Loss of Vision - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

LOSS OF VISION A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Loss of Vision: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00675-8 1. Loss of Vision-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on loss of vision. 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 LOSS OF VISION......................................................................................... 3 Overview........................................................................................................................................ 3 Federally Funded Research on Loss of Vision ................................................................................ 3 The National Library of Medicine: PubMed ................................................................................ 23 CHAPTER 2. NUTRITION AND LOSS OF VISION ............................................................................... 37 Overview...................................................................................................................................... 37 Finding Nutrition Studies on Loss of Vision............................................................................... 37 Federal Resources on Nutrition ................................................................................................... 38 Additional Web Resources ........................................................................................................... 38 CHAPTER 3. ALTERNATIVE MEDICINE AND LOSS OF VISION ........................................................ 41 Overview...................................................................................................................................... 41 National Center for Complementary and Alternative Medicine.................................................. 41 Additional Web Resources ........................................................................................................... 42 General References ....................................................................................................................... 43 CHAPTER 4. BOOKS ON LOSS OF VISION ......................................................................................... 45 Overview...................................................................................................................................... 45 Book Summaries: Online Booksellers........................................................................................... 45 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 49 Overview...................................................................................................................................... 49 NIH Guidelines............................................................................................................................ 49 NIH Databases............................................................................................................................. 51 Other Commercial Databases....................................................................................................... 53 APPENDIX B. PATIENT RESOURCES ................................................................................................. 55 Overview...................................................................................................................................... 55 Patient Guideline Sources............................................................................................................ 55 Finding Associations.................................................................................................................... 58 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 61 Overview...................................................................................................................................... 61 Preparation................................................................................................................................... 61 Finding a Local Medical Library.................................................................................................. 61 Medical Libraries in the U.S. and Canada ................................................................................... 61 ONLINE GLOSSARIES.................................................................................................................. 67 Online Dictionary Directories ..................................................................................................... 67 LOSS OF VISION DICTIONARY ................................................................................................ 69 INDEX .............................................................................................................................................. 107

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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 loss of vision 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 loss of vision, 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 loss of vision, 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 loss of vision. 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 loss of vision, 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 loss of vision. 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 LOSS OF VISION Overview In this chapter, we will show you how to locate peer-reviewed references and studies on loss of vision.

Federally Funded Research on Loss of Vision The U.S. Government supports a variety of research studies relating to loss of vision. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to loss of vision. 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 loss of vision. The following is typical of the type of information found when searching the CRISP database for loss of vision: •

Project Title: AGE RELATED MACULOPATHY-DRUSEN BIOGENESIS Principal Investigator & Institution: Anderson, Don H.; Director; Neuroscience Research Institute; University of California Santa Barbara 3227 Cheadle Hall Santa Barbara, Ca 93106 Timing: Fiscal Year 2002; Project Start 01-AUG-1996; Project End 30-APR-2004

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

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Summary: (Verbatim from applicant's abstract): Age-related macular degeneration (AMD) is characterized by the progressive loss of vision in the central visual field attributable to atrophic, exudative and/or hemorrhagic changes in the macula. One of the hallmarks of AMD is the accumulation of extracellular deposits known as drusen between the retinal pigmented epithelium (RPE) and its blood supply, the choriocapillaris. In this project, our working hypothesis is that specific drusenassociated molecules accumulate in the cytoplasm, or along the basal surface, of "compromised" RPE cells in advance of actual drusen formation. One aim of the proposed research, therefore, is to characterize the role of the RPE in drusen biogenesis. Secondly, having confirmed that a number of drusen-associated molecules do, in fact, have local cellular sources in the retina, RPE, and/or choroid, we propose to determine whether any of these local cell types make a significant biosynthetic contribution to drusen. Accordingly, we propose to identify the relevant cell types, and to determine whether any of these drusen-associated molecules are expressed differentially in individuals with drusen or AMD. Differential expression of gene transcripts in target tissues [cells] in the retina, RPE, and choroid will be analyzed quantitatively using an automated fluorogenic detection system based upon the reverse transcriptasepolymerase chain reaction (RT-PCR). In pursuing these studies, we hope to determine whether changes in the expression of one or more of these genes contributes in a significant way to the cascade of degenerative changes that ultimately manifests itself as AMD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AGE-RELATED MACULAR DEGENERATION PREVENTION TRIAL Principal Investigator & Institution: Fine, Stuart L.; Professor & Chairman; Ophthalmology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 07-DEC-1998; Project End 30-NOV-2003 Summary: Age-related macular degeneration (AMD) is the leading cause of blindness among adults in the United States and several Western countries. Approximately 90% of the blindness is attributable to the neovascular form of AMD and the remainder is attributable to pigment epithelial detachment and geographic atrophy. The Macular Photocoagulation Study has shown that laser treatment is effective in reducing the extent of vision loss in eyes with neovascular AMD. However, most lesions are not amenable to laser treatment and even with treatment visual acuity deteriorates to an average of 20/250 to 20/320. There are no other proven treatments for the advance forms of AMD. Prevention of vision loss from the advanced forms of AMD would have profound public health implications. If an intervention were only 30% effective in preventing choroidal neovascularization (CNV) within the high-risk population, the rate of legal blindness from AMD could be cut in half. The presence of large drusen in the macula is a strong predictor of the development of CNV. Low intensity laser treatment causes high-risk drusen to disappear in most eyes. Controlled, pilot, clinical trials on the effect of laser treatment on development of CNV and loss of vision are underway on two groups of patients: patients with bilateral large drusen and patients with unilateral CNV and the second (fellow) eye with large drusen. Initial reports provide evidence of an increased rate of CNV in treatment fellow eyes, at lest for the first year after treatment. For eyes of patients with bilateral drusen, two small clinical trials show evidence of decreased CNV and better vision in treated eyes at 3 years and one large trial shows little difference between treated and untreated eyes through 18 months. The large segment of the population that might benefit, or be harmed, by laser treatment mandates a thorough evaluation of the treatment. We propose the Complications of

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Age-related Macular Degeneration Prevention Trial (CAPT) to assess the safety and effectiveness of laser treatment in preventing loss of vision among patients with bilateral drusen. Change in visual acuity will be the primary outcome variable. Secondary outcome measures will be the incidence of CNV, pigment epithelial detachment and geographic atrophy, change in contrast threshold, and change in critical point size for reading. In addition, the participating patients will be described with by their scores on both general and vision specific quality of life assessments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ANTIGEN CHORIORETINOPATHIES

IDENTIFICATION

IN

OCCULT

Principal Investigator & Institution: Bennett, Jeffrey L.; Neurology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2007 Summary: (provided by applicant): Acute zonal occult outer retinopathy, multiple evanescent white dot syndrome, acute macular neuroretinopathy, acute idiopathic blind spot enlargement syndrome, multifocal choroiditis, punctuate inner choroidopathy, and diffuse subretinal fibrosis syndrome are a group of chorioretinal inflammatory disorders of unknown etiology. These disorders possess common clinical features, and affected individuals may evolve from one condition to another during their clinical course. Vision loss may vary from mild to severe. To date, however, there are no absolute criteria to define disease subtypes, no available markers to diagnose disease or gauge prognosis, and no effective therapies. As a result, debate remains as to whether these disorders represent a related spectrum of inflammatory chorioretinopathies. Pathologic specimens have revealed a B-cell predominant inflammatory infiltrate with antibody deposition providing a rationale for our hypothesis that antibodies play a role in the pathogenesis of these disorders and are directed against retinal or choroidal antigens that trigger or propagate disease. To identify an antigen specific to occult chorioretinopathies (OC) we will: (1) identify clones in a human uveal cDNA expression Library and a random peptide library whose products react with serum from OC patients; (2) determine the disease-specificity of candidate QC-specific antigens and peptides by screening sera from patients with QC and control ocular uveitides; and (3) characterize, using molecular biologic techniques, OC-specific clones and study their pattern of expression in the retina and choroid. Identification of OC-specific markers will help classify these occult inflammatory disorders as a specific nosologic entity, generate biologic markers to diagnose preclinical and clinical disease, and develop therapeutic strategies to prevent loss of vision in affected individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: APPLIED VISUAL PERFORMANCE TESTS Principal Investigator & Institution: Brabyn, John A.; Director/Senior Scientist; SmithKettlewell Eye Research Institute Research Institute San Francisco, Ca 94115 Timing: Fiscal Year 2002; Project Start 01-JUL-1993; Project End 31-JAN-2004 Summary: The US population is aging dramatically. Vision changes are virtually inevitable with increasing age. Loss of vision is a major obstacle to independent living which reduces the quality of life in old age. The initial phase of this project has extended our knowledge about vision function among the elderly and its relationship to vision task performance, subjective visual complaints and general health and functioning. Data on a wide array of vision functions have been gathered on 902 randomly selected,

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community-living participants over the age of 55 including an unusually large number, nearly 300, over 80 years, a subgroup whose vision function was essentially unknown. Many important goals of aging studies can now be addressed by the proposed longitudinal study for which the established study cohort, validated vision tests and concurrent epidemiologic study of health and functioning present a unique opportunity. The cohort will be tested twice more during the study period using the vision test battery, questionnaires (including the NEI Quality of Life instrument), and visual task performance measures. Driving and medical records will also be collected. An independently funded, longitudinal research program will be continued to evaluate general health, nutrition and physical functioning. This information in combination with the vision-related results will provide a data set unique in scope. Specific goals include characterization of the changes in vision function and visual task performance with age; determination of health, nutrition and other risk factors for loss of vision function; assessment of the ability of the vision measures to prospectively predict health status; and development of combined risk factor models to explain the synergistic interactions between vision and other health/functioning deficits in affecting everyday task performance and quality of life. The existing collaboration between Smith-Kettlewell Eye Research Institute and the epidemiological research program at the Buck Center for Research in Aging is a unique opportunity to address issues of broad scope and importance that would otherwise require enormous financial and human resources. At the same time, valuable data on vision changes with age will be made available on a population of rapidly increasing importance whose vision function has never before been comprehensively studied. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AUTOSOMAL DOMINANT EYE DISEASE: CATALYTIC RNA TREATMENT Principal Investigator & Institution: Lewin, Alfred S.; Professor; Molecular Genetics & Microbiol; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2002; Project Start 01-JUL-1997; Project End 30-JUN-2006 Summary: (provided by applicant): The goal of this project is to develop a genetic therapy for autosomal dominant retinitis pigmentosa (ADRP). Retinitis pigmentosa is a type of inherited retinal degeneration caused by the death of rod photoreceptor cells. It affects about 1 person in 3500 and leads to a progressive loss of vision and ultimately blindness, usually over a period of decades. Mutations in over 30 genes lead to retinitis pigmentosa, but defects in the gene for rhodopsin, the major light-harvesting pigment of the rod cell, are the predominant cause of ADRP. These dominant mutations lead to a malfunctioning, mis-sorted, or poorly folded molecule that eventually kills the rod cell that makes it. Our underlying hypothesis is that reducing the expression of these mutated forms of rhodopsin can rescue rod photoreceptors and preserve vision. The genetic tool we will employ for this purpose is a catalytic RNA molecule or ribozyme. Small ribozymes can be engineered to sever almost any RNA in a sequence-specific manner. The instrument we use to introduce the ribozymes into retinal cells is recombinant Adeno-Associated Virus or AAV. During the current funding period, we have designed ribozymes specific for mutant rhodopsin mRNA present in transgenic rat models of ADRP. When delivered to animals bearing the P23H rhodopsin mutation, these hammerhead and hairpin ribozymes protected photoreceptors structurally and functionally for up to 8 months. In this proposal, we describe plans to extend these promising results by improving the ribozymes and the AAV vectors that deliver them; by testing the therapy in a large animal model of ADRP (transgenic pigs); by developing

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allele-independent ribozymes to treat a variety of rhodopsin mutations; by employing novel RNA catalysts to increase the number of potential target sites in rhodopsin mRNA; and by evaluating gene therapy in outbred mice carrying the P23H mutation. This work will be aided by non-invasive analytical techniques that permit us to monitor retinal degeneration and the efficacy of therapy in living animals. We hope that the successful completion of this project will bring us close to employing AAV-vectored ribozymes as therapy for autosomal dominant retinitis pigmentosa in human patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CADHERIN REGULATION OF AQUEOUS HUMOR OUTFLOW Principal Investigator & Institution: Stamer, W Daniel.; Associate Professor; Ophthalmology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2005 Summary: Glaucoma, the second leading cause of irreversible blindness in the United States, is a group of disorders characterized by progressive loss of retinal ganglion cells with associated loss of vision that is in most cases coincident with elevated intraocular pressure (IOP)1-3. Today and in the foreseeable future, those with glaucoma are managed clinically with pharmaceutical agents that control IP. Elevated IOP in those with glaucoma appears to be a function of defective regulatory processes mean to maintain normal IOP that result in increased resistance to outflow/4-7. A current area of focus for glaucoma research is to understand the molecular and cellular mechanisms that underlie the regulation of aqueous outflow resistance. In the present proposal, we examine the regulation of aqueous humor in the outflow pathway in a novel manner. We will study a family of transmembrane cell-cell adhesion molecules, the cadherins, in the cells of the human outflow pathway. Cadherins form adheren function complex that in the outflow pathway have only been described at the morphological level. Since homophilic protein:protein interactions of the extracellular domains of cadherins on adjacent outflow cells are critical in the integrity of intercellular junctional complexes (including adherens, occludens and gap), we hypothesize that cadherens contribute significantly to the generation of outflow resistance Our study will examine these proteins at the molecular level and a) identify the subtypes present in both TM and SC cells (normal and glaucomatous), b) analyze effects of pressure/flow on relative expression levels, subcellular distribution and turnover and c) monitor signaling molecules that regulate the formation and remodeling of proteins in the adheren complex. If successful, results obtained from these investigations will provide a basic understanding of the role of cadherin subtypes in aqueous outflow resistance, uncover novel therapeutic targets for glaucoma therapy and generate a foundation for future investigations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CANDIDATE GENES FOR PRIMARY OPEN ANGLE GLAUCOMA Principal Investigator & Institution: Hauser, Michael A.; Assistant Research Professor; Medicine; Duke University Durham, Nc 27710 Timing: Fiscal Year 2002; Project Start 02-JUL-2001; Project End 30-JUN-2006 Summary: (provided by applicant): Glaucoma is one of the leading causes of blindness in America, and affects over 15 million individuals. Loss of vision is caused by degeneration of the optic nerve, often accompanied by elevated intraocular pressure. There is a large genetic component to this disease, but the specific genes involved are not yet known. Current treatments are aimed at slowing vision loss by reducing

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intraocular pressure, but do not address the molecular basis of the disease. The goal of this project is to investigate differential gene expression in the trabecular meshwork, in order to identify genes that affect the drainage of fluid, and in turn, intraocular pressure. We hypothesize that the abnormal functioning of trabecular meshwork tissue in patients with primary open angle glaucoma (POAG) is associated with altered patterns of gene expression in this tissue. We will use Serial Analysis of Gene Expression (SAGE) to profile transcription patterns in trabecular meshwork from POAG patients as well as from young (20-40 years) and age-matched (50-70 years) controls. Genes whose expression levels are significantly up- or down-regulated in affected individuals will be investigated as candidate genes for POAG. We will also investigate genes whose expression levels changes significantly with age in normal individuals. These genes will be mapped, providing an excellent resource for future positional cloning of disease genes that affect the trabecular meshwork. Candidate genes will then be tested for association with POAG by family-based association analysis. This double screendifferential expression in affected tissue and statistical association with disease-will provide a powerful mechanism for the identification of candidate susceptibility genes. The most promising candidates will then be characterized at the molecular level and screened for mutations and polymorphisms. The identification of POAG susceptibility genes could provide the basis for diagnostic tests and lead to earlier detection of POAG and a greatly improved prognosis for the millions of patients affected with this debilitating disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ELASTIC FIBER DEFECTS IN PSEUDOXANTHOMA ELASTICUM Principal Investigator & Institution: Boyd, Charles D.; Professor and Research Director; None; University of Hawaii at Manoa Honolulu, Hi 96822 Timing: Fiscal Year 2002; Project Start 01-FEB-2000; Project End 31-JAN-2004 Summary: The aim of this proposal is to understand the biological and pathogenetic basis of elastic fiber defects in a heritable disorder of cutaneous, vascular and ocular tissue, pseudoxanthoma elasticum (PXE). PXE is a heritable disease characterized by the accumulation of abnormal elastic fibers in several elastic tissues, particularly the skin, arteries and the elastic Bruch's membrane of the retina. The aberrant deposition of calcified elastic fibers in these tissues is responsible for the development of the clinical symptoms characteristic of PXE and these include inelastic skin lesions, retinal hemorrhage with partial loss of vision and vascular defects such as gastrointestinal bleeding and myocardial infarction. The pattern of inheritance of PXE is complex and both autosomal dominant and recessive forms of the disease have been reported. Over the last few years, several groups of investigators have attempted to identify the gene mutation(s) responsible for PXE but it has only been in the last two years that three separate laboratories, including our own, have located a major locus for this disease on the short arm of chromosome 16. We have now successfully identified a region at 16p13.1 of 820kb that contains 6 candidate genes, at least one of which will contain the mutations responsible for PXE. With this new information, we hope to identify the 'PXE gene', the mutations in this gene in a cohort of PXE patients and determine a possible function for the product of the PXE gene. These goals are focused on elucidating the biology of PXE and using this information to provide a better understanding of the role of elastic fibers in more common elastic tissue diseases, particularly those skin, vascular and eye disorders characterized by tissue calcification such as the many dystrophic calcification disorders of skin, aneurysms, atherosclerosis and age-related macular degeneration.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FRAGMENTS OF TRPRS TO TREAT NEOVASCULAR EYE DISEASES Principal Investigator & Institution: Friedlander, Martin; Associate Professor; Scripps Research Institute Tpc7 La Jolla, Ca 92037 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): The vast majority of diseases that cause catastrophic loss of vision do so as a result of abnormal angiogenesis. Pathological retinal or choroidal neovascularization lead to visual loss in diabetic retinopathy (DR) and age related macular degeneration (ARMD), respectively. While inhibition of abnormal angiogenesis would not necessarily cure the underlying diseases, it would preserve vision by preventing complications associated with neovascularization such as hemorrhage and edema. We have been studying the anti-angiogenic activity of fragments of tryptophanyl-tRNA synthetase (TrpRS). In normal human cells TrpRS exists as both the full length form and a truncated form (mini-TrpRS) in which an amino-terminal domain is deleted due to alternative splicing of the pre-mRNA. This latter form is preferentially synthesized in cells exposed to interferon-w. Further truncation of mini-TrpRS results in a 42 kD form (T2) that is the most potent of the angiostatic forms of TrpRS evaluated to date. In this application we propose to further characterize the anti-angiogenic activity of TrpRS fragments and identify a candidate drug and delivery system for use in clinical trials of neovascular eye diseases. Specifically, we will: (1) examine the physiological role of TrpRS fragments in the regulation of normal and abnormal ocular angiogenesis; (2) identify and characterize the retinal receptor to which these fragments bind; (3) characterize the structural aspects of TrpRS fragments with anti-angiogenic activity and use this information to model small molecular antagonists with similar activity; (4) develop viral-, cell- and targeted liposome-based vectors for the delivery of T2 to inhibit ocular neovascularization in a variety of animal models; and (5) begin pharmacokinetic and toxicology studies on these vector, recombinant protein and/or small molecule therapeutics as a first step towards human clinical trials for the treatment of neovascular eye diseases such as neovascular ARMD, proliferative DR and rubeotic glaucoma. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENE EXPRESSION ANALYSIS IN MICROCAPTURED RETINAL CELLS Principal Investigator & Institution: Adler, Ruben; Arnall Patz Distinguished Professor; Ophthalmology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 31-MAR-2006 Summary: (provided by applicant): Retinal degenerative diseases are a major cause of visual disability and blindness worldwide. Age-related macular degeneration (AMD), for example, is the leading cause of blindness in the elderly in the Western world. Current treatments do little to alter the inexorable loss of vision due to retinal degenerations. Several studies have shown that intraocular injection of factors such as brain-derived neurotrophic factor (BDNF), ciliary neurotrophic factor (CNTF), or basic fibroblast growth factor-2 (FGF2), slows photoreceptor cell death caused by specific mutations or exposure to constant light. However, the clinical usefulness of these findings may be limited, because rescue effects are partial and transient, and some factors appear to have unwanted side effects. Elucidation of the mechanism by which survival factors delay retinal degenerations appears necessary in order to maximize

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benefits and minimize side effects. Recent studies from our laboratories have suggested that CNTF, BDNF and FGF2 do not act directly on photoreceptors; rather, they appear to act indirectly through other cells, most likely M
ller cells. Based on these observations, we propose to investigate the molecular changes triggered by neurotrophic factors in M
ller cells. The studies involve the combined use of two complementary and demanding state-of-the-art techniques: the generation of cDNA from individual cells, and their analysis using custom designed retinal cDNA microarrays. We will then establish which of these changes are important for photoreceptor survival. The potential impact of the identification of these molecules is clear, since they could offer new avenues for the treatment of these devastating diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENE THERAPY FOR RETINAL DETACHMENT Principal Investigator & Institution: Tomasek, James J.; Professor & Vice Chair for Research; Cell Biology; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2003; Project Start 16-JAN-2003; Project End 31-DEC-2005 Summary: (provided by applicant): Retinal detachment with subsequent loss of vision is a major clinical problem associated with a number of ocular diseases, including proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR). Surgery, the only treatment currently available, has a high rate of recurrence of fibrous epiretinal membrane formation and retinal detachment. Smooth muscle (SM) alphaactin containing myofibroblasts are a major cell type present in the epiretinal membranes that form in PVR and PDR and it is these cells that are responsible for generation of force leading to retinal detachment. The long-term goal of this research is to develop a gene therapy-based approach that targets and blocks the contraction of the myofibroblast. The first objective of this project is to develop a myofibroblast-specific promoter. Recent studies have suggested that the regulation of SM alpha-actin expression is different in myofibroblasts and smooth muscle cells and these studies have begun to identify regulatory elements in the promoter bf SM alpha-actin that might be responsible for these differences. Therefore, the first specific aim is to identify regulatory elements within the SM alpha-actin promoter that are specific to myofibroblasts in epiretinal membranes. To address this aim we will use transgenic mice containing a SM alpha-actin promoter/LacZ transgene in which specific regulatory elements have been deleted or mutated. These mice will be mated with a transgenic mouse model in which an epiretinal membrane containing myofibroblasts forms and contracts, with subsequent retinal detachment. The second part of our long-term goal is to be able to block the contraction of myofibroblasts in the epiretinal membranes. The expression of SM alpha-actin in myofibroblasts is functionally related to the ability of these cells to generate large amounts of contractile force. Therefore, the second specific aim is to determine whether knocking out the SM alpha-actin gene will decrease or inhibit retinal detachment. Specifically we will determine the length of time it takes for retinal detachment to occur in control and SM alpha-actin-null mice. These studies will provide the basis for developing a gene therapy-based approach that can specifically target myofibroblasts in epiretinal membranes and block their generation of contractile force thereby blocking epiretinal membrane contraction and retinal detachment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENETICS OF AGE RELATED MACULAR DEGENERATION Principal Investigator & Institution: Klein, Michael L.; Professor; Ophthalmology; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-AUG-1998; Project End 31-JUL-2003 Summary: Age-related macular degeneration (AMD) is recognized as the leading cause of blindness in the United States. It affects nearly 1.5 million older Americans and causes loss of vision in more than 7 percent of individuals over 75 years of age. Currently, there are no established means of preventing AMD. The only proven effective treatment, laser photocoagulation, is successful in only a small proportion of cases. While the etiology of AMD is unknown, there is considerable evidence implicating a strong genetic component for the disease. Advances in genomic screening and analysis methodologies make a direct genetic approach to the etiology, pathophysiology, and ultimate therapy of AMD viable. Recent successes with other complex traits, which share genetic and epidemiological similarities with AMD, support the idea that identification of genetic loci responsible for AMD is an achievable goal. The long-term objectives of this project are to identify genes responsible for AMD, develop diagnostic tools to identify patients at risk of developing the disease, and to understand its molecular pathophysiology. This understanding will allow the development of preventive measures and improved methods of treatment. The immediate goal of this research proposal is to map genetic loci cosegregating with AMD in a number of affected families. We will employ both parametric and several nonparametric linkage analysis methods. To achieve these goals, we propose to: 1) Continue to collect additional kindreds containing multiple affected living members; 2) Complete genomewide screening of AMD families, beginning with a set of candidate loci; 3) Fine-map loci suggestive of linkage and conduct detailed multi- point parametric and nonparametric linkage analysis; and 4) Refine identified loci and begin studies to identify the specific genetic defects responsible for AMD in these families. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENETICS OF AGE-RELATED MACULOPATHY Principal Investigator & Institution: Gorin, Michael B.; Associate Professor; Ophthalmology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-SEP-1993; Project End 31-JUL-2006 Summary: (provided by applicant): Age-related maculopathy (ARM) is the leading cause of irreversible blindness in the elderly population and heredity is clearly the most important risk factor. Treatment for this group of conditions is extremely limited and primarily focused on minimizing the further loss of vision in patients with advanced disease. The long range objective of this project is to identify the genetic contributions to age-related maculopathy (ARM). The goal is to better understand the causes of this condition so that eventually preventive therapies can be developed and tested in at-risk individuals. We have established a rigorous diagnosis scheme for ARM, screened a series of 12 candidate loci, completed two autosomal 10 cM genome-wide scans on a total of 400 ARM families, and, by the end of the current funding period, will have completed a third 10 cM genome-wide scan on an additional set of 200 ARM families. We have one of the largest datasets of ARM families in the world for molecular genetic studies. While we are preparing to undertake our final genome-wide scan of ARM families with CIDR, we are initiating the investigation of the six regions of potential linkage that we have already identified. We will collect additional ARM families, as well

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Loss of Vision

as sporadic ARM cases and matched controls (from spouses) for additional testing using linkage and association methods. Microsatellite genotyping of ARM families will be done to further refine potential regions of interest. We will then use single nucleotide polymorphisms (SNPs) and association methods to study the two most promising regions that contain genes involved in ARM. From these studies, we can then proceed to evaluated individual candidate genes for their potential role in this condition. We will also use our large set of ARM subjects, families and controls to test candidate genes that are tentatively identified from other research studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EPITHELIUM

HOMEOSTATIC

ABILITY

OF

THE

RETINAL

PIGMENT

Principal Investigator & Institution: Wildsoet, Christine F.; Professor; Optometry; University of California Berkeley Berkeley, Ca 947205940 Timing: Fiscal Year 2002; Project Start 01-FEB-1978; Project End 31-AUG-2003 Summary: (provided by applicant): The retinal pigment epithelium (RPE) lies in the back of the eye between the neural retina and its choroidal blood supply. This layer of epithelial cells serves to protect the health and integrity of the outer retina. In the choroid, abnormal blood vessel growth or choroidal neovascularization (CNV) occurs in diseases such as age related macular degeneration (AMD) - the major cause of blindness for people over the age of 60. Vascular endothelial growth factor (VEGF) and other proor anti-angiogenic factors are constitutively secreted by the RPE into the extracellular space on both sides of the epithelium. The effects of these molecules on RPE physiology are not known. Evidence from human pathologic specimens and from rodent models suggests that increased VEGF production by the RPE is the source of CNV. Research in this area is severely hampered by the lack of a small animal model in which VEGF secretion by the RPE induces CNV. In preliminary experiments, we have used gene transfer techniques to develop a rat model for stimulating blood vessel growth in the back of the eye. This model will be used to test the hypothesis that secretion of VEGF by RPE is critically important in generating choroidal neovascularization (CNV). Gene transfer techniques will be also used to inhibit or reduce this VEGF-induced abnormal blood vessel growth. These experiments should provide a deeper understanding of CNV and the basis for a potential therapy for diseases like AMD. Normally, there is a very close anatomical relationship between the RPE and the retina. Separation of these two tissues occurs in a whole host of pathologies that lead to the abnormal accumulation of fluid in the extracellular or subretinal space. This separation or retinal detachment can lead to a loss of vision. One of our goals is to develop a rat model of retinal detachment. This model will allow us evaluate putatively therapeutic molecules that work directly on the RPE to remove fluid from the subretinal space. This removal will restore the normal anatomical relationship between RPE and retina and should improve vision. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HYPERSPECTRAL IMAGING OF OXYGEN SATURATION IN THE ONH Principal Investigator & Institution: Khoobehi, Bahram; Professor; Ophthalmology; Louisiana State Univ Hsc New Orleans New Orleans, La 70112 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006

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Summary: (provided by applicant): The development of a non-invasive means of measuring oxygen saturation in the fundus of the human eye would be useful in the diagnosis and monitoring of numerous disorders, including diabetic retinopathy, arterial venous occlusion disease, and glaucoma. In these studies, a practical system to evaluate oxygen saturation in the retina and optic nerve head using a recent innovation, hyperspectral imaging, will be developed. The hyperspectral technique measures spectral changes within the visible and infrared spectra and provides information on the molecular state of hemoglobin. The hyperspectral imaging device will allow measurement - non-invasively and in real time - of reduction and/or elevation in tissue oxygenation. The distinct optical signature of biological materials such as oxyhemoglobin and deoxy-hemoglobin as a function of their reflectance spectra will enable determination of their relative concentrations. In recent years, reflectance oximetry has been developed for the non-invasive measurement of oxygen saturation changes in the vessels of the fundus using double, triple, and multiple wavelength reflectance imaging. The hyperspectral reflectance oximetry that will be employed in these studies will permit the first non-invasive measurement for oxygen saturation in the optic nerve head tissue, and the hyperpectral data to be collected will intrinsically include all of the multiple wavelength spectra obtained in earlier approaches. The new system will be tested in two specific aims: 1) hyperspectral imaging will be used to non-invasively evaluate the stimulus-response relationship between perturbations in intraocular pressure (lOP) (10-50 mm Hg) and oxygen saturation in optic nerve head tissues and in retinal artery/vein pairs for a graded series of hypoxic states, and 2) the same studies will be performed in eyes with early stage experimental glaucoma. With this new approach, it will be possible to determine how acute changes in lOP alone or in combination with chronic lOP elevation (glaucoma) affect the three distinct microcirculations of the optic nerve head (surface nerve fiber layer; prelaminar region; lamina cribrosa) independently and/or collectively. The proposed studies are motivated by the potential for clinical application of this innovative technology in the early diagnosis of and monitoring of therapy for ocular vascular diseases in which the associated hypoxia may eventually lead to loss of vision. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IDENTIFYING AND REDUCING ERRORS WITH SURGICAL SIMULATION Principal Investigator & Institution: Fried, Marvin P.; Montefiore Medical Center (Bronx, Ny) Bronx, Ny 104672490 Timing: Fiscal Year 2002; Project Start 27-SEP-2001; Project End 31-AUG-2004 Summary: The training of a surgeon requires the acquisition of a number of characteristics. These include a knowledge base (cognitive), problem formulation, decision processing, psychosocial relationships and others that can be evaluated and graded by objective testing such as National Board or Specialty Certifying examinations. Critical to the surgeon are the technical skills that are at the core of the profession. This proposal responds to the need to create a battery of sophisticated devices and objective measurements to teach and evaluate the inherent technical ability of trainees. We hypothesize that by innovative, state- of-the-art simulation, devices that train both surgical tasks and skills through repetitive proctored challenges, without risk to patients, will allow for detection and analysis of surgical errors and "near misses". In an analogy to flight simulation, "near miss" detection is where potential errors are found and complications prevented Using a number of otolaryngology residencies, a controlled training curriculum will be developed based on complimentary simulation

14

Loss of Vision

tools [the endoscopic sinus surgery simulator (ES3), minimally invasive surgical trainer virtual reality (MIST VR), perceptual and 3- dimensional testing] with objective metrics used for assessment of trainees. Technical errors will be identified, quantified and used to train and monitor surgical performance and for outcomes analysis to improve patient safety. Some current validated metrics include: time- to-completion, errors, economy of motion and psychomotor tracking. Correlation with psychometric parameters (perception, psychomotor, visio-spatial, cognitive mapping, etc.) will be used to identify technical errors and to validate both the simulator and the curriculum. The collaborating investigators and institutions have expertise in the areas of metrics, curriculum, database development, simulator creation and modification, and outcomes analysis. Endoscopic sinus surgery is the operation substrate since it is frequently performed (greater than 300,000 procedures annually) and carries a significant risk of injury to the contiguous structures ofthe eye (loss of vision and /or eye motion) and brain (CSF leakage, meningitis, death). The ES3 is also the most advanced surgical simulation device existing and based largely on jet pilot flight simulation (Lockheed Martin). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INTERACTION OF HSV-1 LAT GENE & DENDRITIC CELLS FUNCTION Principal Investigator & Institution: Benmohamed, Lbachir; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, Ca 900481804 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-AUG-2002 Summary: (Applicant's Abstract): Ocular HSV-1 is a leading cause of corneal blindness due to an infectious agent. Our long term goal is to understand how HSV-1 evades the immune response thereby enhancing latency and recurrent disease even in the face of local and systemic immunity. The antigen presenting dendritic cells (DC) play a central role in initiation and modulation of local and systemic immunity. HSV-1 can infect DC and interfere with their maturation (a process critical to DC function). This may help HSV-1 evade the host immune response. As the only HSV-1 gene abundantly transcribed at all times, LAT is a candidate, for modulating DC activity during both acute and latent infection. Preliminary studies suggest that LAT can alter DC cytokine expression. Thus, LAT can affect DC. We hypothesize here that LAT is critical for HSV1's ability to interfere with DC maturation. We further hypothesize that HSV-1 can inhibit DC trafficking (another critical DC function), and that LAT is also critical for this viral activity. If correct, these hypotheses would reveal a novel immune evasion strategy and open new doors to novel immunotherapeutic interventions against acute and recurrent HSV-1 infections. This would lead to the development of methods to greatly alleviate suffering and loss of vision due to recurrent ocular HSV-1. Our Specific Aims include: 1. Determine if the ability of HSV-1 to interfere with DC maturation is due to LAT. In vitro and in vivo studies will be done to determine if infection of DC with HSV1 LAT+, but not HSV-1 LAT-, will block membrane expression of MHC and costimulatory molecules, and inhibit HSV and non-HSV antigen presentation by DC. The ability of plasmids expressing LAT to block MHC and co-stimulatory molecule expression and inhibit antigen presentation will also be examined. 2: Determine if LAT alters DC migration. (a)Determine if LAT modulates cytokine and chemokine secretion by DC and chemokine-receptor expression on DC, all of which are involved in migratory activity of DC. (b)Determine if LAT changes the observed migratory activity of DC. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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15

Project Title: NEURAL RESCUE AND REPLACEMENT IN GLAUCOMA Principal Investigator & Institution: Jhaveri, Sonal; Principal Research Scientist; Brain and Cognitive Sciences; Massachusetts Institute of Technology Room E19-750 Cambridge, Ma 02139 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 28-FEB-2006 Summary: (provided by applicant): Glaucoma is a disease that affects millions of people worldwide, and for which there is no cure. The major focus of current strategies for glaucoma management is to preserve the vision that remains at the time of diagnosis. In afflicted eyes, retinal ganglion cells (RGCs) are lost, leading to an irrevocable loss of visual function. However, with the discovery of neural stem cells (NSCs), and with the finding that stem cells exist in the ciliary margin of the adult retina, the promise of RGC rescue/replacement, along with recovery of visual function, has becoming increasingly real. The ultimate goal of the work outlined here is intended to help develop a clinical means of restoring normal vision in human glaucoma patients. Using rodent models of glaucoma and RGC apoptosis (the type of cell death seen in glaucoma), we propose a multi-pronged approach that employs NSCs to rescue and replace sick or dead RGCs; we will also use axogenic factors in combination with NSCs to stimulate axon extension from the rescued or replaced neurons. Our pilot observations suggest that one of the NSC lines that we have used may provide trophic support to dying RGCs -these cells will be applied towards rescuing RGCs whose axons have been damaged. A second cell line has reportedly been used successfully to replace damaged retinal neurons (including RGCs) in dystrophic and mechanically damaged eyes; our aim is to use this second type of NSC to replace RGCs in glaucomatous eyes. In addition, specific neurite growth-inducing molecules or surgical manipulations that we have found to induce fiber extension, will be used to stimulate long distance axon projections from replaced RGCs. These experiments will be complemented with similar studies using stem cells harvested from the retina itself. The proposed studies will reveal the potential for using NSCs and axon-growth promoting molecules to reverse loss of vision in glaucomatous eyes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: OCULAR SURFACE HISTATINS: SYNTHESIS AND FUNCTION Principal Investigator & Institution: Steele, Pamela S.; Ophthalmology and Visual Scis; University of Louisville Jouett Hall, Belknap Campus Louisville, Ky 40292 Timing: Fiscal Year 2002; Project Start 30-SEP-2001; Project End 31-AUG-2004 Summary: (Applicant's Abstract) Histatins are small cationic peptides present in human saliva which exhibit potent antifungal properties and contribute to the non-immune (innate) protection of the oral mucosa. Structural, embryological, and functional similarities shared by oral and ocular mucosal membranes suggest the development of common antimicrobial defense strategies. Preliminary studies in this laboratory have, for the first time, demonstrated the presence of histatin in the both the conjunctiva and lacrimal gland. Diverse populations including the immunocompromised, diabetic and elderly patients are particularly susceptible to fungal infection of mucosal surfaces. These infections are often resistant to standard therapies and, in the case of the ocular surface, can lead to permanent loss of vision. Enhancement of innate mucosal defense capabilities is therefore a potentially effective strategy for controlling and combating such infections. We propose to identify and quantify the-histatin in tear film by mass spectroscopy. In situ hybridization of ocular tissues will allow for-the localization of histatin transcripts. Cytokine and microbial challenge to human conjunctival cells and

16

Loss of Vision

subsequent quantification of histatin transcripts by competitive PCR will identify the regulatory mechanisms of histatin transcription. Lastly, we will quantify salivary and lacrimal histatin from Sjogren's patients in order to determine the effect of autoimmune destruction of glandular tissue on the abundance of this antifungal peptide. These studies will contribute to the development of innovative therapeutic strategies to combat fungal infection in ocular tissue. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PAX-6 AS A KEY REGULATOR OF LENS DEVELOPMENT Principal Investigator & Institution: Cvekl, Ales; Ophthalmology and Visual Scis; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2002; Project Start 01-JAN-2000; Project End 31-DEC-2004 Summary: (from abstract): The long-term goal of this application is to identify those interactions between Pax-6 and other transcription factors that are required for normal lens development and transparency. Pax-6, a paired domain and homeodomain containing transcription factor, is essential for lens formation and function. Mutations in Pax-6 cause several human ocular diseases: aniridia, Peter's anomaly, autosomal dominant keratitis, foveal hypoplasia, and some forms of cataract. These defects lead to loss of vision. It is recognized that lens refraction and transparency depend on the accumulation of high concentrations and short-range interaction of multifunctional proteins, the crystallins. Recent in vivo studies demonstrated that missexpression of crystallins can lead to lens opacification resulting in cataracts. In order to carry out this long term goal of this project the following specific aims are proposed,-. (1) To identify and functionally characterize general trancription factors that interact with and mediate the transcriptional activity of Pax-6; (2) To identify and functionally characterize other DNA binding and non-DNA binding transcription factors that synergistically interact with Pax-6. These specific aims will be achieved using an integrative approach involving functional in vitro (transcription using recombinant factors and nuclear extracts) and in vivo (transfections of cultured lens and non-lens cells) studies combined with proteinDNA binding assays using recombinant proteins and lens nuclear extracts, and proteinprotein interactions studied in solution and on a solid matrix. The feasibility of the proposed study is demonstrated by preliminary data demonstrating those lens crystallin genes which are targets for Pax-6, identifying those other transcription factors that act in conjunction with Pax-6 (e.g. retinoic acid activated nuclear receptors), and by demonstrating the function of crystallin promoters fused to reporter genes in both transfected lens cells and in transgenic mice. Collectively, these studies form the basis for a functional model of Pax-6 mediated gene regulation that applies to both crystallin gene regulation and noncrystallin genes expressed in the lens. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PHARMACOLOGICAL NEUROPROTECTION IN GLAUCOMA Principal Investigator & Institution: Neufeld, Arthur H.; Senior Scientist; Ophthalmology and Visual Sci; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 01-JUL-1998; Project End 30-APR-2004 Summary: Primary open-angle glaucoma and normal pressure glaucoma are sight threatening, age-related, eye disease that are often associated with intraocular pressure (IOP). Current treatments of the diseases are based on lowering the IOP, by pharmacological or surgical means, to prevent further degeneration of the optic nerve

Studies

17

and loss of vision. Recent investigations on the cellular basis of neuronal degeneration in general, and the optic nerve in particular, have led to speculation that therapies directly aimed at preventing, slowing or reversing glaucomatous optic neuropathy can be developed. The long-term objective of this work is the identification of a class of compounds that could be developed as a pharmacological neuroprotective agents for the treatment of patients with glaucomatous optic neuropathy. Significant observations, made by this laboratory in human glaucomatous tissue, have described the presence of NOS-1, -1, -3, as well as COX-1 and -2, in the optic nerve head. Some of these pathways may contribute to neurodestruction in this tissue. The completion of the proposed specific aims: 1) identification of which isoforms of nitric oxide synthase (NOS) and cyclooxygenase (COX) pathways are upregulated or induced in human glaucomatous optic neuropathy, 2) demonstration of these specific pathways in the rat eye during optic nerve degeneration, and 3) study of the pharmacological inhibition of these specific pathways in a rat model of elevated IOP, will advance the development of the next generation of drugs to treat glaucoma. The proposed investigations are designed to first extend the observations in humans, by using immunohistochemistry, in situ hybridization, and reverse transcriptase-polymerase chain reaction, so that specific isoform pathways can be targeted for study in the rat. In the rat, optic nerve degeneration will be modeled using three approaches: chronic, moderately elevated IOP by three scleral vessel cautery, retinal ischemia by acute elevated IOP, and optic nerve transection. Specific pharmacological intervention will be tested in the rat model against NOS and COS isoform pathways that are identified in human glaucomatous tissue and potentially contributing to neurodestruction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHYSIOLOGY AND PATHOPHYSIOLOGY OF PHOTORECEPTORS Principal Investigator & Institution: Kraft, Timothy W.; Physiological Optics; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 01-APR-1994; Project End 31-MAR-2005 Summary: Retinal degeneration is a major cause of blindness in our elderly population as well as the tens of thousands of younger Americans afflicted with inherited retinal degenerations such as retinitis pigmentosa (RP). Photoreceptor degeneration is a final common pathway resulting in loss of vision for many insults to the eye, including many mutations of rhodopsin or other proteins of the phototransduction cascade. In retinal degenerations caused by mutations in rod-specific genes, it is equally important to comprehend why the normal cone photoreceptors also die bringing patients from night blindness to near total blindness. We propose experiments on two newly characterized animal models of autosomal dominant retinitis pigmentosa, the transgenic pig carrying mutant rhodopsin. This grant will answer three important questions: (1) How do the P347L and P347S rhodopsin mutations alter normal phototransduction and rod signaling? (2) How do electrophysiological recordings of single cell photoresponses compare to those same responses derived by indirect methods with the electroretinogram (ERG)? This project will document the ERG's capacity as a tool used to probe photoreceptor function. Massive loss of rod photoreceptors in these animals and in patients with RP somehow kills the cone photoreceptors as well. If cone function could be rescued, a substantial portion of human visual behavior would remain intact. (3) What are the pathologic changes in the physiology of cone photoreceptors associated with retinal degeneration due to rhodopsin mutations in the pig? The past decade has seen tremendous advances in the understanding of the biochemistry and molecular biology of phototransduction, yet little is known about photoreceptors pathophysiology.

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We will investigate the single cell photocurrents with the suction electrode technique to examine the changes that take place throughout the course of the retinal degeneration and loss of vision. Several biophysical parameters of the rods and cones will be measured at 3 to 5 stages over a period in which all the rods and half the cones are lost. We will also examine the photoreceptor responses to flickering light which is predicted to be a sensitive indicator of cell health. Statistical analyses will determine major and minor effects. We will establish a quantitative physiological database for photoreceptor function in a degenerating retina coordinated with ERG evaluations of the retina at the same stages of disease. This data base will be useful in judging therapeutic intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RETINOPATHY PATHOGENESIS

OF

PREMATURITY:

UNDERSTAND

ITS

Principal Investigator & Institution: Penn, John S.; Professor; Ophthalmology and Visual Scis; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2002; Project Start 01-APR-1988; Project End 30-JUN-2005 Summary: New developments in neonatal technology have resulted in the survival of smaller infants who have limited retinal vascular development at birth and, thus, greater susceptibility to retinopathy of prematurity (ROP). It is reasoned that as more and smaller premature babies survive, the incidence of visual loss from ROP will continue to increase unless effective treatments are found. Advanced ROP is characterized by a period of unregulated growth of retinal blood vessels. This growth occurs by a process known as angiogenesis, indicating that the new vessels form by an abnormal sprouting of exiting vessels. The loss of vision from angiogenesis is not unique to ROP; collectively, ocular disorders with this feature constitute the leading cause of blindness in the U.S. The significance of research aimed at understanding retinal angiogenesis in an animal model of one of these diseases is amplified by the potential of applying the new knowledge to other ocular conditions in which angiogenesis plays a role. The ultimate goal of this project is to develop methods to prevent retinal angiogenesis based upon understanding gained from studies of relevant models. We propose to use pure cultures of retinal microvascular endothelial cells (RMEC), a well- established rat model of ROP and a mouse model of ROP currently under refinement. With these tools, we will address the following four interrelated aims: 1) investigation of the role of a pivotal tyrosine kinase, Src, in RMEC proliferation and tube formation and in ROP-related retinal angiogenesis; 2) characterization of the proteolytic aspect of ROP-related retinal angiogenesis, emphasizing PAI-1, MMP-2 and 9 and TIMP-2; 3) characterization of the roles of angiopoietins 1 and 2 in retinal vasculogenesis and angiogenesis; and identification of factors responsible for the angiostatic effect of penetrating ocular injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ROLES OF TOXINS IN ENDOPHTHALMITIS Principal Investigator & Institution: Gilmore, Michael S.; Vice President for Research; Microbiology and Immunology; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2002; Project Start 01-AUG-1989; Project End 29-SEP-2006 Summary: (provided by applicant): Endophthalmitis is one of the most sight-threatening complications of ocular surgery or penetrating injury. Despite aggressive therapeutic and surgical intervention, endophthalmitis frequently results in partial to complete loss

Studies

19

of vision, often within a few days of infection. The overarching goal of this research is to develop a scientific basis for management of endophthalmitis, based on the optimized use of antimicrobial and anti-inflammatory agents, toward enhancing the recovery of useful vision. The following specific aims of the proposed 5 year continuation period are designed, based on the results from the previous period of support, to advance this goal: Specific Aim 1: Determine the molecular basis of virulence for the most common etiology of endophthalmitis associated with visual loss. Specific Aim 2: Develop a murine model system that permits complete analysis of host and bacterial factors that contribute to the pathogenesis of endophthalmitis, and determine the basis for 1) differences in pathogenesis of endophthalmitis due to virulent and avirulent organisms, 2) differences in the pathogenesis of endophthalmitis when infection is acquired by anterior and posterior routes, and 3) the contribution of immune privilege to the pathogenesis of endophthalmitis and mechanisms by which this may be undermined by specific pathogens. Specific Aim 3: Resolve the current controversy surrounding the use of anti-inflammatory adjunctive therapies in endophthalmitis management, and test new specifically targeted therapies for their value in mitigating visual loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SOLUTE AND FLUID TRANSPORT ACROSS THE CONJUNCTIVA Principal Investigator & Institution: Candia, Oscar A.; Professor; Ophthalmology; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 01-JAN-1997; Project End 31-DEC-2003 Summary: Ion pumps and cotransport systems in animal cell membranes maintain cellular ionic composition, transport electrolytes and fluid across epithelia and contribute towards the regulation of cell volume. Thus, it is reasonable to expect that ion pumps in the conjunctival epithelium should play a crucial role in maintaining an optimal tear film, a necessity for a normal functioning ocular surface. However, the transport properties of this epithelium, which interfaces with the tears, are virtually unknown. Therefore, this project will use electrophysiological, radio-labelled tracer and microspectrofluorometric techniques to characterize the transport functions of the rabbit conjunctiva. A thorough understanding of the basic physiology of this cell layer may be relevant to the design of future treatment modalities for dry eye syndrome - a disorder, affecting countless individuals worldwide, that can lead to the loss of vision. The PI will 1) determine the effects of biological activators (i.e., hormones, neurotransmitters, etc.) on macroscopic conductances across the rabbit conjunctival epithelium; 2) determine the nature of the Na+ absorptive process in the apical (tear-facing) surface of the epithelium; 3) complete the characterization of the C1- secreting mechanism; 4) determine the identity of electrically silent transporters that may be present, with emphasis on those usually associated with intracellular pH and cell volume regulation; and 5) determine the diffusional H20 permeability (Pdw) and osmotic permeability (Pf). From these studies the PI expects to be able to construct a model detailing whether this epithelium functions as a fluid secreting or absorbing epithelium. Based on this model, he will devise protocols to modify and possibly reverse the secretory/absorptive properties of the tissue. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DYSTROPHY

THE

GENE

FOR

SCHNYDER'S

CRYSTALLINE

CORNEAL

Principal Investigator & Institution: Weiss, Jayne S.; Professor; Ophthalmology; Wayne State University 656 W. Kirby Detroit, Mi 48202

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Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: Schnyder's crystalline corneal dystrophy (SCCD; OMIM number 121800) an autosomal dominant disease in which there is abnormal deposition of cholesterol and lipid in the cornea resulting in opacification and loss of vision. The dystrophy may manifest early in life and clinical appearance includes central corneal opacification, subepithelial cholesterol deposition, mid- peripheral stromal opacification and/or arcus lipoides. SCCD has been mapped to the chromosome 1p36.2-p36.3 with a maximum multipoint lod score of 8.48 in the interval between genetic markers D1S214 and D1S503 using two large Swede-Finn kindreds from Massachusetts. Haplotype analysis suggested that the SCCD gene is located in the 16 cM interval between markers D1S2663 and D1S228. In the present application, we propose to identify the gene which is responsible for SCCD. To accomplish this goal we will: 1) continue to fine map the disease locus with several additional families that display SCCD. The new and the original two large families will also be typed for additional polymorphic markers that map in the disease interval to help narrow the locus; 2) examine potential candidate genes that map to the refined disease interval to search for polymorphisms and/or mutations that may give rise to SCCD. Sequence polymorphisms and/or mutations will be examined for co-segregation with SCCD in the families (NOTE! The defined region will be most likely completely sequenced by the time the grant is funded making it unnecessary to screen cDNA libraries for extended sequence information. Also, this means that the mutation screening can be accomplished by using genomic DNA as a starting material. The term "potential candidate" here means that we will first search for mutations in those genes whose function is known and which are biologically relevant candidates. If no mutations are found in these genes the search will continue to genes with unknown function that are located in the defined candidate interval); and 3) use microarray expression profiling to identify differences in the expression levels of cDNAs mapped to the candidate interval in corneal tissue samples between SCCD patients and controls. Identification of the gene at fault and the specific mutations responsible for SCCD phenotype will not only afford increased understanding about SCCD but may provide insight into lipid metabolism in the cornea and elsewhere. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE ROLE OF GK IN HSV-1 INDUCED CORNEAL SCARRING Principal Investigator & Institution: Ghiasi, Homayon; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, Ca 900481804 Timing: Fiscal Year 2002; Project Start 09-SEP-2002; Project End 30-JUN-2006 Summary: (provided by applicant): Recurrent infection of HSV-1 causes corneal scarring (CS) and is the leading cause of infectious corneal blindness in the United States. Passive transfer experiments have shown that antibody to HSV-1 glycoprotein K(gK) severely exacerbates CS in mice ocularly challenged with HSV-1. The gK antibody produces antibody dependent enhancement (ADE), which results in increased HSV-1 infectivity and higher viral load in the eye. This in turn leads to an increase of all immune responses examined in the eye, including the as yet undetermined immune response that directly causes exacerbation of CS. For whatever reason, protective immune responses, which are presumably also increased by gK antibody ADE, are not able to block the effect of the "harmful" immune response and CS is severely exacerbated. We hypothesize that: (a) In humans anti-gK antibody correlates with HSV-1 induced corneal scarring (CS), and (b) blocking anti-gK antibody will decrease corneal scarring (CS) (by blocking ADE). Our specific aims to test the above hypotheses are: (1) Confirm that antigK antibody correlates with CS in humans; (2) Map the gK epitopes that cause ADE and

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CS; and (3) Block anti-gK-antibody to decrease ADE and CS. If the studies proposed in this grant application confirm that gK antibody is involved in CS in humans, two exciting scenarios will be possible. (i) A method to interfere with or block anti-gK antibody could be developed (for example, blocking with gK peptides). This would decrease the severity of CS and subsequent loss of vision. (ii) Sera from HSV-1 seropositive individuals could be screened for anti-gK antibody titer and those with a high expected susceptibility to recurrent HSV-1 CS could receive prophylactic treatment (such as Acyclovir) even before their first incidence of severe recurrent disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: V1 TO V2 PROJECTIONS IN NORMAL VISION AND AMBLYOPIA Principal Investigator & Institution: Sincich, Lawrence C.; Ophthalmology; University of California San Francisco 3333 California Street, Suite 315 San Francisco, Ca 941430962 Timing: Fiscal Year 2002; Project Start 01-AUG-2002 Summary: In primates, visual information passes from the primary visual area (V1) to the second visual area (V2) before distribution to higher cortical areas. An accurate description of the projections linking V 1 and V2 is crucial for understanding how the brain deciphers visual images. Prior studies have shown that V2 is partitioned into three compartments, known as pale, thin, and thick stripes, defined by their content of a metabolic enzyme called cytochrome oxidase (CO). Our principal goal is to describe the anatomical projections from V1 to each V2 stripe compartment. In Specific Aim #1 we will make injections of a retrograde tracer into single CO stripes in V2 of normal macaques. The resulting pattern of labeled cells in V1 will be correlated with the V2 stripe that received the injection. Our preliminary data indicate that, contrary to a previous report, layer 4B and interblobs both project to thick stripes and pale stripes. In Specific Aim #2 we will make paired injections of two different tracers into adjacent thick stripes and pale stripes to determine if different subpopulations of cells in layer 4B and interblobs project to these V2 compartments. In Specific Aim #3 we will make injections of [3H]proline into V1 to correlate patches of efferent projections with CO staining patterns in V2. In Specific Ai/s #4 we will examine the V1->V2 projections in animals raised with early monocular deprivation. These experiments will advance our knowledge of the mechanisms underlying amblyopia, an important cause of visual loss that affects 2% of the American population. We hypothesize that a selective loss of V1>V2 projections emanating from the ocular dominance columns serving the deprived eye contributes to the loss of vision in amblyopia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: VIDEO RATE OCT FOR EVALUATING GLAUCOMA Principal Investigator & Institution: De Boer, Johannes F.; Assistant Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2007 Summary: (provided by applicant): Glaucoma is the second leading cause of blindness worldwide. In the United States, approximately 2.5 million Americans are affected by this potentially blinding eye disease. Optical coherence tomography is the only noninvasive imaging technique allowing high-resolution cross-sectional imaging of the human retina. Since glaucoma causes thinning of the retinal nerve fiber layer prior to initial loss of vision, optical coherence tomograhy (which can measure the nerve fiber layer thickness) could enable early detection of glaucoma prior to any permanent loss of vision. This earlier detection would enable earlier treatment to prevent permanent loss

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of vision. Since glaucoma also causes progressive nerve fiber layer thinning prior to further loss of vision, optical coherence tomography could enable earlier detection of glaucomatous disease progression prior to further permanent loss of vision, enabling more aggressive preventive treatment. Current clinical techniques only allow diagnosis of glaucomatous loss of vision after up to half of the retinal ganglion cells are permanently lost. The overall goal of this research is A) to develop a video rate Optical Coherence Tomography (OCT) system for 3 dimensional high resolution imaging of the human retina and the retinal nerve fiber layer (RNFL), B) to determine the resolution and reproducibility of in vivo retinal nerve fiber layer thickness determination with video rate OCT in normal and glaucoma subjects, C) to correlate in vivo human OCT images with histology of the same eye. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: X-LINKED RETINITIS PIGMENTOSA Principal Investigator & Institution: Swaroop, Anand; Professor; Ophthalmology and Visual Sciences; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-JUL-1990; Project End 31-DEC-2005 Summary: (provided by applicant): The death of retinal photoreceptors as a result of genetic mutations or environmental abuse leads to irreversible loss of vision. X-linked retinitis pigmentosa (XLRP) is perhaps the most devastating of such diseases because of relative severity of phenotype and an early age of onset. Although several genetic loci have been mapped, a majority of XLRP can be accounted by RP3 and RP2 subtypes; the corresponding genes for the two loci, RPGR and RP2, respectively, have recently been isolated. RPGR and RP2 mutations have so far been identified in <50 percent of North American XLRP families. The RPGR protein shows homology to RCC1 (a guanine nucleotide exchange factor for Ran-GTPase), demonstrates a complex isoform profile because of alternative splicing, and is suggested to be involved in intracellular transport. The RP2 protein has similarity to cofactor C, which is a GTPase-activating protein involved in tubulin processing. The functions of RPGR and RP2 proteins in the retina are unknown. The mechanisms of photoreceptor degeneration caused by mutations in RPGR or RP2 are not understood. No treatment or cure is currently available for XLRP. This competing renewal application requests support to continue our decade-long investigations on the pathogenesis of XLRP. We hypothesize that RPGR and RP2 participate in intracellular transport and/or signaling pathways and that their functions are critical in the photoreceptors or retinal pigment epithelium (RPE). The specific aims of the project are: (1) To determine the expression and subcellular localization of RPGR and RP2 proteins in the developing and mature retina by using a battery of wellcharacterized polyclonal and monoclonal antibodies. (2) To identify proteins that interact and form complexes with RPGR and RP2 in the retina and develop biochemical assays to assess their function. We are using the yeast two-hybrid strategy to initially identify interacting proteins. The specificity of interaction will be further evaluated by GST-pull down and co-immunoprecipitation assays. Immuno-affinity chromatography will be used to purify RPGR- and RP2-containing complexes from bovine retina. Studies will be initiated to examine the biochemical activity of RPGR and RP2 and their interacting proteins. (3) To create conditional null mutations of mouse Rpgr and Rp2in retinal photoreceptors and RPE and investigate the pathogenesis of disease. Cre-lox technology will be utilized to achieve this goal. The proposed studies seek to unravel the biological functions of RPGR and RP2 in the retina with a goal of understanding how mutations in these two cause retinal degeneration. These investigations promise to

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provide significant insights into the pathogenesis of XLRP and may lead to novel targets for gene-based therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with loss of vision, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “loss of vision” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for loss of vision (hyperlinks lead to article summaries): •

A 27-year-old woman with gradual unilateral loss of vision of one year's duration. Author(s): Jennis RS, Govoni AF, Whitney K. Source: Clinical Imaging. 1992 July-September; 16(3): 204-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1498709

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Acquired anomalous head posture following loss of vision in one eye. Author(s): Nucci P, Rosenbaum A. Source: Acta Ophthalmologica Scandinavica. 2002 February; 80(1): 109-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11906317

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Acute aphasia and loss of vision with desferrioxamine overdose. Author(s): Dickerhoff R. Source: Am J Pediatr Hematol Oncol. 1987 Fall; 9(3): 287-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2445217

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Acute loss of vision during pregnancy due to a suprasellar mass. Author(s): Kerrison JB, Lee AG, Weinstein JM. Source: Survey of Ophthalmology. 1997 March-April; 41(5): 402-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9163837

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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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Acute psychiatric decompensation with sudden loss of vision. Author(s): Freedland RJ, Boyden DG, Michelson JB, Mannis M, Sugar A, Sugar J. Source: Survey of Ophthalmology. 1985 November-December; 30(3): 182-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4081978

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Adaptative effects of loss of vision on upright undisturbed stance. Author(s): Rougier P, Farenc I. Source: Brain Research. 2000 July 21; 871(2): 165-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10899283

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Anemia and hypotension as contributors to perioperative loss of vision. Author(s): Brown RH, Schauble JF, Miller NR. Source: Anesthesiology. 1994 January; 80(1): 222-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8291715

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Assessment of colour vision as a screening test for sight threatening diabetic retinopathy before loss of vision. Author(s): Ong GL, Ripley LG, Newsom RS, Casswell AG. Source: The British Journal of Ophthalmology. 2003 June; 87(6): 747-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12770974

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Bilateral eye pain and loss of vision. Author(s): Davidson P, Shockley L. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 1997 November; 4(11): 1068-9, 1086, 1095-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9383493

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Bilateral loss of vision and macular ischemia related to Behcet disease. Author(s): Garcher C, Bielefeld P, Desvaux C, Besancenot JF, Bron A. Source: American Journal of Ophthalmology. 1997 July; 124(1): 116-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9222248

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Bilateral loss of vision in bright light. Author(s): Wiebers DO, Swanson JW, Cascino TL, Whisnant JP. Source: Stroke; a Journal of Cerebral Circulation. 1989 April; 20(4): 554-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2929033

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Bilateral loss of vision in bright light. Author(s): Giroud M, Gras P, Dumas R, Becker F. Source: Stroke; a Journal of Cerebral Circulation. 1991 March; 22(3): 415-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2003316

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Bilateral optic disc edema and multifocal retinal lesions without loss of vision in cat scratch disease. Author(s): Bafna S, Lee AG. Source: Archives of Ophthalmology. 1996 August; 114(8): 1016-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8694710

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Bilateral total loss of vision following eclampsia--a case report. Author(s): Waziri-Erameh MJ, Omoti AE, Edema OT. Source: Afr J Reprod Health. 2003 August; 7(2): 106-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14677305

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Blind drunk: alcoholic pancreatitis and loss of vision. Author(s): Steel JR, Cockcroft JR, Ritter JM. Source: Postgraduate Medical Journal. 1993 February; 69(808): 151-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8506200

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Case record of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 7-2003. A 43-year-old man with fever, rapid loss of vision in the left eye, and cardiac findings. Author(s): Rubin RH, King ME, Mark EJ. Source: The New England Journal of Medicine. 2003 February 27; 348(9): 834-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12606739

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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 2-2002- a 58-year-old woman with unilateral loss of vision and postmenopausal bleeding. Author(s): D'Amico DJ, Dryja T. Source: The New England Journal of Medicine. 2002 January 17; 346(3): 189-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11796854

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Casebook: sudden painless loss of vision. Author(s): Hughes EH, Murphy CC. Source: The Practitioner. 2004 January; 248(1654): 24-7, 29-30, 32-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14997739

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Causes of loss of vision in congenital glaucoma. Author(s): Morin JD, Bryars JH. Source: Archives of Ophthalmology. 1980 September; 98(9): 1575-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7425918

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Common ocular injuries and disorders. Part I: Acute loss of vision. Author(s): Lawlor MC. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 1989 January-February; 15(1): 32-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2664306

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Degas' loss of vision: evidence for a diagnosis of retinal disease. Author(s): Ravin JG, Kenyon CA. Source: Survey of Ophthalmology. 1994 July-August; 39(1): 57-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7974192

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Diabetes mellitus, fever, proptosis, and rapid loss of vision. Author(s): Goswami R, Tandon N, Thulkar S, Kochupillai N. Source: Postgraduate Medical Journal. 1996 October; 72(852): 633-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8977954

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Fulminant orbital cellulitis with complete loss of vision. Author(s): Connell B, Kamal Z, McNab AA. Source: Clinical & Experimental Ophthalmology. 2001 August; 29(4): 260-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11545428

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Giant cell arteritis with polymyalgia rheumatica, loss of vision, and abdominal symptoms occurring during a four year course. Author(s): Simkin PA, Healey LA. Source: Arthritis and Rheumatism. 1969 April; 12(2): 147-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5777770

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Giant cell arteritis: loss of vision during corticosteroid therapy. Author(s): Faarvang KL, Pontoppidan Thyssen E. Source: Journal of Internal Medicine. 1989 March; 225(3): 215-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2703803

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Gradual loss of vision. Author(s): Reich J. Source: Aust Fam Physician. 1998 March; 27(3): 143-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9529700

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HLA-antigens in long standing insulin dependent diabetics with terminal nephropathy and retinopathy with and without loss of vision. Author(s): Jervell J, Solheim B. Source: Diabetologia. 1979 December; 17(6): 391. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=395007

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How do general practitioners diagnose and manage patients with transient monocular loss of vision of sudden onset? Author(s): Donders RC, Kappelle LJ, Algra A, van Dijk GW, van Gijn J. Source: Journal of Neurology. 1999 December; 246(12): 1145-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10653306

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Incidence of loss of vision in the healthy eye in amblyopia. Author(s): Tommila V, Tarkkanen A. Source: The British Journal of Ophthalmology. 1981 August; 65(8): 575-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7295619

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Information loss: the primary psychological trauma of the loss of vision. Author(s): Hershberger PJ. Source: Percept Mot Skills. 1992 April; 74(2): 509-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1594411

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Intracranial plasmacytoma causing acute unilateral loss of vision. Author(s): Chaar BT, Kehdi FJ, Moukarbel GV, Khalifeh RR. Source: Qjm : Monthly Journal of the Association of Physicians. 2003 June; 96(6): 453-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12788965

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Localization of the gene (or genes) for a syndrome with X-linked mental retardation, ataxia, weakness, hearing impairment, loss of vision and a fatal course in early childhood. Author(s): Kremer H, Hamel BC, van den Helm B, Arts WF, de Wijs IJ, Sistermans EA, Ropers HH, Mariman EC. Source: Human Genetics. 1996 November; 98(5): 513-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8882866

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Loss of vision after laser in situ keratomileusis. Author(s): Doughman DJ, Hardten DR. Source: Eye & Contact Lens. 2003 January; 29(1 Suppl): S135-8; Discussion S143-4, S1924. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12772750

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Loss of vision after spinal anesthesia. Author(s): de Lange JJ. Source: Acta Anaesthesiologica Scandinavica. 2003 February; 47(2): 236. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12631057

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Loss of vision after transsphenoidal surgery. Author(s): Barrow DL, Tindall GT. Source: Neurosurgery. 1990 July; 27(1): 60-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2377282

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Loss of vision alone may result in seesaw nystagmus. Author(s): May EF, Truxal AR. Source: Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 1997 June; 17(2): 84-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9176776

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Loss of vision and diarrhoea. Author(s): Grimbacher B, Wenger B, Deibert P, Ness T, Koetter I, Peter HH. Source: Lancet. 1997 December 20-27; 350(9094): 1818. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9428254

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Loss of vision associated with surgical treatment of zygomatic-orbital floor fracture. Author(s): Lederman IR. Source: Plastic and Reconstructive Surgery. 1981 July; 68(1): 94-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7244006

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Loss of vision before ophthalmic referral in blind and partially sighted diabetics in Bristol. Author(s): Clark JB, Grey RH, Lim KK, Burns-Cox CJ. Source: The British Journal of Ophthalmology. 1994 October; 78(10): 741-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7803348

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Loss of vision caused by expansion of intraocular perfluoropropane (C(3)F(8)) gas during nitrous oxide anesthesia. Author(s): Hart RH, Vote BJ, Borthwick JH, McGeorge AJ, Worsley DR. Source: American Journal of Ophthalmology. 2002 November; 134(5): 761-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12429255

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Loss of vision due to central serous chorioretinopathy following psychological stress. Author(s): Gelber GS, Schatz H. Source: The American Journal of Psychiatry. 1987 January; 144(1): 46-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3799839

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Loss of vision due to cryptococcal optochiasmatic arachnoiditis and optocurative surgical exploration--case report. Author(s): Maruki C, Nakano H, Shimoji T, Maeda M, Ishii S. Source: Neurol Med Chir (Tokyo). 1988 July; 28(7): 695-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2462180

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Loss of vision during the retinal stabilization of letters. Author(s): Topolski R, Inhoff AW. Source: Psychological Research. 1995; 58(3): 155-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8570783

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Loss of vision from distant haemorrhage: report of four cases. Author(s): Teshome T, Alemayehu W. Source: East Afr Med J. 1999 December; 76(12): 706-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10734546

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Loss of vision in Gaucher's disease and its reversal by enzyme-replacement therapy. Author(s): vom Dahl S, Niederau C, Haussinger D. Source: The New England Journal of Medicine. 1998 May 14; 338(20): 1471-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9583981

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Loss of vision in one eye following scoliosis surgery. Author(s): West J, Askin G, Clarke M, Vernon SA. Source: The British Journal of Ophthalmology. 1990 April; 74(4): 243-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2337553

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Loss of vision in the ageing eye. Research into Ageing Workshop, London, 10 May 1995. Author(s): Bron AJ, Caird FI. Source: Age and Ageing. 1997 March; 26(2): 159-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9177674

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Loss of vision induced by the color white: a sign of carotid occlusive disease. Author(s): Sempere AP, Duarte J, Coria F, Claveria LE. Source: Stroke; a Journal of Cerebral Circulation. 1992 August; 23(8): 1179. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1636195

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Loss of vision. Author(s): Jamieson M. Source: British Medical Journal (Clinical Research Ed.). 1984 May 19; 288(6429): 1523-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6426625

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Loss of vision. Author(s): LaVene D, Halpern J, Jagoda A. Source: Emergency Medicine Clinics of North America. 1995 August; 13(3): 539-60. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7635082

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Loss of vision: a manifestation of TURP syndrome. A case report. Author(s): Khan-Ghori SN, Khalaf MM, Khan RK, Bakhameez HS. Source: Middle East J Anesthesiol. 1998 October; 14(6): 441-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9859105

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Low titre autoantibodies against recoverin in sera of patients with small cell lung cancer but without a loss of vision. Author(s): Bazhin AV, Shifrina ON, Savchenko MS, Tikhomirova NK, Goncharskaia MA, Gorbunova VA, Senin II, Chuchalin AG, Philippov PP. Source: Lung Cancer (Amsterdam, Netherlands). 2001 October; 34(1): 99-104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11557119

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Muller cell-specific autoantibodies in a patient with progressive loss of vision. Author(s): Peek R, Verbraak F, Coevoet HM, Kijlstra A. Source: Investigative Ophthalmology & Visual Science. 1998 September; 39(10): 1976-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9727423

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Multifocal visual evoked potential, multifocal electroretinography, and optical coherence tomography in the diagnosis of subclinical loss of vision. Author(s): Hedges TR 3rd, Quireza ML. Source: Ophthalmology Clinics of North America. 2004 March; 17(1): 89-105. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15102515

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Nitroglycerin to treat acute loss of vision. Author(s): Ritter JM. Source: The New England Journal of Medicine. 1991 April 4; 324(14): 997-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1900578

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Nitroglycerin to treat acute loss of vision. Author(s): Kuritzky S. Source: The New England Journal of Medicine. 1990 November 15; 323(20): 1428. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2122250

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Oculomotor disturbances and VER findings in patients with early monocular loss of vision. Author(s): Ciancia AO. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 1988; 226(2): 108-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3360333

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Orbital hemorrhage with loss of vision. Author(s): Petrelli RL, Petrelli EA, Allen WE 3rd. Source: American Journal of Ophthalmology. 1980 April; 89(4): 593-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6989256

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Painless loss of vision after transurethral resection of the prostate. Author(s): Russell D. Source: Anaesthesia. 1990 March; 45(3): 218-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2334032

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Painless loss of vision. Author(s): Marsden J. Source: Emergency Nurse : the Journal of the Rcn Accident and Emergency Nursing Association. 1999 February; 6(9): 13-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10542533

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Palmitoyl-protein thioesterase gene expression in the developing mouse brain and retina: implications for early loss of vision in infantile neuronal ceroid lipofuscinosis. Author(s): Zhang Z, Mandal AK, Wang N, Keck CL, Zimonjic DB, Popescu NC, Mukherjee AB. Source: Gene. 1999 April 29; 231(1-2): 203-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10231585

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Periorbital necrotising fasciitis with loss of vision. Author(s): Holliman RE, Catford GV. Source: The Journal of Infection. 1986 July; 13(1): 35-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3734465

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Primary intracranial extradural Burkitt-type lymphoma. A unique presentation with unilateral loss of vision in a child. Author(s): Tekkok IH, Tahta K, Erbengi A, Buyukpamukcu M, Ruacan S, Topcu M. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 1991 June; 7(3): 172-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1878874

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Psychologic management of loss of vision. Author(s): Rakes SM, Reid WH. Source: Can J Ophthalmol. 1982 August; 17(4): 178-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7127204

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Rapid loss of vision with swelling of the optic disc. Author(s): Martin B. Source: The British Journal of Ophthalmology. 1967 September; 51(9): 638-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6050880

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Rapid loss of vision--initial manifestation of bronchogenic carcinoma (a clinicopathologic case report). Author(s): Crawford JB, Reese GA. Source: Trans Am Acad Ophthalmol Otolaryngol. 1969 September-October; 73(5): 964-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5357352

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Reversible loss of vision due to posterior ischemic optic neuropathy. Author(s): Lee AG. Source: Can J Ophthalmol. 1995 October; 30(6): 327-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8574983

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Risk, causes and outcomes of visual impairment after loss of vision in the nonamblyopic eye, a population-based study, by J. S. Rahi, S. Logan, C. Timms, I. RusselEggitt, and D. Taylor. Lancet 360:597-602, 2002. Author(s): Harrad R, Williams C. Source: Survey of Ophthalmology. 2003 March-April; 48(2): 235. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12686309

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Risk, causes, and outcomes of visual impairment after loss of vision in the nonamblyopic eye: a population-based study. Author(s): Rahi J, Logan S, Timms C, Russell-Eggitt I, Taylor D. Source: Lancet. 2002 August 24; 360(9333): 597-602. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12241931

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Severe loss of vision during adjuvant interferon alfa-2b treatment for malignant melanoma. Author(s): Lohmann CP, Kroher G, Bogenrieder T, Spiegel D, Preuner J. Source: Lancet. 1999 April 17; 353(9161): 1326. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10218534

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Sphenoidal sinus mucocoele presenting as mono-ocular painless loss of vision. Author(s): Sundar U, Sharma AL, Yeolekar ME, Pahuja V. Source: Postgraduate Medical Journal. 2004 January; 80(939): 40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14760180

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Sudden and gradual loss of vision. Author(s): Wilson-Holt NJ. Source: The Practitioner. 1988 February 8; 232(1442): 123-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3217327

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Sudden loss of vision following alcohol block of the infraorbital nerve. Case report. Author(s): Markham JW. Source: Journal of Neurosurgery. 1973 May; 38(5): 655-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4711642

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Sudden loss of vision in a monocular patient, caused by visual cortex infarction. Author(s): Kraus E, Meyer E, Zonis S. Source: Ann Ophthalmol. 1986 March; 18(3): 114-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3963680

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Sudden loss of vision in an elderly woman. Author(s): Reich J. Source: Aust Fam Physician. 2000 September; 29(9): 870-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11008391

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Sudden loss of vision--(Part I). Author(s): Messner KH. Source: Trans Pa Acad Ophthalmol Otolaryngol. 1976 Spring; 29(1): 9-13. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=960196

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Sudden loss of vision--(Part II). Lesions affecting the visual pathways. Author(s): Ellenberger C Jr. Source: Trans Pa Acad Ophthalmol Otolaryngol. 1976 Spring; 29(1): 14-21. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=960184

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Sudden loss of vision. Author(s): Stark DJ. Source: Aust Fam Physician. 1985 August; 14(8): 751-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4051889

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Sudden loss of vision. Author(s): Paulman A, Paulman P. Source: The Journal of Family Practice. 2004 April; 53(4): 269-72; Discussion 273. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15068771

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Sudden loss of vision. Author(s): Cormack G, Dhillon B. Source: The Practitioner. 1998 December; 242(1593): 851-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10441883

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Sudden loss of vision. Author(s): McClellan K. Source: Aust Fam Physician. 1998 March; 27(3): 135-8, 140-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9529699

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Temporary loss of vision after postsurgical hypotension. Author(s): Sharma JK, Sharma B. Source: J Oral Surg. 1976 December; 34(12): 1101-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1069113

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Testicular cancer presenting as loss of vision. Author(s): Bettocchi C, Coker CB, Traficante A, Selvaggi FP. Source: British Journal of Urology. 1995 October; 76(4): 519-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7551903

•

The relation of socioeconomic factors to the incidence of proliferative diabetic retinopathy and loss of vision. Author(s): Klein R, Klein BE, Jensen SC, Moss SE. Source: Ophthalmology. 1994 January; 101(1): 68-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8302566

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The role of the ophthalmic nurse in helping the patient adapt to loss of vision. Author(s): Oehler JW. Source: J Ophthalmic Nurs Technol. 1982 May; 1(1): 28-32. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6920419

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Unilateral occipital infarction: evaluation of the risks of developing bilateral loss of vision. Author(s): Bogousslavsky J, Regli F, van Melle G. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1983 January; 46(1): 78-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6842204

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Unilateral proptosis with loss of vision. Author(s): Heitzman EB, Markarian B. Source: N Y State J Med. 1973 June 15; 73(12): 1671-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4513635

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Vigabatrin-associated loss of vision: rarebit perimetry illuminates the dose-damage relationship. Author(s): Frisen L. Source: Acta Ophthalmologica Scandinavica. 2004 February; 82(1): 54-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14738486

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X-linked ataxia, weakness, deafness, and loss of vision in early childhood with a fatal course. Author(s): Arts WF, Loonen MC, Sengers RC, Slooff JL. Source: Annals of Neurology. 1993 May; 33(5): 535-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8498830

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CHAPTER 2. NUTRITION AND LOSS OF VISION Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and loss of vision.

Finding Nutrition Studies on Loss of Vision 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.4 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 “loss of vision” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 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 “loss of vision” (or a synonym): •

Progressive loss of vision in patients with high-grade non-Hodgkin's lymphoma. Author(s): Department of Clinical Oncology and Radiotherapy, Norwegian Radium Hospital, Montebello, Oslo. Source: Holte, H Saeter, G Dahl, I M Abrahamsen, A F Cancer. 1987 November 15; 60(10): 2521-3 0008-543X

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

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

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

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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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/

Nutrition

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

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

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41

CHAPTER 3. ALTERNATIVE MEDICINE AND LOSS OF VISION Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to loss of vision. 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 loss of vision 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 “loss of vision” (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 loss of vision: •

“The man who made Peekskill famous”: Dr. C.R. Johnston--first blind chiropractor. Author(s): Rehm WS. Source: Chiropr Hist. 1998 December; 18(2): 81-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11623685

•

Progressive loss of vision in patients with high-grade non-Hodgkin's lymphoma. Author(s): Holte H, Saeter G, Dahl IM, Abrahamsen AF. Source: Cancer. 1987 November 15; 60(10): 2521-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3664433

•

Transient unilateral loss of vision associated with oxygen at high pressure. Author(s): Nichols CW, Lambertsen CJ, Clark JM.

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Source: Archives of Ophthalmology. 1969 April; 81(4): 548-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5777761

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

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

•

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

•

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

•

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

The following is a specific Web list relating to loss of vision; 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 Cataracts Source: Healthnotes, Inc.; www.healthnotes.com Cataracts Source: Integrative Medicine Communications; www.drkoop.com Glaucoma Source: Integrative Medicine Communications; www.drkoop.com

•

Herbs and Supplements Carotenoids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com

Alternative Medicine 43

Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,763,00.html

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. BOOKS ON LOSS OF VISION Overview This chapter provides bibliographic book references relating to loss of vision. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on loss of vision include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Ability Structure and Loss of Vision (Research, No 18) by Jyrki Juurmaa; ISBN: 0891280022; http://www.amazon.com/exec/obidos/ASIN/0891280022/icongroupinterna

•

Perceiving the Elephant : Living Creatively With Loss of Vision [LARGE PRINT] by Frances Lief Neer; ISBN: 0887391222; http://www.amazon.com/exec/obidos/ASIN/0887391222/icongroupinterna

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APPENDICES

49

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 Institute5: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

5

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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

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

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

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

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

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

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

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

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

Physician Resources

51

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.6 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:7 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

6

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). 7 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway8 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.9 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “loss of vision” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 14114 681 829 27 276 15927

HSTAT10 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.11 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.12 Simply search by “loss of vision” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

8

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

9

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). 10 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 11 12

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists13 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.14 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.15 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

13 Adapted 14

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 15 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.

55

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 loss of vision 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 loss of vision. 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 loss of vision. 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 “loss of vision”:

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Eye Diseases http://www.nlm.nih.gov/medlineplus/eyediseases.html Eye Injuries http://www.nlm.nih.gov/medlineplus/eyeinjuries.html Refractive Errors http://www.nlm.nih.gov/medlineplus/refractiveerrors.html Retinal Disorders http://www.nlm.nih.gov/medlineplus/retinaldisorders.html Vision Impairment and Blindness http://www.nlm.nih.gov/medlineplus/visionimpairmentandblindness.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on loss of vision. 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: •

Preventing Diabetic Eye Problems Source: Clinical Diabetes. 14(6): 153. November-December 1996. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: People with diabetes are four times more likely to develop severe loss of vision than people without diabetes. This brief fact sheet from the American Diabetes Association reminds readers with diabetes of the appropriate steps to take to reduce their risks of diabetes-related eye problems. The fact sheet describes diabetic retinopathy, the general term for all disorders of the retinal blood vessels caused by diabetes. The fact sheet describes nonproliferative retinopathy and its progression to the more serious proliferative retinopathy, as well as related problems with macular edema, glaucoma, and cataracts. The fact sheet then lists several steps readers can take to lower their risk of developing serious eye problems: get regular eye exams from an eye doctor, keep blood glucose levels down, bring high blood pressure under control, be cautious with exercise that may affect retinopathy, and get early treatment for eye problems.

•

About Glaucoma Source: South Deerfield, MA: Channing L. Bete Co., Inc. 1999. 15 p.

Patient Resources

57

Contact: Available from Channing L. Bete, Co., Inc. 200 State Road, South Deerfield, MA 01373-0200. (800) 628-7733. Fax (800) 499-6464. PRICE: $1.05 each; plus shipping and handling; quantity discounts available. Order number 12518. Summary: This illustrated booklet uses a question and answer format to provide readers with information on the causes, diagnosis, and treatment of glaucoma. Glaucoma, which is an eye disorder caused by increased pressure within the eye, can result in loss of vision. People need to learn about glaucoma because it causes permanent loss of vision if undetected and untreated. The disorder can result from inadequate drainage of aqueous humor through the canal of Schlemm or overproduction of aqueous humor by the ciliary body. People at high risk for getting glaucoma are those who have a family history of the disorder, those with certain health problems such as diabetes, those who are over 35 years old, and African Americans. Types of glaucoma include chronic, acute, congenital, and secondary glaucoma. Although the symptoms of glaucoma may come on suddenly, early symptoms are usually not noticeable. Glaucoma is detected with an instrument called a tonometer. Other methods include a visual field examination and an eye examination using other instruments. Treatment options include drug therapy and surgery. The booklet presents special precautions that glaucoma patients should take to control glaucoma and preserve vision. 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 loss of vision. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

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

•

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

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

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

•

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

•

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

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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to loss of vision. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with loss of vision. 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 loss of vision. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “loss of vision” (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 “loss of vision”. 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 “loss of vision” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

Patient Resources

59

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 “loss of vision” (or a synonym) into the search box, and click “Submit Query.”

61

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.16

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

16

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)17: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

17

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

Finding Medical Libraries

63

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries

65

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

67

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).

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

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

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

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

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

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LOSS OF VISION DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [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]

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Affinity Chromatography: In affinity chromatography, a ligand attached to a column binds specifically to the molecule to be purified. [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] 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] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alternative Splicing: A process whereby multiple protein isoforms are generated from a single gene. Alternative splicing involves the splicing together of nonconsecutive exons during the processing of some, but not all, transcripts of the gene. Thus a particular exon may be connected to any one of several alternative exons to form messenger RNA. The alternative forms produce proteins in which one part is common while the other part is different. [NIH] Amblyopia: A nonspecific term referring to impaired vision. Major subcategories include stimulus deprivation-induced amblyopia and toxic amblyopia. Stimulus deprivationinduced amblopia is a developmental disorder of the visual cortex. A discrepancy between visual information received by the visual cortex from each eye results in abnormal cortical development. Strabismus and refractive errors may cause this condition. Toxic amblyopia is a disorder of the optic nerve which is associated with alcoholism, tobacco smoking, and other toxins and as an adverse effect of the use of some medications. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [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-terminal: The end of a protein or polypeptide chain that contains a free amino group (-NH2). [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] 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

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stimulate skeletal growth. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angioid Streaks: Small breaks in the elastin-filled tissue of the retina. [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] Aniridia: A congenital abnormality in which there is only a rudimentary iris. This is due to the failure of the optic cup to grow. Aniridia also occurs in a hereditary form, usually autosomal dominant. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] 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] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU]

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Antiviral: Destroying viruses or suppressing their replication. [EU] Aphakia: Absence of crystalline lens totally or partially from field of vision, from any cause except after cataract extraction. Aphakia is mainly congenital or as result of lens dislocation and subluxation. [NIH] Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Aqueous humor: Clear, watery fluid that flows between and nourishes the lens and the cornea; secreted by the ciliary processes. [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] 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] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Astigmatism: A condition in which the surface of the cornea is not spherical; causes a blurred image to be received at the retina. [NIH] 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] 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] 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

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digested by the gastric juice. [NIH] Avian: A plasmodial infection in birds. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] 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] Bilateral: Affecting both the right and left side of body. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biogenesis: The origin of life. It includes studies of the potential basis for life in organic compounds but excludes studies of the development of altered forms of life through mutation and natural selection, which is evolution. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blind spot: (1) A small area of the retina where the optic nerve enters the eye; occurs normally in all eyes.(2) Any gap in the visual field corresponding to an area of the retina where no visual cells are present; associated with eye disease. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists

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mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] 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] Cadherins: A group of functionally related glycoproteins responsible for the calciumdependent cell-to-cell adhesion mechanism. They are divided into subclasses E-, P-, and Ncadherins, which are distinct in immunological specificity and tissue distribution. They promote cell adhesion via a homophilic mechanism. These compounds play a role in the construction of tissues and of the whole animal body. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] 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]

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Cataract: An opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). [EU] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Adhesion Molecules: Surface ligands, usually glycoproteins, that mediate cell-to-cell adhesion. Their functions include the assembly and interconnection of various vertebrate systems, as well as maintenance of tissue integration, wound healing, morphogenic movements, cellular migrations, and metastasis. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell 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] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Ceroid: A naturally occurring lipid pigment with histochemical characteristics similar to lipofuscin. It accumulates in various tissues in certain experimental and pathological conditions. [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] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chondrocytes: Polymorphic cells that form cartilage. [NIH] Choriocapillaris: A layer of the choroid between the lamina vitrea and Sattler's layer, consisting of a network of capillaries which supplies the outer 5 layers of the retina; the network is densest at the macula. [NIH]

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Chorioretinitis: Inflammation of the choroid in which the sensory retina becomes edematous and opaque. The inflammatory cells and exudate may burst through the sensory retina to cloud the vitreous body. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Choroidal Neovascularization: A pathological process consisting of the formation of new blood vessels in the choroid. [NIH] Choroiditis: Inflammation of the choroid. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciliary Body: A ring of tissue extending from the scleral spur to the ora serrata of the retina. It consists of the uveal portion and the epithelial portion. The ciliary muscle is in the uveal portion and the ciliary processes are in the epithelial portion. [NIH] Ciliary Neurotrophic Factor: A neurotrophic factor that promotes the survival of various neuronal cell types and may play an important role in the injury response in the nervous system. [NIH] Ciliary processes: The extensions or projections of the ciliary body that secrete aqueous humor. [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 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] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colchicine: A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (periodic disease). [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire

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functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray 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] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective

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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] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [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] 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] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Crystallins: A heterogeneous family of water-soluble structural proteins found in cells of the vertebrate lens. The presence of these proteins accounts for the transparency of the lens. The family is composed of four major groups, alpha, beta, gamma, and delta, and several minor groups, which are classed on the basis of size, charge, immunological properties, and vertebrate source. Alpha, beta, and delta crystallins occur in avian and reptilian lenses, while alpha, beta, and gamma crystallins occur in all other lenses. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom

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of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Decompensation: Failure of compensation; cardiac decompensation is marked by dyspnea, venous engorgement, and edema. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [NIH]

Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or

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in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drusen: Tiny yellow or white deposits in the retina or optic nerve head. [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] Dyspnea: Difficult or labored breathing. [NIH] Dystrophic: Pertaining to toxic habitats low in nutrients. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] 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] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [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] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Electroretinogram: The electrical effect recorded from the surface of the eyeball and originated by a pulse of light. [NIH] Electroretinography: Recording of electric potentials in the retina after stimulation by light.

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[NIH]

Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endophthalmitis: Suppurative inflammation of the tissues of the internal structures of the eye; not all layers of the uvea are affected. Fungi, necrosis of intraocular tumors, and retained intraocular foreign bodies often cause a purulent endophthalmitis. [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] 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] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epiretinal Membrane: Membrane viruses are thought to acquire their envelopes by budding through modified portions of the host cell membrane. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a

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nuclear membrane. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Exophthalmos: Abnormal protrusion of both eyes; may be caused by endocrine gland malfunction, malignancy, injury, or paralysis of the extrinsic muscles of the eye. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Faecal: Pertaining to or of the nature of feces. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciitis: Inflammation of the fascia. There are three major types: 1) Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orangepeel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2) Necrotizing fasciitis, a serious fulminating infection (usually by a beta hemolytic Streptococcus) causing extensive necrosis of superficial fascia; 3) Nodular/Pseudosarcomatous/Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma. [NIH] Fat: Total lipids including phospholipids. [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosarcoma: A type of soft tissue sarcoma that begins in fibrous tissue, which holds bones, muscles, and other organs in place. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flatus: Gas passed through the rectum. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a

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fundus. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic Markers: A phenotypically recognizable genetic trait which can be used to identify a genetic locus, a linkage group, or a recombination event. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [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] 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] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat

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and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] 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]

Glycoprotein: A protein that has sugar molecules attached to it. [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] Guanine: One of the four DNA bases. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [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

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failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [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] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Heterozygotes: Having unlike alleles at one or more corresponding loci on homologous chromosomes. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] 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] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperopia: Farsightedness; ability to see distant objects more clearly than close objects; may be corrected with glasses or contact lenses. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hypoxic: Having too little oxygen. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [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] Immunocompromised: Having a weakened immune system caused by certain diseases or

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treatments. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunology: The study of the body's immune system. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] 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 -

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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 Alfa-2b: A recombinant alfa interferon consisting of 165 amino acid residues with arginine in position 23 and histidine in position 34. It is used extensively as an antiviral and antineoplastic agent. [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] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intraocular: Within the eye. [EU] Intraocular pressure: Pressure of the fluid inside the eye; normal IOP varies among individuals. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [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] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratitis: Inflammation of the cornea. [NIH] Lacrimal: Pertaining to the tears. [EU] Lacrimal gland: The small almond-shaped structure that produces tears; located just above the outer corner of the eye. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Legal blindness: In the U.S., (1) visual acuity of 20/200 or worse in the better eye with corrective lenses (20/200 means that a person must be at 20 feet from an eye chart to see

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what a person with normal vision can see at 200 feet) or (2) visual field restricted to 20 d [NIH]

Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] 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] Lipofuscin: A naturally occurring lipid pigment with histochemical characteristics similar to ceroid. It accumulates in various normal tissues and apparently increases in quantity with age. [NIH] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lod: The lowest analyte content which, if actually present, will be detected with reasonable statistical certainty and can be identified according to the identification criteria of the method. If both accuracy and precision are constant over a concentration range. [NIH] Lod Score: The total relative probability, expressed on a logarithmic scale, that a linkage relationship exists among selected loci. Lod is an acronym for "logarithmic odds." [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [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] 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]

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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] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Macula Lutea: An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the superior pole of the eye and slightly below the level of the optic disk. [NIH] Macular Degeneration: Degenerative changes in the macula lutea of the retina. [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] 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]

Mammogram: An x-ray of the breast. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menopause: Permanent cessation of menstruation. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

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

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the original (primary) tumor. The plural is metastases. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [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] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the 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] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocular: Diplopia identified with one eye only; it may be induced with a double prism, or it may occur either as a result of double imagery due to an optical defect in the eye, or as a result of simultaneous use of normal and anomalous retinal correspondence. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU]

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Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Natural selection: A part of the evolutionary process resulting in the survival and reproduction of the best adapted individuals. [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] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Degeneration: Loss of functional activity and trophic degeneration of nerve axons and their terminal arborizations following the destruction of their cells of origin or interruption of their continuity with these cells. The pathology is characteristic of neurodegenerative diseases. Often the process of nerve degeneration is studied in research on neuroanatomical localization and correlation of the neurophysiology of neural pathways. [NIH]

Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural Pathways: Neural tracts connecting one part of the nervous system with another. [NIH]

Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH]

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Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neuroprotective Agents: Drugs intended to prevent damage to the brain or spinal cord from ischemia, stroke, convulsions, or trauma. Some must be administered before the event, but others may be effective for some time after. They act by a variety of mechanisms, but often directly or indirectly minimize the damage produced by endogenous excitatory amino acids. [NIH] Neuroretinitis: Inflammation of the optic nerve head and adjacent retina. [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] Night Blindness: Anomaly of vision in which there is a pronounced inadequacy or complete absence of dark-adaptation. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream. [NIH]

Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] 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] Nystagmus: An involuntary, rapid, rhythmic movement of the eyeball, which may be horizontal, vertical, rotatory, or mixed, i.e., of two varieties. [EU] Occipital Lobe: Posterior part of the cerebral hemisphere. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Opacity: Degree of density (area most dense taken for reading). [NIH] Ophthalmic: Pertaining to the eye. [EU] Ophthalmic Artery: Artery originating from the internal carotid artery and distributing to

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the eye, orbit and adjacent facial structures. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Optic cup: The white, cup-like area in the center of the optic disc. [NIH] Optic disc: The circular area (disc) where the optic nerve connects to the retina. [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] Optic nerve head: The circular area (disc) where the optic nerve connects to the retina. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [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] Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [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]

Oximetry: The determination of oxygen-hemoglobin saturation of blood either by 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] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH]

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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] 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] Particle: A tiny mass of material. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Pelvic: Pertaining to the pelvis. [EU] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Library: A collection of cloned peptides, or chemically synthesized peptides, frequently consisting of all possible combinations of amino acids making up an n-amino acid peptide. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perimetry: Determination of the extent of the visual field for various types and intensities of stimuli. [NIH] 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] Peripheral vision: Side vision; ability to see objects and movement outside of the direct line of vision. [NIH] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU]

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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] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [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] Photoreceptor: Receptor capable of being activated by light stimuli, as a rod or cone cell of the eye. [NIH] Phototransduction: The transducing of light energy to afferent nerve impulses, such as takes place in the retinal rods and cones. After light photons are absorbed by the photopigments, the signal is transmitted to the outer segment membrane by the cyclic GMP second messenger system, where it closes the sodium channels. This channel gating ultimately generates an action potential in the inner retina. [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] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmacytoma: Any discrete, presumably solitary, mass of neoplastic plasma cells either in bone marrow or various extramedullary sites. [NIH] Plasmids: Any extrachromosomal hereditary determinant. Plasmids are self-replicating circular molecules of DNA that are found in a variety of bacterial, archaeal, fungal, algal, and plant species. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis

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with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymyalgia Rheumatica: A syndrome in the elderly characterized by proximal joint and muscle pain, high erythrocyte sedimentation rate, and a self-limiting course. Pain is usually accompanied by evidence of an inflammatory reaction. Women are affected twice as commonly as men and Caucasians more frequently than other groups. The condition is frequently associated with temporal arteritis and some theories pose the possibility that the two diseases arise from a single etiology or even that they are the same entity. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] 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] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Pre-eclamptic: A syndrome characterized by hypertension, albuminuria, and generalized oedema, occurring only in pregnancy. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Proliferative Retinopathy: A disease of the small blood vessels of the retina of the eye. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential

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component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Proptosis: Forward projection or displacement especially of the eyeball : exophthalmos. [EU] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] 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 Isoforms: Different forms of a protein that may be produced from different genes, or from the same gene by alternative splicing. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Pseudoxanthoma: A rare disease of the skin characterized by the appearance of elevated yellowish papules or plaques, particularly on the neck, chest an abdomen and infrequently on the eyelids. [NIH] Pseudoxanthoma Elasticum: A rare, progressive inherited disorder resulting from extensive basophilic degeneration of elastic tissue, usually presenting after puberty and involving the skin, eye, and cardiovascular system. Characteristic manifestations are small, circumscribed yellowish patches at sites of considerable movement of the skin, angioid streaks in the retina, and a tendency towards hemorrhage and arterial insufficiency. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of

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pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombinant Proteins: Proteins prepared by recombinant DNA technology. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractive Errors: Deviations from the average or standard indices of refraction of the eye through its dioptric or refractive apparatus. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be

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cancer in the body. [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] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinae: A congenital notch or cleft of the retina, usually located inferiorly. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Artery: Central retinal artery and its branches. It arises from the ophthalmic artery, pierces the optic nerve and runs through its center, enters the eye through the porus opticus and branches to supply the retina. [NIH] Retinal Detachment: Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). [NIH] Retinal Ganglion Cells: Cells of the innermost nuclear layer of the retina, the ganglion cell layer, which project axons through the optic nerve to the brain. They are quite variable in size and in the shapes of their dendritic arbors, which are generally confined to the inner plexiform layer. [NIH] Retinal Hemorrhage: Bleeding from the vessels of the retina. [NIH] Retinal pigment epithelium: The pigment cell layer that nourishes the retinal cells; located just outside the retina and attached to the choroid. [NIH] Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (chorioretinitis) and of the optic nerve (neuroretinitis). The disease may be confined to one eye, but since it is generally dependent on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Retinitis Pigmentosa: Hereditary, progressive degeneration of the neuroepithelium of the retina characterized by night blindness and progressive contraction of the visual field. [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] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative,

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noninflammatory condition of the retina). [EU] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] 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] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] 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] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Scoliosis: A lateral curvature of the spine. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedimentation: The act of causing the deposit of sediment, especially by the use of a centrifugal machine. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains

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spermatozoa and their nutrient plasma. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serrata: The serrated anterior border of the retina located approximately 8.5 mm from the limbus and adjacent to the pars plana of the ciliary body. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sharpness: The apparent blurring of the border between two adjacent areas of a radiograph having different optical densities. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] 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] Small cell lung cancer: A type of lung cancer in which the cells appear small and round when viewed under the microscope. Also called oat cell lung cancer. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Channels: Cell membrane glycoproteins selective for sodium ions. Fast sodium current is associated with the action potential in neural membranes. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] 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

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types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] 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] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Steroids: Drugs used to relieve swelling and 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] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] 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] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH]

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Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Titre: The quantity of a substance required to produce a reaction with a given volume of another substance, or the amount of one substance required to correspond with a given amount of another substance. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen

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plane and blurred images located above or below the plane. [NIH] Tonometer: For testing the intra-ocular tension. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] 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] Trabecular Meshwork: A porelike structure surrounding the entire circumference of the anterior chamber through which aqueous humor circulates to the canal of Schlemm. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [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] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transurethral: Performed through the urethra. [EU] Transurethral resection: Surgery performed with a special instrument inserted through the urethra. Also called TUR. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trophic: Of or pertaining to nutrition. [EU] Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [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]

Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

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Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [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] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. It is a mitotic inhibitor. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [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] Virulent: A virus or bacteriophage capable only of lytic growth, as opposed to temperate phages establishing the lysogenic response. [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] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Visual Cortex: Area of the occipital lobe concerned with vision. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] Visual Pathways: Set of cell bodies and nerve fibers conducting impulses from the eyes to the cerebral cortex. It includes the retina, optic nerve, optic tract, and geniculocalcarine tract. [NIH]

Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [NIH] Vitreous Hemorrhage: Hemorrhage into the vitreous body. [NIH]

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Vitreous Humor: The transparent, colorless mass of gel that lies behind the lens and in front of the retina and fills the center of the eyeball. [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] 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]

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]

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INDEX A Abdominal, 26, 69, 94 Aberrant, 8, 69 Acetylcholine, 69, 92 Actin, 10, 69 Acuity, 5, 69 Adaptability, 69, 75 Adaptation, 69, 92 Adjuvant, 32, 69 Adrenal Cortex, 69, 78 Adverse Effect, 69, 70, 101 Aerosol, 69, 92 Afferent, 69, 95 Affinity, 22, 69, 70, 101 Affinity Chromatography, 22, 70 Age of Onset, 22, 70 Ageing, 29, 70 Algorithms, 70, 73 Alternative medicine, 70 Alternative Splicing, 9, 22, 70, 97 Amblyopia, 21, 27, 70 Amino acid, 70, 71, 72, 82, 84, 85, 87, 94, 95, 96, 97, 102, 104 Amino Acid Sequence, 70, 71, 82 Amino-terminal, 9, 70 Ampulla, 70, 81 Anal, 70, 88 Analgesic, 70, 92 Anatomical, 12, 21, 70, 75, 86 Androgens, 69, 70, 78 Anesthesia, 27, 28, 71 Angiogenesis, 9, 18, 71 Angioid Streaks, 71, 97 Animal model, 6, 9, 12, 17, 18, 71 Aniridia, 16, 71 Annealing, 71, 95 Antiallergic, 71, 78 Antibacterial, 71, 102 Antibiotic, 71, 102 Antibodies, 5, 71, 72, 81, 84, 86, 88, 90, 95 Antibody, 5, 20, 69, 71, 76, 84, 85, 86, 90, 101 Antifungal, 15, 71 Antigen, 5, 14, 69, 71, 77, 79, 81, 85, 86 Antigen-presenting cell, 71, 79 Anti-inflammatory, 19, 71, 78, 83 Anti-Inflammatory Agents, 19, 71, 78 Antimicrobial, 15, 19, 71

Antineoplastic, 71, 78, 87 Antiviral, 72, 87 Aphakia, 72, 99 Aphasia, 23, 72 Apoptosis, 15, 72 Aqueous, 7, 57, 72, 76, 79, 88, 104 Aqueous humor, 7, 57, 72, 76, 104 Arginine, 72, 87, 92 Arterial, 13, 72, 84, 97 Arteries, 8, 72, 73, 78, 90, 91 Arterioles, 72, 73 Arteritis, 26, 72, 96 Artery, 72, 78, 81, 92, 97, 99 Asphyxia, 72, 92 Astigmatism, 72, 98 Asymptomatic, 72, 94 Ataxia, 27, 35, 72, 103 Atrophy, 4, 72 Autoantibodies, 30, 72 Autoantigens, 72 Autodigestion, 72, 94 Avian, 73, 78 Axons, 15, 73, 91, 93, 99 B Bacteria, 71, 73, 81, 90, 102 Bacteriophage, 73, 105 Basal Ganglia, 72, 73, 83 Basal Ganglia Diseases, 72, 73 Bilateral, 4, 24, 25, 34, 73, 99 Biliary, 73, 94 Biliary Tract, 73, 94 Biochemical, 22, 73 Biogenesis, 4, 73 Biotechnology, 23, 51, 73 Bladder, 73, 82, 97, 104 Blind spot, 5, 73 Blood Glucose, 56, 73, 84, 86 Blood pressure, 56, 73, 84, 85, 90, 101 Blood vessel, 12, 18, 56, 71, 73, 74, 75, 76, 81, 84, 87, 88, 94, 95, 96, 101, 102, 103, 105 Body Fluids, 73, 80, 101 Bone Marrow, 73, 83, 88, 95, 101, 102 Bone scan, 74, 100 Bradykinin, 74, 92 C Cadherins, 7, 74 Calcification, 8, 74

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Calcium, 74, 77, 90 Carbohydrate, 74, 78, 83, 96 Carcinogenic, 74, 86, 97 Carcinoma, 32, 74 Cardiac, 25, 74, 79, 80, 81, 91 Cardiovascular, 74, 97 Cardiovascular System, 74, 97 Carotene, 74, 99 Case report, 25, 29, 30, 32, 33, 74 Cataract, 16, 72, 75, 99 Caudal, 75, 96 Cell Adhesion, 7, 74, 75 Cell Adhesion Molecules, 7, 75 Cell Death, 9, 15, 72, 75, 91 Cell Division, 73, 75, 90, 100 Cell membrane, 19, 75, 81, 101 Cellulitis, 26, 75 Central Nervous System, 69, 75, 80, 83, 84, 93 Cerebellar, 72, 75, 98 Cerebral, 24, 29, 72, 73, 75, 78, 81, 82, 92, 97, 105 Cerebral Cortex, 72, 75, 82, 105 Ceroid, 31, 75, 88 Character, 75, 79 Chin, 75, 89 Cholesterol, 20, 75 Chondrocytes, 75, 82 Choriocapillaris, 4, 75 Chorioretinitis, 76, 99 Choroid, 4, 5, 12, 75, 76, 99, 105 Choroidal Neovascularization, 4, 9, 12, 76 Choroiditis, 5, 76 Chromatin, 72, 76 Chromosome, 8, 20, 76, 88, 100 Chronic, 13, 17, 57, 76, 86, 94, 100, 102, 104 Ciliary, 9, 15, 57, 72, 76, 101, 105 Ciliary Body, 57, 76, 101, 105 Ciliary Neurotrophic Factor, 9, 76 Ciliary processes, 72, 76 CIS, 76, 99 Clinical trial, 3, 4, 9, 51, 76, 98 Cloning, 8, 73, 76 Cofactor, 22, 76, 97 Colchicine, 76, 104 Collagen, 70, 76, 82, 95, 97 Complement, 76, 77, 83 Complementary and alternative medicine, 41, 43, 77 Complementary medicine, 41, 77 Computational Biology, 51, 77 Computed tomography, 77, 100

Computerized axial tomography, 77, 100 Cone, 17, 77, 95 Conjugated, 77, 79 Conjunctiva, 15, 19, 77 Connective Tissue, 74, 75, 76, 77, 78, 82, 84 Constitutional, 78, 99 Constriction, 78, 87 Contraindications, ii, 78 Convulsions, 78, 80, 92 Cornea, 20, 72, 78, 87, 100 Coronary, 78, 90, 91 Coronary Thrombosis, 78, 90, 91 Cortex, 70, 78, 98 Cortical, 21, 70, 78, 82, 103 Corticosteroid, 26, 78 Cranial, 78, 93 Crystallins, 16, 78 Curative, 78, 103 Cutaneous, 8, 78 Cyclic, 78, 84, 92, 95, 100 Cytochrome, 21, 78 Cytokine, 14, 15, 79 Cytoplasm, 4, 72, 75, 79 D Decompensation, 24, 79 Degenerative, 4, 9, 79, 89, 99 Deletion, 72, 79 Denaturation, 79, 95 Dendrites, 79, 91 Dendritic, 14, 79, 89, 99 Dendritic cell, 14, 79 Deprivation, 21, 70, 79 Diabetes Mellitus, 79, 84 Diabetic Retinopathy, 9, 10, 13, 24, 34, 56, 79, 95 Diagnostic procedure, 79 Diarrhoea, 28, 79 Direct, iii, 11, 79, 94, 98, 103 Discrete, 79, 95 Dissociation, 69, 79 Distal, 80 Dominance, 21, 80 Dorsal, 80, 96 Drusen, 4, 80 Duct, 70, 80, 100 Duodenum, 80, 81, 102 Dura mater, 80, 89, 93 Dyspnea, 79, 80 Dystrophic, 8, 15, 80 Dystrophy, 20, 80 E Eclampsia, 25, 80

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Edema, 9, 25, 56, 79, 80, 104 Effector, 69, 77, 80, 92 Effector cell, 80, 92 Efferent, 21, 80 Efficacy, 7, 80 Elastic, 8, 80, 97 Electrode, 18, 80 Electrolyte, 78, 80, 90, 96, 101, 104 Electrophysiological, 17, 19, 80 Electroretinogram, 17, 80 Electroretinography, 30, 80 Embolus, 81, 86 Endemic, 81, 102 Endocrine Glands, 81 Endogenous, 72, 81, 82, 92, 104 Endophthalmitis, 18, 81 Endoscope, 81 Endoscopic, 14, 81 Endothelial cell, 18, 81, 82 Endothelium, 81, 92 Endothelium-derived, 81, 92 Environmental Health, 50, 52, 81 Enzymatic, 70, 74, 77, 81, 95, 99 Enzyme, 21, 29, 80, 81, 83, 84, 95, 97, 102, 104, 106 Eosinophilia, 81, 82 Epidemic, 81, 102 Epidemiological, 6, 11, 81 Epinephrine, 81, 104 Epiretinal Membrane, 10, 81 Epithelial, 4, 12, 76, 81 Epithelial Cells, 12, 81 Epithelium, 4, 12, 19, 81, 87, 99 Epitopes, 20, 81 Eukaryotic Cells, 81, 86, 93 Evoke, 82, 102 Excitatory, 82, 84, 92 Excitatory Amino Acids, 82, 92 Exon, 70, 82 Exophthalmos, 82, 97 Extracellular, 4, 7, 12, 78, 82, 101 Extracellular Space, 12, 82 Extraction, 72, 82, 99 F Faecal, 79, 82 Family Planning, 51, 82 Fasciitis, 31, 82 Fat, 74, 78, 81, 82, 83, 88, 101 Fibroblast Growth Factor, 9, 82 Fibroblasts, 82 Fibrosarcoma, 82 Fibrosis, 5, 82

Flatus, 82, 83 Fold, 82, 93 Forearm, 73, 82 Fundus, 13, 82 Fungi, 71, 81, 83, 90, 106 G Gallbladder, 69, 73, 82, 83 Ganglion, 83, 99 Gas, 28, 82, 83, 85, 92, 102 Gastrointestinal, 8, 74, 81, 83, 102 Gene, 4, 6, 8, 10, 12, 14, 16, 20, 23, 27, 31, 70, 73, 80, 83, 85, 97, 100 Gene Expression, 8, 31, 83 Gene Therapy, 7, 10, 83 General practitioner, 27, 83 Genetic Engineering, 73, 76, 83 Genetic Markers, 20, 83 Genetic testing, 83, 96 Genetics, 6, 27, 80, 83 Genotype, 83, 95 Gland, 69, 82, 83, 94, 95, 97, 100, 102, 103 Glucocorticoids, 69, 78, 83 Glucose, 73, 79, 84, 86 Glutamic Acid, 84, 96 Glycoprotein, 20, 84 Governing Board, 84, 96 Grade, 38, 41, 84 Guanine, 22, 84 Guanylate Cyclase, 84, 92 H Haematoma, 84 Haemorrhage, 29, 84 Haptens, 69, 84 Health Status, 6, 84 Heme, 79, 84 Hemoglobin, 13, 84, 93 Hemoglobin A, 13, 84 Hemoglobinopathies, 83, 84 Hemolytic, 82, 84 Hemorrhage, 9, 31, 85, 97, 98, 102, 105 Hereditary, 71, 85, 95, 99 Heredity, 11, 83, 85 Heterogeneity, 69, 85 Heterozygotes, 80, 85 Histidine, 85, 87 Histology, 22, 85 Homologous, 83, 85, 100 Homozygotes, 80, 85 Hormonal, 72, 78, 85 Hormone, 78, 81, 85, 86, 100, 103 Hybrid, 22, 85 Hydrogen, 74, 79, 85, 90, 93

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Hydrolysis, 85, 96, 97 Hyperopia, 85, 98 Hypoplasia, 16, 85 Hypotension, 24, 34, 78, 85 Hypoxia, 13, 85, 103 Hypoxic, 13, 85 I Idiopathic, 5, 85 Imaging procedures, 85, 104 Immune response, 14, 20, 69, 71, 72, 78, 84, 85, 102, 105 Immune system, 71, 80, 85, 86, 88, 106 Immunocompromised, 15, 85 Immunoglobulin, 71, 86, 90 Immunohistochemistry, 17, 86 Immunology, 18, 69, 86 Impairment, 27, 32, 56, 72, 86, 89 In situ, 15, 17, 27, 86 In Situ Hybridization, 17, 86 In vitro, 14, 16, 83, 86, 95 In vivo, 14, 16, 22, 83, 86 Incision, 86, 87 Infancy, 86 Infantile, 31, 86 Infarction, 33, 34, 86 Infection, 14, 15, 19, 20, 31, 73, 75, 76, 82, 86, 88, 91, 102, 106 Inflammation, 71, 72, 75, 76, 81, 82, 86, 87, 89, 92, 93, 94, 95, 99, 102, 105 Initiation, 14, 86, 104 Insight, 20, 86 Insulin, 26, 86 Insulin-dependent diabetes mellitus, 86 Interferon, 9, 32, 86, 87 Interferon Alfa-2b, 32, 87 Interferon-alpha, 86, 87 Intestines, 69, 83, 87 Intracellular, 19, 22, 86, 87, 92, 96, 100 Intraocular, 7, 9, 13, 16, 28, 81, 87 Intraocular pressure, 7, 13, 16, 87 Intrinsic, 69, 87 Invasive, 7, 13, 14, 21, 87, 89, 93 Involuntary, 73, 87, 91, 92 Ion Channels, 87, 92 Ions, 79, 80, 85, 87, 101 Iris, 71, 78, 87, 98, 105 Ischemia, 17, 24, 72, 87, 92 K Kb, 50, 87 Keratitis, 16, 87 L Lacrimal, 15, 87

Lacrimal gland, 15, 87 Latency, 14, 87 Latent, 14, 87 Legal blindness, 4, 87 Lens, 16, 27, 72, 75, 78, 88, 105, 106 Lesion, 88, 104 Leukemia, 83, 88 Ligament, 88, 97 Ligands, 75, 88 Linkage, 11, 83, 88 Lipid, 20, 75, 86, 88 Lipofuscin, 75, 88 Liposome, 9, 88 Liver, 69, 73, 83, 88, 100 Liver scan, 88, 100 Localization, 15, 22, 27, 86, 88, 91 Localized, 84, 86, 88, 100, 104 Lod, 20, 88 Lod Score, 20, 88 Longitudinal study, 6, 88 Lymph, 81, 88 Lymphatic, 81, 86, 88, 101 Lymphocyte, 71, 88 Lymphoid, 71, 89 Lymphoma, 31, 38, 41, 89 Lytic, 89, 105 M Macula, 4, 75, 89 Macula Lutea, 89 Macular Degeneration, 4, 8, 9, 11, 12, 89 Magnetic Resonance Imaging, 89, 100 Malignant, 32, 71, 82, 89 Malnutrition, 72, 89 Mammogram, 74, 89, 90 Manifest, 20, 89 Mediate, 16, 75, 89 Medical Records, 6, 89 MEDLINE, 51, 89 Melanin, 87, 89, 95, 104 Melanocytes, 89 Melanoma, 32, 89 Membrane, 8, 10, 14, 75, 76, 77, 81, 82, 87, 89, 90, 93, 95, 99, 103, 105 Meninges, 75, 80, 89 Meningitis, 14, 89 Menopause, 89, 96 Mental, iv, 3, 27, 50, 52, 75, 79, 89, 97, 104 Mental Health, iv, 3, 50, 52, 89, 97 Mental Retardation, 27, 89 Metastasis, 75, 89 MI, 67, 90 Microcalcifications, 74, 90

111

Microorganism, 76, 90, 106 Migration, 14, 90 Mineralocorticoids, 69, 78, 90 Mitosis, 72, 90 Modification, 14, 70, 83, 90, 98 Molecular, 5, 6, 7, 8, 9, 10, 11, 13, 17, 19, 51, 53, 73, 77, 90, 104 Molecule, 6, 9, 14, 70, 71, 77, 79, 80, 81, 84, 85, 90, 93, 98, 104, 105 Monitor, 7, 14, 90, 92 Monoclonal, 22, 90 Monoclonal antibodies, 22, 90 Monocular, 21, 27, 31, 33, 90 Mononuclear, 82, 90 Morphological, 7, 70, 89, 90 Morphology, 75, 90 Mucins, 90, 100 Mucosa, 15, 90 Muscular Dystrophies, 80, 91 Myocardial infarction, 8, 78, 90, 91 Myocardium, 90, 91 Myopia, 91, 98, 99 N Narcotic, 91, 92 Natural selection, 73, 91 Necrosis, 72, 81, 82, 86, 90, 91 Neonatal, 18, 91 Neoplastic, 89, 91, 95 Nephropathy, 26, 91 Nerve, 13, 17, 21, 33, 71, 72, 73, 75, 79, 80, 83, 91, 93, 95, 100, 102, 105 Nerve Degeneration, 17, 91 Nerve Fibers, 91, 105 Nervous System, 31, 69, 75, 76, 91, 92, 102 Neural, 12, 15, 69, 91, 99, 101 Neural Pathways, 91 Neuronal, 17, 31, 76, 91 Neurons, 15, 79, 82, 91, 92, 103 Neuropathy, 17, 32, 91 Neurophysiology, 91, 92 Neuroprotective Agents, 17, 92 Neuroretinitis, 92, 99 Neurotransmitters, 19, 82, 92 Night Blindness, 17, 92, 99 Nitric Oxide, 17, 92 Nitrous Oxide, 28, 92 Nuclear, 16, 73, 82, 83, 91, 92, 99 Nuclei, 83, 89, 90, 92, 93 Nucleic acid, 86, 92 Nucleus, 72, 73, 76, 78, 79, 81, 90, 92, 102, 103 Nystagmus, 28, 92

O Occipital Lobe, 92, 105 Occult, 5, 92 Ocular, 5, 8, 9, 10, 13, 14, 15, 16, 18, 19, 21, 26, 33, 92, 104 Opacity, 75, 92 Ophthalmic, 28, 34, 92, 99 Ophthalmic Artery, 92, 99 Opsin, 93, 99, 100 Optic Chiasm, 93 Optic cup, 71, 93 Optic disc, 25, 32, 93 Optic Nerve, 7, 13, 16, 70, 73, 80, 92, 93, 99, 100, 105 Optic nerve head, 13, 17, 80, 92, 93 Orbit, 93 Orbital, 26, 28, 31, 93 Organelles, 79, 89, 93 Osmosis, 93 Osmotic, 19, 93 Otolaryngology, 13, 93 Overdose, 23, 93 Oxidation, 79, 93 Oximetry, 13, 93 Oxygenation, 13, 93 P Pachymeningitis, 89, 93 Palliative, 94, 103 Pancreas, 69, 86, 94 Pancreatic, 94 Pancreatitis, 25, 94 Particle, 88, 94 Pathogenesis, 5, 19, 22, 94 Pathologic, 5, 12, 17, 72, 78, 94 Pathologic Processes, 72, 94 Pathologies, 12, 94 Pathophysiology, 11, 17, 94 Patient Education, 56, 62, 64, 67, 94 Pelvic, 94, 97 Peptide, 5, 16, 70, 82, 94, 96, 97 Peptide Library, 5, 94 Perception, 14, 77, 94 Perfusion, 85, 94, 103 Perimetry, 35, 94 Perioperative, 24, 94 Peripheral vision, 94, 105 Petechiae, 84, 94 Pharmacokinetic, 9, 94 Pharmacologic, 71, 94, 103, 104 Phenotype, 20, 22, 95 Phenylalanine, 95, 104 Photocoagulation, 4, 11, 95

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Loss of Vision

Photoreceptor, 6, 9, 17, 22, 95, 100 Phototransduction, 17, 95, 100 Physiologic, 95, 98 Physiology, 12, 17, 19, 69, 80, 92, 95 Pigment, 4, 6, 75, 88, 89, 95, 99 Pituitary Gland, 78, 82, 95 Plasma, 71, 75, 84, 90, 95, 101, 103, 105 Plasma cells, 71, 95 Plasmacytoma, 27, 95 Plasmids, 14, 95 Platelet Aggregation, 92, 95 Platelets, 92, 95, 103 Pneumonia, 78, 95 Polymerase, 4, 17, 95 Polymerase Chain Reaction, 4, 17, 95 Polymorphic, 20, 75, 96 Polymyalgia Rheumatica, 26, 96 Polypeptide, 70, 76, 96 Polysaccharide, 71, 96 Posterior, 19, 32, 70, 72, 76, 80, 87, 92, 94, 96, 100 Postmenopausal, 25, 96 Postnatal, 96, 102 Potassium, 90, 96 Practice Guidelines, 52, 96 Preclinical, 5, 96 Precursor, 80, 81, 95, 96, 104 Pre-eclamptic, 80, 96 Probe, 17, 96 Progression, 22, 56, 71, 96, 105 Progressive, 4, 6, 7, 22, 30, 38, 41, 91, 96, 97, 99 Projection, 93, 96, 97, 98 Proliferative Retinopathy, 56, 96 Proline, 21, 76, 96 Promoter, 10, 97 Proptosis, 26, 35, 97 Prospective study, 88, 97 Prostate, 31, 97 Protein Isoforms, 70, 97 Protein S, 22, 73, 97 Proteins, 7, 16, 17, 22, 70, 71, 75, 76, 77, 78, 90, 94, 95, 97, 98, 101, 104 Proteolytic, 18, 77, 97 Pseudoxanthoma, 8, 97 Pseudoxanthoma Elasticum, 8, 97 Psychiatric, 24, 97 Psychiatry, 28, 34, 97 Psychic, 89, 97 Psychomotor, 14, 97 Puberty, 97 Public Health, 4, 52, 97

Public Policy, 51, 97 Pulmonary, 73, 97 Pulmonary Artery, 73, 97 Pulse, 80, 90, 93, 97 Pupil, 78, 98 Purpura, 84, 98 Purulent, 81, 98 Q Quality of Life, 5, 98 R Race, 90, 98 Radiation, 98, 100, 106 Radioactive, 74, 85, 88, 90, 92, 98, 100 Radioisotope, 98, 104 Randomized, 80, 98 Receptor, 9, 14, 69, 71, 77, 95, 98 Recombinant, 6, 9, 16, 87, 98, 105 Recombinant Proteins, 16, 98 Recombination, 83, 98 Rectum, 82, 83, 97, 98 Recurrence, 10, 98 Red Nucleus, 72, 98 Refer, 1, 76, 83, 88, 89, 98 Refraction, 16, 91, 98, 102 Refractive Errors, 56, 70, 98 Regeneration, 82, 98 Regimen, 80, 98 Remission, 98 Resection, 99 Respiration, 90, 99 Retinae, 89, 99 Retinal, 4, 5, 6, 7, 8, 9, 10, 12, 13, 15, 17, 18, 21, 22, 25, 26, 29, 56, 77, 79, 90, 93, 95, 99, 100, 105 Retinal Artery, 13, 99 Retinal Detachment, 10, 12, 79, 99 Retinal Ganglion Cells, 7, 15, 22, 93, 99 Retinal Hemorrhage, 8, 99 Retinal pigment epithelium, 12, 22, 99 Retinitis, 6, 17, 22, 99 Retinitis Pigmentosa, 6, 17, 22, 99 Retinol, 99, 100 Retinopathy, 5, 18, 26, 56, 79, 99 Retrograde, 21, 100 Retroviral vector, 83, 100 Rhodopsin, 6, 17, 93, 99, 100 Risk factor, 6, 11, 97, 100 Rod, 6, 17, 95, 100 S Saliva, 15, 100 Salivary, 16, 100 Salivary glands, 100

113

Scans, 11, 100 Sclera, 76, 77, 100 Scleroderma, 82, 100 Scoliosis, 29, 100 Screening, 5, 11, 20, 24, 76, 100 Second Messenger Systems, 92, 100 Secretion, 12, 14, 78, 83, 86, 90, 100 Secretory, 19, 100, 103 Sedimentation, 96, 100, 104 Segregation, 20, 98, 100 Semen, 97, 100 Sequencing, 96, 101 Serous, 28, 81, 101 Serrata, 76, 101 Serum, 5, 76, 90, 101 Sharpness, 101, 105 Shock, 101, 104 Side effect, 9, 69, 101, 104 Skeleton, 69, 101 Small cell lung cancer, 30, 101 Smooth muscle, 10, 101, 102 Social Environment, 98, 101 Sodium, 90, 95, 101 Sodium Channels, 95, 101 Soft tissue, 73, 82, 101 Solid tumor, 71, 101 Solvent, 93, 101 Specialist, 58, 101 Species, 76, 81, 85, 90, 95, 98, 101, 105, 106 Specificity, 5, 22, 69, 74, 101, 103 Spectrum, 5, 102 Sperm, 70, 76, 102, 104 Spinal cord, 75, 80, 83, 89, 91, 92, 93, 102 Sporadic, 12, 102 Stabilization, 29, 102 Staging, 100, 102 Stem Cells, 15, 102 Steroids, 78, 102 Stimulus, 13, 70, 80, 87, 102, 103 Stomach, 69, 72, 82, 83, 85, 87, 102 Strand, 95, 102 Stress, 28, 102 Stroke, 24, 29, 50, 92, 102 Stromal, 20, 102 Subacute, 86, 102 Subclinical, 30, 86, 102 Subcutaneous, 75, 80, 102 Substance P, 100, 102 Substrate, 14, 102 Suction, 18, 102 Suppression, 78, 102 Suppurative, 75, 81, 103

Symphysis, 75, 97, 103 Symptomatic, 94, 103 Synapses, 92, 103 Synergistic, 6, 103 Systemic, 14, 73, 81, 86, 100, 103 T Temporal, 89, 96, 103 Thalamic, 72, 103 Thalamic Diseases, 72, 103 Therapeutics, 9, 103 Thermal, 79, 95, 103 Threshold, 5, 103 Thrombosis, 97, 102, 103 Thrombus, 78, 86, 95, 103 Thyroid, 103, 104 Tissue Distribution, 74, 103 Titre, 30, 103 Tomography, 21, 30, 77, 103 Tonometer, 57, 104 Torsion, 86, 104 Toxic, iv, 70, 80, 91, 104 Toxicology, 9, 52, 104 Toxins, 70, 71, 86, 90, 104 Trabecular Meshwork, 8, 104 Tracer, 19, 21, 104 Transcriptase, 4, 17, 104 Transcription Factors, 16, 104 Transfection, 73, 83, 104 Transurethral, 31, 104 Transurethral resection, 31, 104 Trauma, 27, 73, 91, 92, 94, 103, 104 Trophic, 15, 91, 104 Tubulin, 22, 104 Tunica, 90, 104 Tyrosine, 18, 104 U Ulcer, 75, 104 Uraemia, 94, 104 Urethra, 97, 104 Uterus, 82, 105 Uvea, 81, 105 V Vascular, 8, 12, 13, 18, 76, 81, 86, 92, 103, 105 Vasculitis, 94, 105 Vasodilators, 92, 105 Vector, 9, 105 Vein, 13, 92, 105 Venous, 13, 79, 97, 105 Venules, 73, 105 Veterinary Medicine, 51, 105 Vinblastine, 104, 105

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Loss of Vision

Vincristine, 104, 105 Viral, 9, 14, 20, 105 Viral Load, 20, 105 Virulence, 19, 105 Virulent, 19, 105 Virus, 6, 73, 83, 87, 100, 105 Visual Acuity, 4, 87, 105 Visual Cortex, 33, 70, 105 Visual field, 4, 57, 73, 88, 93, 94, 99, 105 Visual Pathways, 33, 105 Vitreous, 76, 79, 88, 99, 105, 106 Vitreous Body, 76, 99, 105

Vitreous Hemorrhage, 79, 105 Vitreous Humor, 99, 106 Vitro, 106 Vivo, 16, 22, 106 W White blood cell, 71, 88, 89, 95, 106 Wound Healing, 75, 82, 106 X Xenograft, 71, 106 X-ray, 77, 89, 92, 100, 106 Y Yeasts, 83, 95, 106

115

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Loss of Vision