests by enlargement of
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the testicles. Carpal tunnel syndrome is occasionally one of the earliest manifestations of systemic sclerosis. Trigeminal nerve palsy, which is less common than carpal tunnel syndrome, causes pain and loss of sensation in the lower part of the face on just one side. Periodontal ligament resorption may produce pain at the root of the affected teeth. Vocal cord involvement results in severe, persistent, and progressive hoarseness.
Academic Periodicals covering Hypothyroidism Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to hypothyroidism. In addition to these sources, you can search for articles covering hypothyroidism that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for hypothyroidism. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with hypothyroidism. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).
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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to hypothyroidism: Amiodarone •
Systemic - U.S. Brands: Cordarone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202029.html
Corticosteroids •
Dental - U.S. Brands: Kenalog in Orabase; Orabase-HCA; Oracort; Oralone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202010.html
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Inhalation - U.S. Brands: AeroBid; AeroBid-M; Azmacort; Beclovent; Decadron Respihaler; Pulmicort Respules; Pulmicort Turbuhaler; Vanceril; Vanceril 84 mcg Double Strength http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202011.html
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Nasal - U.S. Brands: Beconase; Beconase AQ; Dexacort Turbinaire; Flonase; Nasacort; Nasacort AQ; Nasalide; Nasarel; Nasonex; Rhinocort; Vancenase; Vancenase AQ 84 mcg; Vancenase pockethaler http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202012.html
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Ophthalmic - U.S. Brands: AK-Dex; AK-Pred; AK-Tate; Baldex; Decadron; Dexair; Dexotic; Econopred; Econopred Plus; Eflone; Flarex; Fluor-Op; FML Forte; FML Liquifilm; FML S.O.P.; HMS Liquifilm; Inflamase Forte; Inflamase Mild; I-Pred; Lite Pred; Maxidex; Ocu-Dex; Ocu-Pred; Ocu-Pr http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202013.html
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Otic - U.S. Brands: Decadron http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202014.html
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Rectal - U.S. Brands: Anucort-HC; Anu-Med HC; Anuprep HC; Anusol-HC; Anutone-HC; Anuzone-HC; Cort-Dome; Cortenema; Cortifoam; Hemorrhoidal HC; Hemril-HC Uniserts; Proctocort; Proctosol-HC; Rectosol-HC http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203366.html
Iodine •
Rectal - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203366.html
Sulfonamides •
Ophthalmic - U.S. Brands: Ak-Sulf; Bleph-10; Cetamide; Gantrisin; IsoptoCetamide; I-Sulfacet; Ocu-Sul-10; Ocu-Sul-15; Ocu-Sul-30; Ocusulf-10; Ophthacet; Sodium Sulamyd; Spectro-Sulf; Steri-Units Sulfacetamide; Sulf-10; Sulfair; Sulfair 10; Sulfair 15; Sulfair Forte; Sulfamide; http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202539.html
•
Systemic - U.S. Brands: Gantanol; Gantrisin; Thiosulfil Forte; Urobak http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202540.html
•
Vaginal - U.S. Brands: AVC; Sultrin; Trysul http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202541.html
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Thyroid Hormones •
Systemic - U.S. Brands: Armour Thyroid; Cytomel; Levo-T; Levothroid; Levoxyl; Synthroid; Thyrar; Thyroid Strong; Thyrolar; Triostat; Westhroid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202566.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.
Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to hypothyroidism by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “hypothyroidism” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan
146 Hypothyroidism
drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for hypothyroidism: •
Liothyronine sodium injection (trade name: Triostat) http://www.rarediseases.org/nord/search/nodd_full?code=268
If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute12: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
12
These publications are typically written by one or more of the various NIH Institutes.
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•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
•
National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
•
National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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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
•
National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:14 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
13
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 14 See http://www.nlm.nih.gov/databases/databases.html.
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•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “hypothyroidism” using the “Detailed Search” option. Go directly to the following hyperlink: 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 the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “hypothyroidism” (or synonyms) into the “For these words:” box. The following is a sample result: •
Hypothyroidism Source: New York, NY: Nidus Information Services, Inc. 1994. 8 p. Contact: Available from Nidus Information Services, Inc. 175 Fifth Avenue, Suite 2338, New York, NY 10010. (800) 334-9355 or (212) 260-4268. PRICE: $5.95 if mailed first class; $9.95 if faxed (as of 1995). Bulk discounts available. Summary: This publication is part of a series designed to aid in understanding current medical knowledge of hypothyroidism. The document covers various topics pertaining to hypothyroidism; the causes of hypothyroidism, risk factors for hypothyroidism, including insulin-dependent diabetes; complications of untreated hypothyroidism; tests used to confirm the diagnosis of the disease; and details of several treatment options. The document concludes with an annotated list of resource organizations, through which readers can obtain additional information.
The NLM Gateway15 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “hypothyroidism” (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.
15 16
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
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).
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Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 24695 152 844 17 0 25708
HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.19 Simply search by “hypothyroidism” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists20 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.21 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
17
Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.
18
The HSTAT URL is http://hstat.nlm.nih.gov/.
19
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. 20 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 21 The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
The Genome Project and Hypothyroidism In the following section, we will discuss databases and references which relate to the Genome Project and hypothyroidism. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).23 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “hypothyroidism” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for hypothyroidism: •
Anterior Chamber Cleavage Disorder, Cerebellar Hypoplasia, Hypothyroidism, and Tracheal Stenosis Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601427
•
Ectodermal Dysplasia, Hypohidrotic, with Hypothyroidism and Agenesis of the Corpus Callosum Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?225040
•
Ectodermal Dysplasia, Hypohidrotic, with Hypothyroidism and Ciliary Dyskinesia Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?225050
•
Hypothyroidism, Athyroidal, with Spiky Hair and Cleft Palate Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?241850
23 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
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Hypothyroidism, Congenital, due to Duox2 Deficiency Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607200
•
Myxedema Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?255900
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Genes and Disease (NCBI - Map) The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •
Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html
•
Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html
•
Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html
•
Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html
•
Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html
•
Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html
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•
Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez
Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •
3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
•
Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
•
Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
•
NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
•
Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
•
OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
•
PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
•
ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
•
Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
•
PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
•
Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
•
Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “hypothyroidism” (or synonyms) into the search box and click “Go.”
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Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database24 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database25 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “hypothyroidism” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).
24
Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 25 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on hypothyroidism 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 hypothyroidism. 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 hypothyroidism. 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 “hypothyroidism”:
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•
Other guides Adrenal Gland Disorders http://www.nlm.nih.gov/medlineplus/adrenalglanddisorders.html Hormones http://www.nlm.nih.gov/medlineplus/hormones.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Pituitary Disorders http://www.nlm.nih.gov/medlineplus/pituitarydisorders.html Thyroid Cancer http://www.nlm.nih.gov/medlineplus/thyroidcancer.html Thyroid Diseases http://www.nlm.nih.gov/medlineplus/thyroiddiseases.html
Within the health topic page dedicated to hypothyroidism, the following was listed: •
General/Overviews Thyroid Disease Source: American College of Obstetricians and Gynecologists http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZDMMPX77C &sub_cat=501 Thyroid Disorders Source: National Women's Health Information Center http://www.4woman.gov/faq/thyroid_disease.htm Your Thyroid Gland Source: American Academy of Otolaryngology--Head and Neck Surgery http://www.entnet.org/healthinfo/thyroid/thyroid_gland.cfm
•
Diagnosis/Symptoms Calcium Pentagastrin Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/calciumpentagastri.pdf Neck Swelling: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/514.html T3 (Triiodothyronine): The Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/t3/test.html T4 (Thyroxine): The Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/t4/test.html Thyroid Scan/Thyroid Uptake Study Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/thyroidupt.pdf
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TRH Stimulation Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/trh.pdf TSH (Thyroid-Stimulating Hormone) Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/tsh/test.html •
Treatment Antithyroid Drugs Source: UpToDate http://patients.uptodate.com/frames.asp?page=topic.asp&file=endo_hor/5036 Thyroid Surgery http://www.nlm.nih.gov/medlineplus/tutorials/thyroidsurgeryloader.html Thyroidectomy Source: InteliHealth http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/20758.html
•
Nutrition Preparing to Receive I-131: The Low-Iodine Diet Source: National Institutes of Health http://www.cc.nih.gov/ccc/patient_education/pepubs/lowio.pdf
•
Specific Conditions/Aspects Goiter Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00217 Graves' Dermopathy Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00605 Graves' Disease http://www.thyroid.org/patients/brochures/Graves_brochure.pdf Hashimoto's Disease and the Flu Shot Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00676 Hashimoto's Disease: What It Is and How It's Treated Source: American Academy of Family Physicians http://familydoctor.org/handouts/548.html Hormonal Causes of Ovulatory Disorders Source: Resolve http://www.resolve.org/main/national/treatment/diagnosis/thyroid.jsp?name=t reatment&tag=diagnosis Hyperthyroidism http://www.thyroid.org/patients/brochures/Hyper_brochure.pdf
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Hypothyroidism Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00353 Hypothyroidism: Can It Cause Joint Pain? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00069 Soy: Does It Adversely Affect the Thyroid? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00454 Subacute (Viral) Thyroiditis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00331 Thyroglossal Duct Cyst Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00265 Thyroid Disease and the Eye Source: American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/Pages/thyroid.html Thyroid Nodules Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00491 Thyrotoxic Myopathy Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/thyrotoxic_myopathy. htm What Is an Endocrinologist? Source: Hormone Foundation http://www.hormone.org/publications/what_is_endocr.html •
Children Clinical Hypothyroidism Source: MAGIC Foundation http://www.magicfoundation.org/clinhypo.html Congenital Hypothyroidism Source: MAGIC Foundation http://www.magicfoundation.org/congthyr.html Thyroid Disorders Source: Nemours Foundation http://kidshealth.org/kid/health_problems/gland/thyroid.html Thyroid through the Ages: Birth and Early Childhood (Growth) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-birth.php
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•
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Men Postpartum Thyroiditis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00153 Thyroid through the Ages: Midlife (Menopause) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-midlife.php Thyroid through the Ages: The Reproductive Years (Pregnancy) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-reproyrs.php
•
Organizations American Thyroid Association http://www.thyroid.org/ Hormone Foundation http://www.hormone.org/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/
•
Pictures/Diagrams Atlas of the Body: The Endocrine System Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZW5TZ46JC &sub_cat=514
•
Prevention/Screening How to Take the Thyroid “Neck Check” http://www.aace.com/pub/tam2001/neckcheck3.pdf
•
Research Are Thyroid Nodules That Grow Cancerous? Source: American College of Physicians http://www.annals.org/cgi/content/full/138/4/I-60 Botox Effective in Treating Upper Eyelid Retraction Associated with Thyroid Disease Source: American Academy of Ophthalmology http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZM6LR552D& sub_cat=2 CDC Releases Hanford Thyroid Disease Study Final Report Source: Centers for Disease Control and Prevention http://www.cdc.gov/od/oc/media/pressrel/r020621.htm
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Effects of Removing Thyroid Antigens in Patients with Autoimmune Thyroid Disease Source: American College of Physicians http://www.annals.org/cgi/content/full/139/5_Part_1/I-75 •
Statistics Facts about Thyroid Disease Source: American Medical Women's Association http://www.amwa-doc.org/healthtopics/thyroid2.html
•
Teenagers Thyroid Disease and Teens Source: Nemours Foundation http://kidshealth.org/teen/diseases_conditions/growth/thyroid.html
•
Women Postpartum Thyroiditis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00153 Thyroid through the Ages: Midlife (Menopause) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-midlife.php Thyroid through the Ages: The Reproductive Years (Pregnancy) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-reproyrs.php
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on hypothyroidism. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Clinical hypothyroidism Source: Oak Park, IL: MAGIC Foundation. n.d. 2 pp.
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Contact: Available from MAGIC Foundation for Children's Growth, 1327 North Harlem Avenue, Suite 701, Oak Park, IL 60302. Telephone: (708) 383- 0808 or (800) 3MAGIC3 / fax: (708) 383-0899 / e-mail:
[email protected] / Web site: http://www.magicfoundation. Summary: This brochure provides an overview of hypothyroidism. It explains it causes, symptoms of the disorder, and treatment methods. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “hypothyroidism” (or synonyms). The following was recently posted: •
American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1996 (revised 2002); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3525&nbr=2751&a mp;string=hypothyroidism Healthfinder™
Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
Pituitary Diseases: Disorders & Related Articles Summary: This site contains symptoms and articles of specific diseases of the pituitary gland including cushings disease, acromegaly, growth hormone deficiency, hypothyroidism, hypogonadism and more. Source: Pituitary Network Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2646
•
Thyroid Disorders and Treatments Summary: Having too little hormone, called hypothyroidism, puts you into a dragging slowdown. This is a problem for more than 10 million Americans-of whom 8 million don't know it. Source: Thyroid Foundation of America, Inc. http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7698
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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 hypothyroidism. 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. NORD (The National Organization of Rare Disorders, Inc.) NORD provides an invaluable service to the public by publishing short yet comprehensive guidelines on over 1,000 diseases. NORD primarily focuses on rare diseases that might not be covered by the previously listed sources. NORD’s Web address is http://www.rarediseases.org/. A complete guide on hypothyroidism can be purchased from NORD for a nominal fee. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMD®Health: http://my.webmd.com/health_topics
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to hypothyroidism. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with hypothyroidism. 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 hypothyroidism. For more information,
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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 “hypothyroidism” (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 “hypothyroidism”. 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 “hypothyroidism” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “hypothyroidism” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.26
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
26
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)27: •
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
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
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
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
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/
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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/
27
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
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
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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
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
174 Hypothyroidism
•
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
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
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 hypothyroidism: •
Basic Guidelines for Hypothyroidism CHF Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000158.htm Dementia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000739.htm Hypothyroidism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000353.htm Hypothyroidism - primary Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000367.htm Hypothyroidism - secondary Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000324.htm
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•
Signs & Symptoms for Hypothyroidism Anemia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000560.htm Ankle, feet, and leg swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003104.htm Ataxia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003198.htm Blood pressure, high Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003082.htm Breast development in males Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003165.htm Brittle fingernails Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003247.htm Chest pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Cold intolerance Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003095.htm Coma Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Constipation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003125.htm Decreased hearing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003050.htm Decreased taste and smell Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003050.htm Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Dry, flaky skin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003250.htm Ear noise/buzzing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003043.htm Edema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm
Online Glossaries 177
Excessive sweating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Facial swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003105.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Hair loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003246.htm Hair, dry Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003245.htm Hearing loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Heart sounds Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003266.htm Hoarseness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003054.htm Joint or muscle pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Joint stiffness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Leg swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003104.htm Low blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm Menstrual periods, abnormal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003263.htm Menstruation, absent Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003149.htm Movement, uncoordinated Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003198.htm Muscle atrophy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003188.htm Muscle pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003178.htm
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Muscle spasms (cramps) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Nipple discharge, abnormal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003154.htm Obesity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003101.htm Pale Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003244.htm Puffy face Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003105.htm Restlessness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Short stature Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003271.htm Skin color, patchy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003224.htm Sutures - separated Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003307.htm Sweating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Swelling, overall Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Teeth - delayed or absent formation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003061.htm Thin, brittle fingernails Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003247.htm Tongue problems Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003047.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm Weight gain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003084.htm
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Weight gain (unintentional) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003084.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm •
Diagnostics and Tests for Hypothyroidism Antibody titer Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003333.htm Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm Calcitonin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003699.htm CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Chest X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm Cholesterol levels Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003492.htm Complete blood count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Heart rate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm Prolactin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003718.htm Pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm Resin T3 uptake Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003688.htm Serum sodium Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003481.htm Serum TSH Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm T3 Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003687.htm T3 resin uptake Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003688.htm
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T4 Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003517.htm T4 test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003517.htm Triiodothyronine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003687.htm TSH Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm •
Nutrition for Hypothyroidism High-fiber Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002470.htm
•
Background Topics for Hypothyroidism Endocrine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002351.htm Heart disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000147.htm Hypothalamus Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002380.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Intravenous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002383.htm Metabolism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002257.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Radiation therapy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001918.htm Systemic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002294.htm Thyroid disorders Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001159.htm
Online Glossaries 181
Vital signs Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002341.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
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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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HYPOTHYROIDISM DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylcholinesterase: An enzyme that catalyzes the hydrolysis of acetylcholine to choline and acetate. In the CNS, this enzyme plays a role in the function of peripheral neuromuscular junctions. EC 3.1.1.7. [NIH] Acitretin: An oral retinoid effective in the treatment of psoriasis. It is the major metabolite of etretinate with the advantage of a much shorter half-life when compared with etretinate. [NIH]
Actin: Essential component of the cell skeleton. [NIH] Action Potentials: The electric response of a nerve or muscle to its stimulation. [NIH] Actomyosin: A protein complex of actin and myosin occurring in muscle. It is the essential contractile substance of muscle. [NIH] Acute leukemia: A rapidly progressing cancer of the blood-forming tissue (bone marrow). [NIH]
Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenoma: A benign epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH]
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Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adoptive Transfer: Form of passive immunization where previously sensitized immunologic agents (cells or serum) are transferred to non-immune recipients. When transfer of cells is used as a therapy for the treatment of neoplasms, it is called adoptive immunotherapy (immunotherapy, adoptive). [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal insufficiency: The reduced secretion of adrenal glands. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aetiology: Study of the causes of disease. [EU] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agenesis: Lack of complete or normal development; congenital absence of an organ or part. [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] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin,
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and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-fetoprotein: AFP. A protein normally produced by a developing fetus. AFP levels are usually undetectable in the blood of healthy nonpregnant adults. An elevated level of AFP suggests the presence of either a primary liver cancer or germ cell tumor. [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] Alternative Splicing: A process whereby multiple protein isoforms are generated from a single gene. Alternative splicing involves the splicing together of nonconsecutive exons during the processing of some, but not all, transcripts of the gene. Thus a particular exon may be connected to any one of several alternative exons to form messenger RNA. The alternative forms produce proteins in which one part is common while the other part is different. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amifostine: A phosphorothioate proposed as a radiation-protective agent. It causes splenic vasodilation and may block autonomic ganglia. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH]
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Amiodarone: An antianginal and antiarrhythmic drug. It increases the duration of ventricular and atrial muscle action by inhibiting Na,K-activated myocardial adenosine triphosphatase. There is a resulting decrease in heart rate and in vascular resistance. [NIH] 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] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [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]
Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]
Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angina: Chest pain that originates in the heart. [NIH] Anginal: Pertaining to or characteristic of angina. [EU]
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Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angiogenesis inhibitor: A substance that may prevent the formation of blood vessels. In anticancer therapy, an angiogenesis inhibitor prevents the growth of blood vessels from surrounding tissue to a solid tumor. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [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] Anthropometric measurements: Measurements of human body height, weight, and size of component parts, including skinfold measurement. Used to study and compare the relative proportions under normal and abnormal conditions. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antianginal: Counteracting angina or anginal conditions. [EU] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU]
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Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiserum: The blood serum obtained from an animal after it has been immunized with a particular antigen. It will contain antibodies which are specific for that antigen as well as antibodies specific for any other antigen with which the animal has previously been immunized. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apnoea: Cessation of breathing. [EU] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and
Dictionary 189
the capillaries. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteritis: Inflammation of an artery. [NIH] Arthropathy: Any joint disease. [EU] Articular: Of or pertaining to a joint. [EU] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Asparaginase: A hydrolase enzyme that converts L-asparagine and water to L-aspartate and NH3. EC 3.5.1.1. [NIH] Aspartate: A synthetic amino acid. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrioventricular Node: A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Audiology: The study of hearing and hearing impairment. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH]
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Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Avidity: The strength of the interaction of an antiserum with a multivalent antigen. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Barotrauma: Injury following pressure changes; includes injury to the eustachian tube, ear drum, lung and stomach. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Basal metabolic rate: Represents the minimum energy expenditure required for the maintenance of vital functions; normally the amount of energy expended, measured in calories, per unit of time at rest; measured after 14-18 hours of rest. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH]
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Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Bioassays: Determination of the relative effective strength of a substance (as a vitamin, hormone, or drug) by comparing its effect on a test organism with that of a standard preparation. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the
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hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluid Compartments: The two phases between which water and other body fluids are distributed: extracellular and intracellular. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone Development: Gross development of bones from fetus to adult. It includes osteogenesis, which is restricted to formation and development of bone from the undifferentiated cells of the germ layers of the embryo. It does not include osseointegration. [NIH]
Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or
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within a natural body cavity or implanted directly into the tissues. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [NIH] Brain Neoplasms: Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bullous: Pertaining to or characterized by bullae. [EU] 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] Calcium Metabolism Disorders: Disorders in the processing of calcium in the body, including absorption, transport, storage, and utilization. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and
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become pathologic when the environment is favorable and the host resistance is weakened. [NIH]
Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carboxylic Acids: Organic compounds containing the carboxy group (-COOH). This group of compounds includes amino acids and fatty acids. Carboxylic acids can be saturated, unsaturated, or aromatic. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiac catheterization: A procedure in which a thin, hollow tube is inserted into a blood vessel. The tube is then advanced through the vessel into the heart, enabling a physician to study the heart and its pumping activity. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiotoxicity: Toxicity that affects the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carotid Arteries: Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be
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caused by work with certain hand and wrist postures. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catabolism: Any destructive metabolic process by which organisms convert substances into excreted compounds. [EU] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Adhesion Molecules: Surface ligands, usually glycoproteins, that mediate cell-to-cell adhesion. Their functions include the assembly and interconnection of various vertebrate systems, as well as maintenance of tissue integration, wound healing, morphogenic movements, cellular migrations, and metastasis. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell Lineage: The developmental history of cells as traced from the first division of the original cell or cells in the embryo. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Physiology: Characteristics and physiological processes of cells from cell division to cell death. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and
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adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]
Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrovascular Disorders: A broad category of disorders characterized by impairment of blood flow in the arteries and veins which supply the brain. These include cerebral infarction; brain ischemia; hypoxia, brain; intracranial embolism and thrombosis; intracranial arteriovenous malformations; and vasculitis, central nervous system. In common usage, the term cerebrovascular disorders is not limited to conditions that affect the cerebrum, but refers to vascular disorders of the entire brain including the diencephalon; brain stem; and cerebellum. [NIH] 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] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Cheilitis: Inflammation of the lips. It is of various etiologies and degrees of pathology. [NIH] Chelation: Combination with a metal in complexes in which the metal is part of a ring. [EU] Chelation Therapy: Therapy of heavy metal poisoning using agents which sequester the metal from organs or tissues and bind it firmly within the ring structure of a new compound
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which can be eliminated from the body. [NIH] Chemopreventive: Natural or synthetic compound used to intervene in the early precancerous stages of carcinogenesis. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chimeras: Organism that contains a mixture of genetically different cells. [NIH] Chimeric Proteins: Proteins in individuals that are derived from genetically different zygotes. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Choroid Plexus: A villous structure of tangled masses of blood vessels contained within the third, lateral, and fourth ventricles of the brain. It regulates part of the production and composition of cerebrospinal fluid. [NIH] Chromaffin System: The cells of the body which stain with chromium salts. They occur along the sympathetic nerves, in the adrenal gland, and in various other organs. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH]
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Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]
Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the
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high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray
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machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Consumption: Pulmonary tuberculosis. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] 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] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Arteriosclerosis: Thickening and loss of elasticity of the coronary arteries. [NIH] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH]
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Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cranial Irradiation: The exposure of the head to roentgen rays or other forms of radioactivity for therapeutic or preventive purposes. [NIH] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Cultured cells: Animal or human cells that are grown in the laboratory. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyanogen Bromide: Cyanogen bromide (CNBr). A compound used in molecular biology to digest some proteins and as a coupling reagent for phosphoroamidate or pyrophosphate internucleotide bonds in DNA duplexes. [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] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH]
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Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to
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meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]
Dental Hygienists: Persons trained in an accredited school or dental college and licensed by the state in which they reside to provide dental prophylaxis under the direction of a licensed dentist. [NIH] Depigmentation: Removal or loss of pigment, especially melanin. [EU] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]
Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops
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(mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dimerization: The process by which two molecules of the same chemical composition form a condensation product or polymer. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] 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] Domesticated: Species in which the evolutionary process has been influenced by humans to meet their needs. [NIH] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH]
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Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dwarfism: The condition of being undersized as a result of premature arrest of skeletal growth. It may be caused by insufficient secretion of growth hormone (pituitary dwarfism). [NIH]
Dysgenesis: Defective development. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Ectopic: Pertaining to or characterized by ectopia. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH]
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Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Encephalocele: Cerebral tissue herniation through a congenital or acquired defect in the skull. The majority of congenital encephaloceles occur in the occipital or frontal regions. Clinical features include a protuberant mass that may be pulsatile. The quantity and location of protruding neural tissue determines the type and degree of neurologic deficit. Visual defects, psychomotor developmental delay, and persistent motor deficits frequently occur. [NIH]
Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinologist: A doctor that specializes in diagnosing and treating hormone disorders. [NIH]
Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endocytosis: Cellular uptake of extracellular materials within membrane-limited vacuoles or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endostatin: A drug that is being studied for its ability to prevent the growth of new blood vessels into a solid tumor. Endostatin belongs to the family of drugs called angiogenesis inhibitors. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood
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capillaries. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Ependymal: It lines the cavities of the brain's ventricles and the spinal cord and slowly divides to create a stem cell. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. Also called squamous cell carcinoma. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH]
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Episcleritis: Inflammation of the episclera and/or the outer layers of the sclera itself. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]
Epitope Mapping: Methods used for studying the interactions of antibodies with specific regions of protein antigens. Important applications of epitope mapping are found within the area of immunochemistry. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythema Multiforme: A skin and mucous membrane disease characterized by an eruption of macules, papules, nodules, vesicles, and/or bullae with characteristic "bull's-eye" lesions usually occurring on the dorsal aspect of the hands and forearms. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Erythropoietin: Glycoprotein hormone, secreted chiefly by the kidney in the adult and the liver in the fetus, that acts on erythroid stem cells of the bone marrow to stimulate proliferation and differentiation. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]
Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Etretinate: An oral retinoid used in the treatment of keratotic genodermatosis, lichen planus, and psoriasis. Beneficial effects have also been claimed in the prophylaxis of epithelial neoplasia. The compound may be teratogenic. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Eustachian tube: The middle ear cavity is in communication with the back of the nose through the Eustachian tube, which is normally closed, but opens on swallowing, in order to maintain equal air pressure. [NIH]
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Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]
Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]
External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extraocular: External to or outside of the eye. [NIH] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fetal Alcohol Syndrome: A disorder occurring in children born to alcoholic women who continue to drink heavily during pregnancy. Common abnormalities are growth deficiency (prenatal and postnatal), altered morphogenesis, mental deficiency, and characteristic facies - small eyes and flattened nasal bridge. Fine motor dysfunction and tremulousness are
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observed in the newborn. [NIH] Fetal Development: Morphologic and physiologic growth and development of the mammalian embryo or fetus. [NIH] Fetoprotein: Transabdominal aspiration of fluid from the amniotic sac with a view to detecting increases of alpha-fetoprotein in maternal blood during pregnancy, as this is an important indicator of open neural tube defects in the fetus. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flexor: Muscles which flex a joint. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follicles: Shafts through which hair grows. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Forskolin: Potent activator of the adenylate cyclase system and the biosynthesis of cyclic AMP. From the plant Coleus forskohlii. Has antihypertensive, positive ionotropic, platelet aggregation inhibitory, and smooth muscle relaxant activities; also lowers intraocular pressure and promotes release of hormones from the pituitary gland. [NIH] Fossa: A cavity, depression, or pit. [NIH] Fourth Ventricle: An irregularly shaped cavity in the rhombencephalon, between the medulla oblongata, the pons, and the isthmus in front, and the cerebellum behind. It is continuous with the central canal of the cord below and with the cerebral aqueduct above, and through its lateral and median apertures it communicates with the subarachnoid space. [NIH]
Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and
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sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Silencing: Interruption or suppression of the expression of a gene at transcriptional or translational levels. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic transcription: The process by which the genetic information encoded in the gene, represented as a linear sequence of deoxyribonucleotides, is copied into an exactly complementary sequence of ribonucleotides known as messenger RNA. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH]
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Germ Layers: The three layers of cells comprising the early embryo. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glioma: A cancer of the brain that comes from glial, or supportive, cells. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]
Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Goiter: Enlargement of the thyroid gland. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU]
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Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gp120: 120-kD HIV envelope glycoprotein which is involved in the binding of the virus to its membrane receptor, the CD4 molecule, found on the surface of certain cells in the body. [NIH]
Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granule: A small pill made from sucrose. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guinea Pigs: A common name used for the family Caviidae. The most common species is Cavia porcellus which is the domesticated guinea pig used for pets and biomedical research. [NIH]
Haemodialysis: The removal of certain elements from the blood by virtue of the difference in the rates of their diffusion through a semipermeable membrane, e.g., by means of a haemodialyzer. [EU] Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] 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]
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Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatomegaly: Enlargement of the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]
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Heterodimers: Zippered pair of nonidentical proteins. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Heterozygote: An individual having different alleles at one or more loci in homologous chromosome segments. [NIH] Hoarseness: An unnaturally deep or rough quality of voice. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormonal therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called hormone therapy or endocrine therapy. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrocephalus: Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, intracranial hypertension; headache; lethargy; urinary incontinence; and ataxia (and in infants macrocephaly). This condition may be caused by obstruction of cerebrospinal fluid pathways due to neurologic abnormalities, intracranial hemorrhages; central nervous system infections; brain neoplasms; craniocerebral trauma; and other conditions. Impaired resorption of cerebrospinal fluid from the arachnoid villi results in a communicating form of hydrocephalus. Hydrocephalus ex-vacuo refers to ventricular dilation that occurs as a result of brain substance loss from cerebral infarction and other conditions. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH]
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Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hypergravity: Condition wherein the force of gravity is greater than or is increased above that on the surface of the earth. This is expressed as being greater than 1 g. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hyperthyroxinemia: Excess of thyroxine in the blood. [NIH] Hypertrophic cardiomyopathy: Heart muscle disease that leads to thickening of the heart walls, interfering with the heart's ability to fill with and pump blood. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hypotonia: A condition of diminished tone of the skeletal muscles; diminished resistance of muscles to passive stretching. [EU]
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Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunochemistry: Field of chemistry that pertains to immunological phenomena and the study of chemical reactions related to antigen stimulation of tissues. It includes physicochemical interactions between antigens and antibodies. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of suppressor T-cell populations or by inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH]
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Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Induration: 1. The quality of being hard; the process of hardening. 2. An abnormally hard spot or place. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infectious Mononucleosis: A common, acute infection usually caused by the Epstein-Barr virus (Human herpesvirus 4). There is an increase in mononuclear white blood cells and other atypical lymphocytes, generalized lymphadenopathy, splenomegaly, and occasionally hepatomegaly with hepatitis. [NIH] Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a
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step in a carcinogenic process. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]
Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Interleukin-4: Soluble factor produced by activated T-lymphocytes that causes proliferation and differentiation of B-cells. Interleukin-4 induces the expression of class II major histocompatibility complex and Fc receptors on B-cells. It also acts on T-lymphocytes, mast cell lines, and several other hematopoietic lineage cells including granulocyte, megakaryocyte, and erythroid precursors, as well as macrophages. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH]
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Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intracranial Embolism: The sudden obstruction of a blood vessel by an embolus. [NIH] Intracranial Embolism and Thrombosis: Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures. [NIH] Intracranial Hemorrhages: Bleeding within the intracranial cavity, including hemorrhages in the brain and within the cranial epidural, subdural, and subarachnoid spaces. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intraocular: Within the eye. [EU] Intraocular pressure: Pressure of the fluid inside the eye; normal IOP varies among individuals. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]
Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA
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fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Keratosis: Any horny growth such as a wart or callus. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Labyrinthine: A vestibular nystagmus resulting from stimulation, injury, or disease of the labyrinth. [NIH] Labyrinthitis: Inflammation of the inner ear. [NIH] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Larva: Wormlike or grublike stage, following the egg in the life cycle of insects, worms, and other metamorphosing animals. [NIH] Laryngeal: Having to do with the larynx. [NIH] Laryngectomy: Total or partial excision of the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levothyroxine: Levo isomer of the thyroid hormone thyroxine. It is used for replacement therapy in reduced or absent thyroid function. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
222 Hypothyroidism
Lichen Planus: An inflammatory, pruritic disease of the skin and mucous membranes, which can be either generalized or localized. It is characterized by distinctive purplish, flattopped papules having a predilection for the trunk and flexor surfaces. The lesions may be discrete or coalesce to form plaques. Histologically, there is a "saw-tooth" pattern of epidermal hyperplasia and vacuolar alteration of the basal layer of the epidermis along with an intense upper dermal inflammatory infiltrate composed predominantly of T-cells. Etiology is unknown. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipid Peroxides: Peroxides produced in the presence of a free radical by the oxidation of unsaturated fatty acids in the cell in the presence of molecular oxygen. The formation of lipid peroxides results in the destruction of the original lipid leading to the loss of integrity of the membranes. They therefore cause a variety of toxic effects in vivo and their formation is considered a pathological process in biological systems. Their formation can be inhibited by antioxidants, such as vitamin E, structural separation or low oxygen tension. [NIH] Lipopolysaccharides: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lipoprotein(a): A family of lipoprotein particles varying in density and size depending on the protein-lipid ratio and the protein composition. These particles consist of apolipoprotein B-100 covalently linked to apolipoprotein-a by one or two disulfide bonds. There is a correlation between high plasma levels of this lipoprotein and increased risk for
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atherosclerotic cardiovascular disease. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]
Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] 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] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [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]
Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH]
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Lymphedema: Edema due to obstruction of lymph vessels or disorders of the lymph nodes. [NIH]
Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphokine: A soluble protein produced by some types of white blood cell that stimulates other white blood cells to kill foreign invaders. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lysosomal Storage Diseases: Inborn errors of metabolism characterized by defects in specific lysosomal hydrolases and resulting in intracellular accumulation of unmetabolized substrates. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune responseassociated (Ia) antigens, the immune response (Ir) genes which control the ability of an animal to respond immunologically to antigenic stimuli, and genes which determine the structure and/or level of the first four components of complement. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malaise: A vague feeling of bodily discomfort. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mammary: Pertaining to the mamma, or breast. [EU] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Maxillary Nerve: The intermediate sensory division of the trigeminal (5th cranial) nerve. The maxillary nerve carries general afferents from the intermediate region of the face including the lower eyelid, nose and upper lip, the maxillary teeth, and parts of the dura. [NIH]
Meat: The edible portions of any animal used for food including domestic mammals (the
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major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]
Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medulloblastoma: A malignant brain tumor that begins in the lower part of the brain and can spread to the spine or to other parts of the body. Medulloblastomas are sometimes called primitive neuroectodermal tumors (PNET). [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menarche: The establishment or beginning of the menstrual function. [EU] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menopause: Permanent cessation of menstruation. [NIH]
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Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental deficiency: A condition of arrested or incomplete development of mind from inherent causes or induced by disease or injury. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metamorphosis: The ontogeny of insects, i. e. the series of changes undergone from egg, through larva and pupa, or through nymph, to adult. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methimazole: A thioureylene antithyroid agent that inhibits the formation of thyroid hormones by interfering with the incorporation of iodine into tyrosyl residues of thyroglobulin. This is done by interfering with the oxidation of iodide ion and iodotyrosyl groups through inhibition of the peroxidase enzyme. [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] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid
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secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]
Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]
Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucopolysaccharidoses: Group of lysosomal storage diseases each caused by an inherited deficiency of an enzyme involved in the degradation of glycosaminoglycans (mucopolysaccharides). The diseases are progressive and often display a wide spectrum of clinical severity within one enzyme deficiency. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Multimodality treatment: Therapy that combines more than one method of treatment. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat
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(lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Multivalent: Pertaining to a group of 5 or more homologous or partly homologous chromosomes during the zygotene stage of prophase to first metaphasis in meiosis. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Musculoskeletal System: Themuscles, bones, and cartilage of the body. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myeloma: Cancer that arises in plasma cells, a type of white blood cell. [NIH] Myeloproliferative Disorders: Disorders in which one or more stimuli cause proliferation of hemopoietically active tissue or of tissue which has embryonic hemopoietic potential. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopathy: Any disease of a muscle. [EU] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Myxedema: A condition characterized by a dry, waxy type of swelling with abnormal deposits of mucin in the skin and other tissues. It is produced by a functional insufficiency of the thyroid gland, resulting in deficiency of thyroid hormone. The skin becomes puffy around the eyes and on the cheeks and the face is dull and expressionless with thickened nose and lips. The congenital form of the disease is cretinism. [NIH]
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Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Septum: The partition separating the two nasal cavities in the midplane, composed of cartilaginous, membranous and bony parts. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neonatal period: The first 4 weeks after birth. [NIH] Neonatal Screening: The identification of selected parameters in newborn infants by various tests, examinations, or other procedures. Screening may be performed by clinical or laboratory measures. A screening test is designed to sort out healthy neonates from those not well, but the screening test is not intended as a diagnostic device, rather instead as epidemiologic. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] 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] Neural tube defects: These defects include problems stemming from fetal development of the spinal cord, spine, brain, and skull, and include birth defects such as spina bifida, anencephaly, and encephalocele. Neural tube defects occur early in pregnancy at about 4 to 6 weeks, usually before a woman knows she is pregnant. Many babies with neural tube defects have difficulty walking and with bladder and bowel control. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurologist: A doctor who specializes in the diagnosis and treatment of disorders of the nervous system. [NIH]
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Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neuropil: A dense intricate feltwork of interwoven fine glial processes, fibrils, synaptic terminals, axons, and dendrites interspersed among the nerve cells in the gray matter of the central nervous system. [NIH] Neurosecretory Systems: A system of neurons that has the specialized function to produce and secrete hormones, and that constitutes, in whole or in part, an endocrine organ or system. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]
Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] 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] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Proteins: Proteins found in the nucleus of a cell. Do not confuse with nucleoproteins which are proteins conjugated with nucleic acids, that are not necessarily present in the nucleus. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary
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bases in the two strains. [NIH] Nucleoproteins: Proteins conjugated with nucleic acids. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Nymph: The immature stage in the life cycle of those orders of insects characterized by gradual metamorphosis, in which the young resemble the imago in general form of body, including compound eyes and external wings; also the 8-legged stage of mites and ticks that follows the first moult. [NIH] Nystagmus: Rhythmical oscillation of the eyeballs, either pendular or jerky. [NIH] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Olfaction: Function of the olfactory apparatus to perceive and discriminate between the molecules that reach it, in gas form from an external environment, directly or indirectly via the nose. [NIH] Olfactory Bulb: Ovoid body resting on the cribriform plate of the ethmoid bone where the olfactory nerve terminates. The olfactory bulb contains several types of nerve cells including the mitral cells, on whose dendrites the olfactory nerve synapses, forming the olfactory glomeruli. The accessory olfactory bulb, which receives the projection from the vomeronasal organ via the vomeronasal nerve, is also included here. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oncology: The study of cancer. [NIH] Oocytes: Female germ cells in stages between the prophase of the first maturation division and the completion of the second maturation division. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operon: The genetic unit consisting of a feedback system under the control of an operator gene, in which a structural gene transcribes its message in the form of mRNA upon blockade of a repressor produced by a regulator gene. Included here is the attenuator site of bacterial operons where transcription termination is regulated. [NIH] Ophthalmic: Pertaining to the eye. [EU] Ophthalmologic: Pertaining to ophthalmology (= the branch of medicine dealing with the eye). [EU] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At
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the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [NIH]
Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osseointegration: The growth action of bone tissue, as it assimilates surgically implanted devices or prostheses to be used as either replacement parts (e.g., hip) or as anchors (e.g., endosseous dental implants). [NIH] Ossicles: The hammer, anvil and stirrup, the small bones of the middle ear, which transmit the vibrations from the tympanic membrane to the oval window. [NIH] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Osteocalcin: Vitamin K-dependent calcium-binding protein synthesized by osteoblasts and found primarily in bone. Serum osteocalcin measurements provide a noninvasive specific marker of bone metabolism. The protein contains three residues of the amino acid gammacarboxyglutamic acid (GLA), which, in the presence of calcium, promotes binding to hydroxyapatite and subsequent accumulation in bone matrix. [NIH] Osteoclasts: A large multinuclear cell associated with the absorption and removal of bone. An odontoclast, also called cementoclast, is cytomorphologically the same as an osteoclast and is involved in cementum resorption. [NIH] Osteocytes: Mature osteoblasts that have become embedded in the bone matrix. They occupy a small cavity, called lacuna, in the matrix and are connected to adjacent osteocytes via protoplasmic projections called canaliculi. [NIH] Osteodystrophy: Defective bone formation. [EU] Osteogenesis: The histogenesis of bone including ossification. It occurs continuously but particularly in the embryo and child and during fracture repair. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Osteoradionecrosis: Necrosis of bone following radiation injury. [NIH] Otolaryngologist: A doctor who specializes in treating diseases of the ear, nose, and throat. Also called an ENT doctor. [NIH]
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Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat. [NIH] Otology: The branch of medicine which deals with the diagnosis and treatment of the disorders and diseases of the ear. [NIH] Otosclerosis: The formation of spongy bone in the labyrinth capsule. The ossicles can become fixed and unable to transmit sound vibrations, thereby causing deafness. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovarian Cysts: General term for cysts and cystic diseases of the ovary. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overexpress: An excess of a particular protein on the surface of a cell. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxamic Acid: Amino-substituted glyoxylic acid derivative. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenase: Enzyme which breaks down heme, the iron-containing oxygen-carrying constituent of the red blood cells. [NIH] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is
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comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parent-Child Relations: The interactions between parent and child. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Parturition: The act or process of given birth to a child. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pelvic: Pertaining to the pelvis. [EU] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide T: N-(N-(N(2)-(N-(N-(N-(N-D-Alanyl L-seryl)-L-threonyl)-L-threonyl) L-threonyl)L-asparaginyl)-L-tyrosyl) L-threonine. Octapeptide sharing sequence homology with HIV envelope protein gp120. It is potentially useful as antiviral agent in AIDS therapy. The core pentapeptide sequence, TTNYT, consisting of amino acids 4-8 in peptide T, is the HIV envelope sequence required for attachment to the CD4 receptor. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH]
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Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]
Perilymph: The fluid contained within the space separating the membranous from the osseous labyrinth of the ear. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Periodontal Ligament: Fibrous connective tissue surrounding the root of a tooth that separates it from and attaches it to the alveolar bone. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH] Peroxidase: A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC 1.11.1.7. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Pheromones: Chemical substances which, when secreted by an individual into the environment, cause specific reactions in other individuals, usually of the same species. The substances relate only to multicellular organisms. This includes kairomones. Allomones are repellent pheromones. [NIH]
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Phorbol: Class of chemicals that promotes the development of tumors. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylated: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the
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platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyarteritis Nodosa: A form of necrotizing vasculitis involving small- and medium-sized arteries. The signs and symptoms result from infarction and scarring of the affected organ system. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polymyalgia Rheumatica: A syndrome in the elderly characterized by proximal joint and muscle pain, high erythrocyte sedimentation rate, and a self-limiting course. Pain is usually accompanied by evidence of an inflammatory reaction. Women are affected twice as commonly as men and Caucasians more frequently than other groups. The condition is frequently associated with temporal arteritis and some theories pose the possibility that the two diseases arise from a single etiology or even that they are the same entity. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Porphyria: A group of disorders characterized by the excessive production of porphyrins or their precursors that arises from abnormalities in the regulation of the porphyrin-heme pathway. The porphyrias are usually divided into three broad groups, erythropoietic, hepatic, and erythrohepatic, according to the major sites of abnormal porphyrin synthesis. [NIH]
Porphyrins: A group of compounds containing the porphin structure, four pyrrole rings
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connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [NIH] Precipitation: The act or process of precipitating. [EU] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predictive factor: A situation or condition that may increase a person's risk of developing a certain disease or disorder. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Presbycusis: Progressive bilateral loss of hearing that occurs in the aged. Syn: senile deafness. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primitive neuroectodermal tumors: PNET. A type of bone cancer that forms in the middle (shaft) of large bones. Also called Ewing's sarcoma/primitive neuroectodermal tumor. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body,
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secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Promotor: In an operon, a nucleotide sequence located at the operator end which contains all the signals for the correct initiation of genetic transcription by the RNA polymerase holoenzyme and determines the maximal rate of RNA synthesis. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also).
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The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [NIH] Protein Isoforms: Different forms of a protein that may be produced from different genes, or from the same gene by alternative splicing. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Pseudotumour: An enlargement that resembles a tumour. [EU] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychosis: A mental disorder characterized by gross impairment in reality testing as
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evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Ptosis: 1. Prolapse of an organ or part. 2. Drooping of the upper eyelid from paralysis of the third nerve or from sympathetic innervation. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Embolism: Embolism in the pulmonary artery or one of its branches. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pupa: An inactive stage between the larval and adult stages in the life cycle of insects. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quiescent: Marked by a state of inactivity or repose. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioactivity: The quality of emitting or the emission of corpuscular or electromagnetic
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radiations consequent to nuclear disintegration, a natural property of all chemical elements of atomic number above 83, and possible of induction in all other known elements. [EU] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radionuclide Ventriculography: Imaging of a ventricle of the heart after the injection of a radioactive contrast medium. The technique is less invasive than cardiac catheterization and is used to assess ventricular function. [NIH] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Raloxifene: A second generation selective estrogen receptor modulator (SERM) used to prevent osteoporosis in postmenopausal women. It has estrogen agonist effects on bone and cholesterol metabolism but behaves as a complete estrogen antagonist on mammary gland and uterine tissue. [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] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together
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in either parent; usually applied to linked genes. [EU] Recombinant Proteins: Proteins prepared by recombinant DNA technology. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflective: Capable of throwing back light, images, sound waves : reflecting. [EU] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Repressor: Any of the specific allosteric protein molecules, products of regulator genes, which bind to the operator of operons and prevent RNA polymerase from proceeding into the operon to transcribe messenger RNA. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Response Elements: Nucleotide sequences, usually upstream, which are recognized by specific regulatory transcription factors, thereby causing gene response to various regulatory agents. These elements may be found in both promotor and enhancer regions. [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
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outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rhabdomyolysis: Necrosis or disintegration of skeletal muscle often followed by myoglobinuria. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Ristocetin: An antibiotic mixture of two components, A and B, obtained from Nocardia lurida (or the same substance produced by any other means). It is no longer used clinically because of its toxicity. It causes platelet agglutination and blood coagulation and is used to assay those functions in vitro. [NIH] Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Salicylic: A tuberculosis drug. [NIH] Salicylic Acids: Derivatives and salts of salicylic acid. [NIH] Saline: A solution of salt and water. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each
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consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Scleritis: Refers to any inflammation of the sclera including episcleritis, a benign condition affecting only the episclera, which is generally short-lived and easily treated. Classic scleritis, on the other hand, affects deeper tissue and is characterized by higher rates of visual acuity loss and even mortality, particularly in necrotizing form. Its characteristic symptom is severe and general head pain. Scleritis has also been associated with systemic collagen disease. Etiology is unknown but is thought to involve a local immune response. Treatment is difficult and includes administration of anti-inflammatory and immunosuppressive agents such as corticosteroids. Inflammation of the sclera may also be secondary to inflammation of adjacent tissues, such as the conjunctiva. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [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] Scrotum: In males, the external sac that contains the testicles. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU]
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Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Sella: A deep depression in the shape of a Turkish saddle in the upper surface of the body of the sphenoid bone in the deepest part of which is lodged the hypophysis cerebri. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequela: Any lesion or affection following or caused by an attack of disease. [EU] Sequence Homology: The degree of similarity between sequences. Studies of amino acid and nucleotide sequences provide useful information about the genetic relatedness of certain species. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Sequester: A portion of dead bone which has become detached from the healthy bone tissue, as occurs in necrosis. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH]
Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH]
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Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Shoulder Pain: Unilateral or bilateral pain of the shoulder. It is often caused by physical activities such as work or sports participation, but may also be pathologic in origin. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Behavior: Any behavior caused by or affecting another individual, usually of the same species. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH]
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Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Iodide: Sodium iodide (NaI). A compound forming white, odorless deliquescent crystals and used as iodine supplement, expectorant or in its radioactive (I-131) form as an diagnostic aid, particularly for thyroid function determinants. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] 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] Soybean Oil: Oil from soybean or soybean plant. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spina bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal
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roots are also included. [NIH] Spiral Lamina: The bony plate which extends outwards from the modiolus. It is part of the structure which divides trhe cochlea into sections. [NIH] Spirochete: Lyme disease. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Steady state: Dynamic equilibrium. [EU] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] 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
250 Hypothyroidism
be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Struma: Goitre. [EU] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substrate: A substance upon which an enzyme acts. [EU] Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Supraventricular: Situated or occurring above the ventricles, especially in an atrium or atrioventricular node. [EU] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron
Dictionary 251
releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Synovial: Of pertaining to, or secreting synovia. [EU] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]
Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Tamponade: The inserting of a tampon; a dressing is inserted firmly into a wound or body cavity, as the nose, uterus or vagina, principally for stopping hemorrhage. [NIH] Tectorial Membrane: A gelatinous membrane, attached to the bony spiral lamina, which overlies the hair cells within the cochlea of the inner ear. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temperament: Predisposition to react to one's environment in a certain way; usually refers to mood changes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH]
252 Hypothyroidism
Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalassemia: A group of hereditary hemolytic anemias in which there is decreased synthesis of one or more hemoglobin polypeptide chains. There are several genetic types with clinical pictures ranging from barely detectable hematologic abnormality to severe and fatal anemia. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] 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] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Crisis: Sudden and dangerous increase of the symptoms of thyrotoxicosis. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyroiditis: Inflammation of the thyroid gland. [NIH] Thyrostatic: Antithyroid agent. [EU] Thyrotoxicosis: The clinical syndrome that reflects the response of the peripheral tissues to an excess of thyroid hormone. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus
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refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]
Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH]
254 Hypothyroidism
Translocation: The movement of material in solution inside the body of the plant. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Trigeminal Nerve: The 5th and largest cranial nerve. The trigeminal nerve is a mixed motor and sensory nerve. The larger sensory part forms the ophthalmic, mandibular, and maxillary nerves which carry afferents sensitive to external or internal stimuli from the skin, muscles, and joints of the face and mouth and from the teeth. Most of these fibers originate from cells of the trigeminal ganglion and project to the trigeminal nucleus of the brain stem. The smaller motor part arises from the brain stem trigeminal motor nucleus and innervates the muscles of mastication. [NIH] Trophic: Of or pertaining to nutrition. [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tsh: A glycoprotein secreted by the pars distalis of the pituitary gland in vertebrates that has hormonal activity. It stimulates the growth of the thyroid gland, as well as the secretion of thyroid hormone. [NIH] Tuberculoma: A tumor-like mass resulting from the enlargement of a tuberculous lesion. [NIH]
Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumorigenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH]
Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are
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not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]
Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vancomycin: Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilatation: A state of increased calibre of the blood vessels. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU]
256 Hypothyroidism
Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]
Ventricular Remodeling: The geometric and structural changes that the ventricle undergoes, usually following myocardial infarction. It comprises expansion of the infarct and dilatation of the healthy ventricle segments. While most prevalent in the left ventricle, it can also occur in the right ventricle. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [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] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Villous: Of a surface, covered with villi. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Virus Diseases: A general term for diseases produced by viruses. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is
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dependent mainly on the sharpness of the retinal focus. [NIH] Vitiligo: A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached. [NIH] 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] Vocal cord: The vocal folds of the larynx. [NIH] Vomeronasal Organ: A specialized part of the olfactory system located anteriorly in the nasal cavity within the nasal septum. Chemosensitive cells of the vomeronasal organ project via the vomeronasal nerve to the accessory olfactory bulb. The primary function of this organ appears to be in sensing pheromones which regulate reproductive and other social behaviors. While the structure has been thought absent in higher primate adults, data now suggests it may be present in adult humans. [NIH] Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide. [NIH] Wart: A raised growth on the surface of the skin or other organ. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH]
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Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]
259
INDEX A Abdominal, 67, 183, 233, 235 Aberrant, 36, 37, 183 Acetylcholine, 183, 197 Acetylcholinesterase, 40, 183 Acitretin, 85, 183 Actin, 34, 183, 228 Action Potentials, 97, 125, 183 Actomyosin, 9, 183 Acute leukemia, 102, 183 Adaptability, 183, 195, 196 Adaptation, 97, 183 Adenoma, 46, 101, 183 Adenosine, 183, 186, 193, 236 Adenovirus, 37, 39, 183 Adenylate Cyclase, 39, 183, 210 Adipocytes, 30, 183, 221 Adipose Tissue, 30, 125, 184 Adjustment, 116, 183, 184 Adoptive Transfer, 15, 184 Adrenal Cortex, 184, 201, 239 Adrenal Glands, 184 Adrenal insufficiency, 132, 184 Adrenal Medulla, 184, 195, 207 Adrenergic, 107, 125, 184, 204, 207, 250 Adverse Effect, 11, 33, 184, 247 Aetiology, 14, 44, 184 Afferent, 184, 221 Affinity, 27, 34, 37, 184, 248 Age of Onset, 19, 184, 193 Agenesis, 43, 154, 184 Agonist, 184, 204, 230, 242, 251 Airway, 184, 247 Albumin, 50, 184, 236 Alertness, 185, 193 Algorithms, 185, 191 Alkaline, 185, 193, 251 Alkaloid, 185, 198, 230 Alleles, 6, 185, 215 Alopecia, 17, 185 Alpha Particles, 185, 241 Alpha-fetoprotein, 124, 185, 210 Alternative medicine, 139, 185 Alternative Splicing, 185, 240 Alveolar Process, 185, 243 Amenorrhea, 185, 187 Amifostine, 43, 185 Amino Acid Sequence, 8, 185, 187, 209
Amino Acids, 8, 185, 194, 208, 230, 234, 237, 240, 244, 253, 254 Amiodarone, 100, 144, 186 Amphetamines, 186, 198 Amplification, 22, 186 Amygdala, 16, 186, 190, 222, 251 Anaesthesia, 186, 218 Anal, 186, 207, 223 Analgesic, 186 Analogous, 27, 186, 253 Analytes, 160, 161, 186 Anaphylatoxins, 186, 199 Anaphylaxis, 127, 186 Anatomical, 22, 38, 186, 189, 205, 217, 245 Androgens, 184, 186, 201 Anemia, 127, 156, 176, 186, 210, 235, 252 Anesthesia, 184, 186 Anesthetics, 4, 186, 207 Angina, 186, 187 Anginal, 45, 186, 187 Angiogenesis, 79, 187, 206 Angiogenesis inhibitor, 79, 187, 206 Animal model, 15, 16, 21, 28, 33, 187 Anions, 184, 187, 220, 246 Anomalies, 22, 40, 53, 187 Anorexia, 65, 131, 186, 187 Anorexia Nervosa, 65, 187 Antagonism, 187, 193 Anthropometric measurements, 14, 187 Antiallergic, 187, 201 Antianginal, 186, 187 Antiarrhythmic, 186, 187 Antibiotic, 187, 208, 244, 248 Antibodies, 15, 17, 25, 36, 40, 52, 63, 77, 118, 141, 187, 188, 189, 208, 213, 217, 236, 242 Antibody, 15, 179, 184, 187, 188, 199, 208, 213, 215, 217, 218, 220, 225, 227, 241, 242, 248, 257 Anticoagulant, 187, 240, 257 Antidepressant, 35, 187 Antigen, 184, 186, 187, 188, 190, 199, 212, 215, 216, 217, 218, 225, 242 Antigen-Antibody Complex, 188, 199 Antihypertensive, 188, 210 Anti-infective, 188, 220 Anti-inflammatory, 33, 188, 201, 212, 244, 245
260 Hypothyroidism
Anti-Inflammatory Agents, 188, 201 Antineoplastic, 129, 188, 201 Antioxidant, 188, 233 Antipyretic, 188 Antiserum, 188, 190 Antiviral, 188, 219, 234 Anxiety, 59, 188 Anxiety Disorders, 59, 188 Aorta, 125, 188, 200, 256 Apnea, 188 Apnoea, 61, 188 Apolipoproteins, 188, 222 Aponeurosis, 188, 211 Apoptosis, 7, 32, 37, 188 Aqueous, 116, 188, 190, 202, 221 Aromatic, 188, 194 Arrhythmia, 121, 187, 188 Arterial, 55, 62, 63, 131, 188, 189, 193, 196, 197, 216, 220, 240, 251 Arteries, 131, 188, 192, 194, 196, 200, 201, 223, 226, 228, 237 Arterioles, 188, 192, 194, 228, 255 Arteriovenous, 189, 196 Arteritis, 131, 141, 189, 237 Arthropathy, 128, 141, 189 Articular, 33, 128, 189 Ascites, 189, 231 Asparaginase, 103, 189 Aspartate, 189 Assay, 25, 38, 74, 114, 189, 242, 244 Ataxia, 155, 176, 189, 215, 252 Atrial, 33, 186, 189, 257 Atrial Fibrillation, 33, 189, 257 Atrioventricular, 189, 250 Atrioventricular Node, 189, 250 Atrium, 189, 250, 256 Atrophy, 119, 155, 177, 189 Attenuation, 16, 189 Atypical, 119, 189, 218 Audiology, 129, 189 Auditory, 22, 46, 97, 98, 189, 209, 213 Autoantibodies, 15, 131, 189 Autoantigens, 7, 189 Autoimmune disease, 7, 31, 32, 141, 189, 227 Autoimmunity, 15, 17, 31, 32, 82, 189 Autologous, 101, 189 Autonomic, 183, 185, 190, 235 Autonomic Nervous System, 190, 235 Autosuggestion, 190, 217 Avidity, 52, 190 Axons, 190, 230
B Bacteria, 187, 190, 191, 203, 205, 207, 209, 226, 242, 246, 248, 253, 255 Bacterial Infections, 130, 190, 196 Bacterial Physiology, 183, 190 Bactericidal, 190, 208 Bacteriophage, 190, 253 Bacteriostatic, 190, 208 Barotrauma, 129, 190 Basal Ganglia, 189, 190, 193, 211, 222 Basal Ganglia Diseases, 189, 190 Basal metabolic rate, 141, 190, 216 Base, 7, 190, 202, 220, 251 Benign, 20, 130, 183, 190, 193, 211, 213, 229, 242, 245 Bilateral, 47, 190, 238, 247 Bile, 65, 120, 121, 190, 191, 211, 215, 220, 223, 249 Bile Acids, 120, 121, 190, 191, 249 Bile Acids and Salts, 190, 191 Bile Pigments, 191, 220 Bilirubin, 184, 191, 216 Binding Sites, 21, 191 Bioassays, 15, 191 Biochemical, 11, 20, 29, 31, 37, 38, 98, 116, 185, 191, 221, 246 Biological Markers, 24, 191 Biological response modifier, 191, 219 Biological therapy, 191, 213 Biopsy, 131, 191 Biosynthesis, 25, 39, 191, 210 Biotechnology, 40, 42, 125, 139, 151, 154, 155, 156, 191 Bipolar Disorder, 41, 68, 191 Bladder, 141, 191, 218, 227, 229, 240, 255 Blastocyst, 191, 200, 236 Blood Cell Count, 191, 235 Blood Coagulation, 192, 193, 244 Blood Glucose, 130, 192, 214, 219 Blood Platelets, 192, 246 Blood pressure, 55, 63, 130, 176, 177, 179, 188, 192, 194, 216, 227, 248 Blood-Brain Barrier, 8, 192 Body Fluid Compartments, 55, 192 Body Fluids, 192, 248 Body Mass Index, 192, 233 Bolus, 26, 192 Bolus infusion, 192 Bone Density, 25, 192 Bone Development, 114, 192 Bone Marrow, 183, 192, 201, 208, 217, 223, 248
Index 261
Bone Resorption, 25, 192 Bone scan, 192, 245 Bowel, 186, 192, 203, 218, 229 Bowel Movement, 192, 203 Brachytherapy, 192, 219, 220, 241, 257 Brain Ischemia, 193, 196 Brain Neoplasms, 193, 215, 252 Brain Stem, 193, 196, 254 Branch, 173, 193, 223, 231, 233, 234, 241, 248, 252 Breakdown, 193, 203, 211 Breeding, 22, 193 Bronchi, 193, 207, 209, 253 Buccal, 193, 223 Bullous, 69, 193 C Caffeine, 130, 193 Calcium, 22, 25, 114, 115, 132, 160, 193, 199, 216, 232, 234, 247, 251 Calcium Metabolism Disorders, 114, 193 Callus, 193, 221 Candidiasis, 4, 193 Candidosis, 193 Capillary, 8, 27, 194, 256 Capsules, 194, 204 Carbohydrate, 65, 194, 201 Carbon Dioxide, 194, 211, 236, 243 Carboxy, 194 Carboxylic Acids, 119, 120, 194 Carcinogenesis, 194, 197 Carcinogenic, 194, 219, 239, 249, 254 Carcinogens, 194, 231 Carcinoma, 61, 67, 76, 101, 194 Cardiac catheterization, 194, 242 Cardiomyopathy, 41, 194 Cardiotoxicity, 33, 194 Cardiovascular, 9, 47, 55, 58, 79, 90, 127, 194, 223, 246 Cardiovascular disease, 10, 58, 79, 90, 127, 194, 223 Carotene, 105, 194 Carotid Arteries, 131, 194 Carpal Tunnel Syndrome, 141, 194 Carrier Proteins, 195, 236, 242 Case report, 60, 63, 64, 82, 195, 198 Case series, 195, 198 Catabolism, 25, 195 Catecholamine, 39, 195, 204 Catheters, 18, 195, 217, 219 Caudal, 195, 203, 216, 238 Celiac Disease, 17, 127, 195 Cell Adhesion, 33, 195
Cell Adhesion Molecules, 33, 195 Cell Death, 7, 32, 188, 195, 212, 229 Cell Differentiation, 195, 247 Cell Division, 155, 190, 195, 213, 225, 227, 236, 239, 246 Cell Lineage, 7, 195 Cell membrane, 8, 195, 203, 236 Cell Physiology, 31, 195 Cell proliferation, 195, 247 Cell Survival, 33, 195, 213 Cell Transplantation, 67, 196 Central Nervous System Infections, 196, 213, 215 Centrifugation, 10, 196 Cerebellar, 10, 26, 36, 154, 189, 196, 243 Cerebellum, 10, 26, 36, 41, 193, 196, 210, 243 Cerebral Infarction, 196, 215 Cerebral Palsy, 14, 26, 196, 248 Cerebrospinal, 119, 196, 197, 215 Cerebrospinal fluid, 119, 196, 197, 215 Cerebrovascular, 115, 190, 194, 196, 252 Cerebrovascular Disorders, 115, 196, 252 Cerebrum, 196, 254 Cervical, 196, 225 Character, 196, 202, 212 Cheilitis, 127, 196 Chelation, 101, 105, 196 Chelation Therapy, 101, 105, 196 Chemopreventive, 32, 197 Chemotactic Factors, 197, 199 Chemotherapy, 11, 127, 129, 197 Chimeras, 15, 36, 197 Chimeric Proteins, 15, 197 Cholesterol, 69, 75, 120, 121, 130, 179, 190, 191, 197, 201, 216, 222, 223, 242, 249, 251 Cholesterol Esters, 197, 222 Choline, 183, 197 Cholinergic, 197, 230 Choroid, 14, 39, 197, 244, 255 Choroid Plexus, 14, 39, 197 Chromaffin System, 197, 206 Chromatin, 188, 197, 207 Chromosomal, 186, 197 Chromosome, 71, 197, 215, 222, 246 Chronic renal, 73, 101, 197, 237 Chylomicrons, 197, 222 Circulatory system, 197, 206 Clear cell carcinoma, 197, 203 Cleft Palate, 43, 154, 198 Clinical Medicine, 89, 198, 238 Clinical study, 10, 36, 198
262 Hypothyroidism
Clinical trial, 5, 23, 33, 109, 110, 151, 198, 200, 201, 204, 242 Clone, 5, 198 Cloning, 8, 15, 34, 191, 198 Coagulation, 47, 192, 198, 214, 236, 252, 257 Coca, 198 Cocaine, 11, 198 Cochlea, 198, 219, 249, 251 Cochlear, 22, 97, 125, 129, 198, 253, 256 Cochlear Diseases, 198, 253 Cofactor, 198, 240 Cognition, 13, 23, 51, 59, 88, 198 Colitis, 198, 218 Collagen, 71, 198, 199, 210, 237, 239, 245 Collagen disease, 199, 245 Collapse, 186, 193, 199, 247 Colloidal, 184, 199, 246 Combination Therapy, 20, 199 Complement, 16, 186, 199, 211, 224, 236 Complementary and alternative medicine, 95, 106, 199 Complementary medicine, 95, 199 Computational Biology, 151, 154, 199 Computed tomography, 192, 199, 200, 245 Computerized axial tomography, 200, 245 Conception, 200, 210, 249 Concomitant, 15, 36, 200 Confounding, 18, 200 Confusion, 200, 255 Congestion, 200, 208 Congestive heart failure, 9, 38, 120, 122, 200 Conjugated, 191, 200, 202, 230, 231 Conjunctiva, 200, 245, 254 Connective Tissue, 192, 198, 199, 200, 210, 211, 223, 235, 244, 251 Consciousness, 115, 186, 200, 202, 204 Constipation, 47, 114, 117, 176, 200 Constitutional, 200, 228 Consumption, 29, 200, 231, 233 Contractility, 9, 200 Contraindications, ii, 200 Controlled study, 54, 68, 200 Coordination, 10, 26, 196, 200, 227 Cornea, 200, 245, 255 Coronary, 56, 79, 81, 120, 121, 122, 131, 189, 194, 200, 201, 226, 228 Coronary Arteriosclerosis, 200, 228 Coronary Artery Bypass, 56, 200 Coronary heart disease, 79, 120, 121, 122, 194, 201
Coronary Thrombosis, 201, 226, 228 Cortex, 189, 201, 209, 210, 243 Cortical, 201, 246, 252 Corticosteroid, 127, 131, 201 Cortisol, 26, 185, 201 Cranial, 14, 138, 196, 201, 213, 220, 224, 235, 254, 256 Cranial Irradiation, 138, 201 Craniocerebral Trauma, 190, 201, 213, 215, 252, 253 Creatinine, 55, 201 Crossing-over, 201, 243 Cultured cells, 8, 201 Curative, 140, 201, 252 Cutaneous, 80, 141, 193, 201, 223 Cyanogen Bromide, 116, 201 Cyclic, 183, 193, 201, 210, 238, 239 Cyclosporine, 67, 201 Cytochrome, 36, 202 Cytokine, 32, 33, 202 Cytomegalovirus, 129, 202 Cytoplasm, 188, 195, 202, 207, 213, 244 Cytotoxic, 202, 217, 242, 247 Cytotoxicity, 7, 202 D Databases, Bibliographic, 151, 202 De novo, 38, 202 Decidua, 202, 236 Degenerative, 202, 214 Deletion, 34, 41, 52, 188, 202 Delusions, 6, 202, 241 Dementia, 23, 101, 115, 119, 175, 202 Dendrites, 202, 230, 231 Density, 25, 86, 192, 196, 202, 222, 231, 248 Dental Care, 132, 202 Dental Caries, 4, 203 Dental Hygienists, 4, 203 Depigmentation, 203, 257 Depolarization, 203, 247 Dermal, 203, 222 Dermatitis, 140, 203 DES, 63, 73, 80, 90, 186, 203 Diabetes Insipidus, 82, 203 Diabetes Mellitus, 17, 120, 121, 127, 128, 129, 130, 132, 203, 212, 214 Diagnostic procedure, 113, 139, 203 Diastole, 203 Diastolic, 45, 203, 216 Diencephalon, 196, 203, 216, 252 Dietary Fats, 203, 222 Diffusion, 203, 213, 218
Index 263
Digestion, 116, 190, 191, 192, 203, 222, 223, 249, 255 Digestive system, 110, 203, 227 Digestive tract, 203, 247, 249 Dilatation, 203, 238, 255, 256 Dilation, 203, 215, 255 Dimerization, 37, 204 Direct, iii, 11, 12, 21, 31, 36, 39, 143, 198, 204, 243 Disinfectant, 204, 208 Dissociation, 184, 204 Distal, 7, 200, 204, 240 Diuresis, 193, 204 Dizziness, 130, 204, 256 Domesticated, 204, 213 Dominance, 131, 204 Dopamine, 198, 204 Dorsal, 107, 204, 208, 238, 248 Dorsum, 204, 211 Dosage Forms, 117, 204 Double-blinded, 23, 204 Drug Interactions, 145, 204 Drug Tolerance, 205, 253 Duodenum, 190, 205, 249 Dura mater, 205, 225, 233 Dwarfism, 5, 205 Dysgenesis, 44, 56, 73, 80, 205 Dysplasia, 154, 156, 205 Dystrophy, 155, 205 E Ectopic, 27, 81, 205 Edema, 140, 176, 205, 220, 224, 231 Effector, 37, 183, 199, 205, 230 Efficacy, 23, 33, 205 Effusion, 74, 90, 205 Elastin, 198, 205 Electrocoagulation, 198, 205 Electrolyte, 201, 205, 226, 248 Electrons, 188, 190, 205, 220, 233, 241, 242 Emboli, 205, 220, 257 Embolism, 205, 220, 241, 257 Embolization, 205, 257 Embryo, 191, 192, 195, 205, 210, 212, 218, 232 Enamel, 203, 205 Encephalitis, 119, 206 Encephalitis, Viral, 206 Encephalocele, 206, 229 Endemic, 77, 206, 249 Endocarditis, 193, 206 Endocrine Glands, 206, 234 Endocrine System, 128, 129, 163, 206, 229
Endocrinologist, 4, 162, 206 Endocytosis, 34, 206 Endometrium, 202, 206, 226 Endostatin, 79, 206 Endothelial cell, 27, 40, 192, 206 Endothelium, 62, 206 Endothelium, Lymphatic, 206 Endothelium, Vascular, 206 Endotoxic, 207, 222 Endotoxin, 207, 254 End-stage renal, 197, 207, 237 Energy balance, 207, 221 Enhancer, 7, 207, 243 Environmental Exposure, 191, 207, 231 Environmental Health, 150, 152, 207 Enzymatic, 116, 193, 194, 199, 203, 207, 210 Enzyme, 30, 183, 189, 191, 205, 207, 212, 222, 226, 227, 233, 235, 236, 237, 240, 247, 250, 257 Eosinophilia, 89, 207 Eosinophils, 207, 213, 221 Ependymal, 39, 207 Epidemic, 207, 249 Epidemiologic Studies, 191, 207 Epidemiological, 10, 207 Epidermal, 207, 222, 225 Epidermis, 207, 222 Epidermoid carcinoma, 207, 249 Epinephrine, 30, 184, 204, 207 Episcleritis, 208, 245 Epithelial, 35, 183, 202, 208, 214 Epithelial Cells, 35, 208, 214 Epithelium, 38, 206, 208 Epitope, 15, 208 Epitope Mapping, 15, 208 Erythema, 127, 208, 250, 255 Erythema Multiforme, 127, 208 Erythrocytes, 186, 191, 192, 208, 243 Erythromycin, 129, 208 Erythropoietin, 60, 208 Esophagus, 203, 208, 249 Essential Tremor, 155, 208 Estrogen, 8, 15, 63, 138, 208, 239, 242, 246, 251 Estrogen receptor, 208 Ethanol, 29, 208 Etretinate, 183, 208 Eukaryotic Cells, 208, 218, 232 Eustachian tube, 190, 208 Evacuation, 200, 209 Evoke, 209, 249 Evoked Potentials, 46, 209
264 Hypothyroidism
Exogenous, 28, 209, 240 Exon, 5, 51, 185, 209 Expectorant, 209, 248 Extensor, 209, 240, 257 External-beam radiation, 209, 220, 241, 257 Extracellular, 8, 192, 200, 206, 209, 210, 232, 248, 251 Extracellular Matrix, 200, 209, 210, 232 Extraction, 116, 209 Extraocular, 16, 209 Eye Infections, 183, 209 F Facial, 53, 114, 177, 209, 234 Family Planning, 151, 209 Fat, 29, 39, 44, 95, 120, 121, 183, 184, 191, 192, 194, 201, 205, 209, 221, 222, 227, 233, 237, 244 Fatigue, 47, 117, 140, 141, 177, 209, 214 Fatty acids, 184, 194, 209, 222, 239 Feces, 200, 209 Fetal Alcohol Syndrome, 124, 209 Fetal Development, 210, 229 Fetoprotein, 210 Fetus, 16, 114, 185, 192, 208, 210, 236, 238, 255 Fibrillation, 33, 210 Fibrin, 192, 210, 252 Fibrinolytic, 47, 210 Fibroblasts, 119, 210 Fibrosis, 71, 141, 156, 210, 245 Fissure, 198, 210 Fistula, 130, 210 Flexor, 209, 210, 222 Folate, 210 Fold, 27, 210 Folic Acid, 124, 127, 210 Follicles, 31, 210 Forearm, 192, 210, 225 Forskolin, 27, 105, 210 Fossa, 196, 210 Fourth Ventricle, 197, 210, 252 Fungus, 193, 210 G Gallbladder, 183, 203, 211 Gamma Rays, 211, 241, 242 Ganglia, 107, 183, 185, 190, 211, 229, 235 Ganglion, 114, 211, 254, 256 Gas, 194, 203, 211, 215, 231, 243, 255 Gas exchange, 211, 243 Gastric, 204, 211 Gastrin, 211, 215
Gastrointestinal, 4, 127, 207, 208, 211, 246, 250 Gastrointestinal tract, 4, 208, 211, 246 Gene Expression, 5, 7, 8, 11, 12, 16, 21, 27, 31, 34, 36, 38, 39, 41, 71, 156, 211 Gene Silencing, 12, 211 Generator, 18, 211 Genetic Engineering, 191, 198, 211 Genetic transcription, 211, 239, 253 Genetics, 5, 11, 17, 43, 57, 67, 75, 76, 86, 91, 109, 124, 204, 211 Genotype, 17, 86, 211, 235 Geriatric, 62, 211 Germ Cells, 211, 225, 231, 233, 251 Germ Layers, 192, 212 Gestation, 10, 16, 26, 114, 212, 235, 236 Gestational, 26, 126, 212 Giant Cells, 212, 245 Glioma, 77, 212 Glomerular, 212, 243 Glucocorticoid, 28, 39, 212 Glucose, 47, 78, 96, 155, 192, 203, 212, 214, 219, 245 Glucose Intolerance, 203, 212 Glucuronic Acid, 212, 214 Glutamic Acid, 210, 212, 239 Glutathione Peroxidase, 212, 246 Gluten, 127, 195, 212 Glycoprotein, 7, 116, 208, 212, 213, 254 Glycosaminoglycans, 212, 227 Goiter, 4, 40, 57, 90, 115, 118, 161, 212 Gonad, 212 Gonadal, 18, 212, 249 Governing Board, 213, 238 Gp120, 213, 234 Grade, 72, 77, 131, 213 Graft, 56, 213, 217 Grafting, 200, 213 Granule, 10, 31, 213, 244 Granulocytes, 213, 247, 257 Granuloma, 127, 129, 213 Grasses, 210, 213 Gravis, 17, 213 Growth factors, 132, 213 Guinea Pigs, 97, 125, 213 H Haemodialysis, 69, 213 Hair Cells, 22, 213, 251 Half-Life, 20, 183, 213 Haptens, 184, 213, 242 Headache, 138, 193, 213, 214, 215 Headache Disorders, 213, 214
Index 265
Heart attack, 194, 214 Heart failure, 9, 10, 214, 231 Hematology, 127, 214 Heme, 119, 191, 202, 214, 233, 237, 238 Hemoglobin, 186, 192, 208, 214, 238, 252 Hemoglobinuria, 155, 214 Hemolytic, 214, 252 Hemorrhage, 115, 201, 205, 213, 214, 250, 251 Hemostasis, 127, 214, 246 Heparin, 98, 214 Hepatic, 28, 40, 67, 107, 185, 214, 237 Hepatitis, 69, 214, 218 Hepatocytes, 214 Hepatomegaly, 214, 218 Hereditary, 43, 129, 214, 235, 244, 252 Heredity, 211, 214 Hernia, 114, 214 Heterodimers, 21, 215 Heterogeneity, 17, 19, 35, 119, 184, 215 Heterozygote, 24, 215 Hoarseness, 142, 177, 215 Homeostasis, 25, 27, 30, 120, 121, 215 Homologous, 34, 185, 201, 215, 228, 246, 250 Homozygotes, 204, 215 Hormonal, 3, 11, 15, 25, 38, 161, 189, 201, 215, 254 Hormonal therapy, 11, 215 Hormone Replacement Therapy, 89, 117, 215 Hormone therapy, 215 Humoral, 33, 215 Humour, 215 Hybrid, 198, 215 Hybridization, 36, 215 Hydrocephalus, 119, 215, 220 Hydrogen, 190, 194, 212, 215, 222, 227, 230, 233, 235, 240 Hydrolysis, 9, 183, 216, 236, 237, 240 Hydrophobic, 216, 222 Hydroxylysine, 198, 216 Hydroxyproline, 198, 216 Hyperbilirubinemia, 50, 216, 220 Hypercalcemia, 4, 114, 133, 216 Hypercholesterolemia, 122, 216 Hyperglycemia, 41, 132, 216 Hypergravity, 10, 216 Hyperlipidemia, 120, 121, 122, 216 Hyperplasia, 101, 118, 216, 222 Hypersensitivity, 186, 216, 244
Hypertension, 33, 55, 63, 120, 121, 122, 132, 194, 216, 220 Hyperthyroxinemia, 50, 216 Hypertrophic cardiomyopathy, 9, 216 Hypertrophy, 37, 216 Hypoglycemia, 132, 216 Hypogonadism, 17, 165, 216 Hypothalamic, 4, 11, 16, 18, 28, 35, 39, 57, 126, 216 Hypothalamus, 21, 180, 190, 193, 203, 216, 222, 236, 252 Hypotonia, 114, 216 Hypoxia, 8, 193, 196, 217, 252 I Iatrogenic, 99, 217 Id, 92, 103, 161, 162, 163, 164, 165, 166, 172, 174, 217 Idiopathic, 24, 80, 129, 217, 245 Illusion, 217, 256 Immune response, 7, 15, 32, 34, 187, 189, 201, 213, 217, 224, 245, 250, 256 Immune system, 21, 189, 191, 217, 227, 257 Immunization, 184, 217 Immunochemistry, 208, 217 Immunodeficiency, 63, 155, 217 Immunogenic, 217, 222, 242 Immunoglobulin, 187, 217, 227 Immunohistochemistry, 40, 217 Immunologic, 129, 184, 197, 217, 242 Immunology, 15, 184, 217 Immunosuppressive, 33, 131, 212, 217, 245 Immunosuppressive Agents, 217, 245 Immunotherapy, 184, 191, 217 Impairment, 11, 66, 189, 196, 209, 217, 226, 240 Implant radiation, 217, 219, 220, 241, 257 Impotence, 141, 218 In situ, 5, 8, 16, 22, 38, 218 In Situ Hybridization, 5, 8, 16, 22, 38, 218 In vitro, 11, 22, 34, 36, 39, 101, 125, 218, 244 In vivo, 8, 11, 22, 30, 34, 36, 37, 39, 214, 218, 222 Incontinence, 215, 218 Indicative, 124, 218, 234, 255 Induction, 7, 28, 30, 63, 186, 218, 239, 242 Induration, 141, 218 Infancy, 13, 18, 39, 218 Infantile, 27, 36, 40, 125, 218 Infarction, 193, 196, 218, 237 Infection, 82, 115, 191, 193, 197, 202, 206, 209, 217, 218, 223, 244, 250, 253, 255, 257
266 Hypothyroidism
Infectious Mononucleosis, 128, 218 Infertility, 5, 30, 104, 218 Infiltration, 31, 32, 141, 218 Inflammatory bowel disease, 78, 218 Initiation, 218, 239, 253 Inner ear, 22, 129, 130, 198, 219, 221, 251, 255 Innervation, 219, 225, 241 Inorganic, 28, 219 Insight, 8, 11, 12, 13, 21, 33, 37, 38, 119, 219 Insulator, 219, 228 Insulin, 64, 132, 152, 219 Insulin-dependent diabetes mellitus, 219 Intensive Care, 69, 219 Interferon, 31, 32, 33, 64, 69, 101, 219 Interferon-alpha, 64, 219 Interleukin-2, 101, 219 Interleukin-4, 34, 219 Internal Medicine, 7, 20, 30, 89, 206, 214, 219 Internal radiation, 219, 220, 241, 257 Interstitial, 192, 219, 220, 243, 257 Intestinal, 194, 195, 219, 224 Intestines, 183, 209, 211, 219 Intoxication, 115, 130, 220, 257 Intracellular, 8, 11, 35, 192, 193, 218, 220, 224, 225, 239, 242, 246, 247 Intracellular Membranes, 220, 225 Intracranial Embolism, 196, 220 Intracranial Embolism and Thrombosis, 196, 220 Intracranial Hemorrhages, 215, 220, 252 Intracranial Hypertension, 213, 215, 220, 253 Intraocular, 210, 220 Intraocular pressure, 210, 220 Intravenous, 42, 180, 220 Intrinsic, 184, 220 Invasive, 220, 224, 242 Involuntary, 190, 208, 210, 220, 228 Ionizing, 185, 207, 220, 242 Ions, 190, 204, 205, 215, 220 Irradiation, 4, 140, 220, 257 Ischemia, 189, 193, 220 J Jaundice, 114, 216, 220 Joint, 33, 128, 162, 177, 189, 210, 220, 237, 250, 251 K Kb, 5, 150, 220 Keratolytic, 203, 221 Keratosis, 85, 221
Kidney Disease, 48, 109, 110, 127, 150, 156, 163, 221 Kinetics, 9, 221 L Labile, 199, 221 Labyrinth, 198, 219, 221, 233, 235, 246, 256 Labyrinthine, 130, 221 Labyrinthitis, 129, 130, 221 Lactation, 221, 239 Large Intestine, 203, 219, 221, 243, 247 Larva, 221, 226 Laryngeal, 140, 221 Laryngectomy, 61, 78, 221 Larynx, 221, 253, 257 Lectin, 221, 225 Lens, 221, 243 Leptin, 39, 221 Lesion, 200, 213, 221, 223, 246, 254 Lethargy, 75, 114, 117, 215, 216, 221 Leukemia, 127, 128, 155, 221 Leukocytes, 191, 192, 197, 207, 213, 219, 221, 235, 254 Levothyroxine, 4, 20, 54, 58, 62, 68, 88, 90, 116, 221 Library Services, 172, 221 Lichen Planus, 127, 208, 222 Ligament, 142, 222, 240 Ligands, 7, 119, 120, 121, 122, 195, 222 Limbic, 186, 222 Limbic System, 186, 222 Linkage, 6, 17, 19, 22, 33, 67, 82, 91, 102, 222 Lipase, 30, 98, 222 Lipid, 9, 30, 68, 80, 90, 188, 197, 219, 222, 228, 233 Lipid A, 80, 222 Lipid Peroxidation, 222, 233 Lipid Peroxides, 90, 222 Lipopolysaccharides, 222 Lipoprotein, 30, 48, 68, 69, 222, 223 Lipoprotein(a), 48, 222 Liver cancer, 185, 223 Liver scan, 223, 245 Localization, 8, 17, 31, 217, 223 Localized, 70, 193, 203, 218, 222, 223, 231, 236, 245, 255 Locomotion, 223, 236 Locomotor, 25, 223 Longitudinal study, 67, 88, 223 Loop, 129, 214, 223 Low-density lipoprotein, 49, 69, 222, 223 Lupus, 17, 69, 223, 251
Index 267
Lutein Cells, 223, 239 Lymph, 196, 197, 206, 215, 218, 223, 224, 245 Lymph node, 196, 223, 224, 245 Lymphadenopathy, 218, 223 Lymphatic, 206, 218, 223, 231, 237, 248, 249 Lymphatic system, 223, 248, 249 Lymphedema, 70, 224 Lymphocytic, 32, 224 Lymphoid, 187, 224 Lymphokine, 101, 224 Lymphoma, 155, 224 Lysosomal Storage Diseases, 224, 227 M Magnetic Resonance Imaging, 224, 245 Major Histocompatibility Complex, 219, 224 Malabsorption, 155, 195, 224 Malaise, 131, 224 Malignancy, 67, 127, 129, 133, 224 Malignant, 130, 155, 188, 193, 223, 224, 225, 229, 242 Malnutrition, 10, 90, 185, 189, 224, 228 Mammary, 200, 224, 242, 251 Mandible, 185, 224, 243 Manic, 191, 224, 241 Manic-depressive psychosis, 224, 241 Manifest, 127, 224 Mastication, 224, 254 Maxillary, 224, 254 Maxillary Nerve, 224, 254 Meat, 116, 203, 224 Median Nerve, 194, 225 Mediate, 7, 12, 33, 34, 38, 39, 195, 204, 225 Mediator, 219, 225, 246 Medical Records, 26, 225 Medical Staff, 204, 225 MEDLINE, 151, 154, 156, 225 Medulloblastoma, 60, 225 Megaloblastic, 210, 225 Meiosis, 225, 228, 250 Melanocytes, 225 Melanoma, 101, 155, 225 Membrane Proteins, 31, 35, 225 Memory, 59, 88, 129, 187, 202, 225 Menarche, 66, 225 Meninges, 196, 201, 205, 225 Meningitis, 129, 225 Menopause, 104, 129, 163, 164, 225, 238 Menstrual Cycle, 129, 226, 239 Menstruation, 177, 185, 202, 225, 226
Mental deficiency, 209, 226 Mental Disorders, 111, 226, 240, 241 Mental Health, iv, 5, 111, 150, 153, 226, 241 Mental Retardation, 13, 38, 114, 157, 226 Metabolic disorder, 126, 127, 129, 130, 203, 226 Metabolite, 183, 226, 238 Metamorphosis, 38, 226, 231 Metastasis, 195, 226 Metastatic, 67, 193, 226 Methimazole, 22, 98, 226 MI, 181, 226 Microbiology, 15, 21, 183, 189, 226 Microorganism, 198, 226, 257 Micro-organism, 203, 226 Microscopy, 8, 38, 226 Milliliter, 192, 226 Mineralocorticoids, 184, 201, 226 Miscarriage, 104, 138, 227 Mitochondrial Swelling, 227, 229 Mitosis, 188, 227 Mobility, 128, 227 Modification, 37, 211, 227, 241 Modulator, 227 Molecule, 37, 187, 190, 191, 199, 204, 205, 208, 213, 216, 221, 227, 230, 233, 242, 247, 255 Monitor, 120, 201, 227, 230 Monoclonal, 43, 220, 227, 241, 257 Mononuclear, 31, 131, 213, 218, 227, 254 Morphogenesis, 209, 227 Morphological, 22, 36, 205, 211, 225, 227 Morphology, 214, 227 Motility, 227, 246 Mucinous, 211, 227 Mucocutaneous, 4, 227 Mucopolysaccharidoses, 126, 128, 227 Mucosa, 128, 195, 223, 227, 229, 239 Mucositis, 140, 227 Multimodality treatment, 61, 227 Multiple sclerosis, 17, 227 Multivalent, 190, 228 Muscle Fibers, 16, 189, 228 Muscular Atrophy, 155, 228 Muscular Dystrophies, 205, 228 Musculature, 114, 228 Musculoskeletal System, 141, 228 Mutagenesis, 8, 228 Mutagens, 228 Myasthenia, 17, 228 Myelin, 11, 227, 228
268 Hypothyroidism
Myeloma, 127, 228 Myeloproliferative Disorders, 127, 228 Myocardial infarction, 201, 226, 228, 256, 257 Myocardial Ischemia, 102, 228 Myocardium, 9, 27, 37, 226, 228 Myopathy, 72, 141, 162, 228 Myosin, 16, 34, 37, 183, 228 Myotonic Dystrophy, 155, 228 Myxedema, 72, 116, 117, 141, 155, 228 N Nasal Cavity, 229, 257 Nasal Septum, 229, 257 Nausea, 204, 229, 255 NCI, 1, 110, 149, 229 Necrosis, 79, 140, 141, 188, 196, 218, 226, 228, 229, 232, 244, 245, 246 Need, 3, 63, 86, 123, 125, 126, 140, 141, 146, 152, 167, 197, 229, 253 Neonatal, 4, 10, 13, 14, 18, 21, 26, 28, 47, 49, 50, 56, 58, 64, 67, 68, 70, 71, 72, 80, 84, 85, 88, 98, 99, 100, 102, 125, 229 Neonatal period, 10, 13, 14, 26, 47, 88, 229 Neonatal Screening, 21, 50, 56, 64, 67, 68, 85, 125, 229 Neoplasia, 128, 155, 208, 229 Neoplasm, 109, 229, 254 Neoplastic, 224, 229 Nephropathy, 221, 229 Nervous System, 11, 36, 37, 38, 114, 155, 183, 184, 186, 190, 193, 196, 198, 209, 211, 212, 213, 225, 227, 229, 230, 235, 246, 250, 251 Neural, 124, 184, 206, 210, 215, 229 Neural tube defects, 124, 210, 229 Neuroendocrine, 30, 229 Neurologic, 114, 131, 206, 215, 229 Neurologist, 14, 229 Neuromuscular, 183, 230 Neuromuscular Junction, 183, 230 Neuronal, 26, 38, 230 Neurons, 26, 34, 39, 198, 202, 211, 230, 250, 256 Neuropeptide, 39, 230 Neuropil, 36, 230 Neurosecretory Systems, 206, 230 Neurotoxicity, 26, 230 Neurotoxin, 114, 115, 118, 230 Neurotransmitters, 230 Neutrons, 185, 220, 230, 241 Nicotine, 130, 230
Nuclear, 12, 32, 34, 36, 37, 90, 96, 101, 190, 205, 208, 211, 222, 229, 230, 242 Nuclear Proteins, 37, 230 Nuclei, 89, 99, 185, 186, 205, 211, 222, 224, 227, 230, 240, 256 Nucleic acid, 215, 218, 228, 230, 231 Nucleic Acid Hybridization, 215, 230 Nucleoproteins, 230, 231 Nutritional Status, 89, 99, 132, 231 Nymph, 226, 231 Nystagmus, 221, 231 O Oedema, 80, 231 Ointments, 204, 231 Olfaction, 132, 231 Olfactory Bulb, 231, 257 Oncogene, 155, 231 Oncology, 24, 43, 60, 61, 91, 127, 231 Oocytes, 8, 231 Opacity, 202, 231 Operon, 231, 239, 243 Ophthalmic, 144, 162, 231, 254 Ophthalmologic, 131, 231 Ophthalmology, 47, 163, 231 Optic Chiasm, 216, 231 Oral Health, 4, 126, 127, 128, 232 Oral Manifestations, 126, 128, 232 Orbit, 232 Orbital, 47, 232 Organelles, 196, 202, 225, 232 Orofacial, 127, 232 Osmotic, 184, 227, 232, 246 Osseointegration, 192, 232 Ossicles, 232, 233 Osteoblasts, 25, 132, 232 Osteocalcin, 24, 232 Osteoclasts, 25, 132, 232 Osteocytes, 132, 232 Osteodystrophy, 43, 232 Osteogenesis, 192, 232 Osteoporosis, 90, 104, 120, 121, 122, 141, 232, 242 Osteoradionecrosis, 140, 232 Otolaryngologist, 130, 232 Otolaryngology, 53, 78, 130, 160, 233 Otology, 130, 233 Otosclerosis, 129, 130, 233 Outpatient, 10, 233 Ovarian Cysts, 77, 233 Ovaries, 66, 233, 247 Ovary, 212, 233 Overexpress, 38, 233
Index 269
Overweight, 92, 120, 122, 233 Ovum, 202, 212, 233, 239 Oxamic Acid, 121, 233 Oxidation, 188, 202, 212, 222, 226, 233 Oxidative Stress, 8, 29, 75, 233 Oxygen Consumption, 115, 233, 243 Oxygenase, 119, 233 P Pacemaker, 233 Pachymeningitis, 225, 233 Palate, 198, 233 Palliative, 233, 252 Palsy, 119, 141, 233 Pancreas, 183, 203, 219, 222, 233, 234 Pancreatic, 155, 234 Pancreatic cancer, 155, 234 Paralysis, 234, 241, 248 Parathyroid, 4, 100, 132, 133, 234, 251 Parathyroid Glands, 4, 234 Parathyroid hormone, 133, 234 Parent-Child Relations, 24, 234 Parotid, 234, 245 Paroxysmal, 155, 214, 234 Particle, 9, 234, 248, 253 Parturition, 234, 239 Pathogenesis, 6, 7, 17, 22, 25, 31, 32, 71, 101, 131, 234 Pathologic, 32, 37, 133, 141, 188, 191, 194, 200, 216, 234, 240, 243, 247, 255 Pathologic Processes, 188, 234 Pathologies, 52, 234 Pathophysiology, 8, 19, 26, 36, 234 Patient Education, 164, 170, 172, 181, 234 Pelvic, 234, 240 Peptide, 115, 221, 234, 237, 240, 252 Peptide T, 115, 234 Perception, 129, 234, 245 Perfusion, 217, 234, 253 Pericardium, 235, 251 Perilymph, 130, 235 Perinatal, 14, 25, 36, 73, 100, 235 Periodontal Ligament, 141, 235 Peripheral Nervous System, 98, 233, 235, 250 Peritoneal, 189, 231, 235 Peritoneal Cavity, 189, 231, 235 Pernicious, 17, 225, 235 Pernicious anemia, 17, 235 Peroxidase, 36, 52, 74, 222, 226, 235 Peroxide, 212, 222, 235 PH, 64, 103, 192, 235
Pharmaceutical Preparations, 117, 118, 208, 235 Pharmaceutical Solutions, 204, 235 Pharmacologic, 186, 213, 235, 253 Phenotype, 5, 6, 36, 37, 191, 235 Pheromones, 235, 257 Phorbol, 30, 236 Phospholipases, 236, 247 Phospholipids, 209, 222, 236 Phosphorus, 193, 234, 236 Phosphorylated, 31, 37, 236 Phosphorylation, 9, 31, 37, 39, 236 Photocoagulation, 198, 236 Physical Examination, 4, 236 Physiologic, 8, 20, 30, 37, 39, 40, 184, 191, 210, 213, 226, 236, 239, 242, 243 Physiology, 8, 27, 132, 191, 206, 214, 236 Pigment, 191, 203, 225, 236 Pilot study, 26, 45, 72, 236 Pituitary Gland, 21, 32, 76, 118, 165, 201, 210, 236, 254 Placenta, 27, 40, 236, 239 Plants, 185, 193, 194, 197, 198, 212, 221, 227, 236, 237, 244, 253 Plasma cells, 187, 228, 236 Plasma protein, 184, 206, 236, 246 Platelet Activation, 236, 247 Platelet Aggregation, 186, 210, 237 Platinum, 223, 237 Pleural, 231, 237 Pleural cavity, 231, 237 Plexus, 14, 39, 225, 237 Poisoning, 196, 220, 229, 237 Polyarteritis Nodosa, 129, 237 Polycystic, 156, 237 Polymerase, 237, 239, 243 Polymorphism, 6, 19, 75, 237 Polymyalgia Rheumatica, 131, 141, 237 Polypeptide, 39, 115, 185, 198, 215, 237, 239, 240, 252 Polyunsaturated fat, 98, 237 Porphyria, 127, 237 Porphyrins, 237 Posterior, 47, 186, 189, 196, 197, 204, 233, 238, 245 Postmenopausal, 138, 232, 238, 242 Postnatal, 16, 19, 41, 76, 107, 209, 238, 249 Postsynaptic, 238, 247, 251 Potentiation, 238, 247 Practice Guidelines, 125, 129, 153, 165, 238 Precancerous, 197, 238 Precipitating Factors, 130, 214, 238
270 Hypothyroidism
Precipitation, 116, 238 Preclinical, 33, 238 Precursor, 5, 11, 197, 204, 205, 207, 238, 254 Predictive factor, 62, 238 Prenatal, 13, 28, 114, 124, 205, 209, 238 Presbycusis, 129, 238 Prevalence, 16, 18, 28, 31, 39, 63, 76, 117, 131, 238 Primitive neuroectodermal tumors, 225, 238 Probe, 6, 10, 238 Prodrug, 117, 238 Progesterone, 238, 239, 249 Prognostic factor, 44, 239 Progression, 18, 33, 119, 187, 239 Progressive, 119, 141, 195, 197, 202, 205, 213, 227, 228, 229, 236, 238, 239, 243, 254 Projection, 39, 231, 239, 243 Prolactin, 5, 46, 77, 115, 179, 239 Proline, 198, 216, 239 Promoter, 7, 27, 28, 31, 32, 36, 239 Promotor, 32, 239, 243 Prophase, 228, 231, 239, 250 Prophylaxis, 203, 208, 239, 257 Proportional, 5, 239 Prospective study, 14, 77, 223, 239 Prostaglandin, 239 Prostate, 155, 240 Protease, 199, 240 Protein Binding, 240, 253 Protein C, 116, 183, 184, 185, 188, 190, 222, 232, 240, 254 Protein Conformation, 185, 240 Protein Isoforms, 9, 185, 240 Protein S, 31, 35, 125, 156, 191, 208, 232, 240, 244 Proteolytic, 199, 240 Protons, 185, 215, 220, 240, 241 Proximal, 7, 114, 204, 229, 237, 240 Pruritic, 222, 240 Pseudotumour, 47, 240 Psoriasis, 183, 208, 240 Psychiatric, 6, 38, 95, 191, 226, 240 Psychiatry, 6, 15, 23, 28, 35, 53, 68, 72, 240, 250 Psychic, 240, 246 Psychomotor, 62, 206, 240 Psychosis, 72, 212, 240 Ptosis, 55, 241 Puberty, 18, 71, 241 Public Health, 21, 23, 72, 73, 125, 153, 241
Public Policy, 151, 241 Publishing, 40, 126, 166, 241 Pulmonary, 41, 48, 127, 131, 192, 200, 241, 256, 257 Pulmonary Artery, 192, 241, 256 Pulmonary Embolism, 241, 257 Pulse, 18, 179, 227, 241 Pupa, 226, 241 Q Quality of Life, 23, 49, 132, 241 Quiescent, 241, 257 R Race, 25, 241 Radiation, 43, 60, 61, 127, 140, 180, 185, 207, 209, 211, 219, 220, 232, 241, 242, 245, 250, 257 Radiation therapy, 127, 140, 180, 209, 219, 220, 241, 257 Radioactive, 4, 74, 118, 192, 213, 215, 217, 219, 220, 223, 230, 241, 242, 245, 248, 254, 257 Radioactivity, 201, 241 Radioimmunoassay, 120, 242 Radioimmunotherapy, 242 Radiolabeled, 220, 241, 242, 257 Radionuclide Ventriculography, 45, 242 Radiopharmaceutical, 211, 242 Radiotherapy, 11, 60, 61, 192, 220, 241, 242, 257 Raloxifene, 242, 246 Randomized, 23, 42, 49, 53, 68, 205, 242 Reactive Oxygen Species, 29, 242 Reagent, 201, 242 Reality Testing, 240, 242 Receptors, Serotonin, 242, 246 Recombinant, 15, 33, 37, 77, 115, 242, 243, 255 Recombinant Proteins, 15, 243 Recombination, 34, 243 Rectum, 192, 203, 211, 218, 221, 240, 243 Recurrence, 191, 224, 243 Red blood cells, 208, 214, 233, 243, 245 Red Nucleus, 189, 243 Refer, 1, 193, 199, 204, 223, 230, 241, 242, 243, 256 Reflective, 20, 243 Refractory, 11, 42, 205, 243 Regimen, 53, 205, 243, 244 Relaxant, 210, 243 Remission, 191, 224, 243 Renal failure, 133, 214, 243 Repressor, 13, 231, 243
Index 271
Resection, 60, 243 Resolving, 19, 243 Resorption, 25, 141, 215, 232, 243 Respiration, 188, 194, 227, 243 Respiratory failure, 52, 59, 243 Response Elements, 12, 13, 21, 243 Retina, 197, 221, 232, 243, 244, 255 Retinoblastoma, 155, 244 Retinoid, 16, 21, 32, 138, 183, 208, 244 Retreatment, 76, 244 Retrospective, 44, 244 Rhabdomyolysis, 60, 244 Rheumatic Diseases, 128, 131, 141, 244 Rheumatism, 244 Rheumatoid, 17, 33, 141, 199, 244 Rheumatoid arthritis, 17, 33, 141, 199, 244 Riboflavin, 127, 244 Ribosome, 244, 253 Rigidity, 114, 236, 244 Risk factor, 14, 55, 58, 66, 78, 79, 90, 138, 152, 207, 239, 244 Ristocetin, 244, 255 Rubella, 129 S Salicylate, 244 Salicylic, 244 Salicylic Acids, 244 Saline, 26, 116, 244 Salivary, 202, 203, 234, 244, 257 Salivary glands, 202, 203, 244 Saphenous, 200, 244 Saphenous Vein, 200, 244 Saponins, 244, 249 Sarcoidosis, 127, 129, 245 Scans, 19, 245 Schizoid, 245, 257 Schizophrenia, 6, 75, 245, 257 Schizotypal Personality Disorder, 245, 257 Sclera, 197, 200, 208, 245, 255 Scleritis, 47, 245 Scleroderma, 141, 245 Sclerosis, 17, 141, 155, 199, 227, 245 Screening, 24, 29, 45, 63, 68, 72, 73, 78, 79, 83, 85, 86, 89, 90, 99, 116, 121, 124, 141, 198, 229, 245 Scrotum, 245, 251 Secretory, 30, 35, 246, 250 Segregation, 6, 243, 246 Seizures, 100, 127, 234, 246 Selective estrogen receptor modulator, 15, 242, 246, 251 Selenium, 93, 100, 101, 246
Sella, 204, 236, 246 Semen, 240, 246 Semicircular canal, 219, 246 Senile, 115, 232, 238, 246 Sepsis, 28, 246 Septic, 28, 246 Sequela, 138, 246 Sequence Homology, 234, 246 Sequencing, 19, 246 Sequester, 196, 246 Serotonin, 35, 91, 242, 246, 254 Serous, 206, 246 Sertraline, 35, 246 Serum Albumin, 242, 246 Sex Characteristics, 186, 241, 247, 251 Sex Determination, 155, 247 Shock, 186, 247, 254 Shoulder Pain, 141, 247 Side effect, 4, 117, 140, 143, 146, 184, 191, 247, 253 Signal Transduction, 22, 247 Signs and Symptoms, 3, 237, 243, 247 Skeletal, 4, 9, 80, 90, 186, 205, 216, 228, 244, 247 Skeleton, 183, 220, 239, 247 Skull, 201, 206, 229, 232, 247, 251 Sleep apnea, 85, 247 Small intestine, 197, 205, 215, 219, 247, 256 Smooth muscle, 186, 193, 210, 247, 250 Social Behavior, 247, 257 Social Environment, 241, 247 Sodium, 31, 63, 144, 146, 179, 226, 248 Sodium Iodide, 31, 248 Solid tumor, 187, 206, 248 Solvent, 116, 208, 232, 235, 248 Somatic, 215, 222, 225, 227, 235, 248 Sound wave, 243, 248 Soybean Oil, 237, 248 Spastic, 58, 248 Spasticity, 114, 248 Spatial disorientation, 204, 248 Specialist, 167, 204, 248 Species, 8, 18, 29, 196, 204, 207, 213, 215, 225, 227, 235, 241, 242, 246, 247, 248, 250, 254, 257 Specificity, 12, 25, 27, 30, 184, 248, 253 Spectrum, 227, 248 Sperm, 186, 197, 248, 251 Spina bifida, 229, 248 Spinal cord, 193, 196, 197, 205, 207, 211, 225, 229, 233, 235, 248 Spinal Nerves, 235, 248
272 Hypothyroidism
Spiral Lamina, 249, 251 Spirochete, 249, 251 Spleen, 202, 223, 245, 249 Splenomegaly, 218, 249 Sporadic, 68, 69, 244, 249 Squamous, 61, 207, 249 Squamous cell carcinoma, 61, 207, 249 Squamous cells, 249 Staging, 245, 249 Steady state, 9, 249 Stem Cells, 208, 249 Sterile, 234, 249 Sterility, 218, 249 Steroid, 8, 80, 131, 191, 201, 245, 249 Stimulant, 193, 249 Stimulus, 30, 200, 209, 219, 249, 252 Stomach, 117, 183, 190, 203, 208, 211, 215, 219, 229, 235, 247, 249 Stress, 24, 28, 29, 102, 129, 130, 190, 195, 201, 229, 233, 244, 249, 255 Stroke, 111, 138, 150, 162, 194, 249 Struma, 60, 250 Stupor, 221, 250 Subacute, 63, 162, 218, 250 Subarachnoid, 210, 213, 220, 250 Subcutaneous, 33, 183, 205, 231, 250 Subspecies, 248, 250 Substance P, 208, 226, 244, 245, 250 Substrate, 9, 250 Sunburn, 140, 250 Supplementation, 26, 28, 36, 53, 82, 91, 97, 98, 100, 102, 103, 250 Suppression, 26, 31, 81, 83, 131, 201, 211, 250 Suppressive, 117, 250 Supraventricular, 33, 250 Sympathomimetic, 204, 207, 250 Symphysis, 240, 250 Symptomatic, 131, 250 Synapsis, 250 Synaptic, 34, 230, 247, 250 Synaptic Transmission, 230, 250 Synergistic, 239, 251 Synovial, 33, 251 Syphilis, 129, 251 Systemic, 126, 127, 128, 131, 141, 144, 145, 180, 186, 188, 192, 193, 199, 207, 218, 220, 231, 241, 245, 251, 255, 257 Systemic disease, 126, 128, 251 Systemic lupus erythematosus, 141, 199, 251 Systolic, 216, 251
T Tachycardia, 33, 251 Tamoxifen, 77, 246, 251 Tamponade, 72, 74, 90, 251 Tectorial Membrane, 22, 251 Telangiectasia, 155, 251 Temperament, 24, 251 Temporal, 28, 38, 129, 130, 131, 186, 214, 237, 251 Temporal Lobe, 186, 251 Testicles, 142, 245, 251 Testicular, 141, 251 Testis, 18, 251 Testosterone, 67, 251 Tetany, 234, 251 Thalamic, 189, 251, 252 Thalamic Diseases, 189, 252 Thalassemia, 99, 252 Therapeutics, 15, 96, 145, 252 Third Ventricle, 216, 252 Threonine, 234, 252 Threshold, 216, 252 Thrombosis, 220, 240, 250, 252 Thrombus, 201, 218, 228, 237, 252, 256 Thyroid Crisis, 56, 252 Thyroid Hormones, 4, 16, 20, 29, 37, 39, 106, 120, 121, 133, 145, 226, 252 Thyroiditis, 4, 7, 18, 31, 32, 57, 60, 63, 66, 70, 82, 90, 105, 115, 118, 124, 162, 163, 164, 252 Thyrostatic, 117, 252 Thyrotoxicosis, 27, 54, 71, 74, 100, 126, 128, 141, 252 Thyrotropin, 15, 21, 32, 35, 39, 41, 50, 51, 53, 65, 74, 77, 83, 90, 91, 99, 216, 252 Tin, 194, 237, 252 Tinnitus, 130, 252, 256 Tissue Distribution, 5, 253 Tolerance, 141, 183, 212, 253 Tomography, 47, 96, 200, 253 Tooth Preparation, 183, 253 Topical, 91, 208, 253 Toxic, iv, 4, 90, 202, 207, 213, 222, 230, 246, 253, 255 Toxicity, 194, 204, 244, 253 Toxicology, 98, 152, 253 Toxins, 187, 206, 212, 218, 242, 253 Toxoplasmosis, 129, 253 Trachea, 193, 209, 221, 252, 253 Transcription Factors, 243, 253 Transduction, 9, 22, 247, 253 Transfection, 31, 36, 191, 253
Index 273
Translation, 30, 208, 253 Translational, 6, 30, 211, 253 Translocation, 208, 254 Transplantation, 48, 67, 69, 101, 197, 217, 224, 254 Trauma, 119, 129, 130, 229, 254 Trigeminal, 141, 224, 254 Trigeminal Nerve, 141, 254 Trophic, 36, 254 Tryptophan, 198, 246, 254 Tsh, 161, 254 Tuberculoma, 82, 254 Tuberculosis, 200, 223, 244, 254 Tuberous Sclerosis, 155, 254 Tumor Necrosis Factor, 33, 254 Tumorigenic, 115, 254 Tumour, 79, 211, 240, 254 U Ultrasonography, 44, 49, 254 Unconscious, 186, 217, 254 Urea, 254 Uremia, 130, 243, 254 Urethra, 240, 255 Urinary, 120, 215, 218, 254, 255 Urinate, 141, 255 Urine, 114, 120, 191, 201, 203, 204, 214, 218, 244, 255 Urticaria, 186, 255 Uterus, 196, 202, 206, 226, 233, 239, 251, 255 Uvea, 255 Uveitis, 47, 80, 255 V Vaccines, 255, 256 Vacuoles, 206, 232, 255 Vagina, 193, 203, 226, 251, 255 Vaginitis, 193, 255 Vancomycin, 129, 255 Vascular, 40, 42, 80, 85, 119, 130, 131, 141, 186, 196, 197, 206, 214, 218, 231, 236, 252, 255 Vascular Resistance, 186, 255 Vasculitis, 196, 237, 255 Vasoconstriction, 207, 255 Vasodilatation, 62, 255 Vasodilation, 185, 255 VE, 47, 255 Vector, 253, 255
Vein, 189, 220, 230, 234, 244, 255, 256 Venereal, 251, 255 Venous, 18, 189, 191, 196, 220, 231, 240, 256, 257 Venous Thrombosis, 256, 257 Ventricle, 186, 189, 241, 242, 251, 256 Ventricular, 9, 37, 45, 66, 186, 215, 242, 256 Ventricular Function, 242, 256 Ventricular Remodeling, 10, 256 Venules, 192, 194, 206, 256 Vertigo, 105, 130, 256 Vestibular, 97, 213, 221, 256 Vestibule, 198, 219, 246, 256 Vestibulocochlear Nerve, 253, 256 Vestibulocochlear Nerve Diseases, 253, 256 Veterinary Medicine, 151, 256 Villi, 215, 256 Villous, 195, 197, 256 Viral, 119, 130, 140, 162, 206, 212, 253, 254, 256 Virus, 63, 115, 129, 190, 196, 207, 211, 212, 213, 218, 219, 253, 256 Virus Diseases, 115, 256 Viscosity, 75, 256 Visual Acuity, 245, 256 Vitiligo, 17, 257 Vitro, 34, 214, 257 Vivo, 8, 257 Vocal cord, 141, 257 Vomeronasal Organ, 38, 231, 257 W Warfarin, 127, 257 Wart, 221, 257 Weight Gain, 141, 257 White blood cell, 187, 218, 221, 223, 224, 228, 236, 257 Windpipe, 252, 257 Withdrawal, 44, 257 Wound Healing, 140, 195, 257 X Xenograft, 187, 257 Xerostomia, 140, 257 X-ray, 179, 180, 192, 199, 200, 211, 220, 230, 241, 242, 245, 257 X-ray therapy, 220, 257 Y Yeasts, 193, 210, 235, 258
274 Hypothyroidism
Index 275
276 Hypothyroidism
