JAUNDICE 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., 1960Jaundice: 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: 0-597-83947-6 1. Jaundice-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 jaundice. 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 JAUNDICE .................................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Jaundice......................................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 18 The National Library of Medicine: PubMed ................................................................................ 18 CHAPTER 2. NUTRITION AND JAUNDICE ........................................................................................ 63 Overview...................................................................................................................................... 63 Finding Nutrition Studies on Jaundice ....................................................................................... 63 Federal Resources on Nutrition ................................................................................................... 67 Additional Web Resources ........................................................................................................... 67 CHAPTER 3. ALTERNATIVE MEDICINE AND JAUNDICE .................................................................. 69 Overview...................................................................................................................................... 69 National Center for Complementary and Alternative Medicine.................................................. 69 Additional Web Resources ........................................................................................................... 76 General References ....................................................................................................................... 83 CHAPTER 4. DISSERTATIONS ON JAUNDICE .................................................................................... 85 Overview...................................................................................................................................... 85 Dissertations on Jaundice ............................................................................................................ 85 Keeping Current .......................................................................................................................... 85 CHAPTER 5. PATENTS ON JAUNDICE ............................................................................................... 87 Overview...................................................................................................................................... 87 Patents on Jaundice...................................................................................................................... 87 Patent Applications on Jaundice .................................................................................................. 99 Keeping Current ........................................................................................................................ 101 CHAPTER 6. BOOKS ON JAUNDICE ................................................................................................ 103 Overview.................................................................................................................................... 103 Book Summaries: Federal Agencies............................................................................................ 103 Book Summaries: Online Booksellers......................................................................................... 112 The National Library of Medicine Book Index ........................................................................... 112 Chapters on Jaundice ................................................................................................................. 113 CHAPTER 7. MULTIMEDIA ON JAUNDICE...................................................................................... 117 Overview.................................................................................................................................... 117 Video Recordings ....................................................................................................................... 117 Audio Recordings....................................................................................................................... 118 Bibliography: Multimedia on Jaundice ...................................................................................... 118 CHAPTER 8. PERIODICALS AND NEWS ON JAUNDICE ................................................................... 121 Overview.................................................................................................................................... 121 News Services and Press Releases.............................................................................................. 121 Newsletter Articles .................................................................................................................... 123 Academic Periodicals covering Jaundice .................................................................................... 124 CHAPTER 9. RESEARCHING MEDICATIONS ................................................................................... 125 Overview.................................................................................................................................... 125 U.S. Pharmacopeia..................................................................................................................... 125 Commercial Databases ............................................................................................................... 126 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 129 Overview.................................................................................................................................... 129 NIH Guidelines.......................................................................................................................... 129 NIH Databases........................................................................................................................... 131 Other Commercial Databases..................................................................................................... 135
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The Genome Project and Jaundice.............................................................................................. 135 APPENDIX B. PATIENT RESOURCES ............................................................................................... 139 Overview.................................................................................................................................... 139 Patient Guideline Sources.......................................................................................................... 139 Associations and Jaundice.......................................................................................................... 146 Finding Associations.................................................................................................................. 146 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 149 Overview.................................................................................................................................... 149 Preparation................................................................................................................................. 149 Finding a Local Medical Library................................................................................................ 149 Medical Libraries in the U.S. and Canada ................................................................................. 149 ONLINE GLOSSARIES................................................................................................................ 155 Online Dictionary Directories ................................................................................................... 156 JAUNDICE DICTIONARY .......................................................................................................... 157 INDEX .............................................................................................................................................. 221
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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 jaundice 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 jaundice, 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 jaundice, 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 jaundice. 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 jaundice, 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 jaundice. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON JAUNDICE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on jaundice.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and jaundice, 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 “jaundice” (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: •
Jaundice Source: American Family Physician. 45(3): 1139-1148. March 1992. Summary: Jaundice is a disorder of bilirubin metabolism and has many causes. This article reviews the epidemiology, pathophysiology, diagnosis, and treatment of jaundice. The authors note that the challenge of jaundice for the family physician lies in differentiating its numerous causes, which range from relatively benign to lifethreatening. The authors also focus on the various diagnostic tests used to determine the etiology of jaundice. The treatment is based on this etiology and includes removal of offending medications or toxins, therapy for underlying liver disease, or surgery for extrahepatic obstruction. 3 figures. 7 tables. 35 references. (AA-M).
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Jaundice and Cholestasis: Some Common and Uncommon Causes Source: Postgraduate Medicine. 90(4): 65, 68, 70-71. September 15, 1991. Summary: This article discusses jaundice and cholestasis, focusing on common and uncommon causes of the two conditions. The author notes that there is variability in presentation of cholestasis, and jaundice may be intrahepatic or extrahepatic and acute or chronic. Some intrahepatic causes of cholestatic jaundice seen on medical wards include viral hepatitis, sepsis, postoperative mechanism, Hodgkin's disease, and use of certain drugs. Chronic cholestatic syndromes may result from primary biliary cirrhosis, primary sclerosing cholangitis, and sarcoidosis, among others. The author concludes that individual patients often do not conform to textbook definitions, and the diagnosis of cholestatic jaundice remains elusive. 10 references. (AA-M).
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Jaundice in Pregnancy Source: European Journal of Gastroenterology and Hepatology. 3(12): 892-896. December 1991. Summary: This article presents an overview of the occurrence of jaundice in pregnancy. Topics include the causes of jaundice; disorders specific to pregnancy, including hyperemesis gravidarum, benign recurrent intrahepatic cholestasis of pregnancy, HELLP syndrome (hemolysis, elevated liver enzymes and low platelets), toxemia/eclampsia and liver disease, biliary disease and pregnancy, infections of the liver during pregnancy, hepatocellular disorders and pregnancy, vascular hepatic disorders and pregnancy, and hepatic tumors and pregnancy. The author stresses that knowledge of the biochemical changes that are physiological and that occur in normal pregnancy is imperative in order to avoid mistaken interpretation of the biochemical tests during pregnancy. 1 table. 30 annotated references.
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Etiology, Evaluation, and Outcome of Jaundice in Patients With Acquired Immunodeficiency Syndrome Source: Hepatology. 23(4): 728-733. April 1996. Summary: This article reports on a study of the etiology, evaluation, and outcome of jaundice in patients with acquired immunodeficiency syndrome (AIDS). During the study period (August 1990 through September 1994), 541 HIV-infected patients (511 with AIDS) were evaluated for liver disease; 36 of these patients had jaundice (7 percent). The most common causes of jaundice were drug-induced hepatitis (31 percent of the patients) and alcoholic liver disease (13 percent of the patients). Opportunistic infections or neoplasms were identified in 11 patients (30 percent), with 4 having intrahepatic disease and 7 having extrahepatic disease. The short-term mortality was high, with 9 patients dying during the hospitalization (25 percent) and 7 patients dying within 6 months of evaluation. Liver disease was the cause of death in 7 of these patients. The authors conclude that jaundice is uncommon in AIDS and may result from a variety of both opportunistic and nonopportunistic etiologies. Drug-induced hepatitis is the most common cause and may be fatal. 5 tables. 26 references. (AA-M).
Federally Funded Research on Jaundice The U.S. Government supports a variety of research studies relating to jaundice. 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 jaundice. 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 jaundice. The following is typical of the type of information found when searching the CRISP database for jaundice: •
Project Title: 5-YEAR OUTCOME OF SEVERE NEONATAL JAUNDICE & DEHYDRATION Principal Investigator & Institution: Newman, Thomas B.; Epidemiology and Biostatistics; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 16-JUL-1999; Project End 30-JUN-2004 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BILIARY ATRESIA CONSORTIUM: DATA COORDINATING CENTER Principal Investigator & Institution: Brown, Morton B.; Professor; Biostatistics; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 18-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Biliary atresia and idiopathic neonatal hepatitis are the most common causes of jaundice and hyperbilirubinemia, which extends beyond the newborn period. The long-term goal of the Biliary Atresia Research Clinical Research Consortium (BACRC) is to establish a database of clinical information and serum and tissue samples from children with biliary atresia (BA) and idiopathic neonatal hepatitis (INH) to facilitate and perform clinical, epidemiological and therapeutic research in these two important pediatric liver diseases. This application to be the DCC brings together experienced investigators from biostatistics, pediatric surgery, pediatric hepatology and transplantation. The DCC will: 1. Establish longitudinal cohort database for patients with BA and INH 2. Provide expertise in the design, conduct, and analysis of multicenter trials 3. Coordinate the implementation of the study protocols approved by the steering committee, including centralized database management with either centralized or remote data entry 4. Monitor sites with respect to data quality 5. Develop the plan for the data analysis, perform the analysis and collaborate on the preparation to the publications that will result from these studies6. Establish and maintain a Specimen Core Facility to serve as a central repository for the BACRC. 7. In our application we propose the construction of a longitudinal cohort
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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database and detail how such information would be used to analyze the natural history of patients with biliary atresia who undergo a Kasai procedure. We also propose a multicenter prospective randomized clinical trail of steroid therapy after the Kasai procedure to highlight the role of the DCC in this mission. It is recognized the steering committee will develop and approve all protocols to be implemented. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BILIRUBIN AND PHOTOBILIRUBIN: METABOLISM & EXRETION Principal Investigator & Institution: Mcdonagh, Antony F.; Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2003; Project Start 01-JUL-1980; Project End 31-AUG-2006 Summary: (provided by applicant): Long-term objectives of this proposal are to fully elucidate the mechanism and effects of phototherapy of neonatal jaundice, to improve its effectiveness and safety, and to define the molecular mechanisms involved in the transport, metabolism and excretion of the jaundice pigment bilirubin (BR) and related compounds by the liver. Specific aims are: To fully characterize the photoisomers and other photoproducts of BR and its glucuronides formed during light exposure of humans (particularly jaundiced neonates undergoing phototherapy), elucidate their hepatic transport and metabolism, measure their production with light-emitting diodes of different wavelength emission, and determine whether BR photoisomers interfere with "free" BR measurements by the peroxidase method. To study BR-sensitized degradation of copper-porphyrins under physiologic conditions and identify the products. To identify and characterize the products of alternate, non-glucuronide, pathways of BR metabolism in the jaundiced Gunn rat animal model. To investigate the mechanisms of bilirubin glucuronidation and the role of the canalicular membrane transporter Mrp2 in the biliary efflux of organic anions and glucuronides using novel synthetic di and tetrapyrroles as molecular probes of the influence of shape, hydrogen bonding and constitutional structure. To develop chemical inhibitors of BR formation that could be used to prevent the development of infant jaundice. These aims will be achieved by studying the chemistry, photochemistry, and metabolism of BR and specially designed synthetic model compounds both in vitro and in vivo in animals with congenital defects in liver metabolism. The project is directly related to the prevention of BR-induced brain damage in babies and in patients with the Crigler-Najjar syndrome, to the diagnosis and understanding of liver and biliary disease and jaundice, to the therapeutic and biological effects of light on humans, to the metabolism and elimination of acid drugs by the liver, and to protection from free radicals and oxidative stress. The work will lead to safer more effective treatment of familial hyperbilirubinemia and jaundice in the newborn. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BILIRUBIN TOXICITY IN THE AUDITORY SYSTEM Principal Investigator & Institution: Shapiro, Steven M.; Neurology; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2001; Project Start 01-SEP-1988; Project End 31-DEC-2002 Summary: Brain damage and auditory dysfunction continue to be major complications of bilirubin toxicity despite advances in the treatment of hyperbilirubinemia (jaundice) in newborns. The spectrum of bilirubin encephalopathy ranges from kernicterus, which has recently reemerged in this country due in part to the earlier discharge of newborns from hospitals to more subtle damage, such as isolated peripheral and central auditory
Studies
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dysfunction and cognitive deficits. The incidence of subtle of isolated impairment due to bilirubin toxicity is unknown because it is difficult to relate transient abnormalities that occur in the newborn with those that appear later in life. In addition the pathogenesis, sites of auditory nervous system dysfunction, and the determinants of vulnerability and reversibility are still only partially understood despite decades of study. Therefore, we propose to extend our productive studies using non-invasive brainstem auditory evoked potentials (BAEPs), in combination with intra- and extracellular electrophysiology, light and electron microscopic immunohistochemistry, and quantitative biochemical studies, in the jaundiced Gunn rat model of bilirubin encephalopathy. We will also use cultured cell models and fixed tissues to determine the fundamental mechanisms of bilirubin toxicity. BAEP changes that occur soon after exposure to bilirubin toxicity will be compared to biochemical and immunohistochemical parameters in vivo and in vitro. We will also evaluate hypothesis-driven interventions aimed at preventing and reversing bilirubin toxicity. The specific aims of the proposed studies are all directed toward providing a comprehensive characterization of the localization, susceptibility and reversibility, and pathogenesis of dysfunction due to bilirubin toxicity and its effect on normal developmental processes. The findings of the proposed research should lead to improved non-invasive procedures for predicting, preventing, and treating the neurological and audiological complications of bilirubin toxicity in human newborns. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHILDREN AS RESEARCH SUBJECTS: HISTORY AND ETHICS Principal Investigator & Institution: Edelson, Paul J.; Center for Society & Medicine; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2001 Summary: This grant will support career development in the area of research ethics, with particular attention to the ethics of clinical trials involving children as subjects. Over its 3 year term, the PI. a physician, historian, and experienced clinical investigator, will pursue two general goals, research and practice, with the guidance of his mentor, Prof. David J Rothman, Professor of History and Social Medicine and Director of the Center for the Study of Society and Medicine. The practice segment will involve participation in a variety of Center and medical school activities in ethics teaching and consultation. The research segment involves carrying out a historical analysis of six examples of clinical trials in which children were research subjects: the trial of diphtheria antitoxin treatment (1895), the Salk vaccine trial (1954), the development of therapy for childhood leukemia (1955-60), the introduction of phototherapy for neonatal jaundice (1970s), the Extracorporeal Membrane Oxygenator (1980s), and the use of Azidothymidine to prevent perinatal HIV transmission. Studies will include not only published and unpublished research materials, but also newspaper and magazine treatments of these studies, analysis of the ethical issues as understood at the time by physicians, by commentators in medical ethics and by the general public. The practical strategies used in these trials offer us guidance as we define the ethical standards for future research involving children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SYNDROMEN
CONTROL
HYPERBILIRUBINEMIA
IN
CRIGLER/NAJJAR
Principal Investigator & Institution: Kappas, Atallah; Weill Medical College of Cornell Univ New York, Ny 10021
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Timing: Fiscal Year 2001 Summary: An inhibitor of bilirubin production, which has proved highly successful in ameleorating jaundice in newborns, will be studied in children with Crigler-Najjar Type I to determine if the lethal hyperbilirubinemia characteristics of this genetic disorder can be moderated over the short or long period of time. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENE EXPRESIION WITH ADENOVIRUS-MEDIATED TRANSFER Principal Investigator & Institution: Askari, Frederick K.; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 30-NOV-2001 Summary: (adapted from the application) The goal of this proposal is to develop the gene therapy technology to replace the genetic defect in Crigler-Najjar Syndrome type I and improve the efficacy of adenoviral liver directed gene therapy in the Gunn rat animal model of congenital non-hemolytic unconjugated hyperbilirubinemia, this proposal is linked to K08 DK02438. Crigler-Najjar syndrome type 1, familial nonhemolytic jaundice and kernicterus, is a fatal disease, which can potentially be cured by genetic complementation. The disease results from a genetic defect in the enzyme responsible for glucuronidation of bilirubin. In its severest form, bilirubin accumulates in the serum leading to kernicterus and death. Features of this disease which make it an ideal candidate for liver directed gene therapy include: a) adenovirus mediated gene transfer of HUG Br 1 results in in vivo complementation of the disease, b) the biochemical, genetic, pathophysiological and clinical aspects of Crigler-Najjar syndrome type I have been extensively studied and are well described, c) phenotypic correction may be achieved with correction of substantially less than 100% of normal gene activity, d) an authentic animal model of human disease with an analogous hepatic metabolic deficiency, the Gunn rat, is readily available, e) no effective conventional therapy exists for Crigler-Najjar syndrome type I short of liver transplantation, and f) even partial, year-long correction may have clinical benefit. Adenovirus vector mediated gene transfer of a human bilirubin glucuronosyltransferase cDNA (HUG Br 1) is able to reverse the hyperbilirubinemia in Gunn rats for at least one year. The hypothesis to be tested is whether specific changes in the adenovirus vector sequence designed either to decrease expression of adenoviral proteins and vector immunogenicity and/or overexpression of a "MHC decoy" protein can augment HUG Br 1 gene can diminish immune responses in the Gunn rat. The mechanism of transgene persistence with the endogenous ribosomal promoter as opposed to the virus derived CMV promoter will be studied. The experimental design employs multiple modalities to detect gene transfer so that a drop in serum bilirubin may be correlated with other, more specific measures of gene transfer. This proposal includes several novel interventions designed to augment expression of the transgene leading to increased efficacy of in vivo adenovirus gene therapy. The results obtained in this model should prove valuable to the development of liver directed gene therapy for other genetic and acquired diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GENE THERAPY FOR INHERITED JAUNDICE Principal Investigator & Institution: Roy-Chowdhury, Jayanta R.; Professor of Medicine and Molecular Gene; Medicine; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2001; Project Start 01-AUG-1993; Project End 31-JUL-2003
Studies
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Summary: Our long-term objective is to develop safe and efficient methods for liverdirected gene therapy for genetic disorders of hepatic metabolism, using inherited jaundice due to bilirubin-uridinediphospho-glucuronate glucuronosyltransferase (bilirubin-UGT) deficiency as a model target. Absence of hepatic bilirubin-UGT activity leads to accumulation of the bilirubin in plasma and consequent brain damage, resulting in the potentially lethal Crigler-Najjar syndrome type I (CN-I). Currently, liver transplantation is the only definitive therapy. Gunn rats, the animal model for CN-I, will be used for these studies. During the last four years, both viral and non-viral vehicles for delivery of normal human bilirubin-UGT genes to Gunn rat liver were devised and tested. In this continuation application, two strategies for correcting hepatic bilirubinUGT deficiency in vivo will be pursued. In the first approach, recombinant viral vectors will be used to substitute hepatic bilirubin-UGT by delivering a normal gene. Recombinant adenoviruses are very efficient in transferring genes into the liver in vivo, but the transgene expression is transient because the virus is episomal and the host immune response precludes its repeated administration. Three methods for specific tolerization of the host to adenoviral antigens, developed in our laboratory, show promise for long-term adenovirusmediated gene therapy without immunosuppression. To refine these methods for future clinical application, the mechanisms by which they induce specific tolerance will be elucidated. In addition, a much less immunogenic vector, based on the SV40 virus, will be developed and tested. The second approach will utilize RNA/DNA chimeric molecules to repair the genetic lesion in Gunn rats, using our highly efficient vectors for liver-specific nucleic acid delivery by receptor-mediated endocytosis. The gene transfer efficiency will be assessed by molecular, enzymatic and metabolic studies. Successful completion of these studies will provide a basis for gene therapies for CN-I and other inherited metabolic disorders, such as deficiency of alpha1-antitrypsin and urea cycle enzymes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HUMAN CELLULAR IMMUNE RESPONSES TO LEPTOSPIRA Principal Investigator & Institution: Klimpel, Gary R.; Microbiology and Immunology; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JAN-2008 Summary: (provided by applicant): Leptospirosis, a zoonotic disease caused by spirochetes of the genus Leptospira, is transmitted to humans via urine of infected mammals. Found worldwide in temperate and tropical climates, it is a public health threat in the U.S. and abroad. Human infections by Leptospira have a broad spectrum of clinical manifestations, ranging from asymptomatic seroconversion to undifferentiated febrile syndrome, with or without aseptic meningitis, to fulminant jaundice, renal failure and hemorrhage with a fatality rate up to approximately 25%. There is no vaccine to prevent human leptospirosis and veterinary vaccines may not be used in humans because of toxicity. Little is known about how this organism interacts with human lymphocytes and/or the mechanisms of leptospiral pathogenesis or immunity. We propose to examine molecular and cellular interactions of Leptospira with human peripheral blood mononuclear cells (PBMC) with a focus on different T cell populations. We have found that leptospires activate T cells in PBMC from Leptospira-naive humans, leading to proliferation and production of high IFN gamma levels. Our hypothesis is that Leptospira activation of T cells expressing the alpha/beta or gamma/delta form of the T cell receptor for antigen plays an important regulatory role in protective immunity and immunopathogenesis associated with human infections due to Leptospira spp. Our aims are to: 1) Determine the cell:cell interactions and cytokine profiles of PBMC
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cultures exposed to Leptospira, and characterize the phenotype, function, and specificity of T cells activated in such cultures; 2) Identify and purify Leptospira components that activate T cells; and 3) Determine the relationship between peripheral blood T cell phenotype and function and disease severity of human leptospirosis patients in an endemic region in the Peruvian Amazon. Learning how Leptospira interact with the human immune system will lead us to understand the pathogenesis of leptospirosis and how to develop vaccines and strategies to control the associated pathology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INHERITED GLUCORONIDATION
DISORDERS
OF
HEPATIC
BILIRUBIN
Principal Investigator & Institution: Roy-Chowdhury, Namita; Associate Professor; Medicine; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2003; Project Start 01-JUL-1987; Project End 30-JUN-2007 Summary: (provided by applicant): Bilirubin is the toxic end product of heme breakdown. Efficient biliary excretion of bilirubin requires glucuronidation mediated by uridinediphosphoglucuronate glucuronosyltransferase-1A1 (UGT1A1), the catalytic site of which is located inside the hepatocyte endoplasmic reticulum (ER) lumen. Inherited UGT1A1 deficiency leads to the accumulation of unconjugated bilirubin, causing the potentially lethal Crigler-Najjar syndrome type 1. UGT1A1 also detoxifies estrogen and several drugs and carcinogens. Specific Aim 1 is to characterize the structure-function relationship of UGT1A1. We have shown that UGT1A1 forms dimers, and will test the hypothesis that dimerization is required for activation of the enzyme by stimulation of the import of UDP-glucuronic acid (UDPGA) into the ER lumen by the physiological UGT activator, UDP-N-acetyl glucosamine (UDP-gluc-Nac). We will test whether dimerization explains the dominant negative function of some mutant forms of UGT1A1. Another hypothesis to be tested is that UGT1A1 activity is regulated by phosphorylation. ER localization is important in UGT1A1 function. Therefore, we will delineate the motifs required for membrane incorporation and specific ER localization. Since several drugs cause hyperbilirubinemia by inhibiting UGT1A1 activity, we will delineate domains involved in binding the substrtes, UDPGA and bilirubin. Specific Aim 2 is to characterize UGT1A1 gene expression. We hypothesize that the interaction of cis-acting elements within the regulatory upstream region of UGT1A1 with hepatocellular transactivating factors determine the tissue-specificity of UGT1A1 expression, its induction by Phenobarbital and clofibrate, and its down-regulation by thryroid hormone. We will test this DNase foot-printing, electrophoretic mobility shift assays and expression of promoter-reporter constructs in differentiated human hepatoma cells and immortalized human hepatocytes. Successful completion of this study will elucidate the mechanism of UGT1A1 function in health and inherited disorders. Understanding the regulatory mechanisms of UGT1A1 should assist in identifying enzyme-inducing drugs for improved treatment of neonatal hyperbilirubinemia mad incomplete UGT1A1 deficiency (Crigler-Najjar syndrome type 2). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INFECTION
LONGITUDINAL
COHORT
OF
NEWLY
Principal Investigator & Institution: Kaldor, John M.; Epidemiology/Clncl Res Epidemiology/Clinical Research Sydney,
ACQUIRED Natl
HCV
Centre/Hiv
Studies
11
Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Currently, there is no effective hepatitis C virus (HCV) vaccine. Despite introduction of harm minimization strategies in Australia since the late 1980s, incidence of HCV infection among injecting drug users is extremely high. An estimated 16,000 new HCV infections occur each year in Australia, with approximately 90% related to injecting drug use. This estimate of new HCV infections has increased from 11,000 in 1997, due largely to an increasing prevalence of injecting. Although the vast majority of people with new HCV infection are asymptomatic at the time of infection, an increasing number of cases of newly acquired HCV infection are detected through enhanced HCV surveillance in Australia. For HCV surveillance purposes newly acquired HCV infection is defined as a person with a positive HCV antibody with evidence of a negative HCV antibody in the previous 24 months, or a person with acute clinical hepatitis (e.g. jaundice) with a positive HCV antibody where other causes of acute hepatitis have been excluded. In 2000 approximately 450 cases of newly acquired HCV infection were detected through enhanced surveillance in Australia. Further cases of newly acquired HCV infection are detected through primary care clinics that regularly screen injecting drug users for HCV, and referrals to tertiary care clinics of people with acute hepatitis. We propose to establish a longitudinal cohort of current injecting drug users (injected within previous 12 months) with newly acquired HCV infection. Within this cohort we propose to offer antiviral therapy for HCV infection with a 24-week course of pegylated interferon monotherapy to those people who have evidence of HCV viraemia (HCV-RNA positive) and biochemical hepatic inflammation (elevated liver enzymes). The major objectives of the study are to examine the feasibility of interferon therapy for newly acquired HCV infection among injecting drug users. In addition, the untreated group within the longitudinal cohort will be studied to examine the natural history of early HCV infection. Both groups will continue followup for a period of three years, to examine sustainability of HCV clearance (both through natural and therapeutic means) and monitor incidence of HCV reinfection among people with evidence of HCV clearance. Drug use behavior including injecting drug use will also be closely monitored, to assess the impact of enrollment into the study and specific drug dependency and risk reduction strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MAJIC, MAKING ADVANCES AGAINST JAUNDICE IN INFANT CARE Principal Investigator & Institution: Palmer, R H.; Associate Professor of Health Services; Health Policy and Management; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2001; Project Start 01-MAY-1998; Project End 30-APR-2003 Summary: This project will develop and evaluate a model for a Collaborative Quality Improvement Program in loosely structured managed care organizations (MCOs). Most quality improvement initiatives for hospitals or MCOs have occurred in tightly managed systems. This model addresses how MCOs can fulfill their responsibility for quality improvement among professionals and organizations with whom they have contractual leverage but not direct control. The model will be tested by application to the American Academy of Pediatrics clinical practice guideline for the care of the healthy term newborn with jaundice. Two large managed care organizations will partner with the core research team, enlisting specific patient care units - organizations and professionals responsible for the continuum of care for a baby during the first month of life - to participate. The MCOs will conduct and evaluate two rounds of
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Jaundice
collaborative QI, each focusing on a distinct perspective on quality. In the first, the MCO will focus on improving clinical performance from the professional perspective. In the second, the focus will be improving the parents experience of receiving care for their newborn. The relationship between clinical and consumer perspectives will be explored to test whether clinically excellent providers are more or less successful in providing a high quality patient experience. Clinical performance will be assessed by measuring conformance with selected guideline recommendations for infants with an elevated serum bilirubin level. Data for clinical performance measurement will be obtained from administrative sources (claims, encounter and laboratory databases), the infant's inpatient medical record and if necessary the infant's ambulatory medical record. The parental experience of care will be assessed by a telephone survey of parents, with questions adapted from the AHCPR's Consumer Assessment of Health Plans Survey (CAHPS) to apply to the baby's first month of life and care for jaundice. Approximately 2,200 study-eligible infants are anticipated across the two participating MCOs. Parental experience and clinical performance data will be fed back to the MCOs on a quarterly basis to stimulate and guide QI efforts. Each MCO will collaborate with the other on exchange of performance data, of best practices for patient care, and of quality improvement ideas. They will also be aided in implementing additional, MCO-specific QI interventions. An overall summative evaluation of the effect of the five-year Collaborative QI Program will be conducted. In addition, clinical and parent experience data relating to the same baby will be paired for analyses of the convergence and divergence between the performance of patient care units. Finally, descriptions of the performance measures based on clinical performance and parent experie nce data, together with sample results, will be used to elicit an evaluation by independent panels of purchasers, consumers and physicians of the usefulness of these two types of measures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MEASUREMENT OF END TIDAL CARBON MONOXIDE & BILIRUBIN LEVELS (ETCO) Principal Investigator & Institution: Macmahon, James; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001 Summary: The objective of the study is to establish the utility of breath CO measurements performed by the Natus CO-Stat End Tidal breath analyzer to identify neonates who are at low or high risk of developing hyperbilirubinemia, defined as serum total bilirubin(STB) > 95th percentile, in neonates during the first 168 hours of life. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: NEONATAL BILIRUBIN NEUROTOXICITY AND P-GLYCOPROTEIN Principal Investigator & Institution: Watchko, Jon F.; Professor; Magee-Women's Health Corporation 204 Craft Ave Pittsburgh, Pa 15213 Timing: Fiscal Year 2001; Project Start 17-AUG-1999; Project End 31-JUL-2003 Summary: Unconjugated hyperbilirubinemia is the most common clinical condition in the newborn period and when severe can result in neurologic injury with long term adverse neurodevelopment sequelae as evidenced by the reemergence of kernicterus in near-term infants subject to early hospital discharge. The pathogenesis of hyperbilirubinemic encephalopathy remains unclear but central to its development is
Studies
13
the passage of bilirubin across the blood-brain barrier (BBB) into the central nervous system (CNS). Recent studies suggest that bilirubin is a substrate for the ATP dependent integral plasma membrane efflux pump phosphoglycoprotein or P-gp. P-gp is expressed in abundance on the luminal aspect of brain capillary endothelial cells and limits the brain influx of a variety of lipophilic compounds. We have observed i) that brain bilirubin uptake is significantly increased in adult P-gp deficient transgenie mice, and ii) that P-gp expression (mRNA and protein) is markedly lower in the fetal and neonatal wild type mouse brain as compared with adults. These findings suggest that P-gp plays an important role in preventing the influx of bilirubin into the CNS and that limited Pgp expression in the newborn brain microvasculature may enhance brain bilirubin uptake in this age group. The proposed experiments are designed to test three hypotheses: 1) that bilirubin interacts with and is transported by P-gp; 2) that brain P-gp expression, levels, and function are regulated in a temporal and spatial fashion, and 3) that metabolic inhibition, hypoxia, and/or a combination of hypoxia/ischemia impairs P-gp function. We will use in vitro (radioligand binding and photoaffinity labeling), cellular (mouse brain capillary endothelial cells, and LLC-PK1 cells transfected with the gene for human or mouse P-gp), and in vivo (wild type and P-gp deficient mice) models to characterize the i) interaction between bilirubin and P-gp, ii) the ontogeny and regional expression of CNS P-gp, and iii) the effects of metabolic inhibition on P-gp. Other than our preliminary studies, there is no information regarding the developmental expression of P-gp in the CNS, and only limited data on the interaction between bilirubin and P-gp and the factors that impact P-gp function. Results of the proposed studies will fully test our above stated hypotheses. The information obtained will provide novel insights regarding the role P-gp plays in attenuating brain bilirubin uptake and serve as an impetus towards developing modalities that increase BBB P-gp expression in newborns thereby enhancing protection against neonatal bilirubin neurotoxicity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEONATAL JAUNDICE AS AN EARLY DIAGNOSTIC SIGN OF URINARY TRACT INFECT Principal Investigator & Institution: Garcia, Francisco; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: NEONATAL PHOTOTHERAPY / BILIRUBIN EXCRETION Principal Investigator & Institution: Lightner, David A.; Professor; Chemistry; University of Nevada Reno Reno, Nv 89557 Timing: Fiscal Year 2003; Project Start 01-JUL-1986; Project End 30-APR-2008 Summary: (provided by applicant): Jaundice is the most common clinical diagnosis in the newborn, with 60% of neonates displaying significant unconjugated hyperbilirubinemia during the first 3 days of life. Phototherapy is the most common treatment, with hundreds of thousands of babies in the U.S. being irradiated each year with white or blue light to decrease plasma levels of unconjugated bilirubin and thus reduce the risk of permanent brain damage. Yet the incidence of jaundice is increasing, following early discharge from hospitals, and kernicterus has re-emerged after having largely disappeared. The broad, long-term objectives of the project are to understand the
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Jaundice
interrelationship between bilirubin 3-D structure, physico-chemical properties and hepatic processing, and improve the efficacy of phototherapy. The specific aims are to: 1) Fully characterize the 3-dimensional structure of bilirubin, its anions, conjugates and photoisomers in biomemtic/physiologic environments using molecular dynamics computations and sophisticated spectroscopic methods. 2) Clarify the carboxylic acid pKa of bilirubin, its dependence on hydrogen bonding and aggregation, its influence on polarity and its role in bilirubin transport and metabolism. Is bilirubin an ionophore and ion transporter? 3) Investigate the role of bilirubin phototautomerization and photodissociation, elucidate the mechanism of photocyclization to lumirubins and its stereochemistry, and promote higher yields of E-photoisomers in order to improve the efficacy of phototherapy; explicate the influence of local environment including protein binding, on the channeling of bilirubin photochemical reaction pathways. 4) Synthesize chemically-designed bilirubins of well-defined and varied secondary structure, with differing intramolecular hydrogen bonding and amphiphilicity and substituents of varying size and polarity to: (a) define the physico-chemical properties important in metabolism and phototherapy, and (b) use as biologic molecular probes of the interrelated roles of pigment stereochemistry and intramolecular hydrogen bonding, polarity and pKa acidity, vinyl/C(10) substituents and perimeter hydrophobicity in hepatic uptake, conjugation and efflux. 5) Design and synthesize bilirnbin fluorophores and MRI-sensitive imaging agents and Trojan Horse vehicles for research and clinical applications involving pigment distribution, hepatic uptake, clearance and drug delivery. These studies are directly relevant to the prevention of neurological damage in the jaundiced newborn, to improving our understanding of bilirubin detoxification and liver disease. They are designed to clarify how the molecular structure of bilirubin controls its transhepatic transport, intracellular partitioning, glucuronidation and ABCcassette MRP2-assisted canalicular secretion, and to lead to improved and safer methods of treatment for severe unconjugated hyperbilirubinemia in the neonate and in patients with Crigler-Najjar syndrome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PATHOGENESIS OF LEPTOSPIROSIS Principal Investigator & Institution: Ko, Albert I.; Infectious Diseases; University of California Berkeley Berkeley, Ca 94720 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2003 Summary: The candidate, Dr. Albert Ko, is an infectious disease clinician whose longterm commitment has focused on research in international health and microbial pathogenesis. At present, he is receiving field training under the direction of Dr. Lee Riley at University of California, Berkeley and Dr. Warren Johnson at Cornell University Medical College, while establishing active surveillance and community-based studies for emerging pathogens in Salvador, Brazil. The focus of these activities has been leptospirosis, a spirochetal zoonoses, which investigations in Salvador have demonstrated to be an emerging cause of large urban epidemics. The candidate's future goal is to apply an integrated laboratory and population-based approach to infectious diseases. For this purpose, immediate objectives are to: 1) obtain the laboratory skills to characterize strain-specific determinants of pathogenesis and 2) acquire the advanced epidemiological and statistical tools that will enhance future field studies. During the proposed award period, training will be performed through a research project on leptospirosis in Dr. Lee Riley's laboratory and course work at the School of Public Health, University of California at Berkeley. In leptospirosis, multisystem complications can develop which include jaundice, acute renal failure, pulmonary hemorrhage and
Studies
15
severe anemia. Factors that contribute to the development of these complications after an infection are not known. Such factors may relate to strain-specific characteristics, host susceptibility, or epidemiologic factors that determine infectious inoculum size. This specific project will focus on the strain-specific factors. Adherence and entry into nonphagocytic host cells in vitro have been correlated with virulence of several bacterial organisms in animal models. However, no studies have addressed this association in human leptospirosis. Little progress has been made in identifying the genes encoding virulence factors. The specific aims of this project, therefore, are to: 1) compare virulence characteristics of leptospiral strains isolated from severe, mild, and asymptomatic human infections using a) a guinea pig infection model, and b) tissue culture assays for bacterial adherence, invasion, and cytotoxicity , and 2) identify specific bacterial factors that mediate mammalian cell association. Completion of the research aims of the proposed award will provide the basis to investigate the structure-function of the gene products and determine whether the identified genes are virulence factors. By the end of this award period, the candidate will have developed the complementary laboratory and epidemiological skills needed to identity host, strain and inoculum-specific factors in transmission and pathogenesis of leptospirosis. Such skills focused on this emerging pathogen should enable him to establish his own research focus as an independent investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PERINATAL AND ADOLESCENT FACTORS IN BREAST CANCER Principal Investigator & Institution: Stuver, Sherri O.; Assistant Professor; Epidemiology; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2001; Project Start 16-FEB-2001; Project End 31-JAN-2003 Summary: The epidemiology of breast cancer is complicated and only partially understood, despite a concerted research effort in this area. The primary goal of the proposed study is to examine the association between, on the one hand, perinatal factors that exhibit their hypothesized carcinogenic action during early life and, on the other established breast cancer risk factors that operate during the perimenarcheal years. Our objective will be to explore whether certain perinatal factors may share a common biologic mechanism of action with perimenarcheal risk factors, with respect to breast carcinogenesis. The meet this objective, the following specific aims will be addressed to investigate if there is an association between birth size and indicators of sexual maturity during adolescence, particularly age at menarche and breast development; to study the association between birth size and adolescent somatic growth; to examine the association between perinatal complications, such as pregnancy preeclampsia/eclampsia, jaundice, and prematurity, and indicators of sexual maturity and somatic growth during adolescence. To study these relationships, a retrospective cohort study of the association between perinatal and adolescent factors will be conducted among young girls in Nord Trondelag County in Norway. The population based for this study will be the nearly 5,000 girls, 13 to 19 years of age, who were born between 1977 and 1984 and who participated in general health survey for adolescents that took place in 1996 and 1997. Using the unique personal registration number assigned to all Norwegians, linkage will be made between the relevant information collected during the adolescent health survey and birth record information stored in the national Birth Registry. Access to data of such excellent quality will provide an important opportunity to examine the role of perinatal and perimenarcheal factors in the etiology of breast cancer.
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Jaundice
Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RADIOACTIVE OBSTRUCTIONS
STENTING
OF
MALIGNANT
BILIARY
Principal Investigator & Institution: Bunker, Stephen N.; Implant Sciences Corporation 107 Audubon Rd, #5 Wakefield, Ma 01880 Timing: Fiscal Year 2003; Project Start 10-APR-2003; Project End 31-MAR-2004 Summary: (provided by applicant): Luminal obstructive symptoms such as dysphagia, vomitus, jaundice, or ileus are often the first symptoms noticed by patients or physicians and unfortunately, usually indicate an advanced stage of gastrointestinal disease associated with high mortality. Stenting of malignant biliary obstructions, performed on patients who are not candidates for curative surgery, is currently performed as palliative treatment with limited success. These stents fail one third of the time due to tumor growth through the struts of the stent. Our efforts will be focused on optimizing an iridium-192 radiation source for low dose rate permanent brachytherapy. This medical device would reduce costs and improve quality of life for the patient, because it requires only one intervention compared to other methods of palliative radiotherapy (HDR, EBRT), which require daily treatment regimens, often for weeks at a time. In addition, unlike EBRT, the dose to radiosensitive nontargeted tissue is greatly reduced. The proposed iridium-192 stent also has greatly improved radioopacity for enhancing accurate placement. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF HEME OXYGENASE IN NEONATAL ANIMALS Principal Investigator & Institution: Stevenson, David K.; Associate Professor; Pediatrics; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 10-JUL-1998; Project End 30-JUN-2002 Summary: Neonatal jaundice is a condition that effects children throughout the world. Pathologic jaundice becomes a serious threat to the well-being of neonates in the context of hemolytic disease which is associated with increased bilirubin production. Our laboratory's approach to this problem is to monitor bilirubin production, and assess the efficacy of therapeutic agents that inhibit the activity of key enzymes, heme oxygenase isoenzymes 1 and 2 (HO-1,2), in the catalyses of heme to bilirubin. Expression of the HO-1 isoenzyme varies both in culture and in vivo in response to metabolic cues such as changes in heme concentrations. Metalloporphyrins, heme analogs, are clinically relevant inhibitors of HO enzymatic activity, but some have also been shown to increase HO-1 expression at the level of transcription which may offset therapeutic uses. Here we propose to address the regulation of HO transcription in culture and living animals in the presence and absence of enzyme inhibitors. This proposal contains three specific aims. First, full length, truncated, and condensed HO-1 promoters will be placed upstream of the luciferase coding sequence, and stable cell lines will be generated from this set of promoter-reporter gene fusions. The activity of the HO-1 promoter will be assessed in culture and compared to previously described patterns of expression to map regions of this promoter that respond to specific stimuli. Second, a selected series of metalloporphyrins with potential clinical use will be tested for effects on HO-1 transcription and enzyme activity in culture. Lastly, using our recently developed in vivo monitoring method, modulators of HO gene expression will be evaluated in living animals to determine the in vivo effects of inhibitors of HO enzymatic activity in real time. Differential regulation of both HO isoenzymes will be compared, first in culture
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and then in living animals, using luciferase reporters with two different colors of emission. An inability to correlate in vitro or cell culture data with in vivo observations is a familiar problem in biological chemistry. Here we attempt to address this issue using an integrated approach where the same set of reporter constructs is used in vitro and in vivo, and similarly monitored in both environments. As such, this proposal describes analyses of HO expression that will allow more precise hypotheses about gene expression and specific pathway inhibition. We can then combine this data without knowledge of pharmacologic properties of HO inhibitors to select compounds that control hyperbilirubinemia and prevent or treat neonatal jaundice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STUDIES IN PORPHYRIA III, HEME, AND TIN MESOPORPHYRIN IN ACUTE PORPHYRIAS Principal Investigator & Institution: Anderson, Karl E.; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2001 Summary: Acute porphyrias are inherited metabolic disorders that cause lifethreatening neurological symptoms, and are treated with intravenous heme. The objective is to study tin mesoporphyrin (an inhibitor of heme degradation) for enhancing the effects of heme therapy in these disorders. The specific aims are to determine 1)the optimal dose combinations of tin mesoporphyrin and heme for reducing porphyrin precursor levels in stable patients with acute intermittent porphyria; 2)safety and efficacy of tin mesoporphyrin when given with heme in acture attacks of porphyria 3)safety and efficacy of tin mesoporphyrin for decreasing the frequency heme infusions needed to prevent attacks of porphyria. Heme albumin may be substituted if the supply of heme areginate is limited. Tin mesoporphyrin is likely to be approved for treatment of neonatal jaundice, and will become available for use in porphyria as well. Therefore it is important to know if, as suggested by preliminary reports, it is safe an effective in porphyria and the optimal dosage. The studies will determine whether tin mesoporphyrin is safe and effective and thereby addresses an important management option for patients with acute porphyrias in the U.S. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE ROLE OF NOTCH SIGNALING IN BILE DUCT DEVELOPMENT Principal Investigator & Institution: Loomes, Kathleen M.; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 30-JUN-2005 Summary: (provided by applicant): Disorders of liver and bile duct development are a major source of morbidity and mortality in the pediatric population. The identification of genes orchestrating normal liver and bile duct development could have potential therapeutic implications in the future. The recent identification of Jag1 as the disease gene for Alagille syndrome (AGS), a multisystem developmental disorder involving bile duct paucity as a cardinal feature, implicates the Notch signaling pathway as being crucial for normal bile duct differentiation. A mouse model is an invaluable tool for elucidating the cellular interactions that occur in the embryonic liver. A compound heterozygous mouse for mutations in Jag1, encoding a ligand in the Notch pathway, and Notch2, encoding one of the Notch cell surface receptors, exhibits many features seen in patients affected with Alagille syndrome (AGS). These mice demonstrate congenital heart defects, renal tubular abnormalities, jaundice and bile duct paucity. We propose
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Jaundice
to study this mouse model in detail in order to verify it as a model for AGS and to elucidate the role of Notch signaling in normal bile duct development. We will assay mutant livers for changes in gene expression that could help to identify other genes involved in this process. Our approach is twofold; first, we propose to perform a detailed histologic analysis of the progression of bile duct paucity in the Jag1-/Notch2animals. In patients with Jag1 mutations, we often observe bile duct proliferation prior to the appearance of paucity, and we suspect that a similar process may occur in the mouse model. We propose a series of experiments including immunohistochemistry to identify bile duct precursor cells, TUNEL assays to identify apoptotic cells, and assays for up- or down-regulation of other genes known to be involved in bile duct development, such as HNF6 or HNF1(. Second, we propose a microarray approach to compare gene expression profiles between normal and Jag1-/Notch2- livers. In this way, we will identify downstream targets of the Notch signaling pathway and other genes that may play a crucial role in the complex cellular interactions that result in the formation of a normal liver and biliary system. 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 “jaundice” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for jaundice in the PubMed Central database: •
The jaundice of the cell. by Greenberg DA.; 2002 Dec 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=138521
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The Murine Mutation Jaundiced is Caused by Replacement of an Arginine with a Stop Codon in the mRNA Encoding the Ninth Repeat of [beta]-Spectrin. by Bloom ML, Kaysser TM, Birkenmeier CS, Barker JE.; 1994 Oct 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=44965
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 3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text
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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 jaundice, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “jaundice” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for jaundice (hyperlinks lead to article summaries): •
A 15 year old girl with fever, jaundice, haemolysis, and sudden clinical deterioration. Author(s): Pirisi M, Branca B, Avellini C, Solinas A. Source: Postgraduate Medical Journal. 2002 April; 78(918): 250, 253-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11930035&dopt=Abstract
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A 20-year-old woman with jaundice. Author(s): Kourlas PJ, Archer TP, Dangel M, Mazzaferri EL. Source: Hosp Pract (Off Ed). 2000 August 15; 35(8): 71-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10955036&dopt=Abstract
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A 32-year-old woman with fever, sore throat, jaundice and pulmonary infiltrates. Author(s): Loupa C, Voyatzoglou D, Papadaki H, Kouppari G, Saroglou G. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2000 June; 6(6): 325-6, 340. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11168141&dopt=Abstract
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A 33-year-old woman with jaundice after azithromycin use. Author(s): Suriawinata A, Min AD. Source: Seminars in Liver Disease. 2002; 22(2): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12016551&dopt=Abstract
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A case of biliary carcinoid presenting with pancreatitis and obstructive jaundice. Author(s): Juturi JV, Maghfoor I, Doll DC, Evans ML. Source: The American Journal of Gastroenterology. 2000 October; 95(10): 2973-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11051379&dopt=Abstract
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A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice. Author(s): Sewnath ME, Karsten TM, Prins MH, Rauws EJ, Obertop H, Gouma DJ. Source: Annals of Surgery. 2002 July; 236(1): 17-27. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12131081&dopt=Abstract
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 look on neonatal jaundice. Author(s): Basu K, Das PK, Bhattacharya R, Bhowmik PK. Source: J Indian Med Assoc. 2002 September; 100(9): 556-60, 574. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12455386&dopt=Abstract
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A new system for rapid large-caliber percutaneous transhepatic drainage in patients with obstructive jaundice: a prospective randomized trial. Author(s): Frimberger E, Vente T, Wagenpfeil S, Gerein P, Born P, Fritz N, Allescher HD, Ott R, Weigert N, Classen M, Rosch T. Source: Endoscopy. 2001 March; 33(3): 201-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293750&dopt=Abstract
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A novel hypothesis on the pathophysiology of neonatal jaundice. Author(s): Verkade HJ. Source: The Journal of Pediatrics. 2002 October; 141(4): 594-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12378205&dopt=Abstract
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A novel mutation causing pyruvate kinase deficiency responsible for a severe neonatal respiratory distress syndrome and jaundice. Author(s): Cotton F, Bianchi P, Zanella A, Van Den Bogaert N, Ferster A, Hansen V, Van Herreweghe I, Vertongen F, Gulbis B. Source: European Journal of Pediatrics. 2001 August; 160(8): 523-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11548197&dopt=Abstract
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A puzzling jaundice. Author(s): Pometta R, Fraquelli AC, Losco A, Conte D. Source: Dig Liver Dis. 2003 February; 35(2): 114-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12747630&dopt=Abstract
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A randomized controlled trial of ursodeoxycholic acid in patients with alcoholinduced cirrhosis and jaundice. Author(s): Pelletier G, Roulot D, Davion T, Masliah C, Causse X, Oberti F, Raabe JJ, Van Lemmens C, Labadie H, Serfaty L; URSOMAF Group. Source: Hepatology (Baltimore, Md.). 2003 April; 37(4): 887-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12668982&dopt=Abstract
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A replication-deficient rSV40 mediates liver-directed gene transfer and a long-term amelioration of jaundice in gunn rats. Author(s): Sauter BV, Parashar B, Chowdhury NR, Kadakol A, Ilan Y, Singh H, Milano J, Strayer DS, Chowdhury JR. Source: Gastroenterology. 2000 November; 119(5): 1348-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054394&dopt=Abstract
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A self-expandable metallic stent in combination with cholangioscopic microwave coagulation therapy and chemotherapy with oral TS-1 against obstructive jaundice due to recurrent gastric cancer: a case report of successful treatment. Author(s): Nio Y, Itakura M, Koike M, Omori H, Hashimoto K, Yano S, Higami T. Source: Anticancer Res. 2003 March-April; 23(2C): 1795-801. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12820461&dopt=Abstract
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A survey on community perceptions of jaundice in east Delhi: implications for the prevention and control of viral hepatitis. Author(s): Singh J, Shakya N, Jain DC, Bhatia R, Bora D, Pattanayak PK, Gupta S, Datta KK, Sokhey J. Source: Trans R Soc Trop Med Hyg. 2000 May-June; 94(3): 243-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10974987&dopt=Abstract
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Aching joints and jaundice. Author(s): Tschopp S, Brucker R. Source: Lancet. 2003 March 1; 361(9359): 750. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12620740&dopt=Abstract
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Acquired bladder diverticula can mimic obstructive extrabiliary jaundice. Author(s): Melidis P, Pikoulis E, Pavlakis E, Tsiledaki M, Kondylis FI. Source: Urology. 2003 August; 62(2): 351. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893357&dopt=Abstract
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Acute hepatitis E virus infection presenting as a prolonged cholestatic jaundice. Author(s): Mechnik L, Bergman N, Attali M, Beergabel M, Mosenkis B, Sokolowski N, Malnick S. Source: Journal of Clinical Gastroenterology. 2001 November-December; 33(5): 421-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11606863&dopt=Abstract
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Acute jaundice. Author(s): Burroughs A, Dagher L. Source: Clinical Medicine (London, England). 2001 July-August; 1(4): 285-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11525574&dopt=Abstract
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Acute lymphoblastic leukemia presenting with severe jaundice in an adult. Author(s): Phadke AY, Shah SK, Narawane NM, Abraham P. Source: J Assoc Physicians India. 1999 February; 47(2): 240-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10999101&dopt=Abstract
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Acute myeloid leukemia presenting as obstructive jaundice. Author(s): Goor Y, Goor O, Michalewitcz R, Cabili S. Source: Journal of Clinical Gastroenterology. 2002 April; 34(4): 485-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11907369&dopt=Abstract
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Addisonian-like crisis in congenital hypopituitarism and cholestatic jaundice. Author(s): Lee WS, Lum LC, Harun F. Source: Med J Malaysia. 2003 June; 58(2): 279-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14569750&dopt=Abstract
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Adult T-cell leukemia/lymphoma presenting as obstructive jaundice with complete resolution of jaundice after chemotherapy. Author(s): Rao PK, Mehta P, Krishnamurthy M. Source: Southern Medical Journal. 2002 December; 95(12): 1455-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597317&dopt=Abstract
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Adult-type neuroblastoma originated in retroperitoneum beginning with obstructive jaundice. Author(s): Kawakami M, Koda M, Matsunaga N, Kishimoto Y, Shabana M, Kato H, Nishimuki E, Kojo H, Miura K, Kawasaki H. Source: Clinical Imaging. 2001 July-August; 25(4): 284-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11566092&dopt=Abstract
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Aetiology and prognostic implication of severe jaundice in surgical trauma patients. Author(s): Labori KJ, Bjornbeth BA, Raeder MG. Source: Scandinavian Journal of Gastroenterology. 2003 January; 38(1): 102-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608472&dopt=Abstract
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Alternative metalloporphyrins for the treatment of neonatal jaundice. Author(s): Vreman HJ, Wong RJ, Stevenson DK. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 December; 21 Suppl 1: S108-13; Discussion S125-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803430&dopt=Abstract
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Ampullectomy of carcinoma of the papilla of vater in an elderly patient without jaundice. Author(s): Hamazaki K, Sakai H, Amano T, Ichiki K, Hamada H, Yamauchi T. Source: Hiroshima J Med Sci. 2000 September; 49(3): 139-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11043522&dopt=Abstract
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Amputation neuroma of common bile duct with obstructive jaundice. Author(s): Watanabe O, Haga S, Okabe T, Kumazawa K, Shiozawa S, Tsuchiya A, Kajiwara T, Hirotani T, Aiba M. Source: Journal of Gastroenterology and Hepatology. 2001 August; 16(8): 945-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11555116&dopt=Abstract
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An epidemiological survey on neonatal jaundice in China. Author(s): Ding G, Zhang S, Yao D, Na Q, Wang H, Li L, Yang L, Huang W, Wang Y, Xu J. Source: Chinese Medical Journal. 2001 April; 114(4): 344-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11780450&dopt=Abstract
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An unexpected cause of jaundice. Author(s): McMaster P, Knight K, Shun A, Lam AH, Williams SJ. Source: Journal of Paediatrics and Child Health. 2002 February; 38(1): 89-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11869408&dopt=Abstract
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Analysis of 100 consecutive hepatectomies: risk factors in patients with liver cirrhosis or obstructive jaundice. Author(s): Das BC, Isaji S, Kawarada Y. Source: World Journal of Surgery. 2001 March; 25(3): 266-72; Discussion 272-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11343174&dopt=Abstract
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Anesthesia for cesarean section and newborn jaundice. Author(s): De Amici D, Delmonte P, Gasparoni A, Martinotti L. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2000 June; 20(4): 278. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10879349&dopt=Abstract
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Aneurysm of the gastroduodenal artery: an unusual cause of obstructive jaundice. Author(s): Konstantakos AK, Coogan SM, Husni EA, Raaf JH. Source: The American Surgeon. 2000 July; 66(7): 695-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10917486&dopt=Abstract
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Annular pancreas with obstructive jaundice: beware of underlying neoplasm. Author(s): Shan YS, Sy ED, Lin PW. Source: Pancreas. 2002 October; 25(3): 314-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12370545&dopt=Abstract
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Anorexia and malnutrition in patients with obstructive jaundice. Author(s): Padillo FJ, Andicoberry B, Pera-Madrazo C, Sitges-Serra A. Source: Nutrition (Burbank, Los Angeles County, Calif.). 2002 November-December; 18(11-12): 987-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12431722&dopt=Abstract
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Anorexia and the effect of internal biliary drainage on food intake in patients with obstructive jaundice. Author(s): Padillo FJ, Andicoberry B, Naranjo A, Mino G, Pera C, Sitges-Serra A. Source: Journal of the American College of Surgeons. 2001 May; 192(5): 584-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11333095&dopt=Abstract
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Antibiotic prophylaxis prior to endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice: is it worth the cost? Author(s): Thompson BF, Arguedas MR, Wilcox CM. Source: Alimentary Pharmacology & Therapeutics. 2002 April; 16(4): 727-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11929390&dopt=Abstract
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Anti-inflammatory response in patients with obstructive jaundice caused by biliary malignancy. Author(s): Kimura F, Miyazaki M, Suwa T, Sugiura T, Shinoda T, Itoh H, Nagakawa K, Ambiru S, Shimizu H, Yoshitome H. Source: Journal of Gastroenterology and Hepatology. 2001 April; 16(4): 467-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11354287&dopt=Abstract
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Association of hepatomegaly and jaundice with acute renal failure but not with cerebral malaria in severe falciparum malaria in Thailand. Author(s): Nacher M, Treeprasertsuk S, Singhasivanon P, Silachamroon U, Vannaphan S, Gay F, Looareesuwan S, Wilairatana P. Source: The American Journal of Tropical Medicine and Hygiene. 2001 December; 65(6): 828-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11791981&dopt=Abstract
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Betamethasone in plus phenobarbitone prior to hepatobiliary scintigraphy increases diagnostic accuracy in infants with jaundice. Author(s): Gupta DK, Charles AR, Srinivas M, Dave S, Bal CS. Source: Indian J Pediatr. 2001 November; 68(11): 1039-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11770238&dopt=Abstract
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Bile cultures and sensitivity patterns in malignant obstructive jaundice. Author(s): Neve R, Biswas S, Dhir V, Mohandas KM, Kelkar R, Shukla P, Jagannath P. Source: Indian J Gastroenterol. 2003 January-February; 22(1): 16-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12617446&dopt=Abstract
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Biliary drainage for obstructive jaundice enhances hepatic energy status in humans: a 31-phosphorus magnetic resonance spectroscopy study. Author(s): Mann DV, Lam WW, Magnus Hjelm N, So NM, Yeung DK, Metreweli C, Lau WY. Source: Gut. 2002 January; 50(1): 118-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772978&dopt=Abstract
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Biliary stents in malignant obstructive jaundice due to pancreatic carcinoma: a costeffectiveness analysis. Author(s): Arguedas MR, Heudebert GH, Stinnett AA, Wilcox CM. Source: The American Journal of Gastroenterology. 2002 April; 97(4): 898-904. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12003425&dopt=Abstract
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Bilirubin measured on a blood gas analyser: a suitable alternative for near-patient assessment of neonatal jaundice? Author(s): Peake M, Mazzachi B, Fudge A, Bais R. Source: Annals of Clinical Biochemistry. 2001 September; 38(Pt 5): 533-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11587132&dopt=Abstract
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Bilirubin production, breast-feeding and neonatal jaundice. Author(s): Hansen TW. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 July; 90(7): 716-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11519970&dopt=Abstract
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Binding of bilirubin with albumin-coupled liposomes: implications in the treatment of jaundice. Author(s): Masood AK, Faisal SM, Mushahid MK, Nadeem A, Siddiqui MU, Owais M. Source: Biochimica Et Biophysica Acta. 2002 August 19; 1564(1): 219-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12101016&dopt=Abstract
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Biochemical assessment and clinical evaluation of a non-ionic adsorbent resin in patients with intractable jaundice. Author(s): Pazzi P, Scagliarini R, Puviani AC, Lodi G, Morsiani E, Gullini S. Source: Int J Artif Organs. 2000 May; 23(5): 312-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10872849&dopt=Abstract
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Biochemical profile of erythrocyte membrane of jaundiced neonates. Author(s): Mazumder S, Sarkar U, Sengupta D. Source: Indian J Exp Biol. 2000 January; 38(1): 91-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11233094&dopt=Abstract
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Breastfeeding and jaundice. Author(s): Gartner LM. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 December; 21 Suppl 1: S25-9; Discussion S35-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803412&dopt=Abstract
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Breast-feeding, neonatal jaundice and kernicterus. Author(s): Gourley GR. Source: Seminars in Neonatology : Sn. 2002 April; 7(2): 135-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12208098&dopt=Abstract
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Bullet in the common hepatic duct: a cause of obstructive jaundice. Author(s): Maheshwari M, Chawla A, Dalvi A, Thapar P, Raut A. Source: Clinical Radiology. 2003 April; 58(4): 334-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12662959&dopt=Abstract
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Can anesthesiologic strategies for caesarean section influence newborn jaundice? A retrospective and prospective study. Author(s): De Amici D, Delmonte P, Martinotti L, Gasparoni A, Zizzi S, Ramajoli I, Ramajoli F. Source: Biology of the Neonate. 2001 February; 79(2): 97-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11223650&dopt=Abstract
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Can sunlight replace phototherapy units in the treatment of neonatal jaundice? An in vitro study. Author(s): Salih FM. Source: Photodermatology, Photoimmunology & Photomedicine. 2001 December; 17(6): 272-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11722753&dopt=Abstract
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Can transcutaneous bilirubinometry reduce the need for blood tests in jaundiced full term babies? Author(s): Briscoe L, Clark S, Yoxall CW. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2002 May; 86(3): F190-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11978751&dopt=Abstract
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Capillary electrophoresis for the determination of albumin binding capacity and free bilirubin in jaundiced neonates. Author(s): Yeung CY, Fung YS, Sun DX. Source: Semin Perinatol. 2001 April; 25(2): 50-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11339664&dopt=Abstract
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Captopril-induced jaundice: report of 2 cases and a review of 13 additional reports in the literature. Author(s): Schattner A, Kozak N, Friedman J. Source: The American Journal of the Medical Sciences. 2001 October; 322(4): 236-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11678523&dopt=Abstract
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Case report: hepatic and retro-peritoneal endometriosis presenting as obstructive jaundice with ascites: a case report and review of the literature. Author(s): Jeanes AC, Murray D, Davidson B, Hamilton M, Watkinson AF. Source: Clinical Radiology. 2002 March; 57(3): 226-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952319&dopt=Abstract
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Casebook: jaundice. Author(s): James MW, Ryder S. Source: The Practitioner. 2001 August; 245(1625): 664-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11524938&dopt=Abstract
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Causes of obvious jaundice in South West Wales. Author(s): Forrest EH, Forrest JA. Source: Gut. 2002 October; 51(4): 613-4; Author Reply 614. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12235095&dopt=Abstract
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Changes in calcium-binding protein expression in the auditory brainstem nuclei of the jaundiced Gunn rat. Author(s): Spencer RF, Shaia WT, Gleason AT, Sismanis A, Shapiro SM. Source: Hearing Research. 2002 September; 171(1-2): 129-141. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12204357&dopt=Abstract
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Choledochal semi volvulus with jaundice due to hiatal hernia. Initial percutaneous management. Author(s): Caldeiro JC, Curcio A, Gigena VC, Barbarosa G. Source: Acta Gastroenterol Latinoam. 2001 October; 31(4): 329-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11766545&dopt=Abstract
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Cholestatic jaundice associated with the use of metformin. Author(s): Desilets DJ, Shorr AF, Moran KA, Holtzmuller KC. Source: The American Journal of Gastroenterology. 2001 July; 96(7): 2257-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11467664&dopt=Abstract
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Cholestatic jaundice in infectious mononucleosis. Author(s): Valentini P, Angelone DF, Miceli Sopo S, Ngalikpima CJ, Ranno O. Source: Minerva Pediatr. 2000 May-June; 52(5-6): 303-6. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11085056&dopt=Abstract
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Clear topical ointment decreases transepidermal water loss in jaundiced preterm infants receiving phototherapy. Author(s): Cochrane Database Syst Rev. 2003;(1):CD002255 Source: J Med Assoc Thai. 2002 January; 85(1): 102-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12535434
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Clinical impact of biliary drainage and jaundice resolution in patients with obstructive metastases at the hilum. Author(s): Van Laethem JL, De Broux S, Eisendrath P, Cremer M, Le Moine O, Deviere J. Source: The American Journal of Gastroenterology. 2003 June; 98(6): 1271-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12818268&dopt=Abstract
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Co-amoxiclav jaundice: clinical and histological features and HLA class II association. Author(s): O'Donohue J, Oien KA, Donaldson P, Underhill J, Clare M, MacSween RN, Mills PR. Source: Gut. 2000 November; 47(5): 717-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11034591&dopt=Abstract
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Cohort study of surgical bypass to the gallbladder or bile duct for the palliation of jaundice due to pancreatic cancer. Author(s): Urbach DR, Bell CM, Swanstrom LL, Hansen PD. Source: Annals of Surgery. 2003 January; 237(1): 86-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12496534&dopt=Abstract
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Comment and perspective on Sewnath and colleagues' recent meta-analysis of the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice. Author(s): Pisters PW, Lee JE, Vauthey JN, Evans DB. Source: Annals of Surgery. 2003 April; 237(4): 594-5; Author Reply 595-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12677158&dopt=Abstract
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Compromise of immune function in obstructive jaundice. Author(s): Nehez L, Andersson R. Source: The European Journal of Surgery = Acta Chirurgica. 2002; 168(6): 315-28. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428868&dopt=Abstract
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Congenital acute lymphoblastic leukemia presenting as obstructive jaundice. Author(s): Izumi K, Yun C, Miyake N, Okada M, Kamitamari A, Moriuchi H. Source: Medical and Pediatric Oncology. 2002 January; 38(1): 72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835246&dopt=Abstract
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Congenital oligodendroglioma with initial manifestation of jaundice. Author(s): Hsieh WS, Lien RI, Lui TN, Wang CR, Jung SM. Source: Pediatric Neurology. 2002 September; 27(3): 230-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12393136&dopt=Abstract
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Contained rupture of an abdominal aortic aneurysm presenting as obstructive jaundice: report of a case. Author(s): Dorrucci V, Dusi R, Rombola G, Cordiano C. Source: Surgery Today. 2001; 31(4): 331-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11321343&dopt=Abstract
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Correlation of plasma color index with serum bilirubin in neonatal jaundice. Author(s): Singh M, Batish MK, Singh M, Singh K, Locham KK, Garg R. Source: Indian Pediatrics. 2001 March; 38(3): 278-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255306&dopt=Abstract
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Correlation of plasma color index with serum bilirubin in neonatal jaundice. Author(s): Murki S, Narang A. Source: Indian Pediatrics. 2001 July; 38(7): 801-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11463977&dopt=Abstract
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Correlation of plasma color index with serum bilirubin in neonatal jaundice. Author(s): Kumar A. Source: Indian Pediatrics. 2001 July; 38(7): 800-1; Author Reply 802-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11463976&dopt=Abstract
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Criteria for treatment of neonatal jaundice. Author(s): Bratlid D. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 December; 21 Suppl 1: S88-92; Discussion S104-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803425&dopt=Abstract
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CT findings of cystic duct carcinoma two years before obstructive jaundice. Author(s): Abe H, Tanaka K, Sugiyama S, Katamoto T, Makuuchi M. Source: Hepatogastroenterology. 2003 January-February; 50(49): 24-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629983&dopt=Abstract
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Current palliative treatment of malignant jaundice. Author(s): Hutan M, Salapa M, Poticny V, Bandzak J. Source: Bratisl Lek Listy. 2002; 103(4-5): 174-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413207&dopt=Abstract
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Cysteinyl leukotrienes in the bile of patients with obstructive jaundice. Author(s): Uemura M, Kojima H, Buchholz U, Kikuchi E, Matsumoto M, Kikukawa M, Imazu H, Fukui H, Tsujii T, Keppler D. Source: Journal of Gastroenterology. 2002; 37(10): 821-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12424566&dopt=Abstract
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Cytokines and acute-phase response markers derangements in patients with obstructive jaundice. Author(s): Padillo FJ, Andicoberry B, Muntane J, Lozano JM, Mino G, Sitges-Serra A, Solorzano G, Pera-Madrazo C. Source: Hepatogastroenterology. 2001 March-April; 48(38): 378-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11379313&dopt=Abstract
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Cytological analysis of choledochal mucosa in acute cholangitis in patients with mechanical jaundice. Author(s): Dreval' AA, Perminova GI, Kuznetsov NA, Sokolov AA, Laberko LA, Ryzhkova LV. Source: Bulletin of Experimental Biology and Medicine. 2002 April; 133(4): 408-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12124660&dopt=Abstract
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Deep jaundice in an adolescent. Author(s): Deutsch M, Dourakis SP, Sevastianos VA, Kaloterakis A, Hadziyannis SJ. Source: Postgraduate Medical Journal. 2003 September; 79(935): 544, 548-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13679562&dopt=Abstract
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Delayed development of obstructive jaundice and pancreatitis resulting from traumatic intramural hematoma of the duodenum: report of a case requiring deferred laparotomy. Author(s): Takishima T, Hirata M, Kataoka Y, Naito T, Ohwada T, Kakita A. Source: The Journal of Trauma. 2000 July; 49(1): 160-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10912875&dopt=Abstract
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Diagnostic laparoscopy in prolonged jaundice. Author(s): Senyuz OF, Yesildag E, Emir H, Tekant G, Bozkurt P, Sarimurat N, Soylet Y. Source: Journal of Pediatric Surgery. 2001 March; 36(3): 463-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11226997&dopt=Abstract
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Differentiation and diagnosis of jaundice. Author(s): Hass PL. Source: Aacn Clinical Issues. 1999 November; 10(4): 433-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10865528&dopt=Abstract
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Dilatation of the cystic duct in patients with obstructive jaundice. Author(s): Konno K, Ishida H, Sato M, Naganuma H, Komatsuda T, Kimura H, Ishida J, Watanabe S. Source: Abdominal Imaging. 2003 January-February; 28(1): 75-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12483390&dopt=Abstract
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Direct hyperbilirubinemia: a case study of parenteral nutrition-induced cholestatic jaundice. Author(s): Hengst JM. Source: Neonatal Netw. 2002 June; 21(4): 57-69. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12078321&dopt=Abstract
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Do steroids help jaundice caused by primary sclerosing cholangitis? Author(s): Parkes M, Booth JC, Pillai G, Mee AS. Source: Journal of Clinical Gastroenterology. 2001 October; 33(4): 319-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11588548&dopt=Abstract
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Double phototherapy in jaundiced term infants with hemolysis. Author(s): Thaithumyanon P, Visutiratmanee C. Source: J Med Assoc Thai. 2002 November; 85(11): 1176-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12546314&dopt=Abstract
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Duodenal metastasis from lung cancer presenting as obstructive jaundice. Author(s): Lee KA, Lee SK, Seo DW, Kim MH. Source: Gastrointestinal Endoscopy. 2001 August; 54(2): 228. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11474398&dopt=Abstract
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Early intravenous nutrition for the prevention of neonatal jaundice. Author(s): Faber BM, Mills JF. Source: Cochrane Database Syst Rev. 2003; (3): Cd003846. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12917992&dopt=Abstract
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Early recognition of neonatal jaundice and kernicterus. Author(s): Stokowski LA. Source: Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses. 2002 April; 2(2): 101-14; Quiz 117-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12881930&dopt=Abstract
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Early sepsis, obstructive jaundice and right-sided diaphragmatic hernia in the newborn. Author(s): Garcia-Munoz F, Santana C, Reyes D, Wiehoff A, Lopez-Pinto JM, GarciaAlix A. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 January; 90(1): 96-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11227344&dopt=Abstract
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Effect of internal biliary drainage on plasma levels of endotoxin, cytokines, and Creactive protein in patients with obstructive jaundice. Author(s): Padillo FJ, Muntane J, Montero JL, Briceno J, Mino G, Solorzano G, SitgesSerra A, Pera-Madrazo C. Source: World Journal of Surgery. 2002 November; 26(11): 1328-32. Epub 2002 September 26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12297927&dopt=Abstract
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Effect of pregnancy and obstructive jaundice on inflammatory diseases: the work of P S Hench revisited. Author(s): Crocker I, Lawson N, Fletcher J. Source: Annals of the Rheumatic Diseases. 2002 April; 61(4): 307-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874831&dopt=Abstract
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Effect of publication of the “Practice Parameter for the management of hyperbilirubinemia” on treatment of neonatal jaundice. Author(s): Seidman DS, Paz I, Armon Y, Ergaz Z, Stevenson DK, Gale R. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 March; 90(3): 292-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11332170&dopt=Abstract
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Effective relief of obstructive jaundice in a patient with nonresectable icteric-type hepatocellular carcinoma by external beam radiation therapy: case report. Author(s): Sung KF, Tsang NM, Tseng JH, Yeh CT. Source: Chang Gung Med J. 2001 February; 24(2): 114-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11360401&dopt=Abstract
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Effectiveness of endoscopic biliary drainage for unresectable hepatocellular carcinoma associated with obstructive jaundice. Author(s): Matsueda K, Yamamoto H, Umeoka F, Ueki T, Matsumura T, Tezen T, Doi I. Source: Journal of Gastroenterology. 2001 March; 36(3): 173-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11291880&dopt=Abstract
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Effects of clear topical ointment on transepidermal water loss in jaundiced pretermm infants receiving phototherapy. Author(s): Wananukul S, Praisuwanna P, Kesorncam K. Source: J Med Assoc Thai. 2001 June; 84(6): 837-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11556462&dopt=Abstract
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Effects of obstructive jaundice on the antioxidative capacity of human red blood cells. Author(s): Engin A, Altan N. Source: Haematologia. 2000; 30(2): 91-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10839561&dopt=Abstract
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Elevated tumour marker CA19-9: clinical interpretation and influence of obstructive jaundice. Author(s): Mann DV, Edwards R, Ho S, Lau WY, Glazer G. Source: European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2000 August; 26(5): 474-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11016469&dopt=Abstract
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Endoscopic internal biliary drainage in a child with malignant obstructive jaundice caused by neuroblastoma. Author(s): Okada T, Yoshida H, Matsunaga T, Kouchi K, Ohtsuka Y, Tsuyuguchi T, Yamaguchi T, Saisho H, Ohnuma N. Source: Pediatric Radiology. 2003 February; 33(2): 133-5. Epub 2002 November 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12557071&dopt=Abstract
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Endoscopic retrograde cholangiopancreatographic evaluation of patients with obstructive jaundice. Author(s): Khurram M, Durrani AA, Hasan Z, Butt AA, Ashfaq S. Source: J Coll Physicians Surg Pak. 2003 June; 13(6): 325-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12814529&dopt=Abstract
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EUS with EUS-guided fine-needle aspiration as the first endoscopic test for the evaluation of obstructive jaundice. Author(s): Erickson RA, Garza AA. Source: Gastrointestinal Endoscopy. 2001 April; 53(4): 475-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11275889&dopt=Abstract
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Evaluation of cholestatic jaundice in young infants. Author(s): Matthai J, Paul S. Source: Indian Pediatrics. 2001 August; 38(8): 893-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11521001&dopt=Abstract
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Evaluation of the direct antiglobulin (Coombs') test for identifying newborns at risk for hemolysis as determined by end-tidal carbon monoxide concentration (ETCOc); and comparison of the Coombs' test with ETCOc for detecting significant jaundice. Author(s): Herschel M, Karrison T, Wen M, Caldarelli L, Baron B. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2002 July-August; 22(5): 341-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12082466&dopt=Abstract
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Evolving role of biliary stenting in iatrogenic jaundice. Author(s): Gaffar AA, Haq TU, Pishori T, Burney IA. Source: J Pak Med Assoc. 2002 November; 52(11): 536-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585377&dopt=Abstract
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External and internal-external biliary drainage in children with malignant obstructive jaundice. Author(s): Roebuck DJ, Stanley P. Source: Pediatric Radiology. 2000 October; 30(10): 659-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11075595&dopt=Abstract
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External radiotherapy for decompression of cholangiocellular carcinoma with obstructive jaundice: report of a case. Author(s): Nakayama H, Tsuji K, Matsui R, Shiotani S, Atake S, Isaka N, Wada M, Tokuuye K, Ishikawa A, Akine Y. Source: Radiat Med. 2001 November-December; 19(6): 297-301. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11837580&dopt=Abstract
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Factors predicting nutritional derangements in patients with obstructive jaundice: multivariate analysis. Author(s): Padillo FJ, Andicoberry B, Muntane J, Lozano JM, Mino G, Sitges-Serra A, Pera-Madrazo C. Source: World Journal of Surgery. 2001 April; 25(4): 413-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11344390&dopt=Abstract
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Family teaching toolbox. Newborn jaundice. Author(s): Stokowski LA. Source: Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses. 2002 April; 2(2): 115-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12881931&dopt=Abstract
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Fatal cholestatic jaundice associated with amitriptyline. Author(s): Randeva HS, Bangar V, Sailesh S, Hillhouse EW. Source: Int J Clin Pract. 2000 July-August; 54(6): 405-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11092117&dopt=Abstract
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Fibreoptic phototherapy for neonatal jaundice. Author(s): Mills JF, Tudehope D. Source: Cochrane Database Syst Rev. 2001; (1): Cd002060. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11279748&dopt=Abstract
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Forced expression of murine IL-17E induces growth retardation, jaundice, a Th2biased response, and multiorgan inflammation in mice. Author(s): Pan G, French D, Mao W, Maruoka M, Risser P, Lee J, Foster J, Aggarwal S, Nicholes K, Guillet S, Schow P, Gurney AL. Source: Journal of Immunology (Baltimore, Md. : 1950). 2001 December 1; 167(11): 655967. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11714825&dopt=Abstract
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Fosinopril-induced prolonged cholestatic jaundice and pruritus: first case report. Author(s): Nunes AC, Amaro P, Mac as F, Cipriano A, Martins I, Rosa A, Pimenta I, Donato A, Freitas D. Source: European Journal of Gastroenterology & Hepatology. 2001 March; 13(3): 279-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293449&dopt=Abstract
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Full-blown graft-versus-host disease presenting with skin manifestations, jaundice and diarrhoea: an unusual paraneoplastic phenomenon of a thymoma. Author(s): Sleijfer S, Kaptein A, Versteegh MI, Hegt VN, Snels DG, van Tilburg AJ. Source: European Journal of Gastroenterology & Hepatology. 2003 May; 15(5): 565-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12702918&dopt=Abstract
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Genetic determinants of jaundice and gallstones in haemoglobin E beta thalassaemia. Author(s): Premawardhena A, Fisher CA, Fathiu F, de Silva S, Perera W, Peto TE, Olivieri NF, Weatherall DJ. Source: Lancet. 2001 June 16; 357(9272): 1945-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11425418&dopt=Abstract
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Gilbert's syndrome and jaundice in glucose-6-phosphate dehydrogenase deficient neonates. Author(s): Kaplan M. Source: Haematologica. 2000; 85(E-Letters): E01. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11114816&dopt=Abstract
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Glucose-6-phosphate dehydrogenase (G-6-PD) levels in jaundiced neonates in Calabar. Author(s): Uko EK, Agwunobi SN, Udoh JJ. Source: Niger J Med. 2003 April-June; 12(2): 98-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12956017&dopt=Abstract
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Guidelines for treatment of neonatal jaundice. Is there a place for evidence-based medicine? Author(s): Hansen TW. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 March; 90(3): 239-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11332160&dopt=Abstract
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Helminth infections are associated with protection from malaria-related acute renal failure and jaundice in Thailand. Author(s): Nacher M, Singhasivanon P, Silachamroon U, Treeprasertsuk S, Vannaphan S, Traore B, Gay F, Looareesuwan S. Source: The American Journal of Tropical Medicine and Hygiene. 2001 December; 65(6): 834-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11791982&dopt=Abstract
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Hemobilia and jaundice caused by acalculous cholecystitis. Author(s): Nursal TZ, Yildirim S, Noyan T, Moray G, Haberal M, Yildirim T. Source: Journal of Clinical Gastroenterology. 2002 February; 34(2): 191-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11782621&dopt=Abstract
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Hepatobiliary and pancreatic: a woman with jaundice and anorexia. Author(s): Mikami N. Source: Journal of Gastroenterology and Hepatology. 2001 December; 16(12): 1415, 14189. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11851842&dopt=Abstract
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Hepatobiliary and pancreatic: an old woman with stones and jaundice. Author(s): Mikami N, Okuda K. Source: Journal of Gastroenterology and Hepatology. 2002 September; 17(9): 1032, 10378. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12167127&dopt=Abstract
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Hepatocellular carcinoma with obstructive jaundice: diagnosis, treatment and prognosis. Author(s): Qin LX, Tang ZY. Source: World Journal of Gastroenterology : Wjg. 2003 March; 9(3): 385-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12632482&dopt=Abstract
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Home health nurse clinical assessment of neonatal jaundice: comparison of 3 methods. Author(s): Madlon-Kay DJ. Source: Archives of Pediatrics & Adolescent Medicine. 2001 May; 155(5): 583-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11343502&dopt=Abstract
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Home phototherapy for neonatal jaundice--technology and teamwork meeting consumer and service need. Author(s): Jackson CL, Tudehope D, Willis L, Law T, Venz J. Source: Aust Health Rev. 2000; 23(2): 162-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11010568&dopt=Abstract
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Host immune responses and intestinal permeability in patients with jaundice. Author(s): Parks RW, Halliday MI, McCrory DC, Erwin P, Smye M, Diamond T, Rowlands BJ. Source: The British Journal of Surgery. 2003 February; 90(2): 239-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12555304&dopt=Abstract
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How accurate are neonatologists in identifying clinical jaundice in newborns? Author(s): Riskin A, Abend-Weinger M, Bader D. Source: Clinical Pediatrics. 2003 March; 42(2): 153-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12659389&dopt=Abstract
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Human neutrophil functions in obstructive jaundice. Author(s): Takaoka M, Kubota Y, Tsuji K, Yamamoto S, Ogura M, Yanagitani K, Shimatani M, Shibatani N, Inoue K. Source: Hepatogastroenterology. 2001 January-February; 48(37): 71-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11269002&dopt=Abstract
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Hypokalemia due to Fanconi syndrome in a patient with obstructive jaundice. Author(s): Liamis G, Bairaktari E, Elisaf M. Source: Nephron. 2002; 92(3): 711-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12372962&dopt=Abstract
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Idiopathic fibrosing pancreatitis presenting with obstructive jaundice in a child. Author(s): Keil R, Snajdauf J, Kalousova J, Nevolova P, Kodet R. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2001 October; 11(5): 32830. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11719872&dopt=Abstract
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Imaging strategies in the initial evaluation of the jaundiced patient. American College of Radiology. ACR Appropriateness Criteria. Author(s): Balfe DM, Ralls PW, Bree RL, DiSantis DJ, Glick SN, Levine MS, Megibow AJ, Saini S, Shuman WP, Greene FL, Laine LA, Lillemoe K, Kidd R. Source: Radiology. 2000 June; 215 Suppl: 125-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11037417&dopt=Abstract
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Imatinib administration in two patients with liver metastases from GIST and severe jaundice. Author(s): De Pas T, Danesi R, Catania C, Curigliano G, De Braud F; Italia Sarcoma Group. Source: British Journal of Cancer. 2003 October 20; 89(8): 1403-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14562006&dopt=Abstract
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Imbalance between production and conjugation of bilirubin: a fundamental concept in the mechanism of neonatal jaundice. Author(s): Kaplan M, Muraca M, Hammerman C, Rubaltelli FF, Vilei MT, Vreman HJ, Stevenson DK. Source: Pediatrics. 2002 October; 110(4): E47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359820&dopt=Abstract
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Immunoglobulin infusion for isoimmune haemolytic jaundice in neonates. Author(s): Alcock GS, Liley H. Source: Cochrane Database Syst Rev. 2002; (3): Cd003313. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12137687&dopt=Abstract
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Immunoprotective properties of peptidoglycan monomer linked with zinc in cholestatic jaundice. Author(s): Ravlic-Gulan J, Radosevic-Stasic B, Gulan G, Stimac D, Pavelic K, Rukavina D. Source: International Archives of Allergy and Immunology. 2000 December; 123(4): 35464. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11146394&dopt=Abstract
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Improved cardiac function in patients with obstructive jaundice after internal biliary drainage: hemodynamic and hormonal assessment. Author(s): Padillo J, Puente J, Gomez M, Dios F, Naranjo A, Vallejo JA, Mino G, Pera C, Sitges-Serra A. Source: Annals of Surgery. 2001 November; 234(5): 652-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11685028&dopt=Abstract
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Improved transcutaneous bilirubinometry: comparison of SpectR(X) BiliCheck and Minolta Jaundice Meter JM-102 for estimating total serum bilirubin in a normal newborn population. Author(s): Robertson A, Kazmierczak S, Vos P. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2002 January; 22(1): 12-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840236&dopt=Abstract
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In severe jaundice, major liver resection is contraindicated. Author(s): Lang H, Oldhafer KJ, Dirsch O, Broelsch CE. Source: Surgery. 2002 February; 131(2): 239. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11854714&dopt=Abstract
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In utero development of a warm-reactive autoantibody in a severely jaundiced neonate. Author(s): Blackall DP, Liles LH, Talati AJ. Source: Transfusion. 2002 January; 42(1): 44-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11896311&dopt=Abstract
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Increased renal expression of bilirubin glucuronide transporters in a rat model of obstructive jaundice. Author(s): Tanaka Y, Kobayashi Y, Gabazza EC, Higuchi K, Kamisako T, Kuroda M, Takeuchi K, Iwasa M, Kaito M, Adachi Y. Source: American Journal of Physiology. Gastrointestinal and Liver Physiology. 2002 April; 282(4): G656-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11897625&dopt=Abstract
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Index of suspicion. Case 3. Diagnosis: jaundice. Author(s): Jain SK. Source: Pediatrics in Review / American Academy of Pediatrics. 2001 August; 22(8): 271-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11499425&dopt=Abstract
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Infantile cholestatic jaundice associated with adult-onset type II citrullinemia. Author(s): Tazawa Y, Kobayashi K, Ohura T, Abukawa D, Nishinomiya F, Hosoda Y, Yamashita M, Nagata I, Kono Y, Yasuda T, Yamaguchi N, Saheki T. Source: The Journal of Pediatrics. 2001 May; 138(5): 735-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11343052&dopt=Abstract
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Infectious aetiology of jaundice among pregnant women in Angola. Author(s): Strand RT, Franque-Ranque M, Bergstrom S, Weiland O. Source: Scandinavian Journal of Infectious Diseases. 2003; 35(6-7): 401-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12953953&dopt=Abstract
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Intermittent jaundice and rigors in a patient with longstanding ulcerative colitis. Author(s): Hawkes ND, Mutimer D, Thomas GA. Source: Postgraduate Medical Journal. 2001 June; 77(908): 406-7, 412-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11375459&dopt=Abstract
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Internal hernia presenting as obstructive jaundice and acute pancreatitis. Author(s): Joo YE, Kim HS, Choi SK, Rew JS, Kim HR, Cho CK, Kim SJ. Source: Scandinavian Journal of Gastroenterology. 2002 August; 37(8): 983-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12229977&dopt=Abstract
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Internal hernia presenting as obstructive jaundice. Author(s): Losanoff JE, Richman BW, Jones JW. Source: Scandinavian Journal of Gastroenterology. 2003 January; 38(1): 123. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608475&dopt=Abstract
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Intrahepatic cholangiojejunostomy for unresectable malignant biliary tumors with obstructive jaundice. Author(s): Suzuki S, Kurachi K, Yokoi Y, Tsuchiya Y, Okamoto K, Okumura T, Inaba K, Konno H, Nakamura S. Source: Journal of Hepato-Biliary-Pancreatic Surgery. 2001; 8(2): 124-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11455467&dopt=Abstract
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Intra-operative tube stenting, palliation for jaundice in carcinoma gall bladder. Author(s): Puneet, Khanna R, Khanna AK. Source: J Indian Med Assoc. 2001 October; 99(10): 584-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018544&dopt=Abstract
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Investigation of prolonged neonatal jaundice. Author(s): Hannam S, McDonnell M, Rennie JM. Source: Acta Paediatrica (Oslo, Norway : 1992). 2000 June; 89(6): 694-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10914965&dopt=Abstract
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Is breastfeeding really favoring early neonatal jaundice? Author(s): Bertini G, Dani C, Tronchin M, Rubaltelli FF. Source: Pediatrics. 2001 March; 107(3): E41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11230622&dopt=Abstract
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Is sunlight an effective treatment for infants with jaundice? Author(s): Johnston RV, Anderson JN, Prentice C. Source: The Medical Journal of Australia. 2003 April 21; 178(8): 403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12697014&dopt=Abstract
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Isolated pancreatic tuberculosis and obstructive jaundice. Author(s): Singh B, Moodley J, Batitang S, Chetty R. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2002 May; 92(5): 357-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12108166&dopt=Abstract
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Jaundice after Billroth II resection. A case report. Author(s): Culafic D, Kovacevic N, Milicevic M, Bulajic P. Source: Rom J Gastroenterol. 2002 September; 11(3): 219-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12368942&dopt=Abstract
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Jaundice after surgery for an aortic arch aneurysm. Author(s): Onoguchi K, Hachiya T, Sasaki T, Hashimoto K, Takakura H, Takeuchi S. Source: Jpn J Thorac Cardiovasc Surg. 2001 June; 49(6): 388-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11481845&dopt=Abstract
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Jaundice and breastfeeding. Author(s): Gartner LM, Herschel M. Source: Pediatric Clinics of North America. 2001 April; 48(2): 389-99. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11339159&dopt=Abstract
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Jaundice and hepatocellular damage associated with nevirapine therapy. Author(s): Prakash M, Poreddy V, Tiyyagura L, Bonacini M. Source: The American Journal of Gastroenterology. 2001 May; 96(5): 1571-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11374701&dopt=Abstract
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Jaundice and portal hypertension--double trouble. Author(s): Chaudhary A, Tandon V. Source: Trop Gastroenterol. 2001 January-March; 22(1): 5-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11398251&dopt=Abstract
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Jaundice as an early diagnostic sign of urinary tract infection in infancy. Author(s): Garcia FJ, Nager AL. Source: Pediatrics. 2002 May; 109(5): 846-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11986445&dopt=Abstract
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Jaundice caused by a clinically undetectable T-cell lymphoma infiltrating the sphincter of Oddi. Author(s): Weinstock LB, Swanson PE, Bennett KJ, Van Amburg A, Wald SM, Shah NB. Source: The American Journal of Gastroenterology. 2001 November; 96(11): 3186-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11721770&dopt=Abstract
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Jaundice caused by a pancreatic mass: an exceptional presentation of Crohn's disease. Author(s): Reynaert H, Peters O, Van der Auwera J, Vanstapel MJ, Urbain D. Source: Journal of Clinical Gastroenterology. 2001 March; 32(3): 255-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11246358&dopt=Abstract
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Jaundice clearance and cholangitis in the first year following portoenterostomy for biliary atresia. Author(s): Selvalingam S, Mahmud MN, Thambidorai CR, Zakaria Z, Mohan N, Isa, Sheila M. Source: Med J Malaysia. 2002 March; 57(1): 92-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14569724&dopt=Abstract
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Jaundice in a pregnant woman--a missed diagnosis in historical perspective. Author(s): Mets JT. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2000 October; 90(10): 993. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11081102&dopt=Abstract
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Jaundice in falciparum malaria--some prospective observations. Author(s): Mazumder R, Mishra RK, Mazumder H, Mukherjee P. Source: J Indian Med Assoc. 2002 May; 100(5): 312-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12418632&dopt=Abstract
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Jaundice in hepatitis B immunized. Author(s): John TJ. Source: Indian Pediatrics. 2000 December; 37(12): 1388-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11119350&dopt=Abstract
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Jaundice in non-cirrhotic primary biliary cirrhosis: the premature ductopenic variant. Author(s): Vleggaar FP, van Buuren HR, Zondervan PE, ten Kate FJ, Hop WC; Dutch Multicentre PBC study group. Source: Gut. 2001 August; 49(2): 276-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11454806&dopt=Abstract
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Jaundice in older children and adolescents. Author(s): Pashankar D, Schreiber RA. Source: Pediatrics in Review / American Academy of Pediatrics. 2001 July; 22(7): 219-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11435623&dopt=Abstract
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Jaundice in primary school pupils. Author(s): Stephenson I, Monk P, Gray J, Thuraisingam H. Source: Postgraduate Medical Journal. 2002 January; 78(915): 56, 59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11796881&dopt=Abstract
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Jaundice in the newborn. Author(s): Agrawal R, Aggarwal R, Deorari AK, Paul VK. Source: Indian J Pediatr. 2001 October; 68(10): 977-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11758137&dopt=Abstract
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Jaundice noted in the first 24 hours after birth in a managed care organization. Author(s): Newman TB, Liljestrand P, Escobar GJ. Source: Archives of Pediatrics & Adolescent Medicine. 2002 December; 156(12): 1244-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444838&dopt=Abstract
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Jaundice technologies: prediction of hyperbilirubinemia in term and near-term newborns. Author(s): Bhutani VK, Johnson LH. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 December; 21 Suppl 1: S76-82; Discussion S83-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803423&dopt=Abstract
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Jaundice, genes and promoters. Author(s): Strassburg CP, Manns MP. Source: Journal of Hepatology. 2000 September; 33(3): 476-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11020005&dopt=Abstract
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Jaundice. Author(s): Marschall HU, Trauner M, Lammert F. Source: Scandinavian Journal of Gastroenterology. 2003 March; 38(3): 233-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12737435&dopt=Abstract
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Kernicterus and G6PD deficiency--a case series from Oman. Author(s): Nair PA, Al Khusaiby SM. Source: Journal of Tropical Pediatrics. 2003 April; 49(2): 74-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729287&dopt=Abstract
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Laparoscopy in diagnosis of prolonged neonatal jaundice. Author(s): Shah AA, Sitapara AM, Shah AV. Source: Indian Pediatrics. 2002 December; 39(12): 1138-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12522276&dopt=Abstract
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Lymphoma-associated haemophagocytic syndrome with jaundice and generalised skin involvement. Author(s): Steiner B, Wolff D, Leithauser M, Hartung G, Freund M. Source: European Journal of Haematology. 2003 March; 70(3): 193-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12605666&dopt=Abstract
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Magnetic resonance-guided biliary drainage in a patient with malignant obstructive jaundice and thrombocytopenia. Author(s): Faiss S, Zeitz M, Wolf KJ, Lewin JS, Wacker FK. Source: Endoscopy. 2003 January; 35(1): 89-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12510234&dopt=Abstract
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Malignant obstructive jaundice: comparison of MRCP and ERCP in the evaluation of distal lesions. Author(s): Di Cesare E, Puglielli E, Michelini O, Pistoi MA, Lombardi L, Rossi M, Barile A, Masciocchi C. Source: Radiol Med (Torino). 2003 May-June; 105(5-6): 445-53. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12949455&dopt=Abstract
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Management of obstructive jaundice caused by non-hodgkin lymphoma in children. Author(s): Kutluk T, Varan A, Caglar K, Guler E, Buyukpamukcu M. Source: Medical and Pediatric Oncology. 2001 June; 36(6): 669-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11344506&dopt=Abstract
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Managing the assessment of neonatal jaundice: importance of timing. Author(s): Bhutani VK, Johnson LH. Source: Indian J Pediatr. 2000 October; 67(10): 733-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11105424&dopt=Abstract
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Manganese intake and cholestatic jaundice in neonates receiving parenteral nutrition: a randomized controlled study. Author(s): Fok TF, Chui KK, Cheung R, Ng PC, Cheung KL, Hjelm M. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 September; 90(9): 1009-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11683188&dopt=Abstract
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Maternal assessment of neonatal jaundice after hospital discharge. Author(s): Madlon-Kay DJ. Source: The Journal of Family Practice. 2002 May; 51(5): 445-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12019052&dopt=Abstract
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Metastatic breast cancer causing jaundice by a unique mechanism. Author(s): Chase MP, Thiim M, Heiss FW, Glick ME, Yarze JC. Source: Gastrointestinal Endoscopy. 2000 November; 52(5): 676-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11060198&dopt=Abstract
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Multiple dose IVIG treatment in neonatal immune hemolytic jaundice. Author(s): Tanyer G, SiklarZ, Dallar Y, Yildirmak Y, Tiras U. Source: Journal of Tropical Pediatrics. 2001 February; 47(1): 50-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11245352&dopt=Abstract
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Neonatal cholestasis: a red alert for the jaundiced newborn. Author(s): Pashankar D, Schreiber RA. Source: Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. 2000 November; 14 Suppl D: 67D-72D. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11110615&dopt=Abstract
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Neonatal jaundice and kernicterus. Author(s): AAP Subcommittee on Neonatal Hyperbilirubinemia. Source: Pediatrics. 2001 September; 108(3): 763-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11533348&dopt=Abstract
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Neonatal jaundice and scientific fraud in 1804. Author(s): Hansen TW. Source: Acta Paediatrica (Oslo, Norway : 1992). 2002; 91(10): 1135-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12434903&dopt=Abstract
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Neonatal jaundice and urinary tract infections. Author(s): Maisels MJ, Newman TB. Source: Pediatrics. 2003 November; 112(5): 1213-4; Author Reply 1213-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14595074&dopt=Abstract
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Neonatal jaundice coinciding with or resulting from urinary tract infections? Author(s): Sarici SU, Kul M, Alpay F. Source: Pediatrics. 2003 November; 112(5): 1212-3; Author Reply 1212-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14595073&dopt=Abstract
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Neonatal jaundice in Asian, white, and mixed-race infants. Author(s): Setia S, Villaveces A, Dhillon P, Mueller BA. Source: Archives of Pediatrics & Adolescent Medicine. 2002 March; 156(3): 276-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11876673&dopt=Abstract
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Neonatal jaundice in very low birth weight babies. Author(s): Narang A, Kumar P, Kumar R. Source: Indian J Pediatr. 2001 April; 68(4): 307-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11370434&dopt=Abstract
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Neonatal jaundice, animal-induced injuries, and immunizations. Author(s): Binstadt BA, Bernstein HH. Source: Current Opinion in Pediatrics. 2002 August; 14(4): 498-507. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12130918&dopt=Abstract
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Neonatal jaundice, animal-induced injuries, and immunizations. Author(s): Sandora TJ, Bernstein HH. Source: Current Opinion in Pediatrics. 2001 August; 13(4): 377-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11717566&dopt=Abstract
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Neonatal jaundice, animal-induced injuries, and immunizations. Author(s): Koh AY, Bernstein HH. Source: Current Opinion in Pediatrics. 2000 August; 12(4): 413-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10943826&dopt=Abstract
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Neonatal jaundice: continuing concern and need for research. Author(s): Ohlsson A. Source: Pediatric Research. 2001 December; 50(6): 674-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11726719&dopt=Abstract
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Neonatal jaundice: the role of laparoscopy. Author(s): Hay SA, Soliman HE, Sherif HM, Abdelrahman AH, Kabesh AA, Hamza AF. Source: Journal of Pediatric Surgery. 2000 December; 35(12): 1706-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11101719&dopt=Abstract
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Neonatal jaundice--traditional Chinese medicine approach. Author(s): Fok TF. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 December; 21 Suppl 1: S98-S100; Discussion S104-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803427&dopt=Abstract
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Neuromas of the extrahepatic bile ducts as a cause of obstructive jaundice. Author(s): Wysocki A, Papla B, Budzynski P. Source: European Journal of Gastroenterology & Hepatology. 2002 May; 14(5): 573-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11984159&dopt=Abstract
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New transcutaneous jaundice device with two optical paths. Author(s): Yasuda S, Itoh S, Isobe K, Yonetani M, Nakamura H, Nakamura M, Yamauchi Y, Yamanishi A. Source: Journal of Perinatal Medicine. 2003; 31(1): 81-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12661149&dopt=Abstract
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Newborn jaundice and kernicterus--health and societal perspectives. Author(s): Bhutani VK, Johnson LH. Source: Indian J Pediatr. 2003 May; 70(5): 407-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841402&dopt=Abstract
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Nitinol stents for palliative treatment of malignant obstructive jaundice: should we stent the sphincter of Oddi in every case? Author(s): Hatzidakis AA, Tsetis D, Chrysou E, Sanidas E, Petrakis J, Gourtsoyiannis NC. Source: Cardiovascular and Interventional Radiology. 2001 July-August; 24(4): 245-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11779014&dopt=Abstract
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Non-Hodgkin lymphoma presenting with obstructive jaundice. Author(s): Ravindra KV, Stringer MD, Prasad KR, Kinsey SE, Lodge JP. Source: The British Journal of Surgery. 2003 July; 90(7): 845-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854111&dopt=Abstract
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Non-invasive bilirubinometry in neonatal jaundice. Author(s): Bertini G, Rubaltelli FF. Source: Seminars in Neonatology : Sn. 2002 April; 7(2): 129-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12208097&dopt=Abstract
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Non-parasitic hepatic cysts causing obstructive jaundice: two cases. Author(s): Mehendale VG, Kamdar MS, Shenoy SN, Chaudhari N, Joshi AM. Source: Indian J Gastroenterol. 2003 January-February; 22(1): 26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12617451&dopt=Abstract
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Nonparasitic solitary huge liver cysts causing intracystic hemorrhage or obstructive jaundice. Author(s): Ishikawa H, Uchida S, Yokokura Y, Iwasaki Y, Horiuchi H, Hiraki M, Kinoshita H, Shirouzu K. Source: Journal of Hepato-Biliary-Pancreatic Surgery. 2002; 9(6): 764-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658414&dopt=Abstract
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Objective assessment of the contribution of each diagnostic test and of the ordering sequence in jaundice caused by pancreatobiliary carcinoma. Author(s): Olds G, Isenberg G. Source: Gastrointestinal Endoscopy. 2001 November; 54(5): 669-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11702747&dopt=Abstract
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Obstructive jaundice as the presenting manifestation of Burkitt's lymphoma in a 4year-old boy. Author(s): Hsu CF, Ko SF, Hsiao CC, Shieh CS, Huang CC, Huang FC. Source: J Formos Med Assoc. 2003 February; 102(2): 105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709739&dopt=Abstract
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Obstructive jaundice caused by hepatocellular carcinoma: detection by endoscopic sonography. Author(s): Lee YC, Wang HP, Huang SP, Chang YT, Wu CT, Yang CS, Wu MS, Lin JT. Source: Journal of Clinical Ultrasound : Jcu. 2001 July-August; 29(6): 363-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11424104&dopt=Abstract
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Obstructive jaundice caused by lymphatic remetastasis from the hepatic metastasis of rectosigmoid cancer. Author(s): Ishizaki N, Hamada N, Kadono J, Nakamura N, Taira A. Source: Journal of Hepato-Biliary-Pancreatic Surgery. 2001; 8(5): 469-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11702258&dopt=Abstract
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Obstructive jaundice caused by primary choledochal hydatid cyst mimicking radiologically choledochal cyst. Author(s): Otgun I, Karnak I, Haliloglu M, Senocak ME. Source: Journal of Pediatric Surgery. 2003 February; 38(2): 256-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12596118&dopt=Abstract
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Obstructive jaundice due to a rare cause of biliary stricture. Author(s): Kakar A, Bhalla S, Gupta PS. Source: J Assoc Physicians India. 2000 December; 48(12): 1219-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11280237&dopt=Abstract
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Obstructive jaundice due to common bile duct stone in a patient with Langerhans' cell histiocytosis. Author(s): Sood A, Midha V, Sood N. Source: The American Journal of Gastroenterology. 2000 December; 95(12): 3669. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11151931&dopt=Abstract
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Obstructive jaundice due to internal herniation: a case report and review of the literature. Author(s): Kawakami M, Mukaiya M, Kimura Y, Hata F, Katsuramaki T, Sasaki K, Ura H, Hirata K. Source: Hepatogastroenterology. 2002 July-August; 49(46): 1030-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12143194&dopt=Abstract
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Obstructive jaundice facilitates hepatic metastasis of B16F1 mouse melanoma cells: participation of increased VCAM-1 expression in the liver. Author(s): Kishimoto H, Sasahara K, Yamazaki K, Nagata T, Uotani H, Yamashita I, Tauchi K, Tsukada K. Source: Oncol Rep. 2001 May-June; 8(3): 575-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11295083&dopt=Abstract
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Obstructive jaundice in a case of portal hypertension. Author(s): Chawla A, Maheshwari M, Parmar H. Source: The British Journal of Radiology. 2003 September; 76(909): 667-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14500285&dopt=Abstract
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Obstructive jaundice in a metastatic tumor of the pancreas from breast cancer: a case report. Author(s): Kitamura N, Murata S, Abe H, Hanasawa K, Tsukashita S, Tani T. Source: Japanese Journal of Clinical Oncology. 2003 February; 33(2): 93-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629061&dopt=Abstract
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Obstructive jaundice in adult Ethiopians in a referral hospital. Author(s): Bekele Z, Yifru A. Source: Ethiop Med J. 2000 October; 38(4): 267-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11125501&dopt=Abstract
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Obstructive jaundice in hepatocellular carcinoma: response after percutaneous transhepatic biliary drainage and prognostic factors. Author(s): Lee JW, Han JK, Kim TK, Choi BI, Park SH, Ko YH, Yoon CJ, Yeon KM. Source: Cardiovascular and Interventional Radiology. 2002 May-June; 25(3): 176-9. Epub 2002 March 27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12058212&dopt=Abstract
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Obstructive jaundice secondary to lymphoma in childhood. Author(s): Pietsch JB, Shankar S, Ford C, Johnson JE. Source: Journal of Pediatric Surgery. 2001 December; 36(12): 1792-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11733908&dopt=Abstract
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Occult splenic injury: delayed presentation manifesting as jaundice. Author(s): Simpson RA, Ajuwon R. Source: Emergency Medicine Journal : Emj. 2001 November; 18(6): 504-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11696518&dopt=Abstract
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Onset of jaundice in glucose-6-phosphate dehydrogenase-deficient neonates. Author(s): Kaplan M, Algur N, Hammerman C. Source: Pediatrics. 2001 October; 108(4): 956-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11581450&dopt=Abstract
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Outbreak of jaundice and hemorrhagic fever in the Southeast of Brazil in 2001: detection and molecular characterization of yellow fever virus. Author(s): de Filippis AM, Nogueira RM, Schatzmayr HG, Tavares DS, Jabor AV, Diniz SC, Oliveira JC, Moreira E, Miagostovich MP, Costa EV, Galler R. Source: Journal of Medical Virology. 2002 December; 68(4): 620-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12376973&dopt=Abstract
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Palliative percutaneous tube enterostomy in afferent-loop syndrome presenting as jaundice: clinical effectiveness. Author(s): Kim YH, Han JK, Lee KH, Kim TK, Kim KW, Choi BI. Source: Journal of Vascular and Interventional Radiology : Jvir. 2002 August; 13(8): 8459. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12171989&dopt=Abstract
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Pancreatic head melanoma producing obstructive jaundice: magnetic resonance characteristics aiding differentiation from adenocarcinoma. Author(s): Solomons G, Gibson RN, Tello RJ. Source: Australasian Radiology. 2000 November; 44(4): 471-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11103552&dopt=Abstract
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Pancreatic tumour with jaundice: good prognosis. Author(s): Diamantopoulos GI, Kapiris SA, Anagnostou E, Spiliadi C. Source: Journal of the Royal Society of Medicine. 2000 August; 93(8): 430-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10983508&dopt=Abstract
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Papillary cholangiocarcinoma: a cause of intermittent, obstructive jaundice. Author(s): Fischer CP, Fernandez M, Garden OJ. Source: Surgery. 2002 February; 131(2): 234-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11854709&dopt=Abstract
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Paraganglionoma of extrahepatic biliary tract causing obstructive jaundice. Author(s): Sandhu BS, Kumar N, Sachdeva AK, Negi SS, Sridhar S, Malhotra V, Lamba GS, Puri AS. Source: Indian J Gastroenterol. 2000 July-September; 19(3): 141-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10918729&dopt=Abstract
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Partially reversible renal tubular damage in patients with obstructive jaundice. Author(s): Bairaktari E, Liamis G, Tsolas O, Elisaf M. Source: Hepatology (Baltimore, Md.). 2001 June; 33(6): 1365-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11391524&dopt=Abstract
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Pathogenesis of endotoxemia and multiple organ failure in case of mechanical jaundice and their aggravation after the relief of cholestasis. Author(s): Kordzaya DJ, Goderdzishvili VT. Source: Przegl Lek. 2000; 57 Suppl 5: 36-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11202289&dopt=Abstract
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Percutaneous biliary metal wall stenting in malignant obstructive jaundice. Author(s): Indar AA, Lobo DN, Gilliam AD, Gregson R, Davidson I, Whittaker S, Doran J, Rowlands BJ, Beckingham IJ. Source: European Journal of Gastroenterology & Hepatology. 2003 August; 15(8): 915-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12867803&dopt=Abstract
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Perioperative renal protection in patients with obstructive jaundice using drug combinations. Author(s): Wahbah AM, el-Hefny MO, Wafa EM, el-Kharbotly W, el-Enin AA, Zaglol A, Atallah MM. Source: Hepatogastroenterology. 2000 November-December; 47(36): 1691-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11149033&dopt=Abstract
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Persistence of maternal concerns surrounding neonatal jaundice: an exploratory study. Author(s): Hannon PR, Willis SK, Scrimshaw SC. Source: Archives of Pediatrics & Adolescent Medicine. 2001 December; 155(12): 1357-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732956&dopt=Abstract
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Pharmacological interventions for the treatment of neonatal jaundice. Author(s): Dennery PA. Source: Seminars in Neonatology : Sn. 2002 April; 7(2): 111-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12208095&dopt=Abstract
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Phenobarbitone prophylaxis for neonatal jaundice in babies with birth weight 10001499 grams. Author(s): Kumar R, Narang A, Kumar P, Garewal G. Source: Indian Pediatrics. 2002 October; 39(10): 945-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428041&dopt=Abstract
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Phototherapy for neonatal jaundice--still in need of fine tuning. Author(s): Hansen TW. Source: Acta Paediatrica (Oslo, Norway : 1992). 2000 July; 89(7): 770-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10943954&dopt=Abstract
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Phototherapy use in jaundiced newborns in a large managed care organization: do clinicians adhere to the guideline? Author(s): Atkinson LR, Escobar GJ, Takayama JI, Newman TB. Source: Pediatrics. 2003 May; 111(5 Pt 1): E555-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12728109&dopt=Abstract
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Physical signs for the general dental practitioner. Case 3. Spider naevi and jaundiced sclera. Author(s): Bain S, Hamburger J. Source: Dent Update. 2003 April; 30(3): 160. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12743919&dopt=Abstract
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Pioneers in the scientific study of neonatal jaundice and kernicterus. Author(s): Hansen TW. Source: Pediatrics. 2000 August; 106(2): E15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10920171&dopt=Abstract
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Plant sources for the treatment of jaundice in the tribals of Western Madhya Pradesh of India. Author(s): Samvatsar S, Diwanji VB. Source: Journal of Ethnopharmacology. 2000 November; 73(1-2): 313-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11025171&dopt=Abstract
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Plasmodium vivax and hepatitis E co-infection--a rare cause of malarial jaundice. Author(s): Bansal R, Kadhiravan T, Aggarwal P, Handa R, Biswas A, Wali JP. Source: Indian J Gastroenterol. 2002 September-October; 21(5): 207-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416764&dopt=Abstract
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Poorly differentiated adenocarcinoma with signet-ring cells of the Vater's ampulla, without jaundice but with disseminated carcinomatosis. Author(s): Nabeshima S, Kishihara Y, Nabeshima A, Yamaga S, Kinjo M, Kashiwagi S, Hayashi J. Source: Fukuoka Igaku Zasshi. 2003 July; 94(7): 235-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14509231&dopt=Abstract
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Portal embolization relieves persistent jaundice after complete biliary drainage. Author(s): Ijichi M, Makuuchi M, Imamura H, Takayama T. Source: Surgery. 2001 July; 130(1): 116-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11436025&dopt=Abstract
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Possible ranitidine-induced cholestatic jaundice. Author(s): Liberopoulos EN, Nonni AB, Tsianos EV, Elisaf MS. Source: The Annals of Pharmacotherapy. 2002 January; 36(1): 172. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11816250&dopt=Abstract
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Possible ticlopidine-induced cholestatic jaundice. Author(s): Wengrower D. Source: American Family Physician. 2000 September 15; 62(6): 1258, 1262. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11011856&dopt=Abstract
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Post-decompression gallbladder haemorrhage in obstructive jaundice. A report of 2 cases. Author(s): Assalia A, Schein M. Source: S Afr J Surg. 1994 March; 32(1): 12-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11218433&dopt=Abstract
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Postoperative jaundice and total parenteral nutrition-associated hepatic dysfunction. Author(s): Chung C, Buchman AL. Source: Clinics in Liver Disease. 2002 November; 6(4): 1067-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12516207&dopt=Abstract
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Postoperative jaundice. Author(s): Molina EG, Reddy KR. Source: Clinics in Liver Disease. 1999 August; 3(3): 477-88. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11291235&dopt=Abstract
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Predicting pathologic jaundice: the Chinese perspective. Author(s): Young BW, Chan ML, Ho HT, Ip KS, Chen H, Lo YC. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 December; 21 Suppl 1: S73-5; Discussion S83-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803422&dopt=Abstract
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Preoperative biliary drainage before resection in obstructive jaundice. Author(s): Aly EA, Johnson CD. Source: Digestive Surgery. 2001; 18(2): 84-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11351150&dopt=Abstract
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Presence of the genetic marker for Gilbert syndrome is associated with increased level and duration of neonatal jaundice. Author(s): Roy-Chowdhury N, Deocharan B, Bejjanki HR, Roy-Chowdhury J, Koliopoulos C, Petmezaki S, Valaes T. Source: Acta Paediatrica (Oslo, Norway : 1992). 2002; 91(1): 100-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11883809&dopt=Abstract
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Prolonged jaundice following percutaneous coronary intervention and ticlopidine therapy. Author(s): Tsui PT, Lai ST, Leung WS, Mok NS, Wu CW, Lau ST, Choi YC. Source: Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi / Hong Kong Academy of Medicine. 2002 February; 8(1): 57-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11861996&dopt=Abstract
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Pseudoaneurysm of the gastroduodenal artery as a cause of obstructive jaundice. Author(s): Kossak J, Janik J, Debski J, Rytlewski R, Salacinski A. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2001 July-August; 7(4): 759-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11433208&dopt=Abstract
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Re: Two-stage transcatheter arterial embolization of a large hepatic artery pseudoaneurysm causing obstructive jaundice. Author(s): Kuroiwa T, Yoshimitsu K, Honda H, Irie H, Aibe H, Shinozaki K, Masuda K, Shimada M, Hayashida K. Source: Cardiovascular and Interventional Radiology. 2002 January-February; 25(1): 767. Epub 2002 January 18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11907782&dopt=Abstract
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Recurrent cholestatic jaundice associated with generalized pustular psoriasis: evidence for a neutrophilic cholangitis. Author(s): Allez M, Roux ME, Bertheau P, Erlinger S, Degott C, Morel P, Modigliani R, Rybojad M. Source: Journal of Hepatology. 2000 July; 33(1): 160-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10905601&dopt=Abstract
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Rehospitalisation for neonatal jaundice: risk factors and outcomes. Author(s): Geiger AM, Petitti DB, Yao JF. Source: Paediatric and Perinatal Epidemiology. 2001 October; 15(4): 352-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11703683&dopt=Abstract
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Renal failure and cholestatic jaundice as unusual complications of childhood pustular psoriasis. Author(s): Li SP, Tang WY, Lam WY, Wong SN. Source: The British Journal of Dermatology. 2000 December; 143(6): 1292-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11122037&dopt=Abstract
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Repeated jaundice due to YMDD mutant in a patient with prolonged lamivudine therapy for chronic hepatitis B under prednisolone treatment for Still's disease. Author(s): Joh R, Hasegawa K, Torii N, Ogawa M, Kanai N, Naritomi T, Ishikawa K, Iizuka A, Shizuma T, Hashimoto E, Hayashi N. Source: Intern Med. 2002 September; 41(9): 701-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12322795&dopt=Abstract
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Risk factors for kernicterus in term babies with non-hemolytic jaundice. Author(s): Murki S, Kumar P, Majumdar S, Marwaha N, Narang A. Source: Indian Pediatrics. 2001 July; 38(7): 757-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11463962&dopt=Abstract
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Sepsis presenting with severe jaundice. Author(s): Narita R, Murata M, Kihara Y, Abe S, Tabaru A, Yoshikawa I, Otsuki M. Source: The American Journal of Gastroenterology. 2001 November; 96(11): 3214-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11721785&dopt=Abstract
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Serous cystadenoma of the pancreas associated with obstructive jaundice. Author(s): Horaguchi J, Fujita N, Kobayashi G, Noda Y, Kimura K, Ito K, Kobari M, Yamazaki T. Source: Journal of Gastroenterology. 2003; 38(5): 501-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12768395&dopt=Abstract
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Severe hepatotoxicity with jaundice associated with paroxetine. Author(s): Odeh M, Misselevech I, Boss JH, Oliven A. Source: The American Journal of Gastroenterology. 2001 August; 96(8): 2494-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11513198&dopt=Abstract
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Severe jaundice in a patient with a previously undescribed glucose-6-phosphate dehydrogenase (G6PD) mutation and Gilbert syndrome. Author(s): Beutler E, Gelbart T, Miller W. Source: Blood Cells, Molecules & Diseases. 2002 March-April; 28(2): 104-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064902&dopt=Abstract
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Severe jaundice in Sweden in the new millennium: causes, investigations, treatment and prognosis. Author(s): Bjornsson E, Ismael S, Nejdet S, Kilander A. Source: Scandinavian Journal of Gastroenterology. 2003 January; 38(1): 86-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608470&dopt=Abstract
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Soluble isoforms of CEACAM1 containing the A2 domain: increased serum levels in patients with obstructive jaundice and differences in 3-fucosyl-N-acetyl-lactosamine moiety. Author(s): Draberova L, Cerna H, Brodska H, Boubelik M, Watt SM, Stanners CP, Draber P. Source: Immunology. 2000 October; 101(2): 279-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11012782&dopt=Abstract
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Sonographic diagnosis and follow-up of idiopathic hepatic artery aneurysm, an unusual cause of obstructive jaundice. Author(s): Chandramohan, Khan AN, Fitzgerald S, Sherlock D, Tam E. Source: Journal of Clinical Ultrasound : Jcu. 2001 October; 29(8): 466-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11745854&dopt=Abstract
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Spectrum of outcome in infants with extreme neonatal jaundice. Author(s): Hanko E, Lindemann R, Hansen TW. Source: Acta Paediatrica (Oslo, Norway : 1992). 2001 July; 90(7): 782-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11519982&dopt=Abstract
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Successful left trisegmentectomy for polycystic liver disease accompanied by jaundice. Author(s): Endo I, Tanabe M, Tanaka K, Ishikawa T, Sekido H, Togo S, Nakano A, Shimada H. Source: Digestive Surgery. 2001; 18(4): 320-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11528144&dopt=Abstract
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Surgical bypass is still relevant in the palliation of malignant obstructive jaundice. Author(s): Sharma D, Bhansali M, Raina VK. Source: Trop Doct. 2002 October; 32(4): 216-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405301&dopt=Abstract
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Surgical resection of isolated pancreatic tuberculosis presenting as obstructive jaundice. Author(s): Shan YS, Sy ED, Lin PW. Source: Pancreas. 2000 July; 21(1): 100-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10881940&dopt=Abstract
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System-based approach to management of neonatal jaundice and prevention of kernicterus. Author(s): Johnson LH, Bhutani VK, Brown AK. Source: The Journal of Pediatrics. 2002 April; 140(4): 396-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12006952&dopt=Abstract
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The “jaundice hotline” for the rapid assessment of patients with jaundice. Author(s): Mitchell J, Hussaini H, McGovern D, Farrow R, Maskell G, Dalton H. Source: Bmj (Clinical Research Ed.). 2002 July 27; 325(7357): 213-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12142314&dopt=Abstract
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The abnormal lipid spectrum in malignant obstructive jaundice in relation to endotoxin sensitivity and the result of preoperative biliary drainage. Author(s): Kimmings N, Sewnath ME, Mairuhu WM, Van Zanten AP, Rauws EA, Van Deventer SJ, Gouma DJ. Source: Surgery. 2001 March; 129(3): 282-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11231456&dopt=Abstract
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The anti-inflammatory effects of circulating fatty acids in obstructive jaundice: similarities with pregnancy-induced immunosuppression. Author(s): Crocker IP, Lawson N, Baker PN, Fletcher J. Source: Qjm : Monthly Journal of the Association of Physicians. 2001 September; 94(9): 475-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11528011&dopt=Abstract
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The causes of obvious jaundice in South West Wales: perceptions versus reality. Author(s): Whitehead MW, Hainsworth I, Kingham JG. Source: Gut. 2001 March; 48(3): 409-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11171834&dopt=Abstract
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The changes of protein kinase C activity in peripheral blood lymphocytes in the patients with obstructive jaundice and the implication. Author(s): Wang J, Zou Q, Zou S. Source: J Tongji Med Univ. 2001; 21(2): 119-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11523214&dopt=Abstract
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The effect of neonatal jaundice on biotinidase activity. Author(s): Schulpis KH, Gavrili S, Tjamouranis J, Karikas GA, Kapiki A, Costalos C. Source: Early Human Development. 2003 May; 72(1): 15-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706308&dopt=Abstract
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The endoscopic retrograde cholangiopancreatographic manifestations of histopathologically diagnosed hepatocellular carcinoma with obstructive jaundice. Author(s): Zhao Q, Gong B, Lu N, Liu N. Source: J Huazhong Univ Sci Technolog Med Sci. 2002; 22(3): 237-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658815&dopt=Abstract
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The impact of the maternal experience with a jaundiced newborn on the breastfeeding relationship. Author(s): Willis SK, Hannon PR, Scrimshaw SC. Source: The Journal of Family Practice. 2002 May; 51(5): 465. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12019058&dopt=Abstract
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The jaundice of the cell. Author(s): Greenberg DA. Source: Proceedings of the National Academy of Sciences of the United States of America. 2002 December 10; 99(25): 15837-9. Epub 2002 Dec 02. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461187&dopt=Abstract
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The jaundiced newborn. Understanding and managing transitional hyperbilirubinemia. Author(s): Stevenson DK, Wong RJ, Hintz SR, Vreman HJ. Source: Minerva Pediatr. 2002 October; 54(5): 373-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12244276&dopt=Abstract
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The prevention and treatment of parenteral nutrition-associated jaundice in infants and children. Author(s): Georgeson KE. Source: Transplantation Proceedings. 2002 May; 34(3): 898-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12034227&dopt=Abstract
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The role of lamivudine and predictors of mortality in severe flare-up of chronic hepatitis B with jaundice. Author(s): Chan HL, Tsang SW, Hui Y, Leung NW, Chan FK, Sung JJ. Source: Journal of Viral Hepatitis. 2002 November; 9(6): 424-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12431204&dopt=Abstract
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The significance of functioning gallbladder visualization on hepatobiliary scintigraphy in infants with persistent jaundice. Author(s): Lee CH, Wang PW, Lee TT, Tiao MM, Huang FC, Chuang JH, Shieh CS, Cheng YF. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 2000 July; 41(7): 1209-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10914911&dopt=Abstract
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The spectrum of surgical jaundice in infancy. Author(s): Davenport M, Betalli P, D'Antiga L, Cheeseman P, Mieli-Vergani G, Howard ER. Source: Journal of Pediatric Surgery. 2003 October; 38(10): 1471-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14577070&dopt=Abstract
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Transhepatic placement of an enteral stent to treat jaundice in a tumor recurrence obstructed afferent loop after a whipple procedure. Author(s): Johnsson E, Delle M, Lundell L, Liedman B. Source: Digestive Surgery. 2003; 20(4): 329-31. Epub 2003 June 12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806200&dopt=Abstract
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Treatment of the jaundiced patient with breast carcinoma: case report and alternate therapeutic strategies. Author(s): Gurevich I, Akerley W. Source: Cancer. 2001 February 15; 91(4): 660-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11241231&dopt=Abstract
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True giant common hepatic artery aneurysm associated with obstructive jaundice: a case report. Author(s): Bramis J, Felekouras E, Kontos M, Leonardou P, Griniatsos J, Bastounis E. Source: Int Surg. 2002 July-September; 87(3): 142-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12403087&dopt=Abstract
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Tuberculous biliary strictures: uncommon cause of obstructive jaundice. Author(s): Prasad A, Pandey KK. Source: Australasian Radiology. 2001 August; 45(3): 365-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11531768&dopt=Abstract
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Tuberculous lymphadenitis as a cause of obstructive jaundice: report of a case. Author(s): Obama K, Kanai M, Taki Y, Nakamoto Y, Takabayashi A. Source: Surgery Today. 2003; 33(3): 229-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658393&dopt=Abstract
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Two cases of chronic pancreatitis with pseudocyst complicated by obstructive jaundice. Author(s): Cho HG, Min HY, Jang DS, Shin YW, Kwon KS, Kim YS, Kim MY, Kim KR. Source: Yonsei Medical Journal. 2000 August; 41(4): 522-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10992816&dopt=Abstract
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Type C-chronic hepatitis patients who had autoimmune phenomenon and developed jaundice during interferon therapy. Author(s): Sezaki H, Arase Y, Tsubota A, Suzuki Y, Kobayashi M, Saitoh S, Suzuki F, Akuta N, Someya T, Ikeda K, Kumada H. Source: Journal of Gastroenterology. 2003; 38(5): 493-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12768394&dopt=Abstract
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Understanding newborn jaundice. Author(s): Stevenson DK, Dennery PA, Hintz SR. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 December; 21 Suppl 1: S21-4; Discussion S35-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803411&dopt=Abstract
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Unusual case of obstructive jaundice. Author(s): Jayasuriya N, de Silva M, Fernando D. Source: Ceylon Med J. 2001 December; 46(4): 158-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12164040&dopt=Abstract
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Unusual cause of fever, jaundice, and hepatomegaly in a middle aged man. Author(s): Kumar S, Uthamalingam S, Vasudevan AR, Lim A, Feliz A, Brensilver JM, Yarrish R. Source: Postgraduate Medical Journal. 2002 September; 78(923): 566, 569. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12357023&dopt=Abstract
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Urinary sulfated bile acid concentrations in infants with biliary atresia and breastfeeding jaundice. Author(s): Muraji T, Harada T, Miki K, Moriuchi T, Obatake M, Tsugawa C. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2003 June; 45(3): 281-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828581&dopt=Abstract
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Usefulness of percutaneous transhepatic biliary drainage in patients with surgical jaundice--a prospective randomised study. Author(s): Wig JD, Kumar H, Suri S, Gupta NM. Source: J Assoc Physicians India. 1999 March; 47(3): 271-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10999118&dopt=Abstract
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Validation of ICTERUS, a knowledge-based expert system for Jaundice diagnosis. Author(s): Molino G, Marzuoli M, Molino F, Battista S, Bar F, Torchio M, Lavelle SM, Corless G, Cappello N. Source: Methods of Information in Medicine. 2000 December; 39(4-5): 311-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191699&dopt=Abstract
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Various types of cholestatic jaundice in infants--causes and diagnostic problems. Author(s): Liberek A, Gora-Gebka M, Bako W, Rytlewska M, Kozielska E, Korzon M. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2000 May-June; 6(3): 548-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11208368&dopt=Abstract
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Visual diagnosis: a 10-week-old infant who has jaundice. Author(s): Bisgard LD. Source: Pediatrics in Review / American Academy of Pediatrics. 2001 December; 22(12): 408-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11731681&dopt=Abstract
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CHAPTER 2. NUTRITION AND JAUNDICE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and jaundice.
Finding Nutrition Studies on Jaundice 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 “jaundice” (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 “jaundice” (or a synonym): •
A controlled trial of choleretic and hepatoprotective actions of Livzon and dehydrocholic acid in a model of obstructive jaundice in albino rats. Author(s): Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India. Source: Ratan, J Rohatgi, S Gupta, D K Ratan, S Tohoku-J-Exp-Med. 1997 January; 181(1): 161-6 0040-8727
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Breast milk and breastfeeding jaundice. Author(s): Department of Pediatrics, University of Chicago, Illinois. Source: Gartner, L M Auerbach, K G Adv-Pediatr. 1987; 34249-74 0065-3101
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Changes in calcium-binding protein expression in the auditory brainstem nuclei of the jaundiced Gunn rat. Author(s): Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA. Source: Spencer, R F Shaia, W T Gleason, A T Sismanis, A Shapiro, S M Hear-Res. 2002 September; 171(1-2): 129-141 0378-5955
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Cysteinyl leukotrienes in the bile of patients with obstructive jaundice. Author(s): Third Department of Internal Medicine, Nara Medical University, 840 Shijocho, Kashihara 634-8521, Japan. Source: Uemura, M Kojima, H Buchholz, U Kikuchi, E Matsumoto, M Kikukawa, M Imazu, H Fukui, H Tsujii, T Keppler, D J-Gastroenterol. 2002; 37(10): 821-30 0944-1174
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Development and reversal of endotoxemia and endotoxin-related death in obstructive jaundice. Author(s): Department of Surgery, Queen's University of Belfast, Northern Ireland. Source: Diamond, T Dolan, S Thompson, R L Rowlands, B J Surgery. 1990 August; 108(2): 370-4; discussion 374-5 0039-6060
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Effect of phototherapy on nutrients utilization in newborn infants with jaundice. Source: Tontisirin, K Tejavej, A Siripoonya, P Satayasai, V Gjernsritrakul, C Valaiphatchara, U J-Med-Assoc-Thai. 1989 January; 72 Suppl 1177-82 0125-2208
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Effects of alpha-tocopherol levels in extrusion pellets on in vivo lipid peroxidation levels and antioxidant activities in cultured yellowtail Seriola quinqueradiata injected with the causative bacteria of fish jaundice. Author(s): Kagoshima Univ. (Japan) Source: Ito, T. Murata, H. Tsuda, T. Yamada, T. Yamauchi, K. Ukawa, M. Yamaguchi, T. Yoshida, T. Sakai, T. Fisheries-Science (Japan). (October 1999). volume 65(5) page 679683. seriola jaundice tocopherols lipid peroxidation extrusion 0919-9268
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Effects of S-adenosyl-L-methionine on liver damage in experimental obstructive jaundice. Author(s): Department of Health Public, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Source: Tsai, S M Lee, K T Tsai, L Y Kaohsiung-J-Med-Sci. 2001 September; 17(9): 455-60 1607-551X
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Effects of vitamin A on immunological deficiencies in rats with obstructive jaundice. Author(s): 4th Surgical Department of Numune Hospital, Ankara, Turkey. Source: Karan, B Kama, N A Hascelik, G Ercan, M Eur-J-Surg. 1996 March; 162(3): 217-22 1102-4151
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Effects of vitamin E on neutrophil phagocytosis during experimental obstructive jaundice. Author(s): Cumhuriyet University, Medical School, Department of General Surgery, Sivas, Turkey. Source: Analay, H Canturk, N Z Yildirir, C Canturk, Z Hepatogastroenterology. 2000 Mar-April; 47(32): 355-8 0172-6390
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Etoposide kinetics in patients with obstructive jaundice. Author(s): Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. Source: Hande, K R Wolff, S N Greco, F A Hainsworth, J D Reed, G Johnson, D H J-ClinOncol. 1990 June; 8(6): 1101-7 0732-183X
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Folk medicine from Chittoor District, Andhra Pradesh, India, used in the treatment of jaundice. Source: Raja Reddy, K. Int-J-Crude-Drug-Res. Lisse : Swets & Zeitlinger. October 1988. volume 26 (3) page 137-140. 0167-7314
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Glucose intolerance and pancreatic endocrine dysfunction in dogs with obstructive jaundice. Author(s): First Department of Surgery, Kyushu University Faculty of Medicine, Fukuoka, Japan. Source: Obata, H Koga, A Gastroenterol-Jpn. 1988 December; 23(6): 666-72 0435-1339
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Heliotrope warning [New South Wales; sheep; toxaemic jaundice; treatment]. Author(s): New South Wales Agriculture and Fisheries, Glenfield (Australia) Source: Plant, J.W. Sheep-Health-Newsletter (Australia). (May 1989). (no.24) page 3-4. sheep heliotropium jaundice new south wales
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Hemolytic anemia with jaundice and ascites. Source: Jeffers, L Hosp-Pract-(Off-Ed). 1987 May 30; 22(5A): 38-41 8750-2836
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Human neutrophil functions in obstructive jaundice. Author(s): 3rd Department of Internal Medicine, Kansai Medical University, Fumizonocho, Moriguchi, Osaka 570-8507, Japan. Source: Takaoka, M Kubota, Y Tsuji, K Yamamoto, S Ogura, M Yanagitani, K Shimatani, M Shibatani, N Inoue, K Hepatogastroenterology. 2001 Jan-February; 48(37): 71-5 01726390
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Immunohistochemical localization of calcium-binding proteins in the brainstem vestibular nuclei of the jaundiced Gunn rat. Author(s): Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Medical College of Virginia Campus, Virginia Commonwealth University Health System, Richmond 23298-0599, USA. Source: Shaia, W T Shapiro, S M Heller, A J Galiani, D L Sismanis, A Spencer, R F HearRes. 2002 November; 173(1-2): 82-90 0378-5955
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Impaired response of gastric vessels to prostaglandin E2 in rats with persistent obstructive jaundice. Author(s): First Department of Surgery, Kobe University School of Medicine, Japan. Source: Nagahata, Y Azumi, Y Moritomo, H Numata, N Kawakita, N Yano, M Onoyama, H Yamamoto, M J-Gastroenterol. 1997 August; 32(4): 521-7 0944-1174
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Levels of plasma lipid peroxides before and after choledocholithotomy in patients with obstructive jaundice. Author(s): Division of Clinical Biochemistry, School of Medical Techology, Kaohsiung Medical College, Taiwan, R. O. C.
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Source: Tsai, L Y Tsai, S M Lee, K T Yu, H S J-UOEH. 1992 December 1; 14(4): 261-9 0387821X •
Massive hepatosplenomegaly, jaundice and pancytopenia in miliary tuberculosis. Author(s): Department of Medicine & Infectious Diseases, University Hospital of Wales, Cardiff, UK. Source: Evans, R H Evans, M Harrison, N K Price, D E Freedman, A R J-Infect. 1998 March; 36(2): 236-9 0163-4453
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Modulation of immunosuppression in obstructive jaundice by Tinospora cordifolia. Source: Rege, N N Nazareth, H M Bapat, R D Dahanukar, S A Indian-J-Med-Res. 1989 December; 90478-83 0971-5916
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Neonatal jaundice in Zaria, Nigeria--a second prospective study. Author(s): Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Source: Ahmed, H Yukubu, A M Hendrickse, R G West-Afr-J-Med. 1995 Jan-March; 14(1): 15-23 0189-160X
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Obstructive jaundice alters CD44 expression in rat small intestine. Author(s): Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
[email protected] Source: Sheen Chen, S M Ho, H T Chen, W J Eng, H L Wu, C H Digestion. 2002; 65(2): 112-7 0012-2823
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Pharmacological interventions for the treatment of neonatal jaundice. Author(s): Department of Neonatal and Developmental Medicine, Stanford University, 750 Welch Road, Suite315, Palo Alto, CA 94304, USA.
[email protected] Source: Dennery, P A Semin-Neonatol. 2002 April; 7(2): 111-9 1084-2756
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Pigeons as a remedy (segulah) for jaundice. Author(s): Queens Hospital Center, Jamaica, NY 11432. Source: Rosner, F N-Y-State-J-Med. 1992 May; 92(5): 189-92 0028-7628
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Plasma retinol transport system and taste acuity in patients with obstructive jaundice. Author(s): First Department of Internal Medicine, Gifu University School of Medicine, Japan. Source: Imamine, T Okuno, M Moriwaki, H Ninomiya, M Nishiwaki, S Noma, A Muto, Y Gastroenterol-Jpn. 1990 April; 25(2): 206-11 0435-1339
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Relief of jaundice by 5-fluorouracil and folinic acid in patients with recurrent gastric cancer. Author(s): Department of Surgery, Toranomon Hospital, Tokyo, Japan. Source: Kajiyama, Y Tsurumaru, M Udagawa, H Tsutsumi, K Kinoshita, Y Akiyama, H Surg-Oncol. 1996 August; 5(4): 177-81 0960-7404
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The jaundice-suppressing effect of blood-cooling, circulation-invigorating, visceradredging and cholagogic Chinese herbs in the treatment of hepatitis. Source: Wang, C B Ge, A P Song, W Y Li, L Li, Y Q Xu, J H J-Tradit-Chin-Med. 1987 December; 7(4): 248-50 0254-6272
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Therapeutic effect of secretin in patients with jaundice; double-blind placebocontrolled multicentric trial. Author(s): First Department of Internal Medicine, Yamaguchi University School of Medicine, Japan. Source: Fukumoto, Y Okita, K Kodama, T Matsuda, S Kawamura, S Harima, K Harada, Y Kawaguchi, K Iida, Y Konishi, T Andoh, K Tanaka, H Hanta, T Sekitani, T Takenami,
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T Yamasaki, T Yamashita, S Fujimura, H Shimada, M Kohzu, M Shigeta, K Shirasawa, H J-Gastroenterol. 1996 June; 31(3): 394-403 0944-1174 •
Traditional Chinese medicine and treatment of neonatal jaundice. Author(s): Department of Neonatology 1, Kandang Kerbau Hospital, Singapore. Source: Ho, N K Singapore-Med-J. 1996 December; 37(6): 645-51 0037-5675
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Use of haemostatic parameters as a diagnostic and prognostic index in persistent jaundice: a Zaria experience. Author(s): Department of Haematology and Blood Transfusion, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Source: Mba, E T Adeoye, F A Jaiyesimi, A E Cent-Afr-J-Med. 1990 November; 36(11): 283-7 0008-9176
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Vitamin A toxicity presenting as jaundice. Author(s): Ochsner Clinic, New Orleans, LA 70121. Source: Smith, J W Postgrad-Med. 1989 March; 85(4): 53-4, 56 0032-5481
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMD®Health: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to jaundice; 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 K Alternative names: Menadione, Menaphthone, Menaquinone, Phylloquinone Source: Integrative Medicine Communications; www.drkoop.com
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Minerals Copper Source: Integrative Medicine Communications; www.drkoop.com Manganese Source: Integrative Medicine Communications; www.drkoop.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND JAUNDICE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to jaundice. 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 jaundice 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 “jaundice” (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 jaundice: •
A controlled trial of choleretic and hepatoprotective actions of Livzon and dehydrocholic acid in a model of obstructive jaundice in albino rats. Author(s): Ratan J, Rohatgi S, Gupta DK, Ratan S. Source: The Tohoku Journal of Experimental Medicine. 1997 January; 181(1): 161-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9149351&dopt=Abstract
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A historical study of Chinese drugs for the treatment of Jaundice. Author(s): Miyasita S. Source: The American Journal of Chinese Medicine. 1976 Autumn; 4(3): 239-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=788496&dopt=Abstract
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A survey on community perceptions of jaundice in east Delhi: implications for the prevention and control of viral hepatitis. Author(s): Singh J, Shakya N, Jain DC, Bhatia R, Bora D, Pattanayak PK, Gupta S, Datta KK, Sokhey J.
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Source: Trans R Soc Trop Med Hyg. 2000 May-June; 94(3): 243-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10974987&dopt=Abstract •
An inhibitor of cerebral uptake of noradrenaline in jaundiced blood plasma. Author(s): Bradbury MW, Bloom DS, McDowell M. Source: Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism. 1983 December; 3(4): 51620. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6630321&dopt=Abstract
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An old traditional herbal remedy for neonatal jaundice with a newly identified risk. Author(s): Yeung CY, Leung CS, Chen YZ. Source: Journal of Paediatrics and Child Health. 1993 August; 29(4): 292-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8373675&dopt=Abstract
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Animal-induced injuries and disease, neonatal jaundice, viral infections, and immunizations. Author(s): McIntire SC, Urbach AH, Bloom MD, Mendelsohn MJ, Zitelli BJ, Gartner JC Jr. Source: Current Opinion in Pediatrics. 1993 August; 5(4): 503-17. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8374681&dopt=Abstract
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Ayurvedic treatment for jaundice in Nepal. Author(s): Durkin M. Source: Social Science & Medicine (1982). 1988; 27(5): 491-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3227357&dopt=Abstract
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Care of the neonate and management of neonatal jaundice as practised by Yoruba traditional healers of Nigeria. Author(s): Oyebola DD. Source: Journal of Tropical Pediatrics. 1983 February; 29(1): 18-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6834455&dopt=Abstract
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Changing pattern of neonatal jaundice and kernicterus in Chinese neonates. Author(s): Yeung CY. Source: Chinese Medical Journal. 1997 June; 110(6): 448-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9594246&dopt=Abstract
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Clinical rounds in the well-baby nursery: treating jaundiced newborns. Author(s): Maisels MJ.
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Source: Pediatric Annals. 1995 October; 24(10): 547-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8545162&dopt=Abstract •
Cochlear microphonics in the jaundiced Gunn rat. Author(s): Shapiro SM, Te Selle ME. Source: American Journal of Otolaryngology. 1994 March-April; 15(2): 129-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8179104&dopt=Abstract
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Development of brainstem auditory evoked potentials in heterozygous and homozygous jaundiced Gunn rats. Author(s): Shapiro SM, Hecox KE. Source: Brain Research. 1988 June 1; 469(1-2): 147-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3401796&dopt=Abstract
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Effects of different ways of covering the eyes on behavior of jaundiced infants treated with phototherapy. Author(s): Paludetto R, Mansi G, Rinaldi P, Saporito M, De Curtis M, Ciccimarra F. Source: Biology of the Neonate. 1985; 47(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3967053&dopt=Abstract
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Etoposide kinetics in patients with obstructive jaundice. Author(s): Hande KR, Wolff SN, Greco FA, Hainsworth JD, Reed G, Johnson DH. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1990 June; 8(6): 1101-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2348225&dopt=Abstract
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Hepatic dysfunction and jaundice following high-dose cytosine arabinoside. Author(s): George CB, Mansour RP, Redmond J 3rd, Gandara DR. Source: Cancer. 1984 December 1; 54(11): 2360-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6594185&dopt=Abstract
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High frequency hearing in jaundiced rats. Author(s): Lenhardt ML, Clarke AM, Harkins SW. Source: J Aud Res. 1986 January; 26(1): 19-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3610988&dopt=Abstract
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Histopathologic features of the biopsied liver at onset of childhood B-precursor acute lymphoblastic leukemia presenting as severe jaundice. Author(s): Mori T, Sugita K, Suzuki T, Ishikawa T, Kurosawa H, Matsui A.
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Source: Journal of Pediatric Gastroenterology and Nutrition. 1997 September; 25(3): 3547. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9285391&dopt=Abstract •
Hyperbaric oxygen prevents bacterial translocation in rats with obstructive jaundice. Author(s): Akin ML, Erenoglu C, Dal A, Erdemoglu A, Elbuken E, Batkin A. Source: Digestive Diseases and Sciences. 2001 August; 46(8): 1657-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11508664&dopt=Abstract
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Immunotherapy with Tinospora cordifolia: a new lead in the management of obstructive jaundice. Author(s): Rege N, Bapat RD, Koti R, Desai NK, Dahanukar S. Source: Indian J Gastroenterol. 1993 January; 12(1): 5-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8330924&dopt=Abstract
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Jaundice and intrahepatic cholestasis following high-dose megestrol acetate for breast cancer. Author(s): Foitl DR, Hyman G, Lefkowitch JH. Source: Cancer. 1989 February 1; 63(3): 438-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2912522&dopt=Abstract
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Jaundice associated with flavoxate. Author(s): Sevenoaks M, Gorard DA. Source: Journal of the Royal Society of Medicine. 1999 November; 92(11): 589. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10703502&dopt=Abstract
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Jaundice during treatment of myelomatosis with M & B 938. Author(s): DENMAN AM, WARD HW. Source: Brookhaven Symp Biol. 1960 February 13; 5171: 482. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13815928&dopt=Abstract
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Jaundice following splenectomy in Hodgkin's disease. Author(s): Bichel J, Jensen KB. Source: Acta Med Scand. 1969 March; 185(3): 201-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5811165&dopt=Abstract
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Kernicterus parents' group. Author(s): Sheridan SE. Source: The Journal of Pediatrics. 2002 October; 141(4): 597. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12378209&dopt=Abstract
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Letter: Delayed wound healing in jaundiced rats. Author(s): Bayer I, Branfoot AC, Ellis H. Source: Lancet. 1976 May 29; 1(7970): 1192-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=58247&dopt=Abstract
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'Like a shrivelled blood orange'--bilirubin, jaundice, and phototherapy. Author(s): McDonagh AF, Lightner DA. Source: Pediatrics. 1985 March; 75(3): 443-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3883303&dopt=Abstract
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Modulation of immunosuppression in obstructive jaundice by Tinospora cordifolia. Author(s): Rege NN, Nazareth HM, Bapat RD, Dahanukar SA. Source: The Indian Journal of Medical Research. 1989 December; 90: 478-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2697692&dopt=Abstract
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Neonatal jaundice and diet. Author(s): Gourley GR, Kreamer B, Cohnen M, Kosorok MR. Source: Archives of Pediatrics & Adolescent Medicine. 1999 February; 153(2): 184-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9988249&dopt=Abstract
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Neonatal jaundice and molecular mutations in glucose-6-phosphate dehydrogenase deficient newborn infants. Author(s): Huang CS, Hung KL, Huang MJ, Li YC, Liu TH, Tang TK. Source: American Journal of Hematology. 1996 January; 51(1): 19-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8571933&dopt=Abstract
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Neonatal jaundice in Asia. Author(s): Ho NK. Source: Baillieres Clin Haematol. 1992 January; 5(1): 131-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1596589&dopt=Abstract
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Neonatal jaundice in Zaria, Nigeria--a second prospective study. Author(s): Ahmed H, Yukubu AM, Hendrickse RG. Source: West Afr J Med. 1995 January-March; 14(1): 15-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7626527&dopt=Abstract
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Neonatal jaundice, animal-induced injuries and disease, and immunizations. Author(s): Gerson WT. Source: Current Opinion in Pediatrics. 1997 August; 9(4): 447-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9300206&dopt=Abstract
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Neonatal jaundice, animal-induced injuries, and immunizations. Author(s): Sandora TJ, Bernstein HH. Source: Current Opinion in Pediatrics. 2001 August; 13(4): 377-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11717566&dopt=Abstract
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Neonatal jaundice--traditional Chinese medicine approach. Author(s): Fok TF. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 December; 21 Suppl 1: S98-S100; Discussion S104-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11803427&dopt=Abstract
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Obstructive jaundice in infancy due to compression of the bile ducts by malignant lymph nodes. Author(s): Takayanagi K, Issa M, Cook RC. Source: Journal of Pediatric Surgery. 1980 June; 15(3): 343-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7381675&dopt=Abstract
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Pharmacological interventions for the treatment of neonatal jaundice. Author(s): Dennery PA. Source: Seminars in Neonatology : Sn. 2002 April; 7(2): 111-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12208095&dopt=Abstract
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Photodecay of bilirubin in vitro and in the jaundiced (Gunn) rat. Author(s): Ostrow JD, Branham RV. Source: Birth Defects Orig Artic Ser. 1970 June; 6(2): 93-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5001239&dopt=Abstract
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Pigeons as a remedy (segulah) for jaundice. Author(s): Rosner F. Source: N Y State J Med. 1992 May; 92(5): 189-92. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1614669&dopt=Abstract
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Plant sources for the treatment of jaundice in the tribals of Western Madhya Pradesh of India. Author(s): Samvatsar S, Diwanji VB. Source: Journal of Ethnopharmacology. 2000 November; 73(1-2): 313-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11025171&dopt=Abstract
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Primary chemotherapy for obstructive jaundice caused by intermediate-grade nonHodgkin lymphoma. Author(s): Dudgeon DJ, Brower M.
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Source: Cancer. 1993 May 1; 71(9): 2813-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7682150&dopt=Abstract •
Primary small bowel lymphoma manifested as obstructive jaundice in a patient with AIDS. Author(s): Schoeppner HL, Wong DK, Bresalier RS. Source: Southern Medical Journal. 1995 May; 88(5): 583-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7732453&dopt=Abstract
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Psychological consequences of drug jaundice. Author(s): GROLNICK L. Source: Psychosomatics. 1965 January-February; 58: 40-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14263748&dopt=Abstract
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Serum alkaline phosphatase in infants with obstructive jaundice: relation to vitamin D supplementation. Author(s): Bastis-Maounis B, Matsaniotis N, Maounis F. Source: The Journal of Pediatrics. 1973 January; 82(1): 68-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4681869&dopt=Abstract
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The effect of Luffa echinata (Roxb) on experimental jaundice in rats. Author(s): Bapat SK, Chandra V. Source: Indian J Physiol Pharmacol. 1968 July; 12(3): 119-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5731098&dopt=Abstract
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The jaundice-suppressing effect of blood-cooling, circulation-invigorating, visceradredging and cholagogic Chinese herbs in the treatment of hepatitis. Author(s): Wang CB, Ge AP, Song WY, Li L, Li YQ, Xu JH. Source: J Tradit Chin Med. 1987 December; 7(4): 248-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3449705&dopt=Abstract
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The treatment of jaundice due to liver metastases by quadruple chemotherapy. Author(s): Hughes J, Stoker TA. Source: Postgraduate Medical Journal. 1973 April; 49(570): 265-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4760722&dopt=Abstract
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Traditional Chinese medicine and treatment of neonatal jaundice. Author(s): Ho NK. Source: Singapore Med J. 1996 December; 37(6): 645-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9104069&dopt=Abstract
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Tuberculous lymphadenitis as a cause of obstructive jaundice: report of a case. Author(s): Obama K, Kanai M, Taki Y, Nakamoto Y, Takabayashi A. Source: Surgery Today. 2003; 33(3): 229-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658393&dopt=Abstract
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Yellow oleander poisoning with jaundice and renal failure. Author(s): Samal KK. Source: J Assoc Physicians India. 1990 October; 38(10): 821-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2084106&dopt=Abstract
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Yerakon in the Bible and Talmud: jaundice or anemia? Author(s): Rosner F. Source: The American Journal of Clinical Nutrition. 1972 June; 25(6): 626-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4555999&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMD®Health: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
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The following is a specific Web list relating to jaundice; 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 Cirrhosis Source: Integrative Medicine Communications; www.drkoop.com Gallbladder Disease Source: Integrative Medicine Communications; www.drkoop.com Hepatitis Source: Healthnotes, Inc.; www.healthnotes.com Irritable Bowel Syndrome Alternative names: Spastic Colon Source: Prima Communications, Inc.www.personalhealthzone.com Liver Cirrhosis Source: Healthnotes, Inc.; www.healthnotes.com Liver Disease Source: Integrative Medicine Communications; www.drkoop.com Preeclampsia Source: Healthnotes, Inc.; www.healthnotes.com Pyloric Stenosis Source: Integrative Medicine Communications; www.drkoop.com Rubella Source: Integrative Medicine Communications; www.drkoop.com Viral Hepatitis Source: Prima Communications, Inc.www.personalhealthzone.com
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Alternative Therapy Massage Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,716,00.html Pigeon Remedy Alternative names: pigeon therapy Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html
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Witchcraft Alternative names: the Old Religion Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/w.html •
Chinese Medicine Baimaogen Alternative names: Lalang Grass Rhizome; Rhizoma Imperatae Source: Chinese Materia Medica Baixianpi Alternative names: Densefruit Pittany Root-bark; Cortex Dictamni Source: Chinese Materia Medica Banzhilian Alternative names: Barbated Skullcup Herb; Herba Scutellariae Darbatae Source: Chinese Materia Medica Chixiaodou Alternative names: Rice Bean; Semen Phaseoli Source: Chinese Materia Medica Chuipencao Alternative names: Stringy Stonecrop Herb; Herba Sedi Source: Chinese Materia Medica Dahuang Alternative names: Rhubarb; Radix et Rhizoma Rhei Source: Chinese Materia Medica Daqingye Alternative names: Dyers Woad Leaf; Folium Isatidis Source: Chinese Materia Medica Guangjinqiancoa Alternative names: Snowbellleaf Tickclover Herb; Herba Desmodii Styracifolii Source: Chinese Materia Medica Huangbo Alternative names: Amur Cork-tree; Cortex Phellodendri Source: Chinese Materia Medica Huanglian Alternative names: Golden Thread; Rhizoma Coptidis Source: Chinese Materia Medica Huangqi Alternative names: Milkvetch; Radix Astragali Source: Chinese Materia Medica
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Huangqin Alternative names: Baical Skullcap Root; Radix Scutellariae Source: Chinese Materia Medica Huhuanglian Alternative names: Figwortflower Picrorhiza Rhizome; Rhizoma Picrorhizae Source: Chinese Materia Medica Huzhang Alternative names: Giant Knotweed Rhizome; Rhizoma Polygoni Cuspidati Source: Chinese Materia Medica Jigucao Alternative names: Canton Love-pea Vine; Herba Abri Source: Chinese Materia Medica Jinqiancao Alternative names: Christina Loosestrife; Herba Lysimachiae Source: Chinese Materia Medica Jixuecao Alternative names: Asiatic Pennywort Herb; Herba Centellae Source: Chinese Materia Medica Juju Alternative names: Chicory Herb; Herba Cichorii Source: Chinese Materia Medica Kushen Alternative names: Lightyellow Sophora Root; Radix Sophorae Flavescentis Source: Chinese Materia Medica Lianqiancao Alternative names: Longtube Ground Ivy Herb; Herba Glechomae Source: Chinese Materia Medica Longdan Alternative names: Chinese Gentian; Radix Gentianae Source: Chinese Materia Medica Pugongying Alternative names: Dandelion; Herba Taraxaci Source: Chinese Materia Medica Qiancao Alternative names: Longtube Ground Ivy Herb; Lianqiancao; Herba Glechomae Source: Chinese Materia Medica Qinghao Alternative names: Sweet Wormwood Herb; Herba Artemisiae Annuae Source: Chinese Materia Medica
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Qingyedan Alternative names: Mile Swertia Herb; Herba Swertiae Mileensis Source: Chinese Materia Medica Shisanwei Bangga San Alternative names: Shisanwei Bangga Powder; Shisanwei Bangga San
(Shi San Wei Banq Qa San) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Yinchen Alternative names: Virgate Wormwood Herb; Herba Artemisiae Scopariae Source: Chinese Materia Medica Yujin Alternative names: Turmeric Root Tuber; Radix Curcumae Source: Chinese Materia Medica Zhizi Alternative names: Cape Jasmine Fruit; Fructus Gardeniae Source: Chinese Materia Medica •
Herbs and Supplements Alfalfa Alternative names: Medicago sativa Source: Healthnotes, Inc.; www.healthnotes.com Barberry Alternative names: Berberis vulgaris Source: Healthnotes, Inc.; www.healthnotes.com Barberry Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Black Haw Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Carotenoids Source: Healthnotes, Inc.; www.healthnotes.com Cleavers Alternative names: Galium aparine Source: Healthnotes, Inc.; www.healthnotes.com Dandelion Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca
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Dandelion Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10021,00.html Eyebright Source: Prima Communications, Inc.www.personalhealthzone.com Fringetree Bark Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Gentian Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Glycyrrhiza1 Alternative names: Licorice; Glycyrrhiza glabra L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Greater Celandine Alternative names: Chelidonium majus Source: Healthnotes, Inc.; www.healthnotes.com Lobelia Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Loop Diuretics Source: Integrative Medicine Communications; www.drkoop.com Luffa Alternative names: Luffa sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Menadione Source: Integrative Medicine Communications; www.drkoop.com Menaphthone Source: Integrative Medicine Communications; www.drkoop.com Menaquinone Source: Integrative Medicine Communications; www.drkoop.com Milk Thistle Alternative names: Silybum marianum, Carduus marianus Source: Healthnotes, Inc.; www.healthnotes.com Milk Thistle Alternative names: Silybum marianum, St. Mary's Thistle Source: Integrative Medicine Communications; www.drkoop.com
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Milk Thistle Source: Prima Communications, Inc.www.personalhealthzone.com Oregon Grape Alternative names: Berberis aquifolium Source: Healthnotes, Inc.; www.healthnotes.com Peppermint Source: Prima Communications, Inc.www.personalhealthzone.com Phyllanthus Alternative names: Phyllanthus niruri Source: Healthnotes, Inc.; www.healthnotes.com Phyllanthus/ayurvedic Liver Support Combination Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10050,00.html Phylloquinone Source: Integrative Medicine Communications; www.drkoop.com Picrorhiza Alternative names: Picrorhiza kurroa Source: Healthnotes, Inc.; www.healthnotes.com Red Clover Alternative names: Trifolium pratense , beebread, cow clover, cow grass, meadow clover, purple clover Source: Integrative Medicine Communications; www.drkoop.com Salicylates Source: Integrative Medicine Communications; www.drkoop.com SAMe (S-Adenosylmethionine) Source: Prima Communications, Inc.www.personalhealthzone.com Silybum Marianum Source: Integrative Medicine Communications; www.drkoop.com St. Mary's Thistle Source: Integrative Medicine Communications; www.drkoop.com Taraxacum Alternative names: Dandelion; Taraxacum officinale (Dhudhal) Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Tribulus Puncture Alternative names: Puncture Vine, Goathead; Tribulus terrestris L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org
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Yellow Dock Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON JAUNDICE Overview In this chapter, we will give you a bibliography on recent dissertations relating to jaundice. 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 “jaundice” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on jaundice, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Jaundice 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 jaundice. 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: •
A Cross-cultural Epidemiological Study of Physiologic Jaundice in American and Yucatec Maya Infants (Mexico) by Smerken, Marilyn J., PhD from Southern Illinois University at Carbondale, 1995, 121 pages http://wwwlib.umi.com/dissertations/fullcit/9536593
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Association of a Variant Lipase with Breast Milk Jaundice. by Schultz, Gary Edward, PhD from Wayne State University, 1977, 160 pages http://wwwlib.umi.com/dissertations/fullcit/7805224
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. PATENTS ON JAUNDICE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “jaundice” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on jaundice, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Jaundice By performing a patent search focusing on jaundice, 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
8Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on jaundice: •
Anti-jaundice composition for corpses and method Inventor(s): Garrett; Kurt Anthony (8220 Hobhouse Cir., Raleigh, NC 27615) Assignee(s): none reported Patent Number: 6,387,360 Date filed: November 28, 2000 Abstract: An anti-jaundice composition for providing coloration to a corpse, comprising a bleaching agent, a coloring agent, and a fixing agent, mixed and stored at room temperature, and administered internally to a corpse for providing uniform, controlled coloration of the skin and tissue and for preventing tissue degradation. The invention is also directed to a method for providing an anti-jaundice composition for providing coloration to a corpse. Excerpt(s): The present invention relates generally to a composition and method for providing coloration to corpses and, more particularly, to an anti-jaundice composition for corpses and method for administering the same. The top 3 problems in the mortuary industry include airborne tuberculosis, 3/4 face repair, and jaundice. Jaundice is the yellow-green discoloration of the skin of corpses due to degradation of body tissues and fluids. Embalming is used to try to prevent accelerated degradation of the tissues and fluids, and thus jaundice. Embalming should be performed as soon as possible, or else the blood enzymes may cause premature degradation of the corpse. Generally, the body should be washed thoroughly with soap and water. Next, at least one vein is opened to drain the blood from the body, (usually the femoral and the axillary vein). Massaging of the body in the direction of the heart helps to break up any clots that may have formed. Four to six pints of embalming fluid are added, then the blood is drained away from the vein. Inadequate drainage can lead to premature decomposition. Web site: http://www.delphion.com/details?pn=US06387360__
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Aspartic and malic acid inhibition of ss-glucuronidase Inventor(s): Gourley; Glenn R. (Madison, WI), Kreamer; Bill L. (Madison, WI) Assignee(s): Wisconsin Alumni Research Foundation (Madison, WI) Patent Number: 6,416,783 Date filed: August 18, 2000 Abstract: Disclosed herein are infant dietary supplements containing L-aspartic and/or L-malic acid. The supplements are designed to inhibit.beta.-glucuronidase activity in breast feeding babies, and thereby suppress serum bilirubin levels and the incidence of neonate jaundice. In one form L-aspartic acid is mixed with human breast milk and fed to the neonate on the same schedule that breast feeding would otherwise normally occur. In another form the L-aspartic acid is delivered in an aqueous solution supplemented with sodium and potassium. Excerpt(s): The present invention relates to formulations and methods useful in reducing serum bilirubin, and thus the incidence of infant jaundice, in breast feeding babies. More particularly, it relates to the use of L-aspartic acid and/or L-malic acid in
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formulas and supplements used in addition to breast milk. Bilirubin is the red bile pigment formed during the catabolism of certain compounds such as hemoglobin. Human infants produce more bilirubin per unit of body weight than do adults because of greater red blood cell mass and shorter red blood cell life span. Bilirubin is poorly soluble in water and requires conjugation for excretion from the body. Bilirubin is conjugated with glucuronic acid within the endoplasmic reticulum of the hepatocyte. Bilirubin conjugates in the intestine can act as a substrate for either bacterial or endogenous tissue.beta.-glucuronidase. This enzyme hydrolyzes glucuronic acid from bilirubin glucuronide. The resulting unconjugated bilirubin produced is more rapidly absorbed from the intestine. This intestinal absorption of free bilirubin results in increased serum bilirubin levels in some neonates, which has been associated with infant jaundice. Web site: http://www.delphion.com/details?pn=US06416783__ •
Chemically modified bilirubin oxidase Inventor(s): Inoue; Masayasu (Kumamoto, JP), Maeda; Hiroshi (Kumamoto, JP) Assignee(s): Amano Pharmaceutical Co., Ltd. (Aichi, JP) Patent Number: 4,968,495 Date filed: July 29, 1988 Abstract: A bilirubin oxidase derivative resulting from chemical modification of a watersoluble polymeric substance. The chemically modified bilirubin oxidase is useful as a drug for treating jaundice. Excerpt(s): This invention relates to a chemically modified bilirubin oxidase, and more specifically, to a bilirubin oxidase derivative resulting from chemical modification of bilirubin oxidase with a water-soluble polymeric substance. The chemically modified bilirubin oxidase provided by this invention is useful as a drug for treating jaundice because it acts to specifically decompose and remove bilirubin which abnormally increases in blood in jaundice, and has very high stability in blood. Jaundice is a condition in which bilirubin in blood increases abnormally to yellow the skin, mucous membranes and other tissues. Jaundice accompanying various hepatic diseases involves strong cytotoxin of bilirubin, and often brings about serious results (see Maisels, M. J.: Neonatology, edited by Avery, G. B., Lippicott Co., Philadelphia, 1981, pages 473-544). Thus, neonatal jaundice is treated by light therapy or therapy by exchange transfusion (see Cohen, A. V. and Ostrow, J. D.: Pediatrics, 65: 740-750, 1980). Extracorporeal therapies have also been attempted. For example, bilirubin in blood is adsorbed on various resins (see Scharschmidt, B. F. et al.: J. Clin. Invest., 53: 786-795, 1974), or decomposed and removed by using bilirubin oxidase fixed to a carrier such as a polysaccharide (e.g., cellulose, dextran or agarose), polyacrylamide gel, porous glass and polystyrene (see Labin, A. et al.: Science, 230: 543-545, 1985). Web site: http://www.delphion.com/details?pn=US04968495__
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Cholestasis ameliorant Inventor(s): Koiso; Kumiko (Tokyo, JP), Maeda; Minoru (Tokyo, JP), Sekido; Shozaburo (Tokyo, JP) Assignee(s): Tokyo Tanabe Company Limited (Tokyo, JP) Patent Number: 5,863,550 Date filed: December 1, 1995 Abstract: Disclosed is a cholestasis ameliorant containing tauroursodeoxycholic acid, which is more excellent in solubility than ursodeoxycholic acid, as the active ingredient. The ameliorant is useful for the treatment of intrahepatic cholestasis due to druginduced hepatopathy, viral hepatitis or the like and the treatment of cholestasis occurring after surgical operation for the treatment of obstructive jaundice. Excerpt(s): This application claims benefit of international application PCT JP94/00282, filed Feb. 23, 1994. Cholestasis is a pathological condition where the choleresis, which is one of the important functions of the liver, is suppressed and the bile flow from the liver through the bile duct to the duodenum is reduced, resulting in congestion of biliary components, and it is categorized into extrahepatic obstructive jaundice, which is caused by an apparent mechanical obstruction such as tumor or gallstones, and intrahepatic cholestasis, which occurs with no macroscopically noticeable site of obstruction. Intrahepatic cholestasis is further classified into acute type due to druginduced hepatitis or viral hepatitis, chronic type represented by primary biliary cirrhosis (PBC), recurrent type occurring familially or during pregnancy and the like and the main clinical symptoms common to all types of intrahepatic cholestasis are severe jaundice and persistent itching. Steroid and phenobarbital preparations are currently used for the treatment of intrahepatic cholestasis, showing a certain level of, but often insufficient, efficacy. Web site: http://www.delphion.com/details?pn=US05863550__
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Medical instrument for determining jaundice Inventor(s): Yamanishi; Akio (Tondabayashi, JP) Assignee(s): Minolta Camera Kabushiki Kaisha (Osaka, JP) Patent Number: 4,267,844 Date filed: May 2, 1979 Abstract: An electro-optical medical instrument is provided for measuring the presence of bilirubin in skin tissue. The instrument is preferably hand-held and self-contained and utilizes a source of flash light to provide sufficient energy in the desired wavelength spectrums. The medical instrument can be automatically activated at a predetermined pressure against a patient's skin to provide a pair of measurement electrical signals. These electrical signals can be processed to provide an output signal representative of the bilirubin value which can be conveniently displayed. Excerpt(s): The present invention relates to a medical instrument for examining newborn babies and more particularly to a calibrated optical-electro instrument for objectively determining the degree of jaundice in newborn babies. The medical profession is aware of the importance of determining the existence of jaundice immediately after the birth of a baby. A large number of newborn children exhibit some degree of jaundice and frequently a jaundice test is performed as a regular routine in
Patents 91
the delivery room. The degree of jaundice can range from a physiologically permissible level which will disappear within a short period of time after the birth to various severe degrees of jaundice, progressing to nuclear jaundice which can result in the death of a newborn or cerebral palsy as sequela even when the child is saved from death. While an accurate examination of the intensity of the jaundice condition can be determined by a measurement of the bilirubin value of the blood serum taken from newborns, it can be rather difficult or is often even unnecessary to take blood from each and every newborn for this measurement. Generally, doctors have made a visual observation of the color of the newborn's skin and then decided if there was any necessity to take a blood specimen for measurement of the bilirubin value of the blood serum. To assist the doctors in making this visual observation the Gosset Icterometer has been developed and is employed as a screening test for deciding whether there is a need to test the bilirubin value of the blood serum. Basically, the Gosset Icterometer utilizes a plurality of standard color strips that are pressed against the skin of the baby and visually matched. Problems existed, however, due to the spectral reflection factors of the yellowish reference strips on the Icterometer, particularly under artificial illumination. Accordingly, although the prior art Icterometer has been of great assistance to the medical profession as a preliminary screening method, it frequently was necessary to rely upon the actual measurements of bilirubin in the blood serum from simply a safety point of view. Thus, quite frequently there are occasions of drawing blood from newborns that are in good health. Web site: http://www.delphion.com/details?pn=US04267844__ •
Method for determining bilirubin concentration from skin reflectance Inventor(s): DeWitt; David P. (West Lafayette, IN), Hannemann; Robert E. (West Lafayette, IN), Wiechel; John F. (Houston, TX) Assignee(s): Purdue Research Foundation (West Lafayette, IN) Patent Number: 4,029,085 Date filed: March 26, 1976 Abstract: A method is disclosed for determining the bilirubin concentration in the blood serum of a person from measurement of the spectral reflectance of the skin. The disclosed method detects the severity of jaundice, a common neonatal condition, and enables determination of the type of treatment regimen needed to prevent the bilirubin level from becoming sufficiently high to cause kernicterus which can result in brain damage. The method includes measuring the reflectance of the skin within a predetermined frequency spectrum, and more particularly at a number of specific wavelengths in the visible portion of the spectrum. Excerpt(s): This invention relates to a method for detecting jaundice and establishing the level of severity by direct determination of the bilirubin concentration in the blood serum from measurement of the spectral reflectance of the skin at selected wavelengths. Jaundice, as is well known, is a condition one of the characterizations of which is yellowness of the skin of a person and is due to deposition of bile pigment resulting from excess bilirubin, known as hyperbilirubinemia, in the blood. Bilirubin, in its indirect form, is potentially harmful, for example, to the central nervous system of a newborn infant. The severity of the damage caused is related to the level of bilirubin in the serum of the blood. In its most severe form, this damage is called kernicterus. After jaundice has been detected, treatment regimens, such as exchange transfusions and phototherapy, are commonly used, when considered necessary, to prevent levels of
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bilirubin known to cause kernicterus. It is currently felt that lower levels of bilirubin may also be one of the causes for minimal brain dysfunction, a condition thought to be responsible for a large majority of learning disorders in children. If such a relationship is true, early detection and treatment of lower level hyperbilirubinemia becomes even more critical. Web site: http://www.delphion.com/details?pn=US04029085__ •
Method of treating disorders of the animal or human body by administering amino acids Inventor(s): Houdijk; Alexander Petrus Jacobus (Van der Ghiessenstraat 25, NL-1181 RS Amstelveen, NL), Van Leeuwen; Paulus Aloisius Marie (Haya van Somerenlaan 30, L1187 RB Amstelveen, NL) Assignee(s): none reported Patent Number: 6,001,878 Date filed: October 10, 1996 Abstract: The invention relates to the use of glutamine or a glutamine equivalent for the treatment of disease states where there is a decreased blood flow to the liver or where there are low arginine plasma levels. Such disease states comprise systemic inflammation, high plasma arginase level, bacteremia, jaundice, liver transplantation, increased cytokine production or liver steatosis. Excerpt(s): The invention relates to a method of treating disorders of the animal or human body which require increasing blood flow to intestinal organs as well as to a method of treating disorders which can be treated by administering arginine. The present invention relates in particular to the use of glutamine in the diseased state where there is a decreased blood flow to the liver or where there are low arginine plasma levels. The splanchnic bed consists of several organs all of which drain into the portal vein. A liver receives its blood supply from both the portal vein and the hepatic arteria. 70-80% of the blood flow to the liver is received by the portal vein and therefore most of the nutrients and oxygen is taken out of the blood coming from the portal vein and is thus insufficient during a decrease in blood flow. Glutamine is capable of increasing blood flow through the liver by increasing splanchnic blood flow. Web site: http://www.delphion.com/details?pn=US06001878__
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Method to prevent neonatal jaundice with metalloporphyrin compositions Inventor(s): Stevenson; David K. (Palo Alto, CA), Vreman; Hendrik J. (Los Altos, CA) Assignee(s): The Board of Trustees of the Leland Stanford Junior University (Stanford, CA) Patent Number: 5,081,115 Date filed: March 24, 1989 Abstract: A formulation for administration of a metalloporphyrin compound useful in the treatment or prevention of jaundice is described. The formulation comprises the metalloporphyrin in admixture with an excipient which is a water-soluble organic amine, said composition having been neutralized to neutral pH. The formulation may advantageously contain a stabilizer, such as human serum albumin.
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Excerpt(s): The invention relates to the field of clinical medicine and epidemiology. More specifically, the invention concerns a method to screen human subjects for incipient hyperbilirubinemia and to prevent jaundice in subjects at risk. Infant jaundice, or hyperbilirubinemia, is a significant clinical problem, occurring in about 5% of fullterm infants. The syndrome is the direct result of increased bilirubin levels in the infant body. Adults also have problems with jaundice, but they are generally not as serious or as widespread because most adults are capable of conjugating excess bilirubin with sugars and clearing this toxin from the body. This detoxification mechanism is not fully developed in neonates. Nevertheless, some adults, such as those who have hepatitis or obstructions to bile flow, are subject to jaundice as well. Various treatments have been suggested for both infant and adult jaundice when these problems occur. These treatments include phototherapy, exchange transfusions, extracorporeal filtration systems, and drugs which induce an efficient clearance system. None of these treatments is simple to administer or effective without negative side reactions, including risk of injury or death. If the jaundice is not promptly treated, serious damage to the nervous system can result, especially in infants, as the elevated amounts of bilirubin act as a neurotoxin, and the blood/brain barrier in infants is incompletely developed. Also, the foregoing treatments are administered after the fact--i.e., after the jaundice has already appeared. Web site: http://www.delphion.com/details?pn=US05081115__ •
Neonatal hemolysis detection using end-tidal breath sampler and analyzer apparatus Inventor(s): Stevenson; David K. (Palo Alto, CA), Vreman; Hendrik J. (Los Altos, CA) Assignee(s): Board of Trustees of the Leland Stanford Junior University (Palo Alto, CA) Patent Number: 5,383,469 Date filed: October 12, 1993 Abstract: Apparatus for use in a hospital nursery, clinic, or physician's office for the sampling and analysis of neonatal end-tidal breath for carbon monoxide as an indication of hemolysis and subsequent infant jaundice includes a syringe and plunger for collecting end-tidal breath, a pump for supporting the syringe and including drive means for incrementally withdrawing the plunger and collecting end tidal breath, and a controller for the pump including a thermistor positionable to respond to the temperature of exhaled breath and generating an electrical signal in response to thermistor temperature. A rate detector receives the signal and determines exhalation rate. The signal is delayed in response to exhalation rate and then utilized to energize the pump in incrementally withdrawing the plunger in collecting end tidal breath. The pump can also be used in analysis equipment which extracts the end tidal breath sample with a sensor receiving the sample and determining carbon monoxide content. Alternatively, separate pumps can be employed for the sample collection and for the sample analysis. Excerpt(s): This invention relates generally to the detection of hemolysis and subsequent development of neonatal jaundice, and more particularly the invention relates to improved apparatus for hospital nursery use in sampling and analyzing end tidal breath for carbon monoxide content as an indication of jaundice. The invention has further applications in the detection of other exhaled gasses. Infant hemolysis leading to hyperbilirubinemia and jaundice is a significant clinical problem which results directly from increased bilirubin levels in the infant body. As discussed in U.S. Pat. No. 4,831,024 issued to Vreman and Stevenson for "Method to Prevent Neonatal Jaundice" the toxic
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cause of jaundice and treatment thereof are known. However, in the newborn, or neonate, the visible signs of the disorder usually manifest themselves several days after birth, often after the infant and mother have been discharged from the hospital. A simple non-invasive test for hemolysis and subsequent jaundice is based on carbon monoxide analysis of end expiratory breath sample collected transnasally. As described by D. W. Smith, et al., Journal of Pediatric Gastroenterology and Nutrition (1985) 4: 3844, samples of end-expiratory breath are collected by transnasal placement of a catheter into the posterior nasal pharynx. Expired gas is drawn manually by nursery personnel in small, less than 1 ml, increments at end expiration as determined by the infants chest wall movement. A syringe of sufficient size such as 12 cc is used to permit the collection of a total of approximately 10 ml of expired breath. Ambient air is also sampled, and the sampled measurements are corrected for the contribution of ambient CO which can vary in the range of 0.2-10.mu.l/l. The CO in the samples is then measured in a laboratory using gas chromatography. Web site: http://www.delphion.com/details?pn=US05383469__ •
Physiological stress detector device and method Inventor(s): Sarussi; Israel (Hof Aza, IL) Assignee(s): S.P.O. Medical Equipment Ltd. (Neve Dekalim, IL) Patent Number: 6,553,242 Date filed: February 1, 2000 Abstract: A method and device for measurement of a level of at least one blood constituent. The device includes a light source and a light detector proximate the surface of an organ. The device also includes a pair of adjustable gain amplifiers and a processor/controller connected within a processing unit. The processing unit operates to separate an AC signal component from a DC signal component. The light source includes at least one light emitting unit. Preferably, the light source alternatingly emits light at two different wavelength ranges and normalizes the AC and DC output signals corresponding with the intensity of the light reflected from the organ and calculates a ratio of the normalized signals for each wavelength range. The device may determine the level of the blood constituent and may also use this level for monitoring and/or to activate an alarm when the level falls outside a predetermined range. The device and the method may be applied to monitoring, inter alia, conditions of apnea, respiratory stress, reduced blood flow in organ regions, heart rate, jaundice, and blood flow velocity. Excerpt(s): The present invention relates to instruments which operate on the principle of pulse oximetry, in particular, to non-invasive hemoglobin saturation detectors and methods, and may be generally applied to other electro-optical methods of measuring blood constituents. Electro-optical measurement of blood characteristics has been found to be useful in many areas of blood constituent diagnostics, such as glucose levels, oxygen saturation, hematocrit, billirubin and others. This method is advantageous in that it can be performed in a non-invasive fashion. In particular, much research has been done on oximetry, a way of measuring oxygen saturation in the blood, as an early indicator of respiratory distress. Infants during the first year of life are susceptible to breathing disturbances (apnea) and respiratory distress. Sudden Infant Death Syndrome (SIDS) is a medical condition in which an infant enters respiratory distress and stops breathing, leading to the death of the infant. Although the cause and warning signs of SIDS are not clear, it has been shown that early detection of respiratory distress can provide the time to administer the aid necessary to prevent death.
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Web site: http://www.delphion.com/details?pn=US06553242__ •
Protective eye cover Inventor(s): Welt; Claire Doolin (1137 Schilling Way, Mt. Shasta, CA 96067) Assignee(s): none reported Patent Number: 4,502,476 Date filed: August 18, 1982 Abstract: A protective eye cover designed to cover and protect the eyes of infants undergoing treatment for hyperbilirubinemia (jaundice). The eye cover is comprised of an eye band with eye pads positioned to cover the infant's eyes, a scalp band which passes over the parietal region of the infant's head, and an occiput band which passes below the infant's occipital protuberance. The bands are each attached to a first and a second ear piece. The eye cover affords a soft, comfortable fit while remaining secure and in place on even the most active infant. Excerpt(s): The invention relates to a novel protective eye cover for infants. The eye cover is designed to cover and protect the eyes of infants undergoing treatment for hyperbilirubinemia (jaundice). This treatment consists of exposing an infant's entire body to blue fluorescent light for a period of several days. During this time, the infant's eyes must be covered and protected from the intense and constant light. Previous attempts to provide protection for an infant's eyes while undergoing treatment for hyperbilirubinemia have involved placing cotton pads over the eyes and securing the pads with adhesive tape placed at the temples and the nose. This type of eye shield often caused skin irritation and pressure areas. A prior art eye shield for infants is described in U.S. Pat. No. 3,541,608. This patent shows an eye shield for infants with a headband and a chin strap plus Velcro fastening means. The chin strap required to retain the eye shield in position on the infant's head may cause choking or impede breathing. Web site: http://www.delphion.com/details?pn=US04502476__
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Reagent for measuring direct bilirubin Inventor(s): Kojima; Masami (Chiba-ken, JP), Kondo; Hitoshi (Kyoto, JP), Kurosaka; Keisuke (Kyoto, JP), Senba; Shoji (Kyoto, JP), Suzuki; Hiroshi (Chiba-ken, JP) Assignee(s): Iatron Laboratories, Inc. (Tokyo, JP), Unitika, Ltd. (Hyogo, JP) Patent Number: 5,599,661 Date filed: December 28, 1994 Abstract: A reagent system and method are described for optically measuring direct bilirubin by the reaction of a bilirubin oxidase, oxidizing agent or diazonium salt, with the direct bilirubin, wherein a tetrapyrrole compound is provided in the presence of the bilirubin oxidase, oxidizing agent or diazonium salt. It is possible to accurately measure the direct bilirubin, which is known to increase considerably in the biological fluids of patients having obstructive jaundice, etc. The reagent system and method are useful in clinical settings, etc. Excerpt(s): The present invention relates to reagents to measure direct bilirubin present in biological fluids. Bilirubin is a yellow pigment belonging to tetrapyrroles. It is a degradative product of heme, and is known to be present in the bile in large quantities.
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Bilirubin in the biological fluids is mainly composed of direct and indirect bilirubin. The indirect bilirubin increases significantly in hemolytic anemina and jaundice, etc. while the direct bilirubin increases in obstructive jaundice, etc. For this reason, fractional determination is important in clinical diagnosis, etc. Total and direct bilirubin have conventionally been measured in clinical laboratories. The correct determination of direct bilirubin is indispensable in clinical laboratories. Web site: http://www.delphion.com/details?pn=US05599661__ •
Reagent for measuring direct bilirubin by enzymatic method and method for measurement thereof Inventor(s): Enomoto; Masayasu (Takatsuki, JP), Muramoto; Masahiro (Takatsuki, JP), Takayama; Masaharu (Ibaraki, JP), Taniguchi; Seiichi (Neyagawa, JP) Assignee(s): Nippon Shoji Kaisha, Ltd. (Osaka, JP) Patent Number: 4,571,383 Date filed: December 19, 1983 Abstract: Reagent for the measurement of direct bilirubin comprising a buffer solution having a pH range of 3.5 to 4.5 which contains bilirubin oxidase, preferably in the form of a test kit consisting essentially of (i) a buffer solution having a pH range of 3.5 to 4.5, (ii-a) a lyophilized bilirubin oxidase, (ii-b) a buffer solution for dissolving the lyophilized bilirubin oxidase, and (iii) a standard serum containing a prescribed amount of bilirubin, and a method for measurement of direct bilirubin by using the reagent. The reagent and method are useful for diagnosis of various diseases, for example, various hepatic diseases (e.g. jaundice) and cholepathia. Excerpt(s): The present invention relates to a reagent for measuring direct (conjugate) type bilirubin by an enzymatic method and a method for the measurement thereof. Bilirubin is a representative pigment in vivo which is mainly derived from hemoglobin produced by decomposition of senescent erythrocytes. The free type bilirubin is occasionally converted into a protein-bound type bilirubin or a conjugate type bilirubin with glucuronic acid by the microsomal enzyme in liver and is excreted from the liver cell into the bile and further moved into intestinal tract. The bilirubin moved into intestinal tract is partially absorbed and circulates within intestine and liver, but most thereof is excreted outside the body in the form of urobilin. When the above step of from the production to excretion is disordered or changed, the blood level of bilirubin is increased to induce finally jaundice. Accordingly, when the blood level of bilirubin is measured, the data can be used for diagnosis of some diseases, for example, hepatic diseases and cholepathia, and hence, the measurement of bilirubin in blood has been clinically employed. Bilirubin is usually either in a free type and protein-bound type (it is also called as non-conjugate or indirect type), or in a direct type (it is also called as conjugate type), as mentioned above. The direct type bilirubin (hereinafter, referred to as "direct bilirubin") has a structure that glucuronic acid binds to the propionic side chain of the free (or indirect) type bilirubin (hereinafter, referred to as "indirect bilirubin"), wherein the compound bound with one glucuronic acid is called as "monoglucuronide" and the compound bound with two glucuronic acids are called as diglucuronide". Both of the direct bilirubin and indirect bilirubin are totally called as total bilirubin. Web site: http://www.delphion.com/details?pn=US04571383__
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Synthesis of 1.alpha.,25-dihydroxy-24R-fluorocholecalciferol dihydroxy-24S-fluorocholecalciferol
and
1.alpha.,25-
Inventor(s): Partridge; John J. (Upper Montclair, NJ), Shiuey; Shian-Jan (Nutley, NJ), Uskokovic; Milan R. (Upper Montclair, NJ) Assignee(s): Hoffmann-La Roche Inc. (Nutley, NJ) Patent Number: 4,634,692 Date filed: April 11, 1984 Abstract: 1.alpha.,25-Dihydroxy-24R-fluorocholecalciferol and 1.alpha.,25-dihydroxy24S-fluorocholecalciferol, analogs of 1.alpha.,25-dihydroxy-cholecalciferol which is physiologically the most active metabolite of vitamin D.sub.3, are synthesized in a multistep process from the known substance 1.alpha.,3.beta.-dihydroxyandrost-5-en-17one. The new analogs are characterized by the ability to increase intestinal calcium transport, increase serum calcium and phosphate concentrations and to increase the deposition of these minerals in bones. These compounds will find a ready application as substitutes for natural 1.alpha.,25-dihydroxycholecalciferol in the treatment of disease states characterized by metabolic calcium and phosphate deficiencies. Exemplary of such disease states are the following: osteomalacia, osteoporosis, rickets, osteitis fibrosa cystica, renal osteodystrophy, osteosclerosis, anti-convulsant treatment, osteopenia, fibrogenesis-imperfecta ossium, secondary hyperparathyrodism, hypoparathyroidism, hyperparathyroidism, cirrhosis, obstructive jaundice, drug induced metabolism, medullary carcinoma, chronic renal disease, hypophosphatemic VDRR, vitamin Ddependent rickets, sarcoidosis, glucocorticoid antagonism, malabsorption syndrome, steatorrhea, tropical sprue, idiopathic hypercalcemia and milk fever. Excerpt(s): This invention relates to 24R- and 24S-fluoro analogs of 1.alpha.,25dihydroxycholecalciferol. Vitamin D.sub.3 is a well-known agent for the control of calcium and phosphorous homeostasis. In the normal animal or human this compound is known to stimulate intestinal calcium transport and bone-calcium mobilization and is effective in preventing rickets. It is also now well known that to be effective, vitamin D.sub.3 must be converted in vivo to its hydroxylated forms. For example, the vitamin is first hydroxylated in the liver to form 25-hydroxy-vitamin D.sub.3 and is further hydroxylated in the kidney to produce 1.alpha.,25-dihydroxy vitamin D.sub.3 or 24,25dihydroxy vitamin D.sub.3. The 1.alpha.-hydroxylated form of the vitamin is generally considered to be the physiologically active or hormonal form of the vitamin and to be responsible for what are termed the vitamin D-like activities, such as increasing intestinal absorption of calcium and phosphate, mobilizing bone mineral, and retaining calcium in the kidneys. Web site: http://www.delphion.com/details?pn=US04634692__ •
Therapeutic method and internally illuminated garment for the management of disorders treatable by phototherapy Inventor(s): Rosen; Arye (Cherry Hill Township, Camden County, NJ), Rosen; Danielle (Cherry Hill Township, Camden County, NJ) Assignee(s): AMT, Inc. (Cherry Hill, NJ) Patent Number: 6,045,575 Date filed: January 29, 1998
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Abstract: An apparatus for treating neonatal jaundice is in the form of a garment (10, 40) which has semiconductor light sources (14, 214, 314) affixed thereto for radiating toward the "inside" of the garment when the infant is dressed in the garment. A portable energy source such as batteries (318) or a fuel cell (360) powers the array of light sources. A method according to the invention vests the infant in the garment, and energizes the light sources by coupling a battery to the light sources, or fueling and starting the fuel cell. The therapy is continued for as long as desired or needed. Excerpt(s): This invention relates to methods and apparatuses for medical treatment, and more particularly to the treatment of phototherapy-treatable disorders, such as jaundice. Hyperbilirubinemia (jaundice) is common in infants, and affects, in some degree, up to 50% of full-term infants, and most preterm infants. Bilirubin is the end result of chemical reactions involved in the breakdown of hemoglobin molecules. Bilirubin circulates through the blood stream chiefly in unconjugated form, and is processed by catalysis in the liver for conversion into a water-soluble form, which can then be excreted into the intestines as bile. The livers of newborn infants tend to have limited ability to process bilirubin, so infants are prone to accumulation of unconjugated bilirubin, and thus develop jaundice. In most cases, the jaundice is mild, and resolves spontaneously during the first week of life. However, jaundice is potentially dangerous, as high levels of bilirubin are toxic to brain tissue. While the immaturity of liver cells is the chief cause of jaundice, there may be pathologic causes, which include h.ae butted.molytic anemia, polycythemia, extravasated blood, and even metabolic disorders. These pathologic causes can create sudden and severe onset of excess bilirubin levels. The goal of medical intervention is to mitigate or curtail the rise in bilirubin levels in the blood, to avoid a toxic accumulation. Approximately 10% of newborns require such intervention. Web site: http://www.delphion.com/details?pn=US06045575__ •
Treatment of newborn jaundice Inventor(s): Chowdhury; Jayanta R. (New Rochelle, NY), Dannenberg; Andrew J. (New York, NY) Assignee(s): Albert Einstein College of Medicine of Yeshiva University, a Division of (Bronx, NY), Cornell Research Foundation, Inc. (Ithaca, NY) Patent Number: 5,589,504 Date filed: July 26, 1994 Abstract: Based on the discovery that the human bilirubin/phenol UDPglucuronosyltransferase ugt1 gene complex contains an electrophile responsive element and the knowledge that the rat NADP(H):quinone reductase gene contains an electrophile responsive element, agents which at a concentration of less than 50.mu.M double the quinone reductase specific activity of Hepa 1clc7 cells, e.g., BHT and sulforaphane, are used for the prophylaxis or treatment of newborn jaundice. Excerpt(s): This invention is directed at prophylaxis or treatment of neonatal jaundice. Jaundice of the newborn results from the accumulation of bilirubin in blood. Elevations in the serum level of this end product of heme degradation occur because of delays in the normal postnatal development increase in bilirubin uridinediphospho (UDP)glucuronosyltransferase activity. This enzyme converts unconjugated bilirubin to bilirubin monoglucuronide and bilirubin diglucuronide which are excreted into bile and eliminated from the body. Treatment of jaundiced newborns is a major concern of
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pediatricians because bilirubin can enter neural tissues resulting in central nervous system toxicity. Thus, jaundice continues to be a common cause of prolonged hospitalization in newborns. Phototherapy is the generally recommended form of treatment if bilirubin concentration reaches 14-15 mg/dl. An exchange transfusion is the generally recommended form of treatment if bilirubin concentration reaches levels of 20 mg/dl. These are complicated procedures and add to the expense of health care. Web site: http://www.delphion.com/details?pn=US05589504__
Patent Applications on Jaundice As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to jaundice: •
Color measurement system with color index for skin, teeth, hair and material substances Inventor(s): Billmeyer, Fred W. JR.; (Schenectady, NY), Fairman, Hugh S.; (Princeton, NJ), Macfarlane, Darby S.; (Hastings-on-Hudson, NY), Macfarlane, David K.; (Hastingson-Hudson, NY) Correspondence: Fish & Neave; 1251 Avenue OF The Americas; 50th Floor; New York; NY; 10020-1105; US Patent Application Number: 20020021444 Date filed: January 18, 2001 Abstract: Methods and systems for measuring with a Color Measurement System of predetermined specification and evaluating the color of skin, teeth, hair and material substances with a Color Index. The principles of this invention also relate to techniques for using such a Color Measurement System with the Color Index in medical applications such as the detection of chromogenic disease including bilirubin infant jaundice, cosmetics applications and in the evaluation of the color of hair or teeth, and other applications.The Color Index is measured and calculated from the reflectance spectrum of any skin (or teeth, hair or material substance) by a two step process. The first step is the weighting of the visible spectra with a unique set of weighting factors which calculate a sample's reflectance spectrum's contribution to the appearance of four color components independent of the illuminating condition. The second step places the sample's reflectance spectrum's contribution to the appearance of the four color components in opponency to each other and calculates the Color Index providing attributes representative of correlates of lightness-darkness (L, also referred to as lightness), redness-greenness (M) and yellowness-blueness (N). Excerpt(s): This claims the benefit of copending, commonly-assigned United States Provisional Patent Application No. 60/068,013, filed Dec. 18, 1997 and copending, commonly-assigned United States Provisional Patent Application No. 60/068,237, filed Dec. 19, 1997. This invention relates to techniques for measuring with a Color Measurement System and evaluating the color of skin, teeth, hair and material substances with a Color Index. The invention also relates to techniques for using such a
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This has been a common practice outside the United States prior to December 2000.
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Color Measurement System with the Color Index in medical applications such as the detection of chromogenic disease including bilirubin infant jaundice, cosmetics applications and in the evaluation of the color of hair or teeth and other applications. It is well known that color measuring instruments, such as spectrocolorimeters and spectrophotometers, can be used to measure the color of surfaces for a variety of useful applications. For example, Macfarlane et al. U.S. Pat. No. 5,313,267 describes a method and instrument for selecting personal compatible colors using a color measuring device. Also, PCT Publication No. WO 96/41140 describes methods and apparatus for determining the condition of a test subject based on color by using a color measuring instrument to detect change in a color factor indicative of a condition such as a disease, spoilage, ageing, etc. In particular, those methods and apparatus can be used to detect a medical condition known as hyperbilirubinemia by measuring skin color. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Inhibition of neonatal hyperbilirubinemia in breast fed infants Inventor(s): Gourley, Glenn R.; (Madison, WI), Kreamer, Bill L.; (Madison, WI) Correspondence: Quarles & Brady Llp; 411 E. Wisconsin Avenue, Suite 2040; Milwaukee; WI; 53202-4497; US Patent Application Number: 20020013267 Date filed: September 28, 2001 Abstract: Disclosed herein are infant supplements containing casein, a salt of casein, whey and/or a casein hydrolysate which are free of carbohydrate, and methods for their use with breast feeding babies. The supplements are designed to suppress serum bilirubin levels and the incidence and severity of neonate jaundice. In one form, a dose of such a supplement is mixed with human breast milk and fed to the neonate. Excerpt(s): This application is a continuation-in-part of U.S. Ser. No. 09/641,597 filed Aug. 18, 2000, which in turn claims priority based on U.S. provisional application 60/150,158 filed Aug. 20, 1999. This invention relates to methods useful in reducing serum bilirubin and thus the incidence and severity of infant jaundice. More particularly, it relates to the use of casein (or a salt thereof such as sodium caseinate), whey, and/or certain hydrolyzed casein formulations to supplement, while not interfering with, breast feeding. Pediatricians recommend breast feeding as the most preferred way to feed most human neonates. However, breast feeding has been associated with increased levels of neonatal jaundice. Neonatal jaundice is mostly likely to occur during the first month (especially the first week) after a baby has been born. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Phototherapy eyeshield for babies Inventor(s): Chilton, Howard William; (Willoughby, AU) Correspondence: Gordon & Jacobson; 65 Woods End Road; Stamford; CT; 06905; US Patent Application Number: 20030106128 Date filed: October 10, 2002 Abstract: An eyeshield (10) for protecting babies' eyesight during phototherapy treatment for neonatal jaundice includes a strap (11) of soft material sized and shaped to
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pass around and secured to the head of the baby. An eye pad (18) is attached or formed integrally with the strap (11). A tab (13) extending from the strap (11) adjacent to the eye pad (18) can be grasped to aid in positioning the eyeshield (10) such that the eye pad (18) lies over the baby's eyes. Excerpt(s): The present invention relates to eyeshields. More particularly, though not exclusively, the invention relates to a shield for protecting babies' eyesight during phototherapy treatment for neonatal jaundice. Jaundice is the yellow discolouration of skin and tissues from the deposition in them of the fat-soluble pigment bilirubin excreted by the liver. Jaundice is not uncommon in newborn infants (pre-term or fullterm) when the liver is not physiologically mature, and results from the bile produced by the liver passing into the bloodstream instead of into the intestines. Treatment of neonatal jaundice consists of phototherapy, the exposing of the afflicted infant to visible blue light of wavelength 425-475 nm. Light of that wavelength converts the fat-soluble bilirubin into intermediary, photobilirubin isomers which are water soluble. The watersolubility of the photobilirubins enables that pigment to be excreted easily, unlike the fat-soluble bilirubin which must pass through the liver and be converted (conjugated) into the water-soluble bilirubin diglucuronide before it can be excreted. 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 jaundice, 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 “jaundice” (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 jaundice. You can also use this procedure to view pending patent applications concerning jaundice. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 6. BOOKS ON JAUNDICE Overview This chapter provides bibliographic book references relating to jaundice. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on jaundice 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 “jaundice” (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 jaundice: •
Ascites and Renal Dysfunction in Liver Disease: Pathogenesis, Diagnosis, and Treatment Source: Malden, MA: Blackwell Science, Inc. 1999. 568 p. Contact: Available from Blackwell Science, Inc. 350 Main Street, Malden, MA 02148. (800) 215-1000 or (781)-388-8250. Fax (781) 388-8270. E-mail:
[email protected]. Website: www.blackwellscience.com. PRICE: $125.00 plus shipping and handling. ISBN: 0632043423. Summary: Cirrhosis (liver scarring) is a very prevalent disease and ascites (fluid accumulation) is the most frequent complication. The development of ascites in cirrhosis is the consequence of the simultaneous occurrence of very complex processes leading to impairment in hepatic, circulatory, and renal function. The textbook offers 32 chapters on the pathogenesis, diagnosis and treatment of ascites and renal dysfunction in liver disease. Topics include historical notes on ascites in cirrhosis; characteristics of ascites;
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clinical disorders of renal function in cirrhosis with ascites; clinical disorders of renal function in acute liver failure; renal dysfunction and postoperative renal failure in obstructive jaundice; spontaneous bacterial peritonitis; the etiology, diagnosis, and management of noncirrhotic ascites; extracellular fluid volume homeostasis; physiology of the renal circulation; physiology of the gastrointestinal and liver circulation; the renin angiotensin aldosterone system in cirrhosis; the sympathetic nervous system in cirrhosis; arginine vasopressin in cirrhosis; atrial natriuretic peptide and other natriuretic factors in cirrhosis; arachidonic acid metabolites and the kidney in cirrhosis; nitric oxide and systemic and renal hemodynamic disturbances in cirrhosis; endothelin and systemic, renal, and hepatic hemodynamic disturbances in cirrhosis; the systemic circulation in cirrhosis; the splanchnic circulation in cirrhosis; alterations of hepatic and splanchnic microvascular exchange in cirrhosis (local factors in the formation of ascites); experimental models in the investigation of portal hypertension; renal dysfunction and ascites in carbon tetrachloride induced cirrhosis in rates; bacterial infection of the ascitic fluid in rates with carbon tetrachloride induced cirrhosis; the arterial vasodilation hypothesis of ascites formation in cirrhosis; prognosis of cirrhosis with ascites; the medical treatment of ascites in cirrhosis; treatment of ascites by paracentesis; the treatment of refractory ascites in cirrhosis; the treatment of hepatorenal syndrome in cirrhosis; drug induced renal failure in cirrhosis; liver transplantation in cirrhotic patients with ascites; and the treatment and prophylaxis of spontaneous bacterial peritonitis. Each chapter is written by experts in the field and includes extensive references. The text concludes with a subject index. •
Diseases of the Liver and Biliary System, Eleventh Edition Source: Malden, MA: Blackwell Science, Inc. 2002. 706 p. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail:
[email protected]. Website: www.blackwell-science.com. PRICE: $178.95. ISBN: 0632055820. Summary: Designed to serve practicing physicians, surgeons and pathologists, as well as clinical students, this textbook presents a comprehensive and up-to-date account of diseases of the liver and biliary system. The text offers 38 chapters: anatomy and function; the assessment of liver function; biopsy of the liver; the hematology of liver disease; ultrasound, computed tomography (CT scan) and magnetic resonance imaging (MRI); hepatocellular failure; hepatic encephalopathy; acute liver failure; ascites (fluid accumulation); the portal venous system and portal hypertension; the hepatic artery and hepatic vein, and the liver in circulatory failure; jaundice; cholestasis; primary biliary cirrhosis (PBC); sclerosing cholangitis; viral hepatitis, including general features, hepatitis A, hepatitis E, and other viruses; hepatitis B virus and hepatitis Delta virus; hepatitis C virus; chronic hepatitis, its general features and autoimmune chronic disease; drugs and the liver; hepatic cirrhosis (scarring); alcohol and the liver; iron overload states; Wilson's disease; nutritional and metabolic liver diseases; the liver in infancy and childhood; the liver in pregnancy; the liver is systemic disease, granulomas, and hepatic trauma; the liver in infections; nodules and benign liver lesions; malignant liver tumors; the role of interventional radiology and endoscopy in imaging of the biliary tract; cysts and congenital biliary abnormalities; gallstones and inflammatory gallbladder diseases; benign stricture of the bile ducts; diseases of the ampulla of Vater and the pancreas; tumors of the gallbladder and bile ducts; and hepatic transplantation. The text includes full-color and black-and-white illustrations and photographs. A detailed subject index concludes the volume.
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PDR for Herbal Medicines. 1st ed Source: Montvale, NJ: Medical Economics Company. 1998. 1244 p. Contact: Available from Medical Economics Publishing Inc. P.O. Box 10689, Des Moines, IA 50336. (800) 922-0937. Fax (515) 284-6714. Website: www.medecbookstore.com. PRICE: $59.99. ISBN: 1563632926. Summary: Most of today's herbal remedies exhibit varying degrees of therapeutic value. Some, such as ginkgo, valerian, and saw palmetto, seem genuinely useful, while others, such as ephedra, tansy, and nightshade, can actually be dangerous. As the use of unfamiliar botanicals spreads, the need to steer patients toward the few truly useful preparations and warn them away from ineffective, dangerous alternatives is becoming an increasingly significant priority. This volume, from the publishers of Physicians Desk Reference, brings together the findings of the German Regulatory Authority's herbal watchdog agency (commonly caused Commission E). This agency conducted an intensive assessment of the peer-reviewed literature on some 300 common botanicals, weighing the quality of the clinical evidence and identifying the uses for which the herb can reasonably be considered effective. This reference book contains profiles of over 600 medicinal herbs. Each entry contains up to 9 standard sections: name(s), description, actions and pharmacology, indications and usage, contraindications, precautions and adverse reactions, overdosage, dosage, and literature. The entries have also been indexed by scientific and common name, indications, therapeutic category, and side effects. To assist in identification, the reference book includes a section of full-color plates of the plants included. The book concludes with a glossary of the specialized botanical nomenclature and other unfamiliar terminology, a list of poison control centers, and a list of drug information centers. Some of the herbs are listed for use for abdominal cramps or distress, acid indigestion, appetite stimulation, rectal bleeding, various bowel disorders, stomach cancer, cholelithiasis (gallstones), colic, colitis, constipation, dehydration, diarrhea, digestive disorders, dysentery, enteritis, anal fissure, flatulence (intestinal gas), gastritis, gastroenteritis, gastrointestinal disorders, gout, helminthiasis, hemorrhage, hemorrhoids, hepatitis, hypercholesterolemia, jaundice, liver and gall bladder complaints, liver disorders, malaria, nausea, abdominal pain, and vomiting.
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Alpha 1-Antitrypsin Deficiency Alphabet: From A1 to ZZ Source: Minneapolis, MN: Alpha 1 Association. 1999. [28 p.]. Contact: Available from Alpha 1 Association. 8120 Penn Avenue, South, Suite 549, Minneapolis, MN 55431-1326. (800) 521-3025 or (612) 703-9979. Fax (612) 703-9977. Email:
[email protected]. Website: www.alpha1.org. PRICE: $10.00 plus shipping and handling. Summary: This alphabet book is designed to introduce Alpha 1 Antitrypsin Deficiency to children in families with the disease. The author wanted to explain to her daughters the risks of the disease, the precautions they could take, and the fact that it should in no way inhibit what they do in life. The author uses each letter of the alphabet to highlight one aspect of dealing with Alpha 1. Some examples: B is for Babies (sometimes a baby is diagnosed), D is for Disease (this is not an infectious disease), E is for Everyone Exercising, G is for Genetics, H is for Hospital, J is for Jaundice, L is for Liver and Lungs (Alpha 1 may cause liver and lung problems), N is for No Smoking, P is for Protein, R is for Research, T is for Transplant (some people with Alpha 1 need liver transplantation), U is for Ultrasound, Z is for ZZ (the genetic code for Alpha 1). Each letter is illustrated
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with a colorful drawing; most letters include some brief text describing one aspect of managing Alpha 1. •
Gastroenterology and Hepatology: The Comprehensive Visual Reference. Volume 1: The Liver Source: Philadelphia, PA: Current Medicine. 1996. [200 p.]. Contact: Available from Current Medicine. 400 Market Street, Suite 700, Philadelphia, PA 19106. (800) 427-1796 or (215) 574-2266. Fax (215) 574-2270. E-mail:
[email protected]. Website: current-medicine.com. PRICE: $125.00 plus shipping and handling. ISBN: 1878132784. Summary: This atlas is one in an 8-volume collection of images that pictorially displays the gastrointestinal tract, liver, biliary tree, and pancreas in health and disease, both in children and adults. This volume includes 14 chapters on the liver. Several chapters deal with the major manifestations of liver disease, providing reviews of jaundice, portal hypertension, hepatic encephalopathy, ascites, hepatorenal syndrome, and spontaneous bacterial peritonitis. The spectrum of manifestations of hepatitis (viral, autoimmune, and drug induced) is interwoven throughout the book. In addition, there is a comprehensive discussion of the problems attendant to the development of acute liver failure. The various causes of acute and chronic hepatitis are covered in depth and Hepatitis B and hepatitis C receive individual attention in separate chapters. The spectrum of drug-induced liver disease and the mechanisms by which drug-related liver injuries develop (and can be detected or prevented) is discussed. Liver disease caused by copper and iron receive special attention as do those disorders predominantly affecting the hepatic vasculature or the parnechyma in the form of abscesses or cysts. The volume describes tumors of the liver, once considered therapeutically hopeless, with emphasis on recently acquired information regarding the pathogenic roles of hepatitis B, hepatitis C, iron, and environmental toxins. The book includes a status report evaluating the roles of hepatic resection and transplantation as treatments for tumors. The last chapter of the book covers liver transplantation. The format of the atlas is visual images supported by relatively brief text. Tables, charts, diagrams, and photomicrographs are used extensively.
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Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones Source: New York, NY: Oxford University Press. 1992. 227 p. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This book offers advice on how to take care of and avoid a whole complex of disturbances categorized as indigestion. The author begins with an overview of the anatomy and physiology of digestion, including a chapter on terminology and definitions. After an additional chapter on diagnostic testing, the author turns to specific problems, including acid related problems (heartburn, esophagitis, and hiatal hernia), peptic ulcers, nonulcer dyspepsia, chest pain, gallbladder problems and gallstones, pancreatic diseases, jaundice, malabsorption and maldigestion, food intolerance and food allergies, the impact of aging on the upper digestive tract (including the role of medications and drug interactions), and the brain gut connection. The appendices of the book offer coverage of related problems, including belching, nausea and vomiting, dry mouth and bitter taste, difficulty in tasting, lump in the throat, butterflies, difficulties in
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swallowing, delayed stomach emptying, the effects of diabetes on the upper digestive system, and the controversy over yeast. The author hopes to foster a cooperative dialogue between patients and their physicians as they work together to diagnose and manage upper digestive tract problems. A subject index concludes the book. 8 figures. 6 tables. •
Gastrointestinal and Hepatobiliary Pathophysiology Source: Madison, CT: Fence Creek Publishing. 1998. 475 p. Contact: Available from Blackwell Science, Inc. 350 Main Street, Malden, MA 02148. (800) 215-1000 or (781) 388-8250. Fax (781) 388-8270. E-mail:
[email protected]. Website: www.blackwellscience.com. PRICE: $27.95 plus shipping and handling. ISBN: 1889325015. Summary: This book on gastrointestinal and hepatobiliary pathophysiology is one from a series designed to meet the second and third year medical students' needs for a concise but comprehensive resource that focuses on organ system pathophysiology. The test covers the pathogenesis, diagnosis, treatment, and management of common diseases, using a format that includes one or more clinical cases integrated throughout the chapters to foster direct application of clinical problem solving skills; extensive use of margin notes that concisely highlight important concepts, define key terms, and pinpoint clinical correlations; questions at the end of each chapter, using the NBME format, that offer a means for accurate self assessment; and wide margins to accommodate note taking by students as they study. Thirty chapters cover an overview of gastrointestinal and hepatobiliary function; regulation of the digestive system; the anatomy, histology, and embryology of the gastrointestinal tract; an overview of gastrointestinal motility; gastrointestinal electrolyte and fluid secretion; digestion and absorption; management of water and electrolytes; liver anatomy and physiology; liver metabolism, physiology of bile formation, and gallstones; normal and disordered swallowing; peptic ulcer disease; small bowel disorders; acute and chronic pancreatitis; functional bowel disorders; the mucosal immune system; inflammatory bowel disease; infectious disorders of the gastrointestinal tract; viral hepatitis; hereditary liver disease; autoimmune liver disease; pathogenesis and consequences of portal hypertension; disorders of cholestasis, bilirubin metabolism, and jaundice; orthotopic liver transplantation; alcohol and the gastrointestinal tract; the pathophysiology of abdominal pain and pain syndromes; gastrointestinal disorders in pregnancy; the molecular biology of gastrointestinal malignancies and overview of neoplasms of the gastrointestinal tract; pharmacology; principles of nutritional support in the gastrointestinal patient; and gastrointestinal bleeding. A subject index concludes the textbook.
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Handbook of Liver Disease Source: Philadelphia, PA: Churchill-Livingstone. 1998. 534 p. Contact: Available from W.B. Saunders Company. Book Order Fulfillment Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522. Fax (800) 874-6418. Email:
[email protected]. PRICE: $73.00 plus shipping and handling. ISBN: 0443055203. Summary: This comprehensive handbook in outline format offers easy access to information on the full range of liver disorders, and covers symptoms, signs, differential diagnoses, and treatments. A total of 34 chapters cover the following topics: assessment of liver function and diagnostic studies, acute liver failure, chronic viral hepatitis, acute
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viral hepatitis, autoimmune hepatitis, alcoholic liver disease, fatty liver and nonalcoholic steatohepatitis, drug induced and toxic liver disease, cirrhosis and portal hypertension, portal hypertension and gastrointestinal bleeding, ascites and spontaneous bacterial peritonitis, hepatorenal syndrome, hepatic encephalopathy, primary biliary cirrhosis, primary sclerosing cholangitis, hemochromatosis, Wilson's disease and related disorders, alpha 1 antitrypsin deficiency and other metabolic liver diseases, Budd Chiari syndrome and other vascular disorders, the liver in heart failure, the liver in pregnancy, the liver in systemic disease, pediatric liver disease, liver disease in the elderly, HIV and the liver, granulomatous liver disease, hepatic tumors, hepatic abscesses and cysts, other infections involving the liver, surgery in the patient with liver disease and postoperative jaundice, liver transplantation, cholelithiasis and cholecystitis, diseases of the bile ducts, and tumors of the biliary tract. The book features lists that summarize key information and numerous figures and tables on topics such as acetaminophen toxicity, classifications of chronic hepatitis, and indications for liver transplantation. Each chapter was written by an acknowledged expert in the field and includes references for additional study. A subject index concludes the volume. •
Clinical Practice of Gastroenterology. Volume Two Source: Philadelphia, PA: Current Medicine. 1999. 861 p. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2). Summary: This lengthy textbook brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. This second volume includes 113 chapters in five sections: liver, gallbladder and biliary tract, pancreas, pediatric gastroenterology, and special topics. Specific topics include hepatic (liver) structure and function, jaundice, viral hepatitis, alcoholic liver injury, liver tumors, parasitic diseases of the liver, Wilson's disease, hemochromatosis, the pregnancy patient with liver disease, portal hypertension, hepatic encephalopathy, fulminant hepatic failure, liver transplantation, the anatomy of the gallbladder and biliary tract, gallstones, laparoscopic cholecystectomy (gallbladder removal), cholecystitis (gallbladder infection), primary sclerosing cholangitis, biliary obstruction, pancreatic anatomy and physiology, acute pancreatitis, pancreatic fistulas and ascites (fluid accumulation), chronic pancreatitis, cancer of the pancreas, endoscopic retrograde cholangiopancreatography, esophageal atresia, gastroesophageal reflux in infants and children, achalasia and esophageal motility disorders, caustic and foreign body ingestion, vomiting, chronic abdominal pain, gastritis and peptic ulcer disease in children, malabsorption syndromes in children, inflammatory bowel disease in children and adolescents, acute appendicitis, cystic fibrosis, constipation and fecal soiling (incontinence), hepatitis in children, liver transplantation in children, failure to thrive, pediatric AIDS, the gastrointestinal manifestations of AIDS, the evaluation and management of acute upper gastrointestinal bleeding, principles of endoscopy, eating disorders, nutritional assessment, enteral and parenteral nutrition, gastrointestinal diseases in the elderly and in pregnancy, nosocomial infections, and the psychosocial aspects of gastroenterology (doctor patient interactions). The chapters include figures, algorithms, charts, graphs, radiographs, endoscopic pictures, intraoperative photographs, photomicrographs, tables, and extensive references. The volume concludes with a detailed subject index and a section of color plates.
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Pediatric Gastrointestinal Disease. 2nd ed Source: Philadelphia, PA: W.B. Saunders Company. 1999. 823 p. Contact: Available from W.B. Saunders Company. Book Order Fulfillment Department, 11830 Westline Industrial Drive, Saint Louis, MO 63146-9988. (800) 545-2522 or (314) 4537010. Fax (800) 568-5136 or (314) 453-7095. E-mail:
[email protected]. Website: customerservice.wbsaunders.com. PRICE: $155.00 plus shipping and handling. ISBN: 0721674615. Summary: This medical textbook covers all facets of clinical pediatric gastrointestinal disease. The text emphasizes a clinical focus and incorporates anatomy and physiology considerations into each chapter rather than a separate section. The book is organized into distinct sections, starting with the common clinical problems and followed by organ specific diseases. General chapters on clinical problems cover chronic abdominal pain of childhood and adolescence, vomiting, diarrhea, constipation and encopresis (fecal soiling), failure to thrive, gastrointestinal hemorrhage, eating disorders and obesity, jaundice, ascites, caustic ingestion and foreign bodies, abdominal masses in pediatric patients, and abdominal surgical emergencies. Sections on diseases of the esophagus, stomach, and the small and large bowel (intestine) are followed by chapters reviewing the clinical facets of pediatric liver disease. Specific chapters include gastrointestinal reflux, achalasia and other motor disorders, congenital anomalies, gastric motility disorders, bezoars (a mass of food, hair or other components found in the stomach or intestine), maldigestion and malabsorption, celiac disease, short bowel syndrome, enteric parasites, Crohn's disease, ulcerative colitis, polyps, appendicitis, hernia, Hirschsprung's disease, neoplasms (cancerous and noncancerous), hepatitis, gallbladder diseases, and liver transplantation. The last two sections review diseases of the pancreas and basic nutrition in children, including pancreatitis, cystic fibrosis, nutritional assessment, parenteral (outside the digestive system, for example, intravenous nutrition) and enteral nutrition, and the management of diarrhea. Each chapter offers black and white photographs and figures and concludes with extensive references. A detailed subject index concludes the text.
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Diseases of the Liver and Biliary System. 10th ed Source: Oxford, England: Blackwell Science. 1997. 714 p. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail:
[email protected]. PRICE: $150.00. ISBN: 0865429065. Summary: This medical textbook presents a comprehensive account of diseases of the liver and biliary system, designed to be of use to physicians, surgeons and pathologists, and also as a reference text for the clinical student. Chapters cover anatomy and function; assessment of liver function; needle biopsy of the liver; the hematology of liver disease; ultrasound, computed tomography, and magnetic resonance imaging; hepatocellular failure; hepatic encephalopathy; fulminant hepatic failure; ascites; the portal venous system and portal hypertension; the hepatic artery and hepatic veins, i.e., the liver in circulatory failure; jaundice; cholestasis; primary biliary cirrhosis; sclerosing cholangitis; virus hepatitis; chronic hepatitis; drugs and the liver; hepatic cirrhosis; alcohol and the liver; iron overload states; Wilson's disease; nutritional and metabolic liver disease; the liver in infancy and childhood; the liver in pregnancy; the liver in systemic disease and hepatic trauma; the liver in infections; hepatic tumors, including hepato-cellular carcinoma; imaging of the biliary tract, including interventional radiology and endoscopy; cysts and congenital biliary abnormalities; gallstones and
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inflammatory gallbladder diseases; benign stricture of the bile ducts; diseases of the ampulla of Vater and pancreas; tumors of the gallbladder and bile ducts; and hepatic transplantation. The volume includes full color photographs, extensive reference lists with each chapter, and a detailed subject index. •
What to Do When Your Child Gets Sick Source: Whittier, CA: Institute for Healthcare Advancement. 1999. 181 p. Contact: Available from Institute for Healthcare Advancement. 15111 East Whittier Blvd., Suite 460, Whittier, CA 90603. (800) 434-4633. Fax (562) 907-1963. Website: www.iha4health.org. PRICE: $14.95 plus shipping and handling; bulk copies available. ISBN: 0828114404. Summary: This reference book uses simple everyday language and illustrations to provide information on common childhood illnesses and health problems. Written in nontechnical language designed to be accessible to adults at any reading level, the book features 11 topical chapters: safety tips, caring for the sick child, the newborn baby, the child's eyes, the child's ears and nose, the child's mouth and throat, the child's breathing, the child's stomach, bed wetting, the child's skin, and what to do when the child gets hurt. Topics related to digestive diseases include infection, jaundice, swallowing foreign objects, blood in the bowel movements, colic, constipation, diarrhea, food allergies, hernia, spitting up, stomach pain, vomiting, and poisoning. The book features extensive illustrations, with topics simplified to key points on each page. The book's content is simplified through the use of short, active sentences and single syllable words where appropriate. For most of the topics, the book follows a similar style covering a definition (what is it?), symptoms (what do I see?), how to care for the child (what can I do at home?), how to know when to call the doctor or nurse, and further information (what else should I know about this condition?). The book concludes with a word list (a glossary of terms), a subject index, and a list of acknowledgments. The book is available in either Spanish or English.
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Liver Disorders Sourcebook Source: Detroit, MI: Omnigraphics. 2000. 591 p. Contact: Available from Omnigraphics, Inc. 615 Griswold, Detroit, MI 48226. (800) 2341340. Fax (800) 875-1340. PRICE: $78.00 plus shipping and handling. ISBN: 0780802403. Summary: This Sourcebook provides basic health care information about liver functions, guidelines for liver health, and tests that assess liver distress. The book also presents the symptoms, treatments, and preventive measures available for liver cancer; hepatitis A, B, C, D and E; genetically based liver diseases; and other liver diseases. The liver transplantation process is explained. Specific topics include strategies for protecting the liver, risk factors, common laboratory tests in liver disease, liver biopsy, cancer tumor markers, cirrhosis (scarring of the liver), infectious agents and parasites, pregnancy and the liver, jaundice in the healthy newborn, the liver's response to drugs, alcohol and the liver, acetaminophen, herbs and alternative medicine, galactosemia, Gaucher disease, hereditary hemochromatosis, Niemann-Pick disease, Wilson's disease, biliary atresia, cystic disease of the liver, fatty liver, gallstones, primary biliary cirrhosis, primary sclerosing cholangitis, organ donation, and the bioartificial liver. A glossary, a directory of organizations and support groups with up to date contact information (including websites and email addresses), a listing of transplant centers, and a subject index conclude the volume.
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Pediatric Clinical Gastroenterology. 4th ed Source: St. Louis, MO: Mosby-Year Book, Inc. 1995. 1065 p. Contact: Available from Mosby-Year Book, Inc. 11830 Westline Industrial Drive. St. Louis, MO 63146. (800) 426-4545 or (800) 325-4177 or (314) 872-8370. Fax (314) 432-1380. PRICE: $100 (as of 1995). ISBN: 0815174063. Summary: This textbook of pediatric clinical gastroenterology presents 37 chapters in 5 sections: symptoms and signs; diseases of the gastrointestinal tract; diseases of the liver; diseases of the pancreas; and nutritional support. Specific topics include gastrointestinal (GI) emergencies of the neonate; intestinal obstruction; sucking and swallowing disorders; diseases of the esophagus; disorders of the stomach and duodenum; diarrheal disorders; carbohydrate intolerance; malabsorption syndrome; protein losing gastroenteropathy; immune homeostasis and the gut; inflammatory bowel diseases; constipation, fecal incontinence, and proctologic conditions; functional recurrent abdominal pain; parasitic and fungal disease of the GI tract; neonatal unconjugated hyperbilirubinemias; neonatal hepatitis; prolonged obstructive jaundice; acute and chronic viral hepatitis; bacterial, rickettsial, and parasitic infections and infestations; fulminant hepatic failure and hepatic coma; cirrhosis; portal hypertension; inborn errors of metabolism; hepatic tumors; liver transplantation; congenital anomalies and heredity disorders; cystic fibrosis; pancreatitis and pancreatic tumors; energy and nutrient requirements; infant feeding; and enteral and parenteral alimentation. Each chapter includes numerous references and a subject index concludes the volume.
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Endoscopic Retrograde Cholangiopancreatography: Technique, Diagnosis, and Therapy Source: New York, NY: Raven Press, Ltd. 1992. 426 p. Contact: Available from Raven Press. 1185 Avenue of the Americas, Dept. 5B, New York, NY 10036. (800) 777-2836 or (212) 930-9500. Fax (212) 869-3495. PRICE: $167 plus shipping (as of 1995). Summary: This volume is an up-to-date review of the procedure of endoscopic retrograde cholangiopancreatography (ERCP). The author brings together the disciplines of radiology and endoscopy by presenting endoscopic techniques and findings along with a compendium of radiographs that contain the key elements of interpretation. Three sections (technique, diagnosis, and therapeutic endoscopy) present 14 chapters covering an introduction and history of ECRP; indications, contraindications, and preparation; endoscopic technique; radiologic interpretation of the normal biliary system and variations and the normal pancreatic duct and variations; intrahepatic cholestasis; extrahepatic cholestasis (obstructive jaundice); periampullary findings; advantages and limitations of endoscopic manometry of the Sphincter of Oddi; inflammatory, congenital, and malignant pancreatic disorders; techniques for biliary and pancreatic endoscopic sphincterotomy; stone extraction, lithotripsy, stents and stones; decompression techniques of nasobiliary catheters and endoprostheses; cholangiopancreatoplasty; and the newer techniques of intraluminal radiation, bipolar sphincterotomy, and cholangioscopy. A detailed subject index is included.
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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 “jaundice” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “jaundice” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “jaundice” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Bile Pigments and Jaundice: Molecular, Metabolic, and Medical Aspects (Liver: Normal Function and Disease Series, Vol 4) by J. Donald Ostrow (Editor); ISBN: 0824774280; http://www.amazon.com/exec/obidos/ASIN/0824774280/icongroupinterna
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Jaundice (Bailliere's Clinical Gastroenterology) by Bouchier; ISBN: 0702013471; http://www.amazon.com/exec/obidos/ASIN/0702013471/icongroupinterna
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Jaundice : [proceedings of the second international symposium of the Canadian Hepatic Foundation, held in Montreal, May 31 and June 1, 1974]; ISBN: 0306348020; http://www.amazon.com/exec/obidos/ASIN/0306348020/icongroupinterna
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Judging the judges : the cause, control, and cure of judicial jaundice by David Stein; ISBN: 0682480738; http://www.amazon.com/exec/obidos/ASIN/0682480738/icongroupinterna
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Neonatal Jaundice (Monographs in Clinical Pediatrics) by M. Jeffrey Maisels (Editor), Jon F. Watchko (Editor); ISBN: 9057026260; http://www.amazon.com/exec/obidos/ASIN/9057026260/icongroupinterna
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Neonatal Jaundice: New Trends in Phototherapy by Firmino F. Rubaltelli, Giulio Jori (Editor); ISBN: 0306416697; http://www.amazon.com/exec/obidos/ASIN/0306416697/icongroupinterna
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Phototherapy Treating Neonatal Jaundice by Klaus Jahrig (Author); ISBN: 3861281139; http://www.amazon.com/exec/obidos/ASIN/3861281139/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 “jaundice” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 10
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created
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A clinical and experimental study of bile pigments in jaundice. Author: Hoffman, Harry Natt,; Year: 1817; [Minneapolis] 1957
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A study of the blood lipids and their relationship to jaundice and hepatic disease. Author: Morton, Paul Vanderhoff,; Year: 1963; [Minneapolis] 1946
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An essay on the jaundice: in which the propriety of using the Bath waters in that disease, and also in some particular affections of the liver, is considered Author: Corp, William,; Year: 1972; Bath: Printed by R. Cruttwell, and sold by C. Dilly, London, and by the booksellers of Bath and Bristol, 1785
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Anemia in obstructive and intra-hepatic jaundice; a clinical study of one hundred eight cases. Author: Jordan, Ferdinand Michael,; Year: 1817; [Minneapolis] 1929
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Bile pigments of jaundice. Author: Whitcomb, Fred F.,; Year: 1949; [Minneapolis] 1960
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Clinical approach to jaundice. Author: Schiff, Leon,; Year: 1968; Springfield, Ill., Thomas [c1954]
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Differential diagnosis of jaundice. Author: Ingelfinger, Franz J. (Franz Josef),; Year: 1955; Chicago, Year Book Publishers, 1958
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Jaundice during pregnancy: with special emphasis on recurrent jaundice during pregnancy and its differential diagnosis. Author: Haemmerli, Urs,; Year: 1967; New York, Springer [c1967]
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Jaundice in pregnancy, a clinical study. [Tr. from the Swedish]. Author: Thorling, Leif.; Year: 1967; Uppsala, 1955
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Radiological investigation in jaundice. Author: Marions, O. (Olle); Year: 1962; Stockholm, 1974
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Spirochaetal jaundice, by G. Buchanan. Author: Buchanan, George.; Year: 1974; London, H. M. Stationery off., 1927
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The differential diagnosis of jaundice. Author: Schiff, Leon,; Year: 1958; Chicago, Year book publishers [1946]
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The Jaundiced patient Author: Raymond, Howard W.,; Year: 1969; New York: Grune; Stratton, 1980
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The liver in jaundice Author: Legg, J. Wickham (John Wickham),; Year: 1952; London: H.K. Lewis, 1874
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The thymol and Hanger reactions in the etiological diagnosis of jaundice. Author: Tallroth, Allan.; Year: 1965; Uppsala, 1949
Chapters on Jaundice In order to find chapters that specifically relate to jaundice, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and jaundice 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 “jaundice” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on jaundice:
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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Approach to the Patient with Jaundice Source: in Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 911-928. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-6423. Fax: (301) 223-2400. Website: www.lww.com. PRICE: $289.00. ISBN: 781728614. Summary: Jaundice (icterus) is the yellow discoloration of the skin, sclera, and mucous membranes, caused by the excessive accumulation of bilirubin pigments. Cholestasis (reduced bile flow) results in the accumulation of conjugated bilirubin, bile salts, and cholesterol in the blood. This chapter on the approach to patients with jaundice is from a lengthy, two-volume textbook that integrates the various demands of science, technology, expanding information, good judgment, and common sense into the diagnosis and management of gastrointestinal patients. The authors note that a review of the causes and management of jaundice logically begins with a clear understanding of bilirubin, its clearance through the liver, and its subsequent excretion into the biliary tree and gastrointestinal tract. The optimal approach to the patient with jaundice demands precise localization of the site of disordered bilirubin handling and appropriate tests. The chapter concludes with a discussion of the complications of cholestasis, which can include pruritus (itching), hepatic osteodystrophy, and fat-soluble vitamin deficiency. 3 figures. 4 tables. 125 references.
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Renal Dysfunction and Postoperative Renal Failure in Obstructive Jaundice Source: in Arroyo, V., et al, eds. Ascites and Renal Dysfunction in Liver Disease: Pathogenesis, Diagnosis, and Treatment. Malden, MA: Blackwell Science, Inc. 1999. p.7998. Contact: Available from Blackwell Science, Inc. 350 Main Street, Malden, MA 02148. (800) 215-1000 or (781)-388-8250. Fax (781) 388-8270. E-mail:
[email protected]. Website: www.blackwellscience.com. PRICE: $125.00 plus shipping and handling. ISBN: 0632043423. Summary: Patients with obstructive jaundice (OJ) have an increased risk for a wide array of postoperative complications, namely, bleeding, infections, poor wound healing, and kidney (renal) failure. The three major consequences of biliary obstruction: immunosuppression, malnutrition, and hemodynamic (blood flow) disturbances, are all implicated in the pathogenesis of these complications. This chapter on kidney dysfunction and postoperative kidney failure in OJ is from a textbook on ascites and renal dysfunction in liver disease. The author reviews evidence linking biliary obstruction with kidney dysfunction, emphasizing the pathogenesis (development) of this association according to the most recent experimental and clinical data. This knowledge will improve the perioperative care of patients with obstructive jaundice. The author notes that prevention of perioperative kidney dysfunction is best achieved by accurate monitoring of fluid replacement and diuresis, and avoidance of all potentially nephrotoxic drugs, particularly aminoglycoside antibiotics. Preoperative internal biliary drainage, coupled with appropriate rehydration and metabolic support, appears to be a promising adjunct for improving the condition of patients with OJ, particularly of those with severe hyperbilirubinemia, sepsis, or advanced malnutrition. 5 figures. 9 tables. 75 references.
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Disorders of Cholestasis, Bilirubin Metabolism, and Jaundice Source: in Rose, S. Gastrointestinal and Hepatobiliary Pathophysiology. Malden, MA: Blackwell Science, Inc. 1998. p. 327-334. Contact: Available from Blackwell Science, Inc. 350 Main Street, Malden, MA 02148. (800) 215-1000 or (781) 388-8250. Fax (781) 388-8270. E-mail:
[email protected]. Website: www.blackwellscience. PRICE: $26.00 plus shipping and handling. Summary: This chapter on disorders of cholestasis, bilirubin metabolism, and jaundice is from a textbook that focuses on the pathophysiologic basis of gastrointestinal and hepatobiliary (liver and biliary tract) diseases while encouraging an integrative, problem-solving approach. The chapter begins with a list of learning objectives and an illustrative case study, then covers definitions of each of the three disorders; bile synthesis and secretion; the consequences of alterations in bile secretion; extrahepatic (outside the liver) and intrahepatic (inside the liver) cholestasis and their causes; and disorders of bilirubin metabolism and excretion. The chapter concludes with a follow up to the case study, a list of review questions, and the answers to the review questions, with brief explanations. 3 tables. 2 references.
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Jaundice: Where Does the Yellow Come from, Where Does the Yellow Go? Source: in Janowitz, H.D. Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones. New York, NY: Oxford University Press. 1992. p. 147-152. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This chapter on jaundice is from a book that offers advice on how to take care of and avoid the whole complex of disturbances categorized as indigestion. Jaundice refers to the yellow color of the skin and the whites of the eye that results from the presence of the pigment bilirubin (this is the pigment that gives bile its yellow green color). The process of removing bilirubin goes on all the time, but when larger amounts of bilirubin are formed or the machinery for removing it breaks down, the blood level rises and the pigment gets deposited all over the body. Recognition of jaundice depends simply on someone observing that an individual's skin and eyes are yellow; sometimes the urine is darkened or the stools appear lighter. The author emphasizes the importance of verifying the diagnosis of jaundice, both to determine the underlying cause and to alleviate the symptoms of jaundice, which can include intense itching (pruritus). Also reviewed are the causes of jaundice, a condition called Gilbert's syndrome, and diagnostic considerations. Jaundice due to obstruction requires prompt action. The author briefly discusses the medications that may be used to relieve the severe itching of jaundice while the underlying condition is being treated.
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CHAPTER 7. MULTIMEDIA ON JAUNDICE Overview In this chapter, we show you how to keep current on multimedia sources of information on jaundice. 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.
Video Recordings An excellent source of multimedia information on jaundice is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “jaundice” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, 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 “Videorecording (videotape, videocassette, etc.).” Type “jaundice” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on jaundice: •
Alternatives in the Management of the Jaundiced Patient Source: Atlanta, GA: Emory University Office of Medical Television. 1994. (videocassette). Contact: Available from Robert W. Woodruff Health Sciences Center, Emory University. Office of Medical Television, 1364 Clifton Road, Box M-16, Atlanta, GA 30322. (404) 7279797. Fax (404) 727-9798. PRICE: $75.00 (as of 1996). Also available for rental; contact producer for current fee. Item Number 94-05. Summary: In this continuing education videotape, Dr. David Feliciano familiarizes surgeons and internists with the specific characteristics and management approaches to the benign and malignant causes of surgical jaundice. He stresses that surgeons and internists have significantly different diagnostic approaches to jaundice. Alternatives include the laboratory tests, the use of ultrasound or CT to detect ductal dilatation, and the use of transhepatic cholangiogram or ERCP to differentiate between hilar and extrahepatic obstruction. (AA-M).
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Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, 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 “Sound Recordings.” Type “jaundice” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on jaundice: •
AIDS Update Contact: California Medical Association, Audio Digest Foundation, 1577 E Chevy Chase Dr, Glendale, CA, 91206, (213) 245-8505. Summary: This soundrecording contains the transcripts of talks given to update physicians on AIDS and the practice of gastroenterology. The first speaker, Dr. John Cello, discusses the equipment, supplies, and universal endoscopy precautions used at the University of California San Francisco School of Medicine. He then discusses esophageal complaints, hepatic parenchymal disease, biliary tract disease, AIDS-related diarrhea, and therapies for each. Dr. Friedman's talk concerns gastrointestinal (GI) tract manifestations of HIV disease. It covers diarrhea and its etiologic agents; dysphagia/odynophagia; jaundice, hepatomegaly, or abnormal liver function; and their causative agents. The last speaker, Dr. Steven Wexner, discusses anorectal involvement in HIV disease. He describes Kaposi's sarcoma rectal lesions; HSV-2; Herpes proctitis; lumbosacral radiculopathy syndrome; anal carcinoma; and perianal sepsis. The cassette is accompanied by pre- and post-tests.
Bibliography: Multimedia on Jaundice 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 jaundice (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 jaundice: •
A Diagnostic approach to the jaundiced patient [slide] Source: University of Michigan Medical Center, Independent Study Unit, Department of Postgraduate Medicine and Health Professions Education; Year: 1973; Format: Slide; Ann Arbor: The University: [for loan or sale by its Medical Center Media Library], c1973
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Acute and chronic cholecystitis; The jaundiced patient [slide] Source: Bernard Suster, Lucy Frank Squire; Year: 1985; Format: Slide; Gracie Station, N.Y., N.Y.: Programmed Seminars Incorporated, [1985]
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Alternatives in the management of the jaundiced patient [videorecording] Source: [presented by] the Emory Medical Television Network, Emory University School of Medicine of the Robert W. Woodruff Health Sciences Center; Year: 1993; Format: Videorecording; Atlanta, GA: Emory University, c1993
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Cholecystectomy and common bile duct exploration for obstructive jaundice [videorecording] Source: Videosurgery; Year: 1978; Format: Videorecording; Don Mills, Ont.: Southam Business Publications, c1978
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Endoscopic vs. percutaneous imaging of the biliary tree in jaundice [videorecording] Source: presented by Department of Medicine, Emory University, School of Medicine; Year: 1982; Format: Videorecording; Atlanta, Ga.: Emory Medical Television Network, 1982
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Hepatic transport and jaundice [slide] Source: authors, J. Donald Ostrow, Paul D. Berk; produced by American Gastroenterological Association; Year: 1989; Format: Slide; [Bethesda, Md.]: The Association, c1989
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Hepatobiliary disease and jaundice [slide] Source: [authors, Caroline A. Riely. et al.]; Year: 1989; Format: Slide; [Bethesda, Md.]: American Gastroenterological Association, c1989
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Jaundice [slide] Source: Robert M. Glickman, J. Thomas LaMont; Year: 1975; Format: Slide; New York: Medcom, c1975
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Jaundice [videorecording] Source: produced by Medical Educational Resources Program, Indiana University, School of Medicine; Year: 1981; Format: Videorecording; Indianapolis, Ind.: The Program, 1981
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Jaundice and ultrasound [slide] Source: American Institute of Ultrasound in Medicine; Year: 1980; Format: Slide; [Bethesda, Md.]: The Institute, [1980]
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Jaundice in the newborn [slide] Source: developed at an NMAC Workshop under the auspices of The Audiovisual Committee of the Association of Medical School Pediatric Department Chairmen; Year: 1973; Format: Slide; Atlanta: National Medical Audiovisual Center, 1973
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Jaundice, medical or surgical? [motion picture] Source: a production of WGBH-TV; by Franz Ingelfinger and William McDermott; presented by the Bingham Associates Fund, with the cooperation of the Postgraduate Medical Institute; Year: 1969; Format: Motion picture; [United States]: National Medical Audiovisual Center, [1969]
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Jaundice, the ultrasound approach [videorecording] Source: a presentation of the Radiology Dept., University of Calif., Medical Center, San Diego, in cooperation with the Office of Learning Resources, School of Medicine, University of Calif., San Diego; [produ; Year: 1979; Format: Videorecording; San Diego, Calif.: The Dept., [1979]
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Mechanical small bowel obstruction [sound recording]; Obstructive jaundice Source: American College of Surgeons; Year: 1977; Format: Sound recording; [Chicago]: The College, [1977]
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Mechanisms and differential diagnosis of jaundice [slide] Source: American Gastroenterological Association; Year: 1974; Format: Slide; [Thorofare, N. J.]: The Association, 1974
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Neonatal problems, jaundice [slide]. Year: 1978; Format: Slide; [Birmingham, Ala.]: Uuniversity of Alabama School of Medicine, University of Alabama in Birmingham, c1978
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Obstructive jaundice [sound recording]: its diverse causes and surgical remedies Source: American College of Surgeons; Year: 1976; Format: Sound recording; Chicago, Ill.: The College, c1976
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Obstructive jaundice [videorecording] Source: [presented by] Audio-Video Digest Foundation, in collaboration with the University of California, San Francisco, School of Medicine; sponsored and produced by Extended Programs in Medical Education, School of Medic; Year: 1981; Format: Videorecording; [California]: Regents of the University of California, c1981
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Radiological methods in evaluation of obstructive jaundice [videorecording] Source: WRAMC Television; Year: 1977; Format: Videorecording; Washington: WRAMC-TV, [1977]
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Surgical jaundice [sound recording]: a panel discussion Source: American College of Surgeons; Year: 1980; Format: Sound recording; [Chicago]: The College, [1980]
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The Jaundiced patient [videorecording] Source: Mayo; produced by the Section of Photography and Audiovisual Center; Year: 1975; Format: Videorecording; [Rochester, Minn.]: Mayo Clinic, c1975
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CHAPTER 8. PERIODICALS AND NEWS ON JAUNDICE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover jaundice.
News Services and Press Releases One of the simplest ways of tracking press releases on jaundice 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 “jaundice” (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 jaundice. 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 “jaundice” (or synonyms). The following was recently listed in this archive for jaundice: •
Chinese tea ingredient may help newborn jaundice Source: Reuters Health eLine Date: March 27, 2003
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SpectRx sells BiliChek jaundice monitor line to Respironics Source: Reuters Industry Breifing Date: March 07, 2003
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Jaundiced newborns need immediate attention Source: Reuters Health eLine Date: June 14, 2001
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SpectRx infant jaundice monitor receives expanded FDA approval Source: Reuters Industry Breifing Date: March 22, 2001
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Jaundice an indicator of serious hepatic injury in patients with typhoid fever Source: Reuters Medical News Date: March 29, 1999
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Neonatal jaundice index lowered with casein-hydrolysate formulas Source: Reuters Medical News Date: February 17, 1999
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Short Stay Doesn't Up Baby Jaundice Source: Reuters Health eLine Date: May 27, 1997
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Early Neonatal Discharge Not Associated With Jaundice Source: Reuters Medical News Date: May 23, 1997
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Neonatal Jaundice, Insulin Resistance And More Discussed At Pediatric Research Society Meeting Source: Reuters Medical News Date: May 09, 1995 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 “jaundice” (or synonyms) into the search box, and click on “Search News.” As this service is technology
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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 “jaundice” (or synonyms). If you know the name of a company that is relevant to jaundice, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “jaundice” (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 “jaundice” (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 jaundice: •
Sjogren's Syndrome and the Gastrointestinal Tract Source: Moisture Seekers Newsletter. 17(2): 1, 4-5. March 1999. Contact: Available from Sjogren's Syndrome Foundation, Inc. 8120 Woodmont Avenue, Suite 530, Bethesda, MD 20814-1437. (301) 718-0300 or (800) 475-6473. Fax (301) 718-0322. Website: www.sjogrens.org. Summary: This article on Sjogren's syndrome (SS) and the gastrointestinal tract is from a patient education newsletter for people with SS. The author outlines the areas where the gastroenterologist may play a role in caring for the person with SS, such as dealing with swallowing difficulties, dyspepsia (indigestion), diarrhea, and jaundice (usually due to primary biliary cirrhosis, or scarring). Difficulty in swallowing is usually due to the lack of saliva associated with SS, but occasionally it may be due to a blockage (postcricoid web) or a weakness of the muscle contractions involved in swallowing. In addition, those patients with SS are vulnerable to acid reflux, which causes heartburn symptoms. Children with SS are prone to achalasia, a type of muscle problem involving the lower esophageal sphincter. Dyspepsia (indigestion) is relatively common in patients with SS, as is inflammation of the stomach (gastritis). The author briefly discusses the role of the bacterium Helicobacter pylori in gastritis. There are at least two diseases associated with
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SS and diarrhea: chronic pancreatitis and celiac disease (gluten intolerance). The author notes that the link between SS and gastroenterological conditions is often via abnormal autoantibodies. •
Liver Tests: Simple Blood Tests Can Reveal a Lot Source: Mayo Clinic Health Letter. 18(5): 1-3. May 2000. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037 or (303) 604-1465. Summary: This article, from a health newsletter, reviews the liver function tests that are used to monitor liver health and disease. The author begins by reviewing the healthy functions of the liver, including regulating the composition of the blood, manufacturing vital nutrients (such as cholesterol, vitamin A, certain proteins, bile), and neutralizing toxic substances. Sometimes there is an obvious sign of a problem, such as jaundice, which is a buildup of bilirubin in the blood, resulting in a yellow appearance of the skin and eyes. The various liver tests basically screen for three types of abnormalities: liver cell damage, reduced protein levels in the blood, and failure to eliminate certain substances from the blood. Information from the blood tests, combined with a thorough physical exam and sometimes diagnostic imaging, may be enough to reach a specific diagnosis; sometimes a liver biopsy is added to the list of diagnostic tests. Some of the more common liver disorders that are detected with these tests are viral hepatitis, alcohol or drug related liver disease, liver cancer, nonalcoholic steatohepatitis (a form of fatty liver), and hemochromatosis (high amounts of iron stored in the body). One sidebar reviews the drugs that can lead to liver toxicity. The author concludes that mild liver test abnormalities are normal; however, significantly abnormal test results should never be ignored. 1 figure.
Academic Periodicals covering Jaundice Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to jaundice. In addition to these sources, you can search for articles covering jaundice that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for jaundice. 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 nonprofit 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 jaundice. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to jaundice: Hepatitis A Vaccine Inactivated •
Systemic - U.S. Brands: Havrix; Vaqta http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202902.html
Hepatitis B Vaccine Recombinant •
Systemic - U.S. Brands: Engerix-B http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202281.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
11
These publications are typically written by one or more of the various NIH Institutes.
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•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
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
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
12
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.
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•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The 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 “jaundice” 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 “jaundice” (or synonyms) into the “For these words:” box. The following is a sample result: •
Prunella Vulgaris (Heal - All) Contact: AIDS Project Los Angeles, 3550 Wilshire Blvd Ste 300, Los Angeles, CA, 900102404, (213) 201-1600, http://www.apla.org. Summary: This packet is a compilation of material on Prunella vulgaris (Heal-All), a creeping plant that grows in northern China, northern Europe, and North America. It is used in China to treat jaundice, swollen glands, minor wounds, and other conditions. A research team in Davis, California has reportedly isolated an anti-HIV compound, Prunellin, from the plant. Prunella extracts have also been found with antiviral activity against Herpes. A reprint from a botanical journal describes the plant, its common names, properties and uses, and the proper preparation and dosage. The packet also contains an annotated literature search.
•
Adult T-Cell Leukemia Associated With Human T-Lymphotropic Virus Type I (HTLV-I) Infection - North Carolina Source: Morbidity and Mortality Weekly Report; Vol. 36, no. 49. Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Massachusetts Medical Society, Medical Publishing Group, CSPO Box 9121, Waltham, MA, 02254, (800) 843-6356. Summary: This report contains epidemiologic notes and reports related to adult T-Cell Leukemia/Lymphoma associated with Human T-cell lymphotropic virus type I (HTLV I) infection in North Carolina. The article focuses on a patient who developed jaundice in December 1986 after several weeks of anorexia, fatigue, and fever. The patient's history throughout hospitalization is then reported.
•
Fatal and Severe Hepatitis Associated with Rifampin and Pyrazinamide for the Treatment of Latent Tuberculosis Infection--New York and Georgia, 2000 Source: Morbidity and Mortality Weekly Report Weekly Apr 20 2001;50(15):289-291. Summary: This report presents two case reports to illustrate that the two-month regimen of rifampin (RIF) and pyrazinamide (PZA) for the treatment of latent tuberculosis infection (LBTI) can cause severe hepatitis in some people. The first case is
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that of a 53-year-old incarcerated man who was treated with 600 mg RIF and 1750 mg PZA daily while receiving treatment for hypertension. The patient died of liver necrosis and failure as a result of hepatitis following LTBI treatment. The second case is that of a 59-year-old woman who received 600 mg RIF and 2000 mg PZA for LTBI. She was also receiving treatment for nasal allergies and asthma and had a history of anaphylactic reactions to penicillin and an estrogen sulfates blend. On the 49th and last day of treatment this patient was admitted to a hospital because of jaundice and altered mental states. After treatment with 40 mg prednisone daily, the patient recovered. In these cases biochemical monitoring did not help avoid liver injury. The report advises that patients with LTBI and risk factors for active TB should be offered treatment and should receive instruction and reminders about the symptoms of hepatitis and of stopping medication if symptoms develop. Cases of severe hepatitis that develop in patients being treated for LTBI should be reported to the CDC. •
Practice Parameter: Management of Hyperbilirubinemia in the Healthy Term Newborn: Technical Report Source: Elk Grove Village, IL: American Academy of Pediatrics. 1994. 66 p. Contact: Available from American Academy of Pediatrics. Publications Department, 141 Northwest Point Boulevard, P.O. Box 927, Elk Grove Village, IL 60009-0927. (800) 4339016 or (708) 228-5005. Fax (708) 228-1281. PRICE: $9.95 (members) or $14.95 (nonmembers) plus $4.75 shipping and handling (as of 1996). Item Number AC0019. ISBN: 0910761698. Summary: This technical report supports the practice parameter for evaluating and treating neonatal hyperbilirubinemia. The first part of the report presents evidence pertaining to the incidence of brain damage caused by hyperbilirubinemia in healthy term neonates. Specific topics in the practice parameter are discussed in the next section, including the estimated impact of the practice parameter, phototherapy, difficulties with measuring bilirubin levels, and the impact of breast-feeding. The remainder of the report consists of detailed summaries of recent literature (1989 to 1993) on healthy jaundiced infants. 2 tables. 135 references.
The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “jaundice” (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.
14 15
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 25276 391 853 62 3 26585
HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “jaundice” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
16
Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.
17
The HSTAT URL is http://hstat.nlm.nih.gov/.
18
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. 19 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 20
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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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 Jaundice In the following section, we will discuss databases and references which relate to the Genome Project and jaundice. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “jaundice” (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 jaundice: •
Dysmyelination with Jaundice Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?224250
•
Jaundice, Familial Obstructive, of Infancy Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?308600 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 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
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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
•
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:
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3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
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Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
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NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
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Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
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OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
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Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
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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 “jaundice” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. 23
Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html.
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The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “jaundice” (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 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 jaundice 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 jaundice. 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 jaundice. 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 “jaundice”:
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•
Other guides Cirrhosis http://www.nlm.nih.gov/medlineplus/cirrhosis.html Hepatitis http://www.nlm.nih.gov/medlineplus/hepatitis.html Hepatitis B http://www.nlm.nih.gov/medlineplus/hepatitisb.html Hepatitis C http://www.nlm.nih.gov/medlineplus/hepatitisc.html Infant and Toddler Health http://www.nlm.nih.gov/medlineplus/infantandtoddlerhealth.html Liver Diseases http://www.nlm.nih.gov/medlineplus/liverdiseases.html
Within the health topic page dedicated to jaundice, the following was listed: •
General/Overviews Liver: A Primer Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1004&view_records=1 What Are the Diseases That Affect the Liver? Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1043&view_records=1
•
Diagnosis/Symptoms ERCP (Endoscopic Retrograde Cholangiopancreatography) Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/ercp/index.htm Liver Biopsy Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/liverbiopsy/index.htm Liver-Spleen Scan Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/liverspleen.pdf TIBC (Total Iron-Binding Capacity) & Transferrin Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/tibc/test.html Ultrasound-Abdomen Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/ultrasound-abdomen.htm
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Treatment FDA Approves Drug to Treat Rare Pediatric Liver Disease Source: Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2002/ANS01131.html Interventional Treatments for Liver Disease Source: Society of Interventional Radiology http://www.sirweb.org/patPub/liverDisease.shtml Shunt Surgical Procedures Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1057&view_records=1
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Nutrition Diet and Your Liver Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1022&view_records=1
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Specific Conditions/Aspects Chemical and Drug Induced Liver Injury Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1056&view_records=1 Cystic Disease of the Liver Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1045&view_records=1 Enlarged Liver (Hepatomegaly) Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00624 Kava-Containing Dietary Supplements May Be Associated with Severe Liver Injury Source: Center for Food Safety and Applied Nutrition http://www.cfsan.fda.gov/%7Edms/addskava.html Liver Disease and Diabetes Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00193 Primary Sclerosing Cholangitis Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/primarysclerosingcholangitis/ind ex.htm What Are the Myths Vs. Facts About Alcohol and the Liver? Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1009&view_records=1
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What is NAFLD/NASH? (Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis) Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1027&view_records=1 Zellweger Syndrome Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/zellwege_doc.htm •
Children Alagille Syndrome Source: Children's Liver Association for Support Services http://www.classkids.org/library/alagille.htm Blood Tests: Why Your Child Needs All Those Sticks Source: Children's Liver Association for Support Services http://www.classkids.org/library/bloodtest.htm Galactosemia Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1046&view_records=1 Jaundice in Healthy Newborns Source: Nemours Foundation http://kidshealth.org/parent/pregnancy_newborn/common/jaundice.html Kernicterus - General Information Source: National Center on Birth Defects and Developmental Disabilities http://www.cdc.gov/ncbddd/dd/kernicterus.htm Type I Glycogen Storage Disease Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1053&view_records=1 Tyrosinemia Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1052&view_records=1
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Men Pregnancy and the Liver Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1078&view_records=1
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Organizations American Liver Foundation http://www.liverfoundation.org/
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Children's Liver Association for Support Services http://www.classkids.org/ National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ •
Prevention/Screening 50 Ways to Love Your Liver Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1021&view_records=1 Albumin Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/albumin/test.html ALP (Alkaline Phosphatase) Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/alp/test.html ALT (Alanine Aminotransferase) Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/alt/test.html Bilirubin Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/bilirubin/test.html Liver Panel Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/liver_panel/glance.html
•
Research Acute Liver Failure in the United States Source: American College of Physicians http://www.annals.org/cgi/content/full/137/12/I-24 Liver Disease in Persons with Asymptomatic Hepatitis C Virus Infection Source: American College of Physicians http://www.annals.org/cgi/content/full/137/12/I-36 New AHRQ Report Says More Research Is Needed to Help Clinicians Better Manage Jaundice in Newborns Source: Agency for Healthcare Research and Quality http://www.ahrq.gov/news/press/pr2003/jaundpr.htm Oral Administration of an Antibiotic (Norfloxacin) May Help Treat the Cardiac and Circulatory Complications of Liver Failure Source: American College of Physicians http://www.annals.org/cgi/content/full/139/3/I-62
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•
Statistics FASTATS: Chronic Liver Disease/Cirrhosis Source: National Center for Health Statistics http://www.cdc.gov/nchs/fastats/liverdis.htm Hepatitis and Liver Diseases in the United States Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1008&view_records=1
•
Women Pregnancy and the Liver Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1078&view_records=1
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 jaundice. 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: •
Treating Jaundice in Healthy Newborns: Guidelines for Parents Source: Elk Grove Village, IL: American Academy of Pediatrics. 1995. 2 p. Contact: Available from American Academy of Pediatrics. Publications Department, 141 Northwest Point Boulevard, P.O. Box 927, Elk Grove Village, IL 60009-0927. (800) 4339016 or (708) 228-5005. Fax (708) 228-1281. PRICE: Single copy free; $24.95 for 100 copies (AAP members), $29.95 for 100 copies (nonmembers). Item Number HE0182. Summary: This parent education brochure, from the American Academy of Pediatrics, focuses on jaundice in healthy newborns. Written in a question and answer format, the brochure covers a definition of jaundice; a description of bilirubin and how it is created; complications of jaundice; how to know if a baby has jaundice; treatment options, including light therapy and more frequent feedings; and coping with potential problems with jaundice that may require temporary interruption of breastfeeding. The brochure reassures parents that jaundice in healthy newborns is not serious and usually clears up.
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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 “jaundice” (or synonyms). The following was recently posted: •
ACR Appropriateness Criteria™ or imaging strategies in the evaluation of the jaundiced patient Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2399&nbr=1625&a mp;string=jaundice 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: •
Hemochromatosis Summary: This fact sheet presents a general overview on Hemochromatosis -- a hereditary disease with symptoms that include fatigue, abdominal pain, jaundice (yellowing of skin and eyes), and a change in skin Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=994 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 jaundice. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMD®Health: http://my.webmd.com/health_topics
Associations and Jaundice The following is a list of associations that provide information on and resources relating to jaundice: •
Parents of Infants and Children with Kernicterus Telephone: (205) 979-2021 Fax: (205) 975-7928 Email:
[email protected] Web Site: http://www.PICKonline.org Background: The mission of Parents of Infants and Children with Kernicterus is to prevent kernicterus and trace its causes, provide information and support to families, identify effective therapies and treatment, and seek out and fund promising research. Kernicterus is a rare neurological disorder that affects newborn infants of both sexes in equal numbers. It occurs more often in premature infants, and is characterized by hyperbilirubinemia (excessive levels of bilirubin in the blood) during infancy. Bilirubin is a byproduct of the natural breakdown of hemoglobin in red blood cells. Established in 2001, this voluntary organization provides services to patients and their families, health professionals, and the general public. Relevant area(s) of interest: Jaundice
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to jaundice. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with jaundice. 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 jaundice. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797.
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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 “jaundice” (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 “jaundice”. 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 “jaundice” (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 “jaundice” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.25
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
25
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)26: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
26
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
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 jaundice: •
Basic Guidelines for Jaundice Jaundice-associated conditions Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000210.htm
•
Signs & Symptoms for Jaundice Hepatomegaly Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003275.htm Jaundice Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003243.htm Liver enlargement Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003275.htm Yellow skin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003243.htm
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•
Diagnostics and Tests for Jaundice Bilirubin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003479.htm Liver function tests Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003436.htm
•
Background Topics for Jaundice Bile Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002237.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 Sclera Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002295.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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JAUNDICE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 3-dimensional: 3-D. A graphic display of depth, width, and height. Three-dimensional radiation therapy uses computers to create a 3-dimensional picture of the tumor. This allows doctors to give the highest possible dose of radiation to the tumor, while sparing the normal tissue as much as possible. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Cramps: Abdominal pain due to spasmodic contractions of the bowel. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adenocarcinoma: A malignant 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
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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] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] 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] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]
Agarose: A polysaccharide complex, free of nitrogen and prepared from agar-agar which is produced by certain seaweeds (red algae). It dissolves in warm water to form a viscid solution. [NIH] Ageing: A physiological or morphological change in the life of an organism or its parts, generally irreversible and typically associated with a decline in growth and reproductive vigor. [NIH] Aggravation: An increasing in seriousness or severity; an act or circumstance that intensifies, or makes worse. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU]
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Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acid Substitution: The naturally occurring or experimentally induced replacement of one or more amino acids in a protein with another. If a functionally equivalent amino acid is substituted, the protein may retain wild-type activity. Substitution may also diminish or eliminate protein function. Experimentally induced substitution is often used to study enzyme activities and binding site properties. [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] Amitriptyline: Tricyclic antidepressant with anticholinergic and sedative properties. It appears to prevent the re-uptake of norepinephrine and serotonin at nerve terminals, thus potentiating the action of these neurotransmitters. Amitriptyline also appears to antaganize cholinergic and alpha-1 adrenergic responses to bioactive amines. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of
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organic materials during a large number of metabolically important reactions. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [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] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] 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]
Anaphylactic: Pertaining to anaphylaxis. [EU] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory 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] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [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] Anode: Electrode held at a positive potential with respect to a cathode. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] 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] 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]
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Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] 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] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] 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] Antispasmodic: An agent that relieves spasm. [EU] Antithrombotic: Preventing or interfering with the formation of thrombi; an agent that so acts. [EU] Antitoxin: A purified antiserum from animals (usually horses) immunized by injections of a toxin or toxoid, administered as a passive immunizing agent to neutralize a specific bacterial toxin, e.g., botulinus, tetanus or diphtheria. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Aneurysm: Aneurysm of the aorta. [NIH]
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Apnea: A transient absence of spontaneous respiration. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginase: A ureahydrolase that catalyzes the hydrolysis of arginine or canavanine to yield L-ORNITHINE and urea. Deficiency of this enzyme causes hyperargininemia. EC 3.5.3.1. [NIH]
Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arterial embolization: The blocking of an artery by a clot of foreign material. This can be done as treatment to block the flow of blood to a tumor. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteriovenous Fistula: An abnormal communication between an artery and a vein. [NIH] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Ascitic Fluid: The serous fluid which accumulates in the peritoneal cavity in ascites. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atresia: Lack of a normal opening from the esophagus, intestines, or anus. [NIH]
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Atrial: Pertaining to an atrium. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] 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] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune Hepatitis: A liver disease caused when the body's immune system destroys liver cells for no known reason. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]
Axillary Vein: The venous trunk of the upper limb; a continuation of the basilar and brachial veins running from the lower border of the teres major muscle to the outer border of the first rib where it becomes the subclavian vein. [NIH] Azithromycin: A semi-synthetic macrolide antibiotic structurally related to erythromycin. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Translocation: The passage of viable bacteria from the gastrointestinal tract to extra-intestinal sites, such as the mesenteric lymph node complex, liver, spleen, kidney, and blood. Factors that promote bacterial translocation include overgrowth with gram-negative enteric bacilli, impaired host immune defenses, and injury to the intestinal mucosa resulting
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in increased intestinal permeability. These mechanisms can act in concert to promote synergistically the systemic spread of indigenous translocating bacteria to cause lethal sepsis. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Base Sequence: The sequence of purines and pyrimidines in nucleic acids and polynucleotides. It is also called nucleotide or nucleoside sequence. [NIH] Belching: Noisy release of gas from the stomach through the mouth. Also called burping. [NIH]
Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Bezoars: Concretions of swallowed hair, fruit or vegetable fibers, or similar substances found in the alimentary canal. [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] 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 Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Atresia: Atresia of the biliary tract, most commonly of the extrahepatic bile ducts. [NIH]
Biliary Stricture: A narrowing of the biliary tract from scar tissue. The scar tissue may result from injury, disease, pancreatitis, infection, or gallstones. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biliverdine: 1,3,6,7-Tetramethyl-4,5-dicarboxyethyl-2,8-divinylbilenone. Biosynthesized from hemoglobin as a precursor of bilirubin. Occurs in the bile of amphibia and of birds, but
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not in normal human bile or serum. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] 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] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [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 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 Flow Velocity: A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. [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 Fluids: Liquid components of living organisms. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH]
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Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breast Feeding: The nursing of an infant at the mother's breast. [NIH] Butterflies: Slender-bodies diurnal insects having large, broad wings often strikingly colored and patterned. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caesarean section: A surgical incision through the abdominal and uterine walls in order to deliver a baby. [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-Binding Proteins: Proteins to which calcium ions are bound. They can act as transport proteins, regulator proteins or activator proteins. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] 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]
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Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [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] Cardiovascular: Having to do with the heart and blood vessels. [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] 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] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Caustic: An escharotic or corrosive agent. Called also cauterant. [EU] Celiac Artery: The arterial trunk that arises from the abdominal aorta and after a short course divides into the left gastric, common hepatic and splenic arteries. [NIH] 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 Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellular Structures: Components of a cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH]
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Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [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] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [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] Chemotherapy: Treatment with anticancer drugs. [NIH] Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholangitis: Inflammation of a bile duct. [NIH] Cholecalciferol: An antirachitic oil-soluble vitamin. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Choledochal Cyst: A congenital cystic dilatation of the common bile duct; this condition may be asymptomatic, or cause vomiting, fever, jaundice, or pain in the right upper quadrant. [NIH] Cholelithiasis: Presence or formation of gallstones. [NIH] Choleretic: A choleretic agent. [EU] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [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] Cholic Acid: A major primary bile acid produced in the liver and usually conjugated with glycine or taurine. It facilitates fat absorption and cholesterol excretion. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH]
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Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Codon: A set of three nucleotides in a protein coding sequence that specifies individual amino acids or a termination signal (codon, terminator). Most codons are universal, but some organisms do not produce the transfer RNAs (RNA, transfer) complementary to all codons. These codons are referred to as unassigned codons (codons, nonsense). [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [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] Common Bile Duct: The largest biliary duct. It is formed by the junction of the cystic duct and the hepatic duct. [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
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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] Complementation: The production of a wild-type phenotype when two different mutations are combined in a diploid or a heterokaryon and tested in trans-configuration. [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 machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is
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exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]
Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [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 Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpuscle: A small mass or body; a sensory nerve end bulb; a cell, especially that of the
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blood or the lymph. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cryptosporidiosis: Parasitic intestinal infection with severe diarrhea caused by a protozoan, Cryptosporidium. It occurs in both animals and humans. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyanosis: A bluish or purplish discoloration of the skin and mucous membranes due to an increase in the amount of deoxygenated hemoglobin in the blood or a structural defect in the hemoglobin molecule. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyst: A sac or capsule filled with fluid. [NIH] Cystic Duct: The tube that carries bile from the gallbladder into the common bile duct and the small intestine. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] 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] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also
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sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Dehydrocholic Acid: A semisynthetic bile acid made from cholic acid. It is used as a cholagogue, hydrocholeretic, diuretic, and as a diagnostic aid. [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] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastolic: Of or pertaining to the diastole. [EU] 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] Dihydrotestosterone: Anabolic agent. [NIH] Dihydroxy: AMPA/Kainate antagonist. [NIH]
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Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dimerization: The process by which two molecules of the same chemical composition form a condensation product or polymer. [NIH] Diphtheria: A localized infection of mucous membranes or skin caused by toxigenic strains of Corynebacterium diphtheriae. It is characterized by the presence of a pseudomembrane at the site of infection. Diphtheria toxin, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects. [NIH] Diphtheria Antitoxin: An antitoxin used for the treatment of diphtheria. It is of equine origin and produced against the toxin of Corynebacterium diphtheriae. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [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] Diuretic: A drug that increases the production of urine. [NIH] Diurnal: Occurring during the day. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] 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] Duct: A tube through which body fluids pass. [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] Dysentery: Any of various disorders marked by inflammation of the intestines, especially of the colon, and attended by pain in the abdomen, tenesmus, and frequent stools containing blood and mucus. Causes include chemical irritants, bacteria, protozoa, or parasitic worms. [EU]
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Dyslexia: Partial alexia in which letters but not words may be read, or in which words may be read but not understood. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]
Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]
Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [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] 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] Embryology: The study of the development of an organism during the embryonic and fetal stages of life. [NIH]
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Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Encopresis: Incontinence of feces not due to organic defect or illness. [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] Endocytosis: Cellular uptake of extracellular materials within membrane-limited vacuoles or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]
Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopic retrograde cholangiopancreatography: ERCP. A procedure to x-ray the pancreatic duct, hepatic duct, common bile duct, duodenal papilla, and gallbladder. In this procedure, a thin, lighted tube (endoscope) is passed through the mouth and down into the first part of the small intestine (duodenum). A smaller tube (catheter) is then inserted through the endoscope into the bile and pancreatic ducts. A dye is injected through the catheter into the ducts, and an x-ray is taken. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [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-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxemia: A condition characterized by the presence of endotoxins in the blood. If endotoxemia is the result of gram-negative rod-shaped bacteria, shock may occur. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [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]
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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] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Epidemics: A period of increased prevalence of a particular disease in a population. [NIH] Epidemiologic Factors: Events, characteristics, or other definable entities that have the potential to bring about a change in a health condition or other defined outcome. [NIH] Epidemiological: Relating to, or involving epidemiology. [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] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] ERCP: Endoscopic retrograde cholangiopancreatography (en-do-SKAH-pik RET-ro-grade ko-LAN-jee-o-PAN-kree-a-TAW-gra-fee). A procedure to x-ray the bile and pancreatic ducts. In this procedure, a thin, lighted tube (endoscope) is passed through the mouth and down into the first part of the small intestine (duodenum). A smaller tube (catheter) is then inserted through the endoscope into the bile and pancreatic ducts. A dye is injected through the catheter into the ducts, and an x-ray is taken. [NIH] Erythrocyte Membrane: The semipermeable outer portion of the red corpuscle. It is known as a 'ghost' after hemolysis. [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] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Atresia: Congenital failure of the full esophageal lumen to develop that commonly occurs with tracheoesophageal fistula. Symptoms include excessive salivation, gagging, cyanosis, and dyspnea. [NIH] Esophageal Motility Disorders: Disorders affecting the motor function of the upper or lower esophageal sphincters, the esophageal body, or a combination of these parts. The failure of the sphincters to maintain a tonic pressure may result in the impeding of the passage of food, regurgitation of food, or reflux of gastric acid into the esophagus. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [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
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from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estrogen: One of the two female sex hormones. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excipient: Any more or less inert substance added to a prescription in order to confer a suitable consistency or form to the drug; a vehicle. [EU] Excrete: To get rid of waste from the body. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] 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] Extracorporeal: Situated or occurring outside the body. [EU] Extraction: The process or act of pulling or drawing out. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] 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] Faecal: Pertaining to or of the nature of feces. [EU] Failure to Thrive: A condition in which an infant or child's weight gain and growth are far below usual levels for age. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, 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] Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH]
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Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fine-needle aspiration: The removal of tissue or fluid with a needle for examination under a microscope. Also called needle biopsy. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Flavoxate: A drug that has been used in various urinary syndromes and as an antispasmodic. Its therapeutic usefulness and its mechanism of action are not clear. It may have local anesthetic activity and direct relaxing effects on smooth muscle as well as some activity as a muscarinic antagonist. [NIH] Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Fraud: Exploitation through misrepresentation of the facts or concealment of the purposes of the exploiter. [NIH] Fulminant Hepatic Failure: Liver failure that occurs suddenly in a previously healthy person. The most common causes of FHF are acute hepatitis, acetaminophen overdose, and liver damage from prescription drugs. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Galactosemia: Buildup of galactose in the blood. Caused by lack of one of the enzymes needed to break down galactose into glucose. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the
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gallbladder or bile ducts. [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] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]
Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastritis: Inflammation of the stomach. [EU] Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system. [NIH] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal Hemorrhage: Bleeding in the gastrointestinal tract. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [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]
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Gene Fusion: Fusion of structural genes to analyze protein behavior or fusion of regulatory sequences with structural genes to determine mechanisms of regulation. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [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] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] 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] Glucuronate: Salt of glucuronic acid. [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] Glucuronides: Glycosides of glucuronic acid formed by the reaction of uridine diphosphate glucuronic acid with certain endogenous and exogenous substances. Their formation is important for the detoxification of drugs, steroid excretion and bilirubin metabolism to a more water-soluble compound that can be eliminated in the urine and bile. [NIH] Glucuronosyltransferase: A family of enzymes accepting a wide range of substrates, including phenols, alcohols, amines, and fatty acids. They function as drug-metabolizing enzymes that catalyze the conjugation of UDPglucuronic acid to a variety of endogenous and exogenous compounds. EC 2.4.1.17. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glutamine: A non-essential amino acid present abundantly throught the body and is involved in many metabolic processes. It is synthesized from glutamic acid and ammonia. It is the principal carrier of nitrogen in the body and is an important energy source for many
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cells. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Gonadal: Pertaining to a gonad. [EU] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Granulomas: Small lumps in tissues caused by inflammation. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemolysis: Disruption of the integrity of the red cell membrane causing release of haemoglobin. Haemolysis may be caused by bacterial haemolysins, by antibodies that cause complement-dependent lysis, by placing red cells in a hyptonic solution, or by defects in the red cell membrane. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Helminthiasis: Infestation with parasitic worms of the helminth class. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For
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example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemochromatosis: A disease that occurs when the body absorbs too much iron. The body stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hemoglobin M: A group of abnormal hemoglobins in which amino acid substitutions take place in either the alpha or beta chains but near the heme iron. This results in facilitated oxidation of the hemoglobin to yield excess methemoglobin which leads to cyanosis. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [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] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatic: Refers to the liver. [NIH] Hepatic Artery: A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum. [NIH] Hepatic Duct, Common: Predominantly extrahepatic bile duct which is formed by the junction of the right and left hepatic ducts, which are predominantly intrahepatic, and, in turn, joins the cystic duct to form the common bile duct. [NIH] Hepatic Encephalopathy: A condition that may cause loss of consciousness and coma. It is usually the result of advanced liver disease. Also called hepatic coma. [NIH] Hepatic Veins: Veins which drain the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH]
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Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatobiliary: Pertaining to the liver and the bile or the biliary ducts. [EU] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatocyte: A liver cell. [NIH] Hepatology: The field of medicine concerned with the functions and disorders of the liver. [NIH]
Hepatoma: A liver tumor. [NIH] Hepatomegaly: Enlargement of the liver. [NIH] Hepatorenal Syndrome: Renal failure in those with liver disease, usually liver cirrhosis or obstructive jaundice. Historically called Heyd disease, urohepatic syndrome, or bile nephrosis. [NIH] Hepatotoxicity: How much damage a medicine or other substance does to the liver. [NIH] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [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]
Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histiocytosis: General term for the abnormal appearance of histiocytes in the blood. Based on the pathological features of the cells involved rather than on clinical findings, the histiocytic diseases are subdivided into three groups: Langerhans cell histiocytosis, nonLangerhans cell histiocytosis, and malignant histiocytic disorders. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH]
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Host: Any animal that receives a transplanted graft. [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] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Bonding: A low-energy attractive force between hydrogen and another element. It plays a major role in determining the properties of water, proteins, and other compounds. [NIH]
Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] 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] Hyperemesis: Excessive vomiting. [EU] 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] Hypertension, Portal: Abnormally increased pressure in the portal venous system; frequently seen in cirrhosis of the liver and in other conditions which cause obstruction of the portal vein. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] 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] Icterus: Jaundice. [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] Ileus: Obstruction of the intestines. [EU]
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Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immaturity: The state or quality of being unripe or not fully developed. [EU] Immune function: Production and action of cells that fight disease or infection. [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] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] 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] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] 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] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] 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] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus,
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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] 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]
Information Centers: Facilities for collecting and organizing information. They may be specialized by subject field, type of source material, persons served, location, or type of services. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inoculum: The spores or tissues of a pathogen that serve to initiate disease in a plant. [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] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intestinal: Having to do with the intestines. [NIH] Intestinal Obstruction: Any impairment, arrest, or reversal of the normal flow of intestinal
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contents toward the anus. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intrahepatic: Within the liver. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ion Transport: The movement of ions across energy-transducing cell membranes. Transport can be active or passive. Passive ion transport (facilitated diffusion) derives its energy from the concentration gradient of the ion itself and allows the transport of a single solute in one direction (uniport). Active ion transport is usually coupled to an energy-yielding chemical or photochemical reaction such as ATP hydrolysis. This form of primary active transport is called an ion pump. Secondary active transport utilizes the voltage and ion gradients produced by the primary transport to drive the cotransport of other ions or molecules. These may be transported in the same (symport) or opposite (antiport) direction. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iridium: A metallic element with the atomic symbol Ir, atomic number 77, and atomic weight 192.22. [NIH] Irritants: Drugs that act locally on cutaneous or mucosal surfaces to produce inflammation; those that cause redness due to hyperemia are rubefacients; those that raise blisters are vesicants and those that penetrate sebaceous glands and cause abscesses are pustulants; tear gases and mustard gases are also irritants. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Isozymes: The multiple forms of a single enzyme. [NIH] 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]
Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage.
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Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Lamivudine: A reverse transcriptase inhibitor and zalcitabine analog in which a sulfur atom replaces the 3' carbon of the pentose ring. It is used to treat HIV disease. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Laparotomy: A surgical incision made in the wall of the abdomen. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Learning Disorders: Conditions characterized by a significant discrepancy between an individual's perceived level of intellect and their ability to acquire new language and other cognitive skills. These disorders may result from organic or psychological conditions. Relatively common subtypes include dyslexia, dyscalculia, and dysgraphia. [NIH] Leptospirosis: Infections with bacteria of the genus Leptospira. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [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] Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal tract and the immune system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
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Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Lightness: The attribute of visual sensation in accordance with which a body seems to transmit or reflect diffusely a greater or smaller fraction of the incident light. [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] Lipid: Fat. [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] Lipodystrophy: A collection of rare conditions resulting from defective fat metabolism and characterized by atrophy of the subcutaneous fat. They include total, congenital or acquired, partial, abdominal infantile, and localized lipodystrophy. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] Lipoxygenase: An enzyme of the oxidoreductase class that catalyzes reactions between linoleate and other fatty acids and oxygen to form hydroperoxy-fatty acid derivatives. Related enzymes in this class include the arachidonate lipoxygenases, arachidonate 5lipoxygenase, arachidonate 12-lipoxygenase, and arachidonate 15-lipoxygenase. EC 1.13.11.12. [NIH] Lithotripsy: The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is laser lithotripsy. [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 Circulation: The circulation of blood through the vessels of the liver. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Liver metastases: Cancer that has spread from the original (primary) tumor to the liver. [NIH]
Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localization: The process of determining or marking the location or site of a lesion or
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disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]
Luciferase: Any one of several enzymes that catalyze the bioluminescent reaction in certain marine crustaceans, fish, bacteria, and insects. The enzyme is a flavoprotein; it oxidizes luciferins to an electronically excited compound that emits energy in the form of light. The color of light emitted varies with the organism. The firefly enzyme is a valuable reagent for measurement of ATP concentration. (Dorland, 27th ed) EC 1.13.12.-. [NIH] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphadenitis: Inflammation of the lymph nodes. [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] Lymphoblastic: One of the most aggressive types of non-Hodgkin lymphoma. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in
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clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Manometry: Tests that measure muscle pressure and movements in the GI tract. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Megestrol: 17-Hydroxy-6-methylpregna-3,6-diene-3,20-dione. A progestational hormone used most commonly as the acetate ester. As the acetate, it is more potent than progesterone both as a progestagen and as an ovulation inhibitor. It has also been used in the palliative treatment of breast cancer. [NIH] Megestrol Acetate: A drug that belongs to the group of hormones called progestins, used as hormone therapy to block estrogen and to suppress the effects of estrogen and androgens. [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]
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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] Mental Health: The state wherein the person is well adjusted. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [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] Metalloporphyrins: Porphyrins which are combined with a metal ion. The metal is bound equally to all four nitrogen atoms of the pyrrole rings. They possess characteristic absorption spectra which can be utilized for identification or quantitative estimation of porphyrins and porphyrin-bound compounds. [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] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microsomal: Of or pertaining to microsomes : vesicular fragments of endoplasmic reticulum
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formed after disruption and centrifugation of cells. [EU] Mineralization: The action of mineralizing; the state of being mineralized. [EU] 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] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Probes: A group of atoms or molecules attached to other molecules or cellular structures and used in studying the properties of these molecules and structures. Radioactive DNA or RNA sequences are used in molecular genetics to detect the presence of a complementary sequence by molecular hybridization. [NIH] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] 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] Monotherapy: A therapy which uses only one drug. [EU] 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] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple Organ Failure: A progressive condition usually characterized by combined failure of several organs such as the lungs, liver, kidney, along with some clotting mechanisms, usually postinjury or postoperative. [NIH] Multivariate Analysis: A set of techniques used when variation in several variables has to
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be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [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] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myoglobin: A conjugated protein which is the oxygen-transporting pigment of muscle. It is made up of one globin polypeptide chain and one heme group. [NIH] 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] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [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] Needle biopsy: The removal of tissue or fluid with a needle for examination under a microscope. Also called fine-needle aspiration. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neonatal Hepatitis: Irritation of the liver with no known cause. Occurs in newborn babies.
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Symptoms include jaundice and liver cell changes. [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] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotoxic: Toxic or destructive to kidney cells. [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] Neuroblastoma: Cancer that arises in immature nerve cells and affects mostly infants and children. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuroma: A tumor that arises in nerve cells. [NIH] 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] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]
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] Neutrophil: A type of white blood cell. [NIH] Nevirapine: A potent, non-nucleoside reverse transcriptase inhibitor used in combination with nucleoside analogues for treatment of HIV infection and AIDS. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as
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acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Non-nucleoside: A member of a class of compounds, including delavirdine, loviride and nevirapine, that acts to directly combine with and block the action of HIV's reverse transcriptase. [NIH] Nonulcer Dyspepsia: Constant pain or discomfort in the upper GI tract. Symptoms include burning, nausea, and bloating, but no ulcer. Possibly caused by muscle spasms. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nosocomial: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Odynophagia: A painful condition of the esophagus. [NIH] Oligodendroglial: A cell that lays down myelin. [NIH] Oligodendroglioma: A rare, slow-growing tumor that begins in brain cells called oligodendrocytes, which provide support and nourishment for cells that transmit nerve impulses. Also called oligodendroglial tumor. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Omentum: A fold of the peritoneum (the thin tissue that lines the abdomen) that surrounds the stomach and other organs in the abdomen. [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]
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Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteitis Fibrosa Cystica: A fibrous degeneration, cyst formation, and the presence of fibrous nodules in bone, usually due to hyperparathyroidism. [NIH] Osteodystrophy: Defective bone formation. [EU] Osteomalacia: A condition marked by softening of the bones (due to impaired mineralization, with excess accumulation of osteoid), with pain, tenderness, muscular weakness, anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium. [EU]
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] Osteosclerosis: An abnormal hardening or increased density of bone tissue. [NIH] Overdosage: 1. The administration of an excessive dose. 2. The condition resulting from an excessive dose. [EU] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidative metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, cell respiration, or aerobic metabolism. [NIH] 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] Oximetry: The determination of oxygen-hemoglobin saturation of blood either by
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withdrawing a sample and passing it through a classical photoelectric oximeter or by electrodes attached to some translucent part of the body like finger, earlobe, or skin fold. It includes non-invasive oxygen monitoring by pulse oximetry. [NIH] Oxygenase: Enzyme which breaks down heme, the iron-containing oxygen-carrying constituent of the red blood cells. [NIH] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatic Ducts: Ducts that collect pancreatic juice from the pancreas and supply it to the duodenum. [NIH] Pancreatic Fistula: Abnormal passage communicating with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Pancytopenia: Deficiency of all three cell elements of the blood, erythrocytes, leukocytes and platelets. [NIH] Papilla: A small nipple-shaped elevation. [NIH] Paracentesis: A procedure in which fluid is withdrawn from a body cavity via a trocar and cannula, needle, or other hollow instrument. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parasitic Diseases: Infections or infestations with parasitic organisms. They are often contracted through contact with an intermediate vector, but may occur as the result of direct exposure. [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] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU]
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Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of depression. [NIH]
Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] 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] Penicillin: An antibiotic drug used to treat infection. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perianal: Located around the anus. [EU] 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]
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Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Perioperative Care: Interventions to provide care prior to, during, and immediately after surgery. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral stem cells: Immature cells found circulating in the bloodstream. New blood cells develop from peripheral stem cells. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] 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] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenobarbital: A barbituric acid derivative that acts as a nonselective central nervous system depressant. It promotes binding to inhibitory GABA subtype receptors, and modulates chloride currents through receptor channels. It also inhibits glutamate induced depolarizations. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorous: Having to do with or containing the element phosphorus. [NIH]
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Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] 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] Phototherapy: Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths. [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] 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 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 Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Poison Control Centers: Facilities which provide information concerning poisons and treatment of poisoning in emergencies. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together
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chemically. [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 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] Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein. [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] Postoperative: After surgery. [NIH] Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Pre-Eclampsia: Development of hypertension with proteinuria, edema, or both, due to pregnancy or the influence of a recent pregnancy. It occurs after the 20th week of gestation, but it may develop before this time in the presence of trophoblastic disease. [NIH] Pre-eclamptic: A syndrome characterized by hypertension, albuminuria, and generalized oedema, occurring only in pregnancy. [NIH]
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Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary Biliary Cirrhosis: A chronic liver disease. Slowly destroys the bile ducts in the liver. This prevents release of bile. Long-term irritation of the liver may cause scarring and cirrhosis in later stages of the disease. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Progeny: The offspring produced in any generation. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] 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] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring
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secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein 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 S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] 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] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] 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] 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 Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH]
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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]
Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyrazinamide: A pyrazine that is used therapeutically as an antitubercular agent. [NIH] Pyruvate Kinase: ATP:pyruvate 2-O-phosphotransferase. A phosphotransferase that catalyzes reversibly the phosphorylation of pyruvate to phosphoenolpyruvate in the presence of ATP. It has four isozymes (L, R, M1, and M2). Deficiency of the enzyme results in hemolytic anemia. EC 2.7.1.40. [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] 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] Radicular: Having the character of or relating to a radicle or root. [NIH] Radiculopathy: Disease involving a spinal nerve root (see spinal nerve roots) which may result from compression related to intervertebral disk displacement; spinal cord injuries; spinal diseases; and other conditions. Clinical manifestations include radicular pain, weakness, and sensory loss referable to structures innervated by the involved nerve root. [NIH]
Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays,
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gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Ranitidine: A non-imidazole blocker of those histamine receptors that mediate gastric secretion (H2 receptors). It is used to treat gastrointestinal ulcers. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] 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] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [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] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Rehydration: The restoration of water or of fluid content to a body or to substance which has become dehydrated. [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 Circulation: The circulation of the blood through the vessels of the kidney. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and
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progressive renal glomerular tubular or interstitial disease. [NIH] Renal Osteodystrophy: Decalcification of bone due to hyperparathyroidism secondary to chronic kidney disease. [NIH] Renal tubular: A defect in the kidneys that hinders their normal excretion of acids. Failure to excrete acids can lead to weak bones, kidney stones, and poor growth in children. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] 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 distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] 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] Rod: A reception for vision, located in the retina. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Salivation: 1. The secretion of saliva. 2. Ptyalism (= excessive flow of saliva). [EU]
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Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretin: A hormone made in the duodenum. Causes the stomach to make pepsin, the liver to make bile, and the pancreas to make a digestive juice. [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] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH]
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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] Seroconversion: The change of a serologic test from negative to positive, indicating the development of antibodies in response to infection or immunization. [EU] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] 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]
Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin Manifestations: Dermatologic disorders attendant upon non-dermatologic disease or injury. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol
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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] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spasmodic: Of the nature of a spasm. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., wounds, gunshot; whiplash injuries; etc.). [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Splanchnic Circulation: The circulation of blood through the vessels supplying the abdominal viscera. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenectomy: An operation to remove the spleen. [NIH] Splenic Vein: Vein formed by the union (at the hilus of the spleen) of several small veins from the stomach, pancreas, spleen and mesentery. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU]
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Spores: The reproductive elements of lower organisms, such as protozoa, fungi, and cryptogamic plants. [NIH] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Steatorrhea: A condition in which the body cannot absorb fat. Causes a buildup of fat in the stool and loose, greasy, and foul bowel movements. [NIH] Steatosis: Fatty degeneration. [EU] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Sterile: Unable to produce children. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclavian: The direct continuation of the axillary vein at the lateral border of the first rib. It passes medially to join the internal jugular vein and form the brachiocephalic vein on each side. [NIH] Subclavian Vein: The continuation of the axillary vein which follows the subclavian artery and then joins the internal jugular vein to form the brachiocephalic vein. [NIH] 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] 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] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfates: Inorganic salts of sulfuric acid. [NIH]
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Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sulfuric acid: A strong acid that, when concentrated is extemely corrosive to the skin and mucous membranes. It is used in making fertilizers, dyes, electroplating, and industrial explosives. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Tenesmus: Straining, especially ineffectual and painful straining at stool or in urination. [EU] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or
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intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [NIH] Thymoma: A tumor of the thymus, an organ that is part of the lymphatic system and is located in the chest, behind the breastbone. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Ticlopidine: Ticlopidine is an effective inhibitor of platelet aggregation. The drug has been found to significantly reduce infarction size in acute myocardial infarcts and is an effective antithrombotic agent in arteriovenous fistulas, aorto-coronary bypass grafts, ischemic heart disease, venous thrombosis, and arteriosclerosis. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [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] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Topical: On the surface of the body. [NIH] Toxemia: A generalized intoxication produced by toxins and other substances elaborated by an infectious agent. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH]
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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]
Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Tracheoesophageal Fistula: Abnormal communication between the esophagus and the trachea, acquired or congenital, often associated with esophageal atresia. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcutaneous: Transdermal. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translocating: The attachment of a fragment of one chromosome to a non-homologous chromosome. [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] Tropical Sprue: A condition of unknown cause. Abnormalities in the lining of the small intestine prevent the body from absorbing food normally. [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 marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] 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]
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Typhoid fever: The most important member of the enteric group of fevers which also includes the paratyphoids. [NIH] Typhoid fever: The most important member of the enteric group of fevers which also includes the paratyphoids. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Unresectable: Unable to be surgically removed. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]
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 not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Uridine Diphosphate: A uracil nucleotide containing a pyrophosphate group esterified to C5 of the sugar moiety. [NIH] Uridine Diphosphate Glucuronic Acid: A nucleoside diphosphate sugar which serves as a source of glucuronic acid for polysaccharide biosynthesis. It may also be epimerized to UDP iduronic acid, which donates iduronic acid to polysaccharides. In animals, UDP glucuronic acid is used for formation of many glucosiduronides with various aglycones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [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] Ursodeoxycholic Acid: An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of
Dictionary 217
chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Valerian: Valeriana officinale, an ancient, sedative herb of the large family Valerianaceae. The roots were formerly used to treat hysterias and other neurotic states and are presently used to treat sleep disorders. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] 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] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] VATER: A word made from the first letters of a group of birth defects. It is used when all of these birth defects affect the same child. The birth defects are [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] 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] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Viraemia: The presence of virus in blood or blood plasma. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Viral vector: A type of virus used in cancer therapy. The virus is changed in the laboratory and cannot cause disease. Viral vectors produce tumor antigens (proteins found on a tumor cell) and can stimulate an antitumor immune response in the body. Viral vectors may also
218 Jaundice
be used to carry genes that can change cancer cells back to normal cells. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitamin D: The vitamin that mediates intestinal calcium absorption, bone calcium metabolism, and probably muscle activity. It usually acts as a hormone precursor, requiring 2 stages of metabolism before reaching actual hormonal form. It is isolated from fish liver oils and used in the treatment and prevention of rickets. [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] Volvulus: A twisting of the stomach or large intestine. May be caused by the stomach being in the wrong position, a foreign substance, or abnormal joining of one part of the stomach or intestine to another. Volvulus can lead to blockage, perforation, peritonitis, and poor blood flow. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] War: Hostile conflict between organized groups of people. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Whipple: An intestinal lipodystrophy; occurs in men and usually is associated with arthritis, diarrhea, and fat malabsorption. [NIH] Whipple procedure: A type of surgery used to treat pancreatic cancer. The head of the pancreas, the duodenum, a portion of the stomach, and other nearby tissues are removed. [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] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] 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] Yellow Fever: An acute infectious disease primarily of the tropics, caused by a virus and transmitted to man by mosquitoes of the genera Aedes and Haemagogus. [NIH]
Dictionary 219
Yellow Fever Virus: The type species of the Flavivirus genus. Principal vector transmission to humans is by Aedes spp. mosquitoes. [NIH] Zalcitabine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication at low concentrations, acting as a chainterminator of viral DNA by binding to reverse transcriptase. Its principal toxic side effect is axonal degeneration resulting in peripheral neuropathy. [NIH] Zoonoses: Diseases of non-human animals that may be transmitted to man or may be transmitted from man to non-human animals. [NIH] Zygote: The fertilized ovum. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
221
INDEX 3 3-dimensional, 14, 157 A Abdomen, 140, 157, 165, 168, 174, 177, 185, 188, 189, 190, 197, 199, 201, 211, 212, 213, 218 Abdominal Cramps, 105, 157 Abdominal Pain, 105, 107, 108, 109, 111, 145, 157, 180, 192, 201, 216 Acceptor, 157, 190, 198 Acetaminophen, 108, 110, 157, 179 Acetylcholine, 157, 168, 197 Acquired Immunodeficiency Syndrome, 4, 157 Actin, 157, 195 Acuity, 66, 157 Acute lymphoblastic leukemia, 21, 29, 71, 157 Acute lymphocytic leukemia, 157 Acute renal, 14, 24, 36, 157, 183 Adenocarcinoma, 50, 52, 157, 184 Adenosine, 157, 202 Adenovirus, 8, 9, 158 Adolescence, 15, 109, 158 Adrenal Cortex, 158, 159, 172, 204 Adrenergic, 158, 159 Adverse Effect, 158, 210 Aetiology, 22, 39, 158 Afferent, 50, 59, 158, 211 Affinity, 158, 190, 211 Agar, 158 Agarose, 89, 158 Ageing, 100, 158 Aggravation, 51, 158 Albumin, 17, 25, 26, 143, 158, 202 Aldosterone, 104, 159 Algorithms, 108, 159, 165 Alimentary, 24, 159, 164, 176, 199, 200 Alkaline, 75, 143, 159, 166 Alkaline Phosphatase, 75, 143, 159 Allylamine, 159 Alpha Particles, 159, 206 Alpha-1, 159 Alternative medicine, 110, 122, 159 Amine, 92, 159, 184 Amino Acid Sequence, 159, 161, 181 Amino Acid Substitution, 159, 183
Amino Acids, 92, 159, 160, 162, 169, 177, 181, 200, 205, 213, 216 Amitriptyline, 34, 159 Ammonia, 159, 181, 216 Ampulla, 52, 104, 110, 160, 168, 176 Anaesthesia, 160, 186 Anal, 105, 118, 160, 178, 195 Anal Fissure, 105, 160 Analgesic, 157, 160 Analog, 160, 179, 189 Analogous, 8, 160, 215 Analytes, 140, 143, 160 Anaphylactic, 133, 160 Anaphylaxis, 160 Anatomical, 160, 163, 165, 168, 174, 186, 209 Androgens, 158, 160, 172, 192 Anemia, 15, 65, 76, 98, 113, 136, 160, 183, 192, 206 Aneurysm, 23, 41, 56, 59, 160, 161, 217 Angiotensinogen, 160, 208 Animal model, 6, 8, 9, 15, 160 Anions, 6, 14, 158, 160, 188, 210 Anode, 160 Anomalies, 109, 111, 160 Anorectal, 118, 160 Anorexia, 24, 36, 132, 160, 180, 198, 216 Antagonism, 97, 160 Antibacterial, 161, 211 Antibiotic, 24, 143, 160, 161, 163, 177, 200, 211 Antibodies, 161, 163, 182, 183, 186, 191, 206, 210 Antibody, 11, 158, 161, 169, 186, 187, 194, 206, 207, 211 Anticholinergic, 159, 161 Anticoagulant, 161, 205 Antidepressant, 159, 161 Antigen, 9, 158, 160, 161, 170, 181, 185, 186, 187 Anti-inflammatory, 24, 57, 157, 161, 172, 181, 203 Antimetabolite, 161, 179 Antineoplastic, 161, 172, 179 Antioxidant, 64, 161, 198 Antipyretic, 157, 161 Antispasmodic, 161, 179 Antithrombotic, 161, 214
222 Jaundice
Antitoxin, 161, 174 Antiviral, 11, 132, 161, 187 Anuria, 161, 189 Anus, 160, 161, 162, 166, 179, 188, 200, 207 Aorta, 161, 167, 217 Aortic Aneurysm, 29, 161 Apnea, 94, 162 Appendicitis, 108, 109, 162 Aqueous, 88, 162, 164, 185 Arachidonic Acid, 104, 162, 189, 204 Arginase, 92, 162 Arginine, 18, 92, 104, 162, 196 Arterial, 54, 104, 159, 162, 167, 185, 205, 213 Arterial embolization, 54, 162 Arteries, 161, 162, 165, 167, 171, 193, 214 Arterioles, 162, 165, 166, 193 Arteriosclerosis, 162, 214 Arteriovenous, 162, 193, 214 Arteriovenous Fistula, 162, 214 Ascites, 27, 65, 103, 104, 106, 108, 109, 114, 162 Ascitic Fluid, 104, 162 Aseptic, 9, 162, 198 Aspartic, 88, 162 Aspartic Acid, 88, 162 Aspiration, 162 Assay, 18, 162 Asymptomatic, 9, 11, 15, 143, 162, 168, 199 Ataxia, 136, 162, 213 Atresia, 5, 162, 164 Atrial, 104, 163 Atrium, 163, 217 Atrophy, 136, 163, 190 Atypical, 163, 187 Auditory, 6, 27, 64, 71, 163, 178 Autoantibodies, 124, 163 Autoantigens, 163 Autodigestion, 163, 199 Autoimmune Hepatitis, 108, 163 Autonomic, 157, 163, 197, 211, 213 Autonomic Nervous System, 163, 213 Autosuggestion, 163, 185 Axillary, 88, 163, 212 Axillary Vein, 88, 163, 212 Azithromycin, 19, 163 B Bacteremia, 92, 163 Bacterial Translocation, 72, 163 Bacterium, 123, 164, 171, 183 Basal Ganglia, 162, 164 Basal Ganglia Diseases, 162, 164
Base, 164, 172, 173, 181, 188, 189, 213, 216 Base Sequence, 164, 181 Belching, 106, 164 Benign, 3, 4, 104, 110, 117, 164, 167, 196, 206 Bezoars, 109, 164 Bile Acids, 164, 180, 212 Bile Acids and Salts, 164 Bile Ducts, 46, 74, 104, 108, 110, 164, 180, 204 Bile Pigments, 112, 113, 164, 188 Biliary Atresia, 5, 42, 60, 110, 164 Biliary Stricture, 48, 59, 164 Biliary Tract, 50, 104, 108, 109, 115, 118, 164, 166, 199 Biliverdine, 164 Biochemical, 4, 7, 8, 11, 25, 133, 161, 165, 189, 210 Biological response modifier, 165, 187 Biopsy, 104, 110, 124, 140, 165, 200 Biosynthesis, 162, 165, 216 Biotechnology, 18, 112, 122, 131, 135, 136, 137, 165 Bladder, 21, 40, 105, 165, 186, 190, 205, 216 Bloating, 165, 186, 192, 197 Blood Cell Count, 165, 182 Blood Coagulation, 165, 166, 214 Blood Flow Velocity, 94, 165 Blood Glucose, 165, 183 Blood Platelets, 165, 210, 214 Blood pressure, 165, 185, 194, 211 Blood vessel, 165, 167, 168, 176, 182, 183, 188, 191, 200, 202, 210, 212, 213, 214, 217 Blood-Brain Barrier, 13, 165 Body Fluids, 165, 166, 174, 179, 197, 211, 215 Body Regions, 165, 169 Bone Marrow, 157, 165, 182, 186, 191, 212 Bowel Movement, 110, 166, 173, 212 Brachial, 163, 166 Brachytherapy, 16, 166, 187, 206 Bradykinin, 166, 197, 202 Branch, 153, 166, 183, 191, 200, 205, 211, 213 Breakdown, 10, 98, 146, 166, 173, 180 Breast Feeding, 88, 100, 166 Butterflies, 106, 166 Bypass, 28, 56, 166, 214 C Caesarean section, 26, 166 Calcium, 27, 64, 65, 97, 166, 169, 185, 198, 199, 218
Index 223
Calcium-Binding Proteins, 65, 166 Calculi, 166, 182 Cannula, 166, 199 Capillary, 13, 26, 166, 217 Carbohydrate, 100, 111, 166, 172, 202 Carcinogenesis, 15, 166 Carcinogenic, 15, 166, 204, 212 Carcinogens, 10, 166, 197 Carcinoid, 19, 167 Carcinoma, 22, 25, 29, 34, 40, 47, 59, 97, 109, 118, 166, 167 Cardiac, 38, 143, 159, 167, 180, 195, 212 Cardiovascular, 47, 49, 54, 167, 189, 210 Case report, 21, 27, 32, 35, 41, 48, 49, 59, 132, 167, 169 Case series, 43, 167, 169 Catabolism, 89, 167 Catheters, 111, 167, 186, 187 Caudal, 167, 203 Causal, 167, 183 Cause of Death, 4, 167 Caustic, 108, 109, 167 Celiac Artery, 167, 183 Celiac Disease, 109, 124, 167 Cell Division, 136, 163, 167, 202 Cell membrane, 167, 182, 188, 201 Cellobiose, 167 Cellular Structures, 167, 194 Cellulose, 89, 167, 202 Central Nervous System, 13, 91, 99, 157, 163, 167, 178, 180, 181, 189, 198, 201, 210 Centrifugation, 168, 182, 194 Cerebellar, 162, 168, 207 Cerebral, 24, 70, 91, 162, 164, 165, 168, 171, 192, 200 Cerebral Palsy, 91, 168 Cerebrum, 168, 215 Cesarean Section, 23, 168 Character, 168, 173, 182, 206 Chemotherapy, 21, 22, 74, 75, 168 Chenodeoxycholic Acid, 168, 216 Chest Pain, 106, 168 Chest wall, 94, 168 Chin, 66, 75, 95, 168 Cholangitis, 4, 30, 31, 42, 54, 104, 108, 109, 110, 141, 168 Cholecalciferol, 97, 168 Cholecystectomy, 108, 118, 168 Cholecystitis, 36, 108, 118, 168 Choledochal Cyst, 48, 168 Cholelithiasis, 105, 108, 168 Choleretic, 64, 69, 168, 217
Cholestasis, 4, 45, 51, 72, 90, 104, 107, 109, 111, 114, 115, 168 Cholesterol, 114, 124, 164, 168, 179, 185, 212 Cholic Acid, 168, 173 Cholinergic, 159, 168 Chromosome, 168, 171, 182, 190, 215 Chronic Disease, 104, 169 Chronic renal, 97, 169, 202, 216 CIS, 10, 169 Clinical Medicine, 21, 93, 169, 203 Clinical study, 113, 169 Clinical trial, 5, 7, 131, 169, 171, 207 Cloning, 165, 169 Coagulation, 21, 165, 169, 202 Codon, 18, 169, 181 Cofactor, 169, 205, 214 Colic, 105, 110, 169 Colitis, 105, 169 Collapse, 160, 166, 169 Colloidal, 158, 169, 175, 210 Common Bile Duct, 23, 48, 118, 168, 169, 172, 183 Complement, 169, 170, 182, 202 Complementary and alternative medicine, 69, 83, 170 Complementary medicine, 69, 170 Complementation, 8, 170 Computational Biology, 131, 135, 170 Computed tomography, 104, 109, 170 Computerized axial tomography, 170 Computerized tomography, 170 Congestion, 90, 170 Conjugated, 89, 101, 114, 164, 168, 170, 195 Conjugation, 14, 38, 89, 170, 181 Connective Tissue, 165, 171, 179, 180, 191, 209 Consciousness, 160, 171, 173, 183 Constipation, 105, 108, 109, 110, 111, 171, 201 Constitutional, 6, 171 Constriction, 171, 188 Consultation, 7, 171 Consumption, 171, 180, 208 Contamination, 171, 184 Continuum, 11, 171 Contraindications, ii, 105, 111, 171 Controlled study, 44, 171 Conventional therapy, 8, 171 Conventional treatment, 171 Convulsions, 171, 175 Cornea, 171, 209
224 Jaundice
Coronary, 54, 171, 193, 214 Coronary Thrombosis, 171, 193 Corpuscle, 171, 177 Cortex, 78, 162, 172, 178, 207 Corticosteroid, 172, 203, 212 Cortisol, 158, 172 Cortisone, 172, 203 Cryptosporidiosis, 163, 172 Cues, 16, 172 Curative, 16, 172, 208, 213 Cyanosis, 172, 177, 183 Cyclic, 172, 182, 197, 203, 204 Cyst, 48, 172, 198 Cystic Duct, 29, 31, 169, 172, 183 Cytokine, 9, 92, 172 Cytosine, 71, 172 Cytotoxic, 172, 206, 207 Cytotoxicity, 15, 159, 172 D Databases, Bibliographic, 131, 172 Deamination, 172, 216 Decompression, 34, 53, 111, 172, 173 Decompression Sickness, 172, 173 Degenerative, 173, 183 Dehydration, 105, 173 Dehydrocholic Acid, 64, 69, 173 Dementia, 157, 173 Density, 168, 173, 198 Detoxification, 14, 93, 173, 181 Deuterium, 173, 185 Diabetes Mellitus, 173, 183 Diagnostic Imaging, 124, 173 Diagnostic procedure, 87, 123, 173 Diaphragm, 173, 184 Diarrhea, 105, 109, 110, 118, 123, 172, 173, 192, 218 Diarrhoea, 35, 173, 180 Diastolic, 173, 185 Diffusion, 173, 188 Digestion, 66, 106, 107, 159, 164, 165, 173, 175, 186, 188, 190, 200, 212, 217 Digestive system, 107, 109, 173, 180 Digestive tract, 106, 173, 210 Dihydrotestosterone, 173, 207 Dihydroxy, 97, 159, 173 Dilatation, 31, 117, 160, 168, 174, 217 Dilatation, Pathologic, 174, 217 Dilation, 166, 174, 217 Dimerization, 10, 174 Diphtheria, 7, 161, 174 Diphtheria Antitoxin, 7, 174 Diploid, 170, 174, 202
Direct, iii, 11, 31, 34, 91, 93, 95, 96, 107, 125, 169, 174, 179, 199, 203, 207, 212 Distal, 44, 174, 180, 205 Diuresis, 114, 174 Diuretic, 173, 174 Diurnal, 166, 174 Diverticula, 21, 174 Diverticulum, 174 Dorsal, 174, 203, 211 Drive, ii, vi, 63, 93, 107, 108, 109, 111, 174, 188 Drug Interactions, 106, 126, 174 Drug Tolerance, 174, 214 Duct, 17, 26, 28, 90, 111, 160, 166, 168, 169, 174, 176, 178, 183, 208 Duodenum, 30, 90, 111, 164, 174, 176, 177, 180, 183, 199, 209, 212, 218 Dura mater, 174, 193, 199 Dysentery, 105, 174 Dyslexia, 175, 189 Dyspepsia, 123, 175, 186 Dysphagia, 16, 118, 175 Dysplasia, 136, 175 Dyspnea, 175, 177 Dystrophy, 136, 175 E Eating Disorders, 108, 109, 175 Eclampsia, 4, 15, 175 Edema, 175, 203, 216 Efficacy, 8, 14, 16, 17, 19, 28, 90, 175 Electrocoagulation, 169, 175 Electrolysis, 160, 175 Electrolyte, 107, 159, 172, 175, 179, 189, 197, 203, 211, 216 Electrons, 161, 164, 175, 188, 191, 198, 206, 207 Electrophoresis, 26, 175 Elementary Particles, 175, 191, 196, 205 Emaciation, 157, 175 Emboli, 53, 175 Embolization, 53, 175 Embryo, 175, 186 Embryology, 107, 175 Encephalopathy, 6, 12, 176 Encopresis, 109, 176 Endemic, 10, 176, 192, 211 Endocytosis, 9, 176 Endometrial, 176 Endometriosis, 27, 176 Endometrium, 176 Endoscope, 176, 177
Index 225
Endoscopic, 24, 32, 33, 48, 58, 108, 111, 119, 140, 176, 177 Endoscopic retrograde cholangiopancreatography, 24, 108, 111, 176, 177 Endoscopy, 20, 31, 33, 44, 47, 104, 108, 109, 111, 118, 176 Endothelial cell, 13, 165, 176, 214 Endothelium, 176, 196 Endothelium-derived, 176, 196 Endotoxemia, 51, 64, 176 Endotoxin, 32, 57, 64, 176 End-stage renal, 169, 176, 202 Enteral Nutrition, 109, 176 Enteritis, 105, 176 Enterocolitis, 176 Environmental Exposure, 176, 197 Environmental Health, 130, 132, 177 Enzymatic, 9, 16, 96, 166, 170, 177, 184 Enzyme Inhibitors, 16, 177, 202 Epidemics, 14, 177 Epidemiologic Factors, 15, 177 Epidemiological, 5, 14, 23, 85, 177 Epidermis, 177, 206 Epigastric, 177, 199 Epithelial, 157, 177 ERCP, 44, 111, 117, 140, 176, 177 Erythrocyte Membrane, 25, 177 Erythrocytes, 96, 160, 165, 177, 183, 199, 207 Erythromycin, 163, 177 Esophageal, 108, 118, 177, 215 Esophageal Atresia, 108, 177, 215 Esophageal Motility Disorders, 108, 177 Esophagitis, 106, 177 Esophagus, 109, 111, 162, 173, 177, 180, 182, 191, 197, 201, 207, 212, 215 Essential Tremor, 136, 177 Estrogen, 10, 133, 178, 192 Evacuation, 171, 178 Evoked Potentials, 7, 71, 178 Excipient, 92, 178 Excrete, 161, 178, 189, 208 Exhaustion, 160, 178, 192 Exocrine, 178, 199 Exogenous, 178, 181, 205 Expiration, 94, 178, 208 Expiratory, 94, 178 Extensor, 178, 205 External-beam radiation, 178, 206 Extracellular, 7, 104, 171, 176, 178, 211 Extracorporeal, 7, 89, 93, 178
Extraction, 111, 168, 178 Extravasation, 178, 183 Eye Infections, 158, 178 F Faecal, 173, 178 Failure to Thrive, 108, 109, 178 Family Planning, 131, 178 Fat, 101, 114, 162, 164, 165, 168, 172, 175, 178, 190, 212, 218 Fatigue, 132, 145, 178, 182 Fatty acids, 57, 158, 178, 181, 190, 204, 214 Fatty Liver, 108, 110, 124, 142, 178 Febrile, 9, 178, 192 Fecal Incontinence, 111, 178, 186 Feces, 171, 176, 178, 179, 212 Femoral, 88, 179 Femur, 179 Fetus, 168, 179 Fibrin, 165, 179, 201, 214 Fibrosis, 108, 109, 111, 136, 159, 179, 209 Filtration, 93, 179, 189 Fine-needle aspiration, 33, 179, 195 Fistula, 179, 180 Flatulence, 105, 179 Flatus, 178, 179, 180 Flavoxate, 72, 179 Fluid Therapy, 179, 197 Fluorouracil, 66, 179 Fold, 179, 193, 197, 199 Foramen, 168, 179, 201 Fraud, 45, 179 Fulminant Hepatic Failure, 108, 109, 111, 179 Fungi, 170, 178, 179, 193, 212, 218 G Galactosemia, 110, 142, 179 Gallstones, 35, 90, 104, 105, 106, 107, 108, 109, 110, 115, 164, 168, 179, 217 Gamma Rays, 180, 206, 207 Ganglia, 157, 164, 180, 196, 211, 213 Gas, 25, 94, 105, 159, 164, 173, 179, 180, 185, 186, 192, 196, 197, 212 Gastric, 21, 65, 66, 109, 163, 167, 177, 180, 182, 184, 200, 207 Gastric Acid, 177, 180 Gastric Juices, 180, 200 Gastric Mucosa, 180, 200 Gastrin, 180, 184 Gastritis, 105, 108, 123, 180 Gastroduodenal, 23, 54, 180 Gastroenteritis, 105, 180 Gastroenterologist, 123, 180
226 Jaundice
Gastroesophageal Reflux, 108, 180 Gastrointestinal Hemorrhage, 109, 180 Gastrointestinal tract, 106, 107, 111, 114, 123, 163, 179, 180, 189, 210, 212, 215 Gastrostomy, 176, 180 Gene, 8, 9, 10, 13, 15, 16, 17, 20, 98, 112, 137, 138, 158, 165, 180, 181, 190, 197 Gene Expression, 10, 16, 18, 137, 180 Gene Fusion, 16, 181 Genetic Code, 105, 181, 197 Genetics, 105, 171, 181, 194 Genotype, 181, 201 Gestation, 181, 200, 203 Giant Cells, 181, 209 Gland, 158, 172, 181, 191, 199, 200, 205, 209, 212, 214 Glomerular, 181, 189, 208 Glucocorticoid, 97, 181, 203 Glucose, 35, 50, 55, 65, 73, 94, 136, 165, 167, 173, 179, 181, 183, 209 Glucuronate, 9, 181 Glucuronic Acid, 10, 89, 96, 181, 216 Glucuronides, 6, 181 Glucuronosyltransferase, 8, 9, 10, 98, 181 Glutamate, 181, 201 Glutamic Acid, 181 Glutamine, 92, 181 Gluten, 124, 167, 182 Gonadal, 182, 212 Gout, 105, 182 Governing Board, 182, 203 Grade, 74, 177, 182 Graft, 35, 182, 185 Graft-versus-host disease, 35, 182 Gram-negative, 163, 176, 182 Granulomas, 104, 182 Growth, 15, 16, 35, 136, 158, 160, 161, 178, 182, 187, 192, 196, 197, 198, 202, 208, 209, 215 Guanylate Cyclase, 182, 197 H Haematoma, 182 Haemolysis, 19, 182 Haemorrhage, 53, 182 Hair follicles, 182, 218 Haploid, 182, 202 Heart failure, 108, 182 Heartburn, 106, 115, 123, 182, 184, 186 Helminthiasis, 105, 182 Hematocrit, 94, 165, 182 Hematology, 73, 104, 109, 183 Hematoma, 30, 183
Heme, 10, 16, 17, 95, 98, 164, 183, 195, 199, 203 Hemochromatosis, 108, 110, 124, 145, 183 Hemodialysis, 183, 189 Hemoglobin, 89, 94, 96, 98, 146, 160, 164, 165, 172, 177, 183, 198, 203 Hemoglobin A, 164, 183, 203 Hemoglobin M, 98, 172, 183 Hemoglobinuria, 136, 183 Hemolysis, 4, 31, 34, 93, 177, 183 Hemolytic, 8, 16, 45, 55, 65, 96, 183, 206 Hemorrhage, 9, 14, 47, 105, 175, 183, 206 Hemorrhoids, 105, 183 Hepatic Artery, 54, 56, 59, 104, 109, 183 Hepatic Duct, Common, 176, 183 Hepatic Encephalopathy, 104, 106, 108, 109, 183 Hepatic Veins, 109, 183 Hepatitis A, 106, 126, 132, 133, 184 Hepatobiliary, 24, 36, 58, 107, 115, 119, 184 Hepatocellular, 4, 10, 32, 36, 41, 48, 49, 58, 104, 184 Hepatocellular carcinoma, 32, 36, 48, 49, 58, 184 Hepatocyte, 10, 89, 168, 184 Hepatology, 4, 5, 20, 23, 24, 35, 36, 43, 46, 51, 54, 106, 184 Hepatoma, 10, 184 Hepatomegaly, 24, 60, 118, 141, 155, 184, 187 Hepatorenal Syndrome, 104, 106, 108, 184 Hepatotoxicity, 55, 184 Hepatovirus, 184 Hereditary, 107, 110, 145, 182, 184, 201, 208 Heredity, 111, 180, 181, 184 Hernia, 32, 40, 109, 110, 184 Hiatal Hernia, 27, 106, 184 Histamine, 184, 207 Histiocytosis, 48, 184 Histology, 107, 184 Homeostasis, 97, 104, 111, 184 Homogeneous, 171, 184 Hormonal, 38, 97, 163, 172, 184, 218 Hormone, 10, 159, 172, 180, 184, 192, 193, 199, 204, 209, 213, 218 Hormone therapy, 184, 192 Host, 9, 15, 37, 163, 185, 186, 189, 218 Hybridization, 185, 194 Hydrogen, 6, 14, 157, 159, 164, 166, 173, 185, 190, 194, 196, 198, 205, 219 Hydrogen Bonding, 6, 14, 185
Index 227
Hydrogen Peroxide, 185, 190 Hydrolysis, 162, 167, 185, 188 Hypercalcemia, 97, 185 Hypercholesterolemia, 105, 185 Hyperemesis, 4, 185 Hypersensitivity, 160, 185, 189 Hypertension, 41, 49, 104, 106, 107, 108, 109, 111, 133, 185, 203, 216 Hypertension, Portal, 108, 185 Hyperuricemia, 182, 185 Hypoxia, 13, 185, 213 Hysterotomy, 168, 185 I Iatrogenic, 34, 185 Icterus, 114, 185 Id, 67, 76, 141, 145, 152, 154, 185 Idiopathic, 5, 37, 56, 97, 185, 209 Ileus, 16, 185 Imidazole, 184, 186, 207 Immaturity, 98, 186 Immune function, 28, 186 Immune response, 8, 9, 37, 161, 163, 172, 186, 212, 217, 218 Immune system, 10, 107, 163, 186, 189, 191, 195, 217, 218 Immunity, 9, 157, 186 Immunization, 186, 210 Immunodeficiency, 136, 157, 186 Immunogenic, 9, 186 Immunohistochemistry, 7, 18, 186 Immunologic, 186, 207 Immunosuppressant, 179, 186 Immunosuppressive, 181, 186 Impairment, 7, 103, 162, 168, 178, 186, 187 Implant radiation, 186, 187, 206 In vitro, 6, 7, 13, 15, 17, 26, 74, 186, 214 In vivo, 6, 7, 8, 9, 13, 16, 64, 96, 97, 186, 190, 214 Incision, 166, 185, 186, 188, 189 Incompetence, 180, 186 Incontinence, 108, 176, 186 Indicative, 100, 112, 186, 200, 217 Indigestion, 105, 106, 115, 123, 186 Induction, 10, 160, 186 Infancy, 41, 59, 74, 104, 109, 135, 146, 186, 208 Infarction, 171, 186, 193, 214 Infectious Mononucleosis, 28, 187 Inflammatory bowel disease, 107, 108, 111, 187 Information Centers, 105, 187 Infusion, 38, 187, 215
Ingestion, 108, 109, 187, 202 Inhalation, 187, 202 Inoculum, 15, 187 Interferon, 11, 60, 187, 191 Interferon-alpha, 187 Intermittent, 17, 39, 50, 179, 187 Internal Medicine, 8, 64, 65, 66, 180, 183, 187 Internal radiation, 187, 206 Interstitial, 166, 187, 208 Intervertebral, 187, 206 Intestinal, 37, 89, 92, 96, 97, 105, 106, 111, 115, 163, 167, 168, 172, 176, 187, 192, 218 Intestinal Obstruction, 111, 187 Intestine, 89, 96, 109, 164, 165, 176, 188, 189, 218 Intoxication, 188, 214 Intracellular, 14, 187, 188, 193, 197, 203, 204 Intrahepatic, 4, 40, 72, 90, 111, 115, 183, 188 Intramuscular, 188, 199 Intravenous, 17, 31, 109, 187, 188, 199 Invasive, 7, 47, 94, 186, 188, 191, 199 Involuntary, 164, 177, 178, 188, 195 Ion Transport, 14, 188 Ionizing, 159, 176, 188, 206 Ions, 164, 166, 175, 185, 188, 194 Iridium, 16, 188 Irritants, 174, 188 Ischemia, 13, 163, 188 Isoenzyme, 16, 188 Isozymes, 188, 206 J Jejunostomy, 176, 188 K Kb, 130, 188 Kidney Disease, 130, 136, 145, 188, 208 Kidney Failure, 114, 176, 189 Kidney Failure, Acute, 189 Kidney Failure, Chronic, 189 Kinetics, 65, 71, 189 L Lamivudine, 55, 58, 189 Laparoscopy, 30, 43, 46, 189 Laparotomy, 30, 189 Large Intestine, 173, 188, 189, 207, 210, 218 Latent, 132, 189 Learning Disorders, 92, 189 Leptospirosis, 9, 14, 189 Lesion, 9, 189, 190, 210, 216 Lethal, 8, 9, 10, 164, 189
228 Jaundice
Leukemia, 7, 22, 132, 136, 189 Leukocytes, 165, 187, 189, 199, 201 Leukotrienes, 30, 64, 162, 189 Library Services, 152, 189 Ligament, 190, 205 Lightness, 99, 190 Linkage, 15, 167, 190 Lipid, 57, 64, 65, 162, 190, 198 Lipid Peroxidation, 64, 190, 198 Lipid Peroxides, 65, 190 Lipodystrophy, 190, 218 Lipophilic, 13, 190 Liposomes, 25, 190 Lipoxygenase, 189, 190 Lithotripsy, 111, 190 Liver cancer, 110, 124, 190 Liver Circulation, 104, 190 Liver Cirrhosis, 23, 77, 184, 190 Liver metastases, 38, 75, 190 Liver Transplantation, 8, 9, 92, 104, 105, 106, 107, 108, 109, 110, 111, 190 Localization, 7, 10, 65, 114, 186, 190 Localized, 174, 182, 183, 187, 190, 191, 202, 216 Locomotion, 191, 202 Loop, 50, 59, 81, 184, 191 Lower Esophageal Sphincter, 123, 177, 180, 191 Luciferase, 16, 191 Lumen, 10, 166, 177, 191 Lymph, 74, 163, 172, 176, 187, 191, 209 Lymph node, 74, 163, 191, 209 Lymphadenitis, 59, 76, 191 Lymphadenopathy, 187, 191 Lymphatic, 48, 176, 187, 191, 211, 214 Lymphatic system, 191, 211, 214 Lymphoblastic, 191 Lymphoblasts, 157, 191 Lymphocyte, 157, 161, 191 Lymphocyte Count, 157, 191 Lymphoid, 161, 191 Lymphoma, 22, 41, 43, 44, 47, 48, 49, 74, 75, 132, 136, 191 M Magnetic Resonance Imaging, 104, 109, 191, 192 Magnetic Resonance Spectroscopy, 25, 191 Malabsorption, 97, 106, 108, 109, 111, 136, 167, 192, 210, 218 Malabsorption syndrome, 97, 108, 111, 192, 210
Malaria, 24, 36, 42, 105, 192 Malaria, Falciparum, 192 Malaria, Vivax, 192 Malignancy, 24, 192 Malnutrition, 24, 114, 158, 163, 192, 195 Mandible, 168, 192 Manifest, 94, 192 Manometry, 111, 192 Mediate, 15, 192, 207 MEDLINE, 131, 135, 136, 192 Medullary, 97, 192 Megestrol, 72, 192 Megestrol Acetate, 72, 192 Melanocytes, 192 Melanoma, 49, 50, 136, 192 Membrane, 6, 7, 10, 13, 167, 170, 176, 182, 190, 193, 194, 198, 201 Membrane Proteins, 190, 193 Memory, 160, 173, 193 Menarche, 15, 193 Meninges, 167, 174, 193 Meningitis, 9, 193 Mental Health, iv, 5, 130, 134, 193, 205 Mesenteric, 163, 193, 203 Meta-Analysis, 19, 28, 193 Metabolic disorder, 9, 17, 98, 182, 193 Metabolite, 97, 193 Metalloporphyrins, 16, 22, 193 Metastasis, 31, 48, 49, 193 Metastatic, 44, 49, 193, 209 Methionine, 64, 193, 213 MI, 35, 37, 110, 156, 193 Microbe, 193, 215 Microcirculation, 190, 193 Microorganism, 169, 193, 200, 218 Microsomal, 96, 193 Mineralization, 194, 198 Mitochondrial Swelling, 194, 195 Mobility, 10, 194 Mobilization, 97, 194 Modification, 89, 194, 206, 219 Molecular, 6, 8, 9, 14, 50, 73, 107, 112, 131, 134, 135, 165, 170, 190, 194 Molecular Probes, 6, 14, 194 Molecular Structure, 14, 194 Molecule, 161, 164, 170, 176, 185, 194, 198, 207, 215, 217 Monitor, 5, 11, 16, 54, 61, 121, 122, 124, 194, 197 Monoclonal, 194, 206 Mononuclear, 9, 187, 194 Monotherapy, 11, 194
Index 229
Morphological, 158, 175, 192, 194 Morphology, 183, 194 Motility, 107, 109, 194, 210 Motion Sickness, 194, 195 Mucins, 194, 208 Mucosa, 30, 163, 167, 176, 180, 194 Mucus, 174, 194, 216 Multiple Organ Failure, 51, 194 Multivariate Analysis, 34, 194 Muscle Contraction, 123, 195 Muscle Fibers, 195 Muscular Atrophy, 136, 195 Muscular Dystrophies, 175, 195 Myocarditis, 174, 195 Myocardium, 193, 195 Myoglobin, 195, 203 Myosin, 195 Myotonic Dystrophy, 136, 195 N Naive, 9, 195 Nasogastric, 176, 195 Nausea, 105, 106, 180, 186, 195, 197, 216 NCI, 1, 129, 169, 195 Necrosis, 133, 186, 193, 195, 209 Need, 3, 26, 37, 46, 52, 91, 103, 105, 113, 117, 122, 123, 132, 147, 169, 195, 214 Needle biopsy, 109, 179, 195 Neonatal Hepatitis, 5, 111, 195 Neoplasia, 136, 196 Neoplasm, 23, 196, 209, 215 Neoplastic, 191, 196 Nephropathy, 189, 196 Nephrosis, 184, 196 Nephrotoxic, 114, 196 Nerve, 158, 159, 162, 168, 171, 196, 197, 198, 200, 206, 209, 211, 212, 217 Nervous System, 7, 93, 136, 158, 163, 167, 196, 212, 213 Neural, 99, 158, 196 Neuroblastoma, 22, 33, 196 Neurologic, 12, 196 Neuroma, 23, 196 Neurons, 180, 196, 211, 213 Neurotic, 196, 217 Neurotoxicity, 13, 196 Neurotoxin, 93, 196 Neurotransmitters, 159, 196 Neutrons, 159, 196, 206 Neutrophil, 37, 65, 196 Nevirapine, 41, 196, 197 Nitric Oxide, 104, 196
Nitrogen, 158, 159, 160, 173, 181, 189, 193, 197 Non-nucleoside, 196, 197 Nonulcer Dyspepsia, 106, 197 Norepinephrine, 158, 159, 197 Nosocomial, 108, 197 Nuclear, 58, 91, 164, 170, 175, 180, 195, 197 Nuclei, 27, 64, 65, 159, 171, 175, 191, 196, 197, 198, 205 Nucleic acid, 9, 164, 172, 181, 185, 197, 219 Nucleus, 163, 164, 172, 173, 175, 180, 194, 196, 197, 205, 213 Nutritional Support, 107, 111, 180, 197 O Odynophagia, 118, 197 Oligodendroglial, 197 Oligodendroglioma, 29, 197 Oliguria, 189, 197 Omentum, 183, 197 Oncogene, 136, 197 Opportunistic Infections, 157, 198 Optic Nerve, 198, 199, 209 Organ Culture, 198, 214 Osmotic, 158, 194, 198, 210 Ossification, 198, 208 Osteitis Fibrosa Cystica, 97, 198 Osteodystrophy, 114, 198 Osteomalacia, 97, 198 Osteoporosis, 97, 198 Osteosclerosis, 97, 198 Overdosage, 105, 198 Overdose, 179, 198 Ovulation, 192, 198 Oxidation, 157, 161, 183, 190, 198 Oxidative metabolism, 189, 198 Oxidative Stress, 6, 198 Oximetry, 94, 198 Oxygenase, 16, 199 P Pachymeningitis, 193, 199 Palliative, 16, 30, 47, 50, 192, 199, 213 Pancreatic, 25, 28, 36, 40, 41, 47, 48, 50, 56, 65, 106, 108, 111, 136, 176, 177, 180, 199, 218 Pancreatic cancer, 28, 136, 199, 218 Pancreatic Ducts, 176, 177, 199 Pancreatic Fistula, 108, 199 Pancreatic Juice, 180, 199 Pancreatitis, 19, 30, 37, 40, 59, 107, 108, 109, 111, 124, 164, 199 Pancytopenia, 66, 199 Papilla, 22, 176, 199
230 Jaundice
Paracentesis, 104, 199 Parasite, 199 Parasitic, 47, 108, 111, 172, 174, 182, 199 Parasitic Diseases, 108, 199 Parathyroid, 199, 208 Parathyroid Glands, 199, 208 Parenteral, 31, 44, 53, 58, 108, 109, 111, 199, 200 Parenteral Nutrition, 31, 44, 53, 58, 108, 200 Parietal, 95, 200, 201 Parietal Lobe, 200 Parotid, 200, 209 Paroxetine, 55, 200 Paroxysmal, 136, 200 Pathogen, 15, 187, 200 Pathogenesis, 7, 9, 12, 14, 51, 103, 107, 114, 200 Pathologic, 16, 53, 98, 165, 171, 185, 200, 203, 205 Pathophysiology, 3, 20, 107, 115, 200 Patient Education, 123, 144, 150, 152, 156, 200 Pelvic, 176, 200, 205 Penicillin, 133, 160, 200 Pepsin, 200, 209 Pepsin A, 200 Peptic, 106, 107, 108, 200 Peptic Ulcer, 106, 107, 108, 200 Peptide, 104, 200, 205 Percutaneous, 20, 27, 49, 50, 51, 54, 60, 119, 190, 200 Perforation, 179, 200, 218 Perfusion, 185, 200 Perianal, 118, 200 Perinatal, 7, 15, 22, 23, 26, 29, 34, 38, 43, 46, 53, 54, 60, 74, 200 Perioperative, 51, 114, 201 Perioperative Care, 114, 201 Peripheral blood, 9, 57, 187, 201 Peripheral stem cells, 182, 201 Peritoneal, 27, 162, 201 Peritoneal Cavity, 162, 201 Peritoneum, 197, 201 Peritonitis, 104, 106, 108, 201, 218 Peroxidase, 6, 190, 201 Peroxide, 201 Petechiae, 182, 201 Phagocytosis, 65, 201 Pharmaceutical Preparations, 167, 201 Pharmacologic, 17, 201, 215 Pharynx, 94, 180, 201
Phenobarbital, 10, 90, 201 Phenotype, 10, 170, 201 Phospholipids, 178, 201 Phosphorous, 97, 201 Phosphorus, 25, 166, 199, 201, 202 Phosphorylation, 10, 202, 206 Photocoagulation, 169, 202 Phototherapy, 6, 7, 13, 26, 28, 31, 33, 35, 37, 52, 64, 71, 73, 91, 93, 97, 98, 99, 100, 101, 112, 133, 202 Physiologic, 6, 14, 85, 165, 173, 202, 204, 207 Physiology, 39, 104, 106, 107, 108, 109, 180, 183, 202 Pigment, 6, 14, 89, 91, 95, 96, 101, 115, 164, 192, 195, 202 Plants, 105, 162, 181, 194, 197, 202, 209, 212, 215 Plasma, 9, 13, 29, 32, 65, 66, 70, 92, 158, 161, 167, 183, 189, 202, 208, 209, 210, 217 Plasma protein, 158, 202, 210 Platelet Aggregation, 197, 202, 214 Platelets, 4, 197, 199, 202, 214 Platinum, 191, 202 Poison Control Centers, 105, 202 Poisoning, 76, 110, 180, 188, 195, 202 Polycystic, 56, 136, 202 Polysaccharide, 89, 158, 161, 167, 202, 216 Porphyria, 17, 203 Porphyrins, 6, 193, 203 Portal Vein, 92, 185, 203 Posterior, 94, 160, 162, 174, 199, 203, 209 Postmenopausal, 198, 203 Postnatal, 98, 203 Postoperative, 4, 53, 104, 108, 114, 194, 203 Postoperative Complications, 114, 203 Potassium, 88, 159, 203 Potentiating, 159, 203 Practice Guidelines, 134, 145, 203 Precursor, 17, 18, 71, 160, 162, 164, 177, 197, 203, 216, 218 Prednisolone, 55, 203 Prednisone, 133, 203 Pre-Eclampsia, 15, 203 Pre-eclamptic, 175, 203 Prevalence, 11, 177, 204 Primary Biliary Cirrhosis, 4, 42, 90, 104, 108, 109, 110, 123, 204 Problem Solving, 107, 204 Progeny, 171, 204 Progesterone, 192, 204, 212 Prognostic factor, 49, 204
Index 231
Progression, 18, 160, 204 Progressive, 169, 173, 174, 182, 189, 194, 195, 204, 207, 215 Promoter, 8, 10, 16, 204 Prone, 98, 123, 204 Prophylaxis, 24, 51, 98, 104, 204, 208 Prospective study, 26, 66, 73, 204 Prostaglandin, 65, 204, 214 Prostaglandins A, 204 Prostate, 136, 205, 215 Protein Binding, 14, 205 Protein C, 8, 158, 159, 169, 205, 216 Protein S, 112, 136, 137, 165, 177, 181, 205 Proteinuria, 203, 205 Protons, 159, 185, 188, 191, 205, 206 Protozoa, 170, 174, 193, 205, 212 Proximal, 174, 205 Pruritus, 35, 114, 115, 205, 216 Psoriasis, 54, 55, 205, 208 Public Health, 9, 11, 14, 15, 134, 205 Public Policy, 131, 205 Publishing, 18, 105, 107, 132, 205 Pulmonary, 14, 19, 165, 171, 189, 205, 217 Pulmonary Edema, 189, 205 Pulse, 94, 194, 199, 206 Purpura, 182, 206 Pustular, 54, 55, 206 Pyrazinamide, 132, 206 Pyruvate Kinase, 20, 206 Q Quality of Life, 16, 206 R Race, 45, 206 Radiation, 16, 32, 111, 157, 175, 176, 178, 180, 187, 188, 206, 218 Radiation therapy, 32, 157, 178, 187, 206 Radicular, 206 Radiculopathy, 118, 206 Radioactive, 185, 186, 187, 194, 197, 206 Radioimmunotherapy, 206, 207 Radiolabeled, 206 Radiological, 113, 120, 140, 200, 206 Radiology, 26, 27, 33, 34, 37, 47, 49, 50, 54, 59, 104, 109, 111, 119, 140, 141, 145, 206 Radiotherapy, 16, 34, 166, 206 Randomized, 6, 20, 44, 175, 207 Ranitidine, 53, 207 Reagent, 95, 96, 191, 207 Receptor, 9, 161, 178, 201, 207, 210 Recombinant, 9, 126, 207, 217 Recombination, 171, 207 Rectal, 105, 118, 207
Rectum, 160, 161, 166, 173, 179, 180, 186, 187, 189, 205, 207 Recurrence, 59, 207 Red blood cells, 33, 146, 177, 183, 199, 207, 209 Red Nucleus, 162, 207 Reductase, 98, 207 Refer, 1, 169, 179, 191, 195, 196, 197, 206, 207, 217 Reflux, 109, 123, 177, 180, 207 Refraction, 207, 211 Refractory, 104, 175, 207 Regimen, 91, 132, 175, 207 Regurgitation, 177, 180, 182, 207 Rehydration, 114, 207 Remission, 207 Renal Circulation, 104, 207 Renal failure, 9, 55, 76, 104, 184, 207 Renal Osteodystrophy, 97, 208 Renal tubular, 17, 51, 208 Renin, 104, 160, 208 Resection, 39, 41, 53, 56, 106, 208, 210 Respiration, 162, 194, 198, 208 Respiratory distress syndrome, 20, 208 Restoration, 207, 208, 218 Retinoblastoma, 136, 208 Retinoids, 208, 218 Retinol, 66, 208 Retrograde, 33, 58, 111, 140, 208 Retrospective, 15, 26, 208 Rickets, 97, 208, 218 Rigidity, 202, 208 Risk factor, 15, 23, 54, 55, 110, 133, 204, 208 Rod, 164, 176, 208 S Saliva, 123, 208 Salivary, 173, 199, 208 Salivary glands, 173, 208 Salivation, 177, 208 Saponins, 209, 212 Sarcoidosis, 4, 97, 209 Sarcoma, 38, 118, 209 Sclera, 52, 114, 156, 209 Sclerosis, 136, 162, 209 Screening, 91, 169, 209 Sebaceous, 188, 209, 218 Secondary tumor, 193, 209 Secretin, 66, 209 Secretion, 14, 107, 115, 172, 184, 194, 207, 208, 209, 217 Sedative, 159, 209, 217
232 Jaundice
Seizures, 200, 209 Semen, 78, 205, 209 Semisynthetic, 173, 209 Senile, 198, 209 Sensor, 93, 209 Sensory loss, 206, 209, 213 Sepsis, 4, 32, 55, 114, 118, 164, 210 Septic, 162, 210 Sequela, 91, 210 Seroconversion, 9, 210 Serologic, 210 Serotonin, 159, 200, 210 Serous, 55, 162, 176, 210 Serum, 5, 8, 12, 29, 38, 56, 75, 88, 91, 92, 96, 97, 98, 100, 158, 165, 169, 189, 201, 210 Serum Albumin, 92, 210 Sex Characteristics, 158, 160, 210, 213 Sex Determination, 136, 210 Shock, 160, 176, 190, 210, 215 Short Bowel Syndrome, 109, 210 Side effect, 105, 125, 158, 185, 210, 214, 219 Skeleton, 157, 179, 204, 210 Skin Manifestations, 35, 210 Skull, 210, 213 Small intestine, 66, 164, 168, 172, 174, 176, 177, 184, 188, 195, 210, 215 Smooth muscle, 159, 179, 184, 210, 212 Social Environment, 206, 210 Sodium, 88, 100, 159, 182, 210 Soma, 211 Somatic, 15, 158, 211 Spasmodic, 157, 211 Specialist, 146, 174, 211 Species, 180, 192, 194, 199, 206, 211, 215, 218, 219 Specificity, 10, 158, 211 Spectrum, 6, 9, 56, 57, 59, 91, 99, 106, 211 Sphincter, 41, 47, 111, 211 Spinal cord, 166, 167, 168, 174, 193, 196, 199, 206, 211, 213 Spinal Cord Injuries, 206, 211 Spinal Nerve Roots, 206, 211 Splanchnic Circulation, 104, 211 Spleen, 140, 163, 191, 209, 211 Splenectomy, 72, 211 Splenic Vein, 203, 211 Splenomegaly, 187, 211 Sporadic, 208, 211 Spores, 187, 212 Stabilizer, 92, 212 Steatorrhea, 97, 212 Steatosis, 92, 178, 212
Stent, 16, 21, 47, 59, 212 Sterile, 162, 199, 212 Steroid, 6, 90, 164, 172, 181, 209, 212 Steroid therapy, 6, 212 Stimulus, 174, 178, 212, 214 Stool, 186, 189, 212, 213 Stress, 94, 163, 172, 180, 195, 198, 212 Stricture, 104, 110, 212 Stromal, 176, 212 Subacute, 187, 212 Subclavian, 163, 212 Subclavian Vein, 163, 212 Subclinical, 187, 209, 212 Subcutaneous, 175, 190, 199, 212 Substance P, 177, 193, 209, 212 Substrate, 13, 89, 177, 212 Suction, 179, 212 Sulfates, 133, 212 Sulfur, 189, 193, 213 Sulfuric acid, 212, 213 Supplementation, 75, 213 Support group, 110, 213 Sympathetic Nervous System, 104, 163, 213 Symphysis, 168, 205, 213 Symptomatic, 199, 213 Systemic, 92, 104, 108, 109, 126, 160, 161, 164, 165, 174, 187, 203, 206, 209, 213 Systemic disease, 104, 108, 109, 213 Systolic, 185, 213 T Tachycardia, 163, 213 Tachypnea, 163, 213 Telangiectasia, 136, 213 Temporal, 13, 213 Tenesmus, 174, 213 Testosterone, 207, 213 Thalamic, 162, 213 Thalamic Diseases, 162, 213 Therapeutics, 24, 126, 213 Thigh, 179, 213 Thorax, 157, 213 Threshold, 185, 213 Thrombin, 179, 202, 205, 214 Thrombocytes, 202, 214 Thrombocytopenia, 44, 214 Thrombomodulin, 205, 214 Thrombosis, 205, 214 Thromboxanes, 162, 214 Thymoma, 35, 214 Thymus, 186, 191, 214 Thyroxine, 158, 214
Index 233
Ticlopidine, 53, 54, 214 Tin, 17, 202, 214 Tissue Culture, 15, 214 Tolerance, 9, 214 Tomography, 192, 214 Tonic, 177, 214 Tonicity, 183, 214 Topical, 28, 33, 110, 185, 214 Toxemia, 4, 214 Toxic, iv, 10, 93, 98, 108, 124, 171, 172, 174, 176, 186, 190, 196, 214, 215, 219 Toxicity, 6, 9, 67, 99, 108, 124, 174, 215 Toxicology, 132, 215 Toxins, 3, 106, 161, 181, 187, 206, 214, 215 Toxoplasmosis, 163, 215 Trace element, 214, 215 Trachea, 201, 215 Tracheoesophageal Fistula, 177, 215 Transcriptase, 189, 196, 197, 215, 219 Transcutaneous, 26, 38, 46, 215 Transfection, 165, 215 Transfusion, 39, 67, 89, 99, 215 Translocating, 164, 215 Transplantation, 5, 58, 104, 106, 108, 110, 169, 186, 189, 215 Trauma, 22, 30, 104, 109, 164, 177, 195, 199, 213, 215 Tropical Sprue, 97, 215 Tuberculosis, 40, 56, 66, 88, 132, 171, 215 Tuberous Sclerosis, 136, 215 Tumor marker, 110, 215 Tumour, 33, 50, 215 Typhoid fever, 122, 216 U Ulcer, 197, 200, 216 Ulcerative colitis, 39, 109, 187, 216 Unconscious, 185, 216 Unresectable, 32, 40, 216 Uraemia, 199, 216 Urea, 9, 162, 189, 216 Uremia, 189, 207, 216 Ureter, 190, 216 Urethra, 205, 216 Uric, 182, 185, 216 Uridine Diphosphate, 181, 216 Uridine Diphosphate Glucuronic Acid, 181, 216 Urinary, 41, 45, 60, 166, 179, 186, 197, 216 Urinary tract, 41, 45, 216 Urinary tract infection, 41, 45, 216 Urine, 9, 115, 161, 165, 174, 181, 183, 186, 189, 197, 205, 216
Ursodeoxycholic Acid, 20, 90, 216 V Vaccine, 7, 9, 11, 126, 217 Vacuoles, 176, 217 Valerian, 105, 217 Vascular, 4, 50, 108, 159, 160, 165, 176, 187, 190, 193, 196, 217 Vasculitis, 199, 217 Vasodilation, 104, 217 Vasodilators, 196, 217 VATER, 22, 217 Vector, 8, 9, 199, 217, 219 Vein, 88, 92, 104, 160, 162, 188, 197, 200, 203, 211, 212, 217 Venous, 104, 109, 162, 163, 165, 183, 185, 205, 214, 217 Venous Thrombosis, 214, 217 Ventricle, 206, 213, 217 Venules, 165, 166, 193, 217 Vesicular, 193, 217 Vestibular, 65, 217 Vestibule, 217 Veterinary Medicine, 131, 217 Villous, 167, 217 Viraemia, 11, 217 Viral, 4, 9, 21, 58, 69, 70, 77, 90, 104, 106, 107, 108, 111, 124, 181, 217, 219 Viral Hepatitis, 4, 21, 58, 69, 77, 90, 104, 107, 108, 111, 124, 217 Viral vector, 9, 217 Virulence, 15, 215, 218 Virus, 8, 9, 11, 21, 104, 109, 132, 143, 157, 181, 187, 217, 218 Viscera, 66, 75, 211, 218 Vitamin A, 67, 97, 208, 218 Vitamin D, 97, 114, 208, 218 Vitro, 17, 218 Vivo, 8, 9, 16, 218 Volvulus, 27, 218 Vulgaris, 80, 132, 218 W War, 4, 218 Weight Gain, 178, 218 Whipple, 59, 218 Whipple procedure, 59, 218 White blood cell, 157, 161, 187, 189, 191, 194, 196, 218 Windpipe, 201, 218 Wound Healing, 73, 114, 218 X Xenograft, 160, 218 X-ray, 170, 176, 177, 180, 197, 206, 212, 218
234 Jaundice
Y Yeasts, 179, 201, 218 Yellow Fever, 50, 218, 219 Yellow Fever Virus, 50, 219
Z Zalcitabine, 189, 219 Zoonoses, 14, 219 Zygote, 171, 219 Zymogen, 205, 219
Index 235
236 Jaundice
