Myelomeningocele - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

MYELOMENINGOCELE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J A...

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MYELOMENINGOCELE 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., 1960Myelomeningocele: 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: 0-497-00737-1 1. Myelomeningocele-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 myelomeningocele. 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 MYELOMENINGOCELE .............................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Myelomeningocele......................................................................... 5 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. ALTERNATIVE MEDICINE AND MYELOMENINGOCELE .............................................. 55 Overview...................................................................................................................................... 55 National Center for Complementary and Alternative Medicine.................................................. 55 Additional Web Resources ........................................................................................................... 60 General References ....................................................................................................................... 61 CHAPTER 3. DISSERTATIONS ON MYELOMENINGOCELE ................................................................ 63 Overview...................................................................................................................................... 63 Dissertations on Myelomeningocele ............................................................................................ 63 Keeping Current .......................................................................................................................... 63 CHAPTER 4. PERIODICALS AND NEWS ON MYELOMENINGOCELE................................................. 65 Overview...................................................................................................................................... 65 News Services and Press Releases................................................................................................ 65 Academic Periodicals covering Myelomeningocele...................................................................... 67 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 71 Overview...................................................................................................................................... 71 NIH Guidelines............................................................................................................................ 71 NIH Databases............................................................................................................................. 73 Other Commercial Databases....................................................................................................... 75 APPENDIX B. PATIENT RESOURCES ................................................................................................. 77 Overview...................................................................................................................................... 77 Patient Guideline Sources............................................................................................................ 77 Finding Associations.................................................................................................................... 79 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 81 Overview...................................................................................................................................... 81 Preparation................................................................................................................................... 81 Finding a Local Medical Library.................................................................................................. 81 Medical Libraries in the U.S. and Canada ................................................................................... 81 ONLINE GLOSSARIES.................................................................................................................. 87 Online Dictionary Directories ..................................................................................................... 89 MYELOMENINGOCELE DICTIONARY ................................................................................... 91 INDEX .............................................................................................................................................. 121

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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 myelomeningocele 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 myelomeningocele, 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 myelomeningocele, 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 myelomeningocele. 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 myelomeningocele, 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 myelomeningocele. 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 MYELOMENINGOCELE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on myelomeningocele.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and myelomeningocele, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “myelomeningocele” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Impact of Urinary Incontinence of Self-Concept in Children with Spina Bifida Source: Journal of Urology. 171(4): 1659-1662. April 2004. Summary: Low self-concept and self-esteem are thought to be the main predictors of psychological problems in children and adolescents. Children with spina bifida are thought to be at an increased risk for low self-concept and self-esteem given their disabilities. This article reports on a study that examined the impact of urinary continence on self-concept in children with myelomeningocele. A total of 50 patients aged 7 to 19 years old with spina bifida were evaluated using the Harner self-perception profile. There were no statistically significant differences between continent patients with spina bifida and controls. Overall, children with spina bifida rated lower in scholastic competence, social acceptance, and behavioral conduct than the controls. Girls

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with spina bifida scored lower in perceived athleticism, physical appearance, and global self-worth than boys with spina bifida. Continent girls were self-rated higher in social acceptance and global self-worth than incontinent girls. Continent boys were self-rated higher in scholastic competence, social acceptance, physical appearance, and behavior compared to incontinent boys. The authors conclude that urologists' efforts to promote continence are likely to have a positive effect on self-concept in boys and girls with spina bifida. 3 tables. 15 references. •

Spina Bifida Source: Family Urology. 4(1): 8, 12. 1999. Contact: Available from American Foundation for Urologic Disease. 1126 North Charles Street, Baltimore, MD 21201. (800) 242-2383 or (410) 468-1800. Fax (410) 468-1808. Website: www.afud.org. Summary: Spina bifida (myelomeningocele) is a defect found in the developing spinal cord of some infants before birth. It is most often characterized as a hole in the spinal cord that produces neurological, musculoskeletal, and urologic difficulties. This brief article reviews the urologic care of children with spina bifida. The author notes that because of the severity of the neurological and orthopedic problems, urinary tract problems are often neglected. However, today most children with spina bifida can be rendered socially continent, urinary infections can be minimized, and renal failure usually prevented. This is primarily because of the introduction of multidisciplinary clinics for the treatment of these children. During the first few years, the urologist assists patients with spina bifida to prevent or treat hydronephrosis (dilation of the urinary tract which can lead to kidney damage) through regular examinations, and interventions such as medications, catheterizations, or surgery. At some point (usually in the preschool years) the concern shifts to providing urinary continence for the patient. In adolescence, concerns about sexual function and fertility emerge.

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Urological Issues with the Spina Bifida Population Source: Journal of Urological Nursing. 12(1): 333-344. January/February/March 1993. Summary: Spina bifida, or myelomeningocele, is one of the most common birth defects in the United States, affecting approximately one in every thousand births. This article addresses urological issues that occur within the spina bifida population. Topics include urological issues for the newborn, assessment of bladder function, treatment of urinary tract infections (UTI), issues of care across the lifespan, controlling UTIs and bladder pressure to prevent kidney damage, the use of continent ostomies and indwelling catheters in this population, the use of clean intermittent catheterization (CIC), surgical methods used to enhance urinary continence, problems with latex allergy, and the importance of skin care. The author focuses on the nursing interventions necessary to help with the urological concerns of the spina bifida population. A detailed nursing care plan is included. 1 table. 19 references.

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Male Sling for Stress Urinary Incontinence: A Prospective Study Source: Journal of Urology. 167(2 Part 1): 597-601. February 2002. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2334. Fax (301) 824-7290. Summary: This article reports on a prospective study of the male sling surgical technique used for treating stress urinary incontinence (SUI). A total of 21 men

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underwent sling surgery. There were 2 titanium screws loaded with polypropylene suture placed in each descending pubic ramus through a 3.5 centimeter perineal incision at the level of the bulbar urethra. A polypropylene mesh was placed over the urethra and tied to the bone anchors, adjusting sling tension to a compression of 60 centimeters water. Followup was done with the incontinence section of the University of California, Los Angeles RAND Prostate Cancer Index. Mean followup was 12 months (range 5 to 21 months). Overall, incontinence was cured in 16 patients (76 percent), substantially improved (SUI very small or small problem, 1 pad daily) in 3 patients (14 percent), somewhat improved in 1 patient (5 percent), and no improvement in 1 patient (5 percent). The patients with SUI after undergoing transurethral prostatectomy (TURP) were cured, as was the individual with myelomeningocele. Of the 18 patients with SUI after radical prostatectomy, 13 were cured, including 1 of 2 who underwent previous artificial urinary sphincter placement and 2 of adjuvant radiation. There was significant improvement in each survey question, and the total score improved. The author concludes that this minimally invasive sling surgery has not been associated with any significant complication, and early results compare favorably with artificial urinary sphincter. Prior radiation or artificial urinary sphincter does not appear to be a contraindication to sling surgery. An editorial comment is appended to the article. 4 figures. 30 references.

Federally Funded Research on Myelomeningocele The U.S. Government supports a variety of research studies relating to myelomeningocele. 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 myelomeningocele. 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 myelomeningocele. The following is typical of the type of information found when searching the CRISP database for myelomeningocele: •

Project Title: FETAL BIOLOGY AND THERAPY TRAINING PROGRAM Principal Investigator & Institution: Flake, Alan W.; Professor of Pediatric Surgery; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 191044399 Timing: Fiscal Year 2004; Project Start 01-MAY-2004; Project End 30-APR-2009 Summary: (provided by applicant): The goal of this T32 Training Program proposal is to facilitate the development of a new generation of medical and surgical fetal specialists that will be well trained to carry out innovative and scientifically rigorous laboratory

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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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and clinical research directed toward novel and effective strategies for fetal treatment. The need for such a program is highlighted by the present lack of specific subspecialty training and preparation of investigators for treatment of the fetus as a patient. At the same time, the perception of the fetus as a patient is gaining momentum, and the number of claimed successful interventions applicable to the fetus has increased rapidly. There is thus a compelling need for well trained physician scientists in this field for developmental research and analysis of efficacy and outcomes. The Program will support Trainees for up to 3 years of clinical or laboratory research training at the postdoctoral fellowship level. The Training faculty includes 16 Faculty Mentors from The Children's Hospital and the University of Pennsylvania School of Medicine and 1 from Cornell University, who have outstanding credentials and a focused interest in laboratory or clinical research directed toward fetal treatment. These mentors will supervise Trainees in basic laboratory research and/or patient-oriented research projects related to fetal treatment. Research opportunities will include four major areas of basic research 1) Stem cell therapy in the fetus; 2) Fetal gene therapy; 3) Fetal wound healing; and 4) Fetal anatomic malformations and fetal lung growth. Patient oriented research opportunities will be derived from the CHOP Center for Fetal Diagnosis and Treatment and will include opportunities derived from two existing NICHD sponsored multicenter, randomized, clinical trials examining fetal treatment of myelomeningocele and Twin-Twin Transfusion Syndrome at CHOP as well as participation in the design and implementation of new studies of various aspects of fetal therapy. The Program includes training in all aspects of research, including biostatistics and bioethics, with a specific program in ethics in the context of fetal therapy, molecular biology, and related. The Program is strongly supported by access to a superb range of institutional resources, including the CHOP Center for Fetal Diagnosis and Therapy, the CHOP GCRC and the U. Penn Graduate School and IHGT. This request is made for 2 Trainee slots in year 1, 3 Trainee slots in year 2, and 4 Trainee slots each year thereafter. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HINDBRAIN MYELOMENINGOCELE

HERNIATION

IN

SHEEP

MODEL

OF

Principal Investigator & Institution: Von Koch, Cornelia S.; Neurological Surgery; University of California San Francisco 3333 California Street, Suite 315 San Francisco, Ca 941430962 Timing: Fiscal Year 2002; Project Start 15-JUL-2002; Project End 22-JUN-2003 Summary: (provided by applicant): Myelomeningocele (MMC), seen in 0.5-1 per 1000 live births, is almost always associated with hindbrain herniation or Chiari II malformation, and represents one of the most debilitating birth defects in humans. Hindbrain herniation results in impaired brainstem and cranial nerve function. Abnormal cerebral spinal fluid flow results in syrinx formation and hydrocephalus. Therefore, patients present with respiratory depression, apneic spells, lower cranial nerve palsies, and quadriparesis. Hydrocephalus develops in 83-90% of patients and almost always requires shunting. Shunt malfunction and infection represent the most common late mortality in MMC patients. We propose to prevent hindbrain herniation and hydrocephalus formation in sheep via in utero repair of surgically created MMC. Fetal lambs will undergo MMC creation at mid-gestation and half will be repaired in utero at 2/3 of gestation. At birth, lambs with in utero MMC repair should be free of hindbrain herniation and not develop hydrocephalus, in comparison with lambs without in utero MMC repair. If this holds true, in utero repair in humans may prevent the devastating consequences of hindbrain herniation and hydrocephalus. Furthermore,

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we will characterize in lambs gross pathological and axonal pathfinding anomalies usually seen in the human disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR ANALYSIS OF COLLAGEN IN NON-COMPLIANT BLADDERS Principal Investigator & Institution: Howard, Pamela S.; Associate Professor; Anatomy and Cell Biology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 30-SEP-1993; Project End 30-NOV-2003 Summary: (Adapted from the Applicant's Abstract): The major goal of this proposal is to determine the cellular and molecular mechanisms responsible for activation of extracellular matrix genes in bladder fibrosis. Congenital and acquired obstructive uropathies, as the sequelae to neurologic lesions (myelomeningocele, tethered cord syndrome) or physical alteration (posterior urethral valves, benign prostatic hyperplasia, radiation therapy) can result in fibrosis of the bladder wall. The applicant has demonstrated that the terminal response is an accumulation of type III collagen in an abnormal location and an alteration in the ratio of types III to I collagen. To evaluate potential molecular control mechanisms responsible for bladder fibrosis, she will utilize a cell culture model system consisting of human bladder wall cells (detrusor smooth muscle cells and lamina propria fibroblasts) and bladder wall cells from mice which carry genetic mutations in the potential regulatory pathway proteins, transforming growth factor-beta (TGFB) and angiotensin. She will test the hypothesis that extracellular matrix changes in bladder wall cells are regulated by expression of transforming grow factor-beta via a cascade mechanism involving a positive feedback response of angiotensin. She will determine the role of these tissue factors in regulating cell growth (hyperplasia), cell enlargement (hypertrophy) and extracellular matrix gene and protein expression. These experiments will allow determination of the molecular and biochemical impact of each stimulus on a given cell type to determine further what role each cell type within the bladder wall contributes to the pathologic process. In vivo model of mice which have been genetically manipulated to produce less type I collagen or type III collagen, thereby producing a bladder model in which the normal type III: type I collagen ratio has been altered. Using length-tension studies and whole bladder cystometry on these genetically altered bladders; biochemical alterations will be correlated to physiologic functional properties (bladder compliance). We will initiate studies in vivo and in vitro to attempt to identify signaling molecules and transcription factors, which are part of the signaling pathways, which lead to bladder fibrosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOLECULAR RESPONSE OF THE BLADDER TO OBSTRUCTION Principal Investigator & Institution: Macarak, Edward J.; Associate Professor; Anatomy and Cell Biology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 01-MAR-1999; Project End 31-JAN-2004 Summary: (Adapted from the Applicant's Abstract): Bladder muscle stretch and relaxation during fetal life are required for normal bladder development. A lack of an adequate level of mechanical exercise or volume work or a disruption of the normal patterns of stretch within the bladder wall will lead to biochemical and structural alterations within the bladder muscle and structural proteins ultimately affecting bladder function. The majority of fetal stress conditions are related to urogenital pathologies which occur developmentally, such as posterior urethral valves, functional

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bladder obstructions secondary to myelomeningocele and oligohydramnios which can affect lung development. The objectives of this study are: 1) to establish an animal model of fetal bladder obstruction and reversal, and the efficacy of surgical interventions, 2) to determine the role of mechanical signals, i.e. stretch, in regulating extracellular matrix synthesis and accumulation in the developing fetal sheep model; 3) to determine the effect of physical obstruction of the developing bladder on matrix and growth factor expression (immediate early genes and TGF-betas, basic FGF, NGF); 4) to determine the parameters and kinetics of matrix and growth factor expression following obstruction reversal; 5) to determine if stretch, in the absence of high pressures induced by obstruction (vesicotomy model), or absence of stretch and volume-work (bilateral nephrectomy) allows the bladder to remodel and maintain itself as a functional organ and 6) to determine the role of the transcription factor, the Wilms tumor gene product (wt-1) in the regulation of bladder development, obstruction and reversal. Physiological measurements of bladder function will be determined by cystometry. Cystometrograms will be correlated with longitudinal analyses of extracellular matrix steady state mRNA and protein expression (amino acid analyses, desmosine analysis ELISA) to evaluate the kinetics of activation or repression, histological and immunohistochemical analyses to determine localization of these proteins during development and any alteration as a result of obstruction. Electron microscopy will be performed to determine if collagen fibril diameter is altered and correlated with changes in thpeIII:type I collagen rations and functional physiologic compliance measurements. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MULTICENTER TRIAL OF FETAL MYELOMENINGOCELE REPAIR Principal Investigator & Institution: Adzick, N Scott.; Surgeon-In-Chief; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 191044399 Timing: Fiscal Year 2002; Project Start 15-MAR-2002; Project End 28-FEB-2007 Summary: (provided by applicant): Since 1997, 180 fetuses have had in utero closure of myelomeningocele (MMC) by open fetal surgery. Preliminary clinical evidence suggests that this procedure reduces the incidence of shunt-dependent hydrocephalus and restores the cerebellum and brainstem to more normal configuration. However, clinical results of fetal surgery for MMC are based on comparisons with historical controls and examine only efficacy and not safety. The Myelomeningocele Repair Randomized Trial is a multi-center unblinded randomized clinical trial of 200 patients that will be conducted at three Fetal Surgery Units (FSUs), the University of CaliforniaSan Francisco, Children s Hospital of Philadelphia, and Vanderbilt University Medical Center, along with an independent Data and Study Coordinating Center (DSCC), the George Washington University Biostatistics Center. The primary objective of the trial is to determine if intrauterine repair of fetal myelomeningocele at 18 to 25 weeks gestation improves outcome, as measured by (1) death or the need for ventricular decompressive shunting by one year of life and (2) death or Bayley Mental Development Index, as compared to standard postnatal repair. Consenting patients who satisfy eligibility criteria will be centrally randomized to either intrauterine or standard postnatal repair of the MMC. Patients assigned to the fetal surgery group will be discharged to nearby accommodation following surgery, unless unfeasible, in which case they will return to their assigned FSU at 32 weeks gestation for delivery at 37 weeks gestation by cesarean section. Patients assigned to the postnatal surgery group will return home and at 37 weeks, return to their assigned FSU for delivery by cesarean section. Magnetic resonance imaging will be conducted at enrollment, discharge or term gestation, and one year of age to determine if intrauterine repair improves the degree of the Chiari II

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malformation. Neonatal morbidity will be recorded as will the number of surgical procedures for conditions related to the MMC, muscle strength, ambulation status and urinary and fecal continence. Infants will make follow-up visits at twelve and thirty months corrected age for detailed neuromotor function analysis, cognitive testing and evaluation of neurodevelopmental status. In addition, the long term psychosocial and reproductive consequences in mothers will be evaluated. In summary, the proposed trial is expected to demonstrate whether fetal intervention offers improved outcome with a reasonable quality of life for spina bifida children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MYELOMENINGOCELE REPAIR RANDOMIZED TRIAL-DSCC Principal Investigator & Institution: Thom, Elizabeth A.; Associate Research Professor of Statisti; Statistics; George Washington University 2121 I St Nw Washington, Dc 20052 Timing: Fiscal Year 2002; Project Start 11-APR-2002; Project End 31-MAR-2007 Summary: Since 1997, 180 fetuses have had in utero closure of myelomeningocele (MMC) by open fetal surgery. Preliminary clinical evidence suggests that this procedure reduces the incidence of shunt-dependent hydrocephalus and restores the cerebellum and brainstem to more normal configuration. However, clinical results of fetal surgery for MMC are based on comparisons with historical controls and examine only efficacy and not safety. The Myelomeningocele Repair Randomized Trial is a multi-center unblinded randomized clinical trial of 200 patients that will be conducted at three Fetal Surgery Units (FSU), the University of California-San Francisco, Children's Hospital of Philadelphia, and Vanderbilt University Medical Center. The primary objective of the trial is to determine if intrauterine repair of fetal myelomeningocele at 18(0) to 25(6) weeks gestation improves outcome, as measured by 1) death or the need for ventricular decompressive shunting by one year of life and 2) death or Bayley Mental Development Index, as compared to standard postnatal repair This proposal is for the George Washington University Biostatistics Center to serve as the Data and Study Coordinating Center (DSCC) for the MMC Repair Trial. The purpose of the DSCC, an important but independent member of the multi-center collaborative study group, is to provide expertise and support in study design, study conduct and statistical analysis. We will provide scientific leadership in the design of the study and prepare the final study documents including the protocol, manual of operations and case report forms. The DSCC will be responsible for all publicity for the MMC Repair Trial such as establishing a central web site, mailing of physician brochures, presenting trial information at appropriate professional meetings and placing print advertisements in medical journals and patient oriented publications. We will also serve as the central referral site for patients to learn more about the trial, conduct preliminary review of patient eligibility and assign the patient to a Fetal Surgery Unit for final evaluation. The DSCC will maintain an Internet randomization system and web-based data entry system for the patient eligibility data. We will provide a comprehensive data processing system including central data entry, data base management and data quality control. The DSCC will use appropriate statistical techniques to conduct interim and final analyses. We will assist the investigators in preparation of manuscripts and abstracts from study results. In summary, we will participate in cooperation with the FSUs on the proposed trial with the goal of demonstrating whether fetal intervention offers improved outcome with a reasonable quality of life for spina bifida children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Myelomeningocele

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 myelomeningocele, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “myelomeningocele” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for myelomeningocele (hyperlinks lead to article summaries): •

A conceptual model of higher cortical function impairments in myelomeningocele. Author(s): Kinsman SL, Rawlins C, Finney K, Ruffing V, Speedie L. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1998 December; 8 Suppl 1: 69-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9926339

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A cross-sectional study of dehydroepiandrosterone sulfate in prepubertal children with myelomeningocele. Author(s): Trollmann R, Langhans B, Strehl E, Wenzel D, Dorr HG. Source: Hormone Research. 2001; 56(1-2): 19-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11815723

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A kyphectomy technique with reduced perioperative morbidity for myelomeningocele kyphosis. Author(s): Nolden MT, Sarwark JF, Vora A, Grayhack JJ. Source: Spine. 2002 August 15; 27(16): 1807-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12195076

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A longitudinal study of cognitive abilities and achievement status of children with myelomeningocele and their relationship with clinical types. Author(s): Casari EF, Fantino AG. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1998 December; 8 Suppl 1: 52-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9926327

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

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A multicentre study of the hospital care of 1500 patients with myelomeningocele. Author(s): Bea Munoz M, Diaz Llopis I, Martinez Agullo E, Lopez A, Garcia Aymerich V, Forner Valero JV. Source: Paraplegia. 1994 August; 32(8): 561-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7970861

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A rare association of myelomeningocele with cloacal duplication malformation. Author(s): Telmesani A. Source: Annals of Tropical Paediatrics. 1994; 14(3): 253-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7826000

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A renal size nomogram for the patient with myelomeningocele. Author(s): Sutherland RW, Wiener JS, Roth DR, Gonzales ET Jr. Source: The Journal of Urology. 1997 September; 158(3 Pt 2): 1265-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9258191

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About the rate of shunt complications in patients with hydrocephalus and myelomeningocele. Author(s): Rolle U, Grafe G. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1999 December; 9 Suppl 1: 51-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10661803

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Acquired spinal cord injury in human fetuses with myelomeningocele. Author(s): Hutchins GM, Meuli M, Meuli-Simmen C, Jordan MA, Heffez DS, Blakemore KJ. Source: Pediatric Pathology & Laboratory Medicine : Journal of the Society for Pediatric Pathology, Affiliated with the International Paediatric Pathology Association. 1996 September-October; 16(5): 701-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9025869

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Adolescents with myelomeningocele: activities, beliefs, expectations, and perceptions. Author(s): Buran CF, Sawin KJ, Brei TJ, Fastenau PS. Source: Developmental Medicine and Child Neurology. 2004 April; 46(4): 244-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15077702

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Age related bladder capacity and bladder capacity growth in children with myelomeningocele. Author(s): Palmer LS, Richards I, Kaplan WE. Source: The Journal of Urology. 1997 September; 158(3 Pt 2): 1261-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9258190

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Ambulation in patients with myelomeningocele: a 12-year follow-up. Author(s): Bartonek A, Saraste H, Samuelsson L, Skoog M. Source: Journal of Pediatric Orthopedics. 1999 March-April; 19(2): 202-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10088689

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Ambulation with the reciprocating-gait orthosis. Experience in 15 children with myelomeningocele or paraplegia. Author(s): Gerritsma-Bleeker CL, Heeg M, Vos-Niel H. Source: Acta Orthopaedica Scandinavica. 1997 October; 68(5): 470-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9385249

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An examination of the knee function during gait in children with myelomeningocele. Author(s): Ounpuu S, Thomson JD, Davis RB, DeLuca PA. Source: Journal of Pediatric Orthopedics. 2000 September-October; 20(5): 629-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11008743

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Anterior only fusion for scoliosis in patients with myelomeningocele. Author(s): Sponseller PD, Young AT, Sarwark JF, Lim R. Source: Clinical Orthopaedics and Related Research. 1999 July; (364): 117-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10416400

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Anthropomorphic measurements of patients with myelomeningocele. Author(s): Trollmann R, Dorr HG. Source: European Journal of Pediatrics. 1996 October; 155(10): 914-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8891567

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Apophyseolysis of the fourth lumbar vertebra: an early postoperative complication following kyphectomy in myelomeningocele. Author(s): Bohm H, ElSaghir H. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2000 December; 9(6): 586-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11189931

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Appendicostomy for antegrade enema: effects on somatic and psychosocial functioning in children with myelomeningocele. Author(s): Aksnes G, Diseth TH, Helseth A, Edwin B, Stange M, Aafos G, Emblem R. Source: Pediatrics. 2002 March; 109(3): 484-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11875145

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Application of the Token Test with myelomeningocele and shunted hydrocephalus. Author(s): Vachha B, Adams RC. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2002 December; 12 Suppl 1: S33-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12585253

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Are dermoid and epidermoid tumors preventable complications of myelomeningocele repair? Author(s): Storrs BB. Source: Pediatric Neurosurgery. 1994; 20(2): 160-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8161490

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BAEPs in infants with myelomeningocele and later development of Chiari II malformation-related brainstem dysfunction. Author(s): Worley G, Erwin CW, Schuster JM, Park Y, Boyko OB, Griebel ML, Weidman ER, Radtke RA, Oakes WJ. Source: Developmental Medicine and Child Neurology. 1994 August; 36(8): 707-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8050624

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Behavioral and emotional problems in children with myelomeningocele (MMC). Author(s): Bilenberg N, Lie HR. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2001 December; 11 Suppl 1: S44-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11848048

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Benign symmetric lipomatosis with myelomeningocele in an adolescent: An uncommon association-case report. Author(s): Nounla J, Rolle U, Grafe G, Kraling K. Source: Journal of Pediatric Surgery. 2001 July; 36(7): E13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11431798

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Bladder epithelium is abnormal in patients with neurogenic bladder due to myelomeningocele. Author(s): Schlager TA, Grady R, Mills SE, Hendley JO. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 2004 March; 42(3): 163-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15001981

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Bladder neck wrap: a modified fascial sling in treatment of incontinence in myelomeningocele patients. Author(s): Ghoniem GM. Source: European Urology. 1994; 25(4): 340-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8056030

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Bladder-outlet reconstruction in neurogenic bladder due to myelomeningocele. Author(s): Johnson HW, Weckworth PF, Coleman GU, Arnold WJ, Sawatzky BJ, Moloney PJ, Stewart D. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1988 January; 31(1): 22-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3337968

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Bladder-sphincter dysfunction in myelomeningocele. Author(s): van Gool JD, Dik P, de Jong TP. Source: European Journal of Pediatrics. 2001 July; 160(7): 414-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11475578

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Body composition in myelomeningocele. Author(s): Shepherd K, Roberts D, Golding S, Thomas BJ, Shepherd RW. Source: The American Journal of Clinical Nutrition. 1991 January; 53(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1984332

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Body composition of children with myelomeningocele, determined by 40K, urinary creatinine and anthropometric measures. Author(s): Grogan CB, Ekvall SM. Source: Journal of the American College of Nutrition. 1999 August; 18(4): 316-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12038474

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Body composition studies in cystic fibrosis and myelomeningocele. Author(s): Thomas BJ, Shepherd RW, Holt TL, Shepherd K, Greer R, Cleghorn GJ. Source: Basic Life Sci. 1990; 55: 23-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2088272

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Bone density in myelomeningocele: the effects of ambulatory status and other factors. Author(s): Rosenstein BD, Greene WB, Herrington RT, Blum AS. Source: Developmental Medicine and Child Neurology. 1987 August; 29(4): 486-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3678627

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Bone mineral density in children with myelomeningocele: effect of hydrochlorothiazide. Author(s): Quan A, Adams R, Ekmark E, Baum M. Source: Pediatric Nephrology (Berlin, Germany). 2003 September; 18(9): 929-33. Epub 2003 July 23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12883972

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Botulinum-A toxin injection into the detrusor: a safe alternative in the treatment of children with myelomeningocele with detrusor hyperreflexia. Author(s): Riccabona M, Koen M, Schindler M, Goedele B, Pycha A, Lusuardi L, Bauer SB. Source: The Journal of Urology. 2004 February; 171(2 Pt 1): 845-8; Discussion 848. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14713840

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Bowel and bladder control of children with myelomeningocele: a Nordic study. Author(s): Lie HR, Lagergren J, Rasmussen F, Lagerkvist B, Hagelsteen J, Borjeson MC, Muttilainen M, Taudorf K. Source: Developmental Medicine and Child Neurology. 1991 December; 33(12): 1053-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1778342

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Bowel function in Danish children with myelomeningocele. Author(s): Krogh K, Lie HR, Bilenberg N, Laurberg S. Source: Apmis. Supplementum. 2003; (109): 81-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12874955

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Brace treatment of scoliosis in children with myelomeningocele. Author(s): Muller EB, Nordwall A. Source: Spine. 1994 January 15; 19(2): 151-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8153822

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Brain malformation associated with neural tube defects. Report of three cases of partial agenesis of the corpus callosum and myelomeningocele. Author(s): Ruggiero R, Mongini T, Colangelo M, Schiffer D, Ambrosio A. Source: Journal of Neuroradiology. Journal De Neuroradiologie. 1987; 14(3): 287-92. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3440881

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Brainstem auditory and visual evoked potentials in infants with myelomeningocele. Author(s): Taylor MJ, Boor R, Keenan NK, Rutka JT, Drake JM. Source: Brain & Development. 1996 March-April; 18(2): 99-104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8733898

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Centre of mass motion during gait in persons with myelomeningocele. Author(s): Gutierrez EM, Bartonek A, Haglund-Akerlind Y, Saraste H. Source: Gait & Posture. 2003 October; 18(2): 37-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14654206

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Cervical diastematomyelia and syringohydromyelia in a myelomeningocele patient. Author(s): Jaeger HJ, Schmitz-Stolbrink A, Mathias KD. Source: European Radiology. 1997; 7(4): 477-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9204323

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Cervical myelomeningocele--follow-up of five patients. Author(s): Meyer-Heim AD, Klein A, Boltshauser E. Source: European Journal of Paediatric Neurology : Ejpn : Official Journal of the European Paediatric Neurology Society. 2003; 7(6): 407-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14623220

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Characteristic gait kinematics in persons with lumbosacral myelomeningocele. Author(s): Gutierrez EM, Bartonek A, Haglund-Akerlind Y, Saraste H. Source: Gait & Posture. 2003 December; 18(3): 170-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14667950

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Children with myelomeningocele: the impact of disability on family dynamics and social conditions. A Nordic study. Author(s): Lie HR, Borjeson MC, Lagerkvist B, Rasmussen F, Hagelsteen JH, Lagergren J. Source: Developmental Medicine and Child Neurology. 1994 November; 36(11): 1000-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7958505

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Clinical and radiographic predictors of scoliosis in patients with myelomeningocele. Author(s): Trivedi J, Thomson JD, Slakey JB, Banta JV, Jones PW. Source: The Journal of Bone and Joint Surgery. American Volume. 2002 August; 84-A(8): 1389-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12177269

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Clinical outcomes that fetal surgery for myelomeningocele needs to achieve. Author(s): Cochrane DD, Irwin B, Chambers K. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2001 December; 11 Suppl 1: S18-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11813128

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Colonic transit time in patients with myelomeningocele. Author(s): Pigeon N, Leroi AM, Devroede G, Watier A, Denis P, Weber J, Arhan P. Source: Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society. 1997 June; 9(2): 63-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9198081

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Comparison of different systems to classify the neurological level of lesion in patients with myelomeningocele. Author(s): Bartonek A, Saraste H, Knutson LM. Source: Developmental Medicine and Child Neurology. 1999 December; 41(12): 796-805. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10619277

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Comparison of simultaneous versus delayed ventriculoperitoneal shunt insertion in children undergoing myelomeningocele repair. Author(s): Miller PD, Pollack IF, Pang D, Albright AL. Source: Journal of Child Neurology. 1996 September; 11(5): 370-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8877603

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Complications of intravesical oxybutynin chloride therapy in the pediatric myelomeningocele population. Author(s): Palmer LS, Zebold K, Firlit CF, Kaplan WE. Source: The Journal of Urology. 1997 February; 157(2): 638-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8996387

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Complications of scoliosis surgery in children with myelomeningocele. Author(s): Geiger F, Parsch D, Carstens C. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 1999; 8(1): 22-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10190850

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Congenital kyphosis in myelomeningocele. The effect of cordotomy on bladder function. Author(s): Lalonde F, Jarvis J. Source: The Journal of Bone and Joint Surgery. British Volume. 1999 March; 81(2): 245-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10204929

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Congenital kyphosis in myelomeningocele: results following operative and nonoperative treatment. Author(s): Martin J Jr, Kumar SJ, Guille JT, Ger D, Gibbs M. Source: Journal of Pediatric Orthopedics. 1994 May-June; 14(3): 323-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8006162

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Contemporaneous shunting with repair of myelomeningocele. Author(s): Parent AD, McMillan T. Source: Pediatric Neurosurgery. 1995; 22(3): 132-5; Discussion 136. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7786805

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Control of reaching movements in children and young adults with myelomeningocele. Author(s): Norrlin S, Dahl M, Rosblad B. Source: Developmental Medicine and Child Neurology. 2004 January; 46(1): 28-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14974644

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Creation of myelomeningocele in utero: a model of functional damage from spinal cord exposure in fetal sheep. Author(s): Tanyel FC, Ciftci AO. Source: Journal of Pediatric Surgery. 1996 October; 31(10): 1466-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8906696

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Current concepts in myelomeningocele. Author(s): Drennan JC. Source: Instr Course Lect. 1999; 48: 543-50. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10098082

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Current considerations for myelomeningocele repair. Author(s): Blanco-Davila F, Luce EA. Source: The Journal of Craniofacial Surgery. 2000 September; 11(5): 500-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11314072

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Current management of the infant with myelomeningocele. Author(s): Sutherland RW, Gonzales ET. Source: Current Opinion in Urology. 1999 November; 9(6): 527-31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10668572

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Decreased bladder compliance in patients with myelomeningocele treated with radiological observation. Author(s): Kaufman AM, Ritchey ML, Roberts AC, Rudy DC, McGuire EJ. Source: The Journal of Urology. 1996 December; 156(6): 2031-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8965337

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Delayed CSF pseudocyst following shunt malfunction after myelomeningocele repair. Author(s): Takahashi Y, Muraoka N, Sakata K, Nonaka Y, Hattori G, Tokutomi T, Shigemori M. Source: Kurume Med J. 2000; 47(3): 225-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11059224

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Dermoid and epidermoid tumors in myelomeningocele patients. Author(s): Martinez-Lage JF, Poza M, Sola J. Source: Pediatric Neurosurgery. 1994; 20(4): 274. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8080576

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Dermoid in the filum terminale of a newborn with myelomeningocele. Author(s): Chadduck WM, Roloson GJ. Source: Pediatric Neurosurgery. 1993 March-April; 19(2): 81-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8443101

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Dermoid inclusion cysts and early spinal cord tethering after fetal surgery for myelomeningocele. Author(s): Mazzola CA, Albright AL, Sutton LN, Tuite GF, Hamilton RL, Pollack IF. Source: The New England Journal of Medicine. 2002 July 25; 347(4): 256-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12140301

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Detrusor action in children with myelomeningocele. Author(s): Cooper DG. Source: Archives of Disease in Childhood. 1968 August; 43(230): 427-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5661872

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Development of pathological lumbar kyphosis in myelomeningocele. Author(s): Carstens C, Koch H, Brocai DR, Niethard FU. Source: The Journal of Bone and Joint Surgery. British Volume. 1996 November; 78(6): 945-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8951012

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Development of scoliosis in myelomeningocele. Differences in the history caused by idiopathic pattern. Author(s): Eysel P, Hopf C, Schwarz M, Voth D. Source: Neurosurgical Review. 1993; 16(4): 301-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8127444

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Development of the urodynamic pattern in infants with myelomeningocele. Author(s): Sillen U, Hansson E, Hermansson G, Hjalmas K, Jacobsson B, Jodal U. Source: British Journal of Urology. 1996 October; 78(4): 596-601. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8944517

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Developmental outcomes of children with myelomeningocele: prenatal predictors. Author(s): Coniglio SJ, Anderson SM, Ferguson JE. Source: American Journal of Obstetrics and Gynecology. 1997 August; 177(2): 319-24; Discussion 324-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9290446

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Diagnosis and management of prenatally detected myelomeningocele: a preliminary report. Author(s): Hogge WA, Dungan JS, Brooks MP, Dilks SA, Abbitt PL, Thiagarajah S, Ferguson JE. Source: American Journal of Obstetrics and Gynecology. 1990 September; 163(3): 1061-4; Discussion 1064-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2206057

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Disbanding a multidisciplinary clinic: effects on the health care of myelomeningocele patients. Author(s): Kaufman BA, Terbrock A, Winters N, Ito J, Klosterman A, Park TS. Source: Pediatric Neurosurgery. 1994; 21(1): 36-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7947308

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Dislocation of hip in myelomeningocele. The McKay hip stabilization. Author(s): Tosi LL, Buck BD, Nason SS, McKay DW. Source: The Journal of Bone and Joint Surgery. American Volume. 1996 May; 78(5): 66473. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8642022

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Dislocation of the hip in myelomeningocele. The McKay hip stabilization. Author(s): Menelaus MB, Broughton NS. Source: The Journal of Bone and Joint Surgery. American Volume. 1997 November; 79(11): 1750-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9384435

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Dizygotic twins with myelomeningocele. Author(s): Das G, Aggarwal A, Faridi MM. Source: Indian J Pediatr. 2003 March; 70(3): 265-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12785300

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Do children with myelomeningocele and hydrocephalus display nonverbal learning disabilities? An empirical approach to classification. Author(s): Yeates KO, Loss N, Colvin AN, Enrile BG. Source: Journal of the International Neuropsychological Society : Jins. 2003 May; 9(4): 653-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12755177

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Does growth hormone (GH) enhance growth in GH-deficient children with myelomeningocele? Author(s): Trollmann R, Strehl E, Wenzel D, Dorr HG. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 August; 85(8): 2740-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10946874

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Double myelomeningocele. A case report. Author(s): Bertan V, Wilson CB. Source: Turk J Pediatr. 1968 July; 10(2): 88-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4883122

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Double myelomeningocele: case report and review. Author(s): Richards TA, Kortesis BG, Glazier S, Argenta LC, David LR. Source: British Journal of Plastic Surgery. 2003 April; 56(3): 306-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12859934

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Dramatic subperiosteal bone formation following physeal injury in patients with myelomeningocele. Author(s): Khoury JG, Morcuende JA. Source: Iowa Orthop J. 2002; 22: 94-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12180621

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Early evolution of bladder emptying after myelomeningocele closure. Author(s): Stoneking BJ, Brock JW, Pope JC, Adams MC. Source: Urology. 2001 November; 58(5): 767-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11711357

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Early management and decision-making for the treatment of myelomeningocele at the University of Oklahoma Health Sciences Center: observations clinical and ethical. Author(s): Allsopp ME. Source: Linacre Q. 1986 February; 53(1): 56-65. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11650727

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Effect of intrauterine myelomeningocele repair on central nervous system structure and function. Author(s): Tulipan N, Bruner JP, Hernanz-Schulman M, Lowe LH, Walsh WF, Nickolaus D, Oakes WJ. Source: Pediatric Neurosurgery. 1999 October; 31(4): 183-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10705927

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Effect of seated posture on interface pressure in children who are able-bodied and who have myelomeningocele. Author(s): Vaisbuch N, Meyer S, Weiss PL. Source: Disability and Rehabilitation. 2000 November 20; 22(17): 749-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11194615

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Effects of GnRH analogues in the treatment of precocious puberty in children with myelomeningocele--preliminary results. Author(s): Trollmann R, Strehl E, Maier-Brandt B, Drexler S, Dorr HG. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1996 December; 6 Suppl 1: 42-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9008827

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Efficacy of botulinum-a toxin in children with detrusor hyperreflexia due to myelomeningocele: preliminary results. Author(s): Schulte-Baukloh H, Michael T, Schobert J, Stolze T, Knispel HH. Source: Urology. 2002 March; 59(3): 325-7; Discussion 327-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11880062

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Efficacy of bracing the lower limbs and ambulation training in children with myelomeningocele. Author(s): Mazur JM, Kyle S. Source: Developmental Medicine and Child Neurology. 2004 May; 46(5): 352-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15132267

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Electromyographic and manometric anorectal evaluation in children affected by neuropathic bladder secondary to myelomeningocele. Author(s): Marte A, Cotrufo AM, Di Iorio G, De Pasquale M. Source: Minerva Pediatr. 2001 June; 53(3): 171-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11455303

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Electromyographic assessment of neurological function in patients with myelomeningocele caused by spina bifida. Author(s): Hong CZ. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2001 September; 64(9): 516-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11768281

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Endoscopic coverage of fetal myelomeningocele in utero. Author(s): Bruner JP, Richards WO, Tulipan NB, Arney TL. Source: American Journal of Obstetrics and Gynecology. 1999 January; 180(1 Pt 1): 153-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9914596

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Endoscopic coverage of fetal open myelomeningocele in utero. Author(s): Bruner JP, Tulipan NE, Richards WO. Source: American Journal of Obstetrics and Gynecology. 1997 January; 176(1 Pt 1): 256-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9024126

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Energy consumption and gait analysis in children with myelomeningocele. Author(s): Galli M, Crivellini M, Fazzi E, Motta F. Source: Funct Neurol. 2000 July-September; 15(3): 171-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11062846

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Energy consumption in children with myelomeningocele: a comparison between reciprocating gait orthosis and hip-knee-ankle-foot orthosis ambulators. Author(s): Cuddeford TJ, Freeling RP, Thomas SS, Aiona MD, Rex D, Sirolli H, Elliott J, Magnusson M. Source: Developmental Medicine and Child Neurology. 1997 April; 39(4): 239-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9183262

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Energy cost of walking in low lumbar myelomeningocele. Author(s): Moore CA, Nejad B, Novak RA, Dias LS. Source: Journal of Pediatric Orthopedics. 2001 May-June; 21(3): 388-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11371826

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Estimating detrusor pressure at home in pediatric patients with myelomeningocele. Author(s): Damaser MS, Brzezinski K, Walter JS, Wheeler JS, Schroeder LS, Hatch DA. Source: The Journal of Urology. 1999 October; 162(4): 1410-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10492226

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Estimating mechanical cost in subjects with myelomeningocele. Author(s): McDowell B, Cosgrove A, Baker R. Source: Gait & Posture. 2002 February; 15(1): 25-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11809578

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Ethical problems in the management of myelomeningocele and hydrocephalus--1. Author(s): Lorber J. Source: Nurs Times. 1976 26 February 5-8; 72(8): Centre P. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11664615

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Ethical problems in the management of myelomeningocele and hydrocephalus--2. Author(s): Lorber J. Source: Nurs Times. 1976 25 March 9-11; 72(12): Centre P. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11664616

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Evaluation of femur length during the second and third trimesters in fetuses with myelomeningocele. Author(s): Williams G, Coakley FV, Qayyum S, Glenn OA, Breiman RS, Callen PW. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2004 February; 23(2): 148-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14770394

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External urethral sphincter dilation for the management of high risk myelomeningocele: 15-year experience. Author(s): Park JM, McGuire EJ, Koo HP, Schwartz AC, Garwood CK, Bloom DA. Source: The Journal of Urology. 2001 June; 165(6 Pt 2): 2383-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11371982

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Factors influencing ambulation in myelomeningocele: a cross-sectional study. Author(s): Bartonek A, Saraste H. Source: Developmental Medicine and Child Neurology. 2001 April; 43(4): 253-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11305403

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Factors of significance for mobility in children with myelomeningocele. Author(s): Norrlin S, Strinnholm M, Carlsson M, Dahl M. Source: Acta Paediatrica (Oslo, Norway : 1992). 2003; 92(2): 204-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12710647

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Failure of oral acetazolamide to avert hydrocephalus in infants with myelomeningocele. Author(s): Mealey J Jr, Barker DT. Source: The Journal of Pediatrics. 1968 February; 72(2): 257-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4865650

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Fascial closure in low myelomeningocele repairs. Technical note. Author(s): Voorhies RM, Fraser RA. Source: Journal of Neurosurgery. 1983 January; 58(1): 144-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6336627

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Fetal intervention for myelomeningocele: effect on postnatal bladder function. Author(s): Holmes NM, Nguyen HT, Harrison MR, Farmer DL, Baskin LS. Source: The Journal of Urology. 2001 December; 166(6): 2383-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11696792

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Fetal MRI in the evaluation of intrauterine myelomeningocele. Author(s): Mangels KJ, Tulipan N, Tsao LY, Alarcon J, Bruner JP. Source: Pediatric Neurosurgery. 2000 March; 32(3): 124-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10867558

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Fetal myelomeningocele repair: short-term clinical outcomes. Author(s): Johnson MP, Sutton LN, Rintoul N, Crombleholme TM, Flake AW, Howell LJ, Hedrick HL, Wilson RD, Adzick NS. Source: American Journal of Obstetrics and Gynecology. 2003 August; 189(2): 482-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14520222

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Fetal myelomeningocele. Is antenatal ultrasound useful in predicting neonatal outcome? Author(s): Brumfield CG, Aronin PA, Cloud GA, Davis RO. Source: J Reprod Med. 1995 January; 40(1): 26-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7722971

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Fetal reconstructive surgery: experimental use of the latissimus dorsi flap to correct myelomeningocele in utero. Author(s): Meuli-Simmen C, Meuli M, Hutchins GM, Harrison MR, Buncke HJ, Sullivan KM, Adzick NS. Source: Plastic and Reconstructive Surgery. 1995 October; 96(5): 1007-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7568473

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Fetal surgery for myelomeningocele and the incidence of shunt-dependent hydrocephalus. Author(s): Bruner JP, Tulipan N, Paschall RL, Boehm FH, Walsh WF, Silva SR, HernanzSchulman M, Lowe LH, Reed GW. Source: Jama : the Journal of the American Medical Association. 1999 November 17; 282(19): 1819-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10573272

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Fetal surgery for myelomeningocele. Author(s): Sutton LN, Adzick NS, Johnson MP. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2003 August; 19(7-8): 587-91. Epub 2003 July 15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12879345

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Fetal surgery for myelomeningocele. Author(s): Jobe AH. Source: The New England Journal of Medicine. 2002 July 25; 347(4): 230-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12140297

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Fetal surgery for myelomeningocele. Author(s): Hirose S, Farmer DL, Albanese CT. Source: Current Opinion in Obstetrics & Gynecology. 2001 April; 13(2): 215-22. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11315877

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Fetal surgery for myelomeningocele. Author(s): Olutoye OO, Adzick NS. Source: Semin Perinatol. 1999 December; 23(6): 462-73. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10630542

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Fetal surgery for myelomeningocele: panacea or peril? Author(s): Hirose S, Meuli-Simmen C, Meuli M. Source: World Journal of Surgery. 2003 January; 27(1): 87-94. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12557043

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Fetal surgery for myelomeningocele: promise, progress, and problems. Author(s): Simpson JL. Source: Jama : the Journal of the American Medical Association. 1999 November 17; 282(19): 1873-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10573281

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Fractures in children with myelomeningocele. Author(s): Reikeras O, Hellum C. Source: Archives of Orthopaedic and Trauma Surgery. 1981; 98(1): 25-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7235874

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Fractures in patients who have myelomeningocele. Author(s): Lock TR, Aronson DD. Source: The Journal of Bone and Joint Surgery. American Volume. 1989 September; 71(8): 1153-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2777841

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Functional deterioration following placode untethering in myelomeningocele. Author(s): Cochrane DD, Rassekh SR, Thiessen PN. Source: Pediatric Neurosurgery. 1998 February; 28(2): 57-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9693332

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Functional motor outcome in children with myelomeningocele: correlation with anatomic level on prenatal ultrasound. Author(s): Coniglio SJ, Anderson SM, Ferguson JE 2nd. Source: Developmental Medicine and Child Neurology. 1996 August; 38(8): 675-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8761163

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Gait analysis in children affected by myelomeningocele: comparison of the various levels of lesion. Author(s): Galli M, Albertini G, Romei M, Santambrogio GC, Tenore N, Crivellini M. Source: Funct Neurol. 2002 October-December; 17(4): 203-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12675264

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Gait analysis in low lumbar myelomeningocele patients with unilateral hip dislocation or subluxation. Author(s): Gabrieli AP, Vankoski SJ, Dias LS, Milani C, Lourenco A, Filho JL, Novak R. Source: Journal of Pediatric Orthopedics. 2003 May-June; 23(3): 330-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12724595

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Gait analysis in myelomeningocele: possibilities and applications. Author(s): Fabry G, Molenaers G, Desloovere K, Eyssen M. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 2000 June; 9(3): 170-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10904903

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Gait electromyography in children with myelomeningocele at the sacral level. Author(s): Park BK, Song HR, Vankoski SJ, Moore CA, Dias LS. Source: Archives of Physical Medicine and Rehabilitation. 1997 May; 78(5): 471-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9161364

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Gestational age at intrauterine myelomeningocele repair does not influence the risk of prematurity. Author(s): Hamdan AH, Walsh W, Heddings A, Bruner JP, Tulipan N. Source: Fetal Diagnosis and Therapy. 2002 March-April; 17(2): 66-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11844907

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Glycosaminoglycans: urinary excretion in children with myelomeningocele. Author(s): Salvaggio E, Antuzzi D, Ferrara P, Scanu M, Pulitano S, Venuti L, Tarquini E, De Michele T, Ricci R. Source: Urologia Internationalis. 2001; 66(3): 156-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11316979

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Grip force parameters in precision grip of individuals with myelomeningocele. Author(s): Golge M, Schutz C, Dreesmann M, Kuhtz-Buschbeck JP, Hoppe B, Wenzelburger R, Stephani U, Illert M. Source: Developmental Medicine and Child Neurology. 2003 April; 45(4): 249-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12647926

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Ground reaction forces on the plantar surface of the foot after talectomy in the myelomeningocele. Author(s): Sherk HH, Marchinski LJ, Clancy M, Melchonni J. Source: Journal of Pediatric Orthopedics. 1989 May-June; 9(3): 269-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2723045

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Group B streptococcal infections of the central nervous system in infants with myelomeningocele. Author(s): Ellenbogen RG, Goldmann DA, Winston KR. Source: Surgical Neurology. 1988 March; 29(3): 237-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3278398

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Growth and metabolic consequences of bladder augmentation in children with myelomeningocele and bladder exstrophy. Author(s): Mingin GC, Nguyen HT, Mathias RS, Shepherd JA, Glidden D, Baskin LS. Source: Pediatrics. 2002 December; 110(6): 1193-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12456918

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Growth hormone deficiency in children with myelomeningocele (MMC)--effects of growth hormone treatment. Author(s): Trollmann R, Strehl E, Dorr HG. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1997 December; 7 Suppl 1: 58-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9497133

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Growth hormone treatment of children with myelomeningocele. Author(s): Rotenstein D, Breen TJ. Source: The Journal of Pediatrics. 1996 May; 128(5 Pt 2): S28-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8627465

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Growth of trunk and legs of children with myelomeningocele. Author(s): Duval-Beaupere G, Kaci M, Lougovoy J, Caponi MF, Touzeau C. Source: Developmental Medicine and Child Neurology. 1987 April; 29(2): 225-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3582793

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Hand function and tactile perception in a sample of children with myelomeningocele. Author(s): Grimm RA. Source: Am J Occup Ther. 1976 April; 30(4): 234-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=779488

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Hand function in children with myelomeningocele. Author(s): Turner A. Source: The Journal of Bone and Joint Surgery. British Volume. 1985 March; 67(2): 26872. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3980539

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Hand function in children with myelomeningocele. Author(s): Sand PL, Taylor N, Hill M, Kosky N, Rawlings M. Source: Am J Occup Ther. 1974 February; 28(2): 87-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4590308

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Hand positioning sense in children with spina bifida myelomeningocele. Author(s): Hwang R, Kentish M, Burns Y. Source: The Australian Journal of Physiotherapy. 2002; 48(1): 17-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11869161

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Hand preference in children with myelomeningocele and hydrocephalus. Author(s): Lonton AP. Source: Dev Med Child Neurol Suppl. 1976; (37): 143-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=797608

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Hemodynamic instability of myelomeningocele patients during anterior spinal surgery. Author(s): Karol LA, Richards BS, Prejean E, Safavi F. Source: Developmental Medicine and Child Neurology. 1993 March; 35(3): 261-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8462760

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High prevalence of sensitization to inhalant allergens in patients with myelomeningocele allergic to latex products. Author(s): Palmieri A, Battistini E, Cama A, Maccio IL, Fregonese B, Spallarossa D, Silvestri M. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1998 December; 8 Suppl 1: 67-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9926337

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Hip instability in children with myelomeningocele. Author(s): Carroll NC. Source: The Orthopedic Clinics of North America. 1978 April; 9(2): 403-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=662307

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Hip instability in myelomeningocele. 158 patients followed for 15 years. Author(s): Samuelsson L, Eklof O. Source: Acta Orthopaedica Scandinavica. 1990 February; 61(1): 3-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2336947

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Hip instability in patients with myelomeningocele. Author(s): Rueda J, Carroll NC. Source: The Journal of Bone and Joint Surgery. British Volume. 1972 August; 54(3): 42231. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4559838

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Hip stability and ambulatory status in myelomeningocele. Author(s): Lee EH, Carroll NC. Source: Journal of Pediatric Orthopedics. 1985 September-October; 5(5): 522-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4044809

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Hip surgery in the lumbar level myelomeningocele patient. Author(s): Bazih J, Gross RH. Source: Journal of Pediatric Orthopedics. 1981; 1(4): 405-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7334120

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Hippuran renography and scintigraphy in children with myelomeningocele. Author(s): Thomsen F, Thorup J, Johnsen A. Source: European Urology. 1986; 12(1): 12-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3948894

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Home bladder pressure monitoring in children with myelomeningocele. Author(s): Andros GJ, Hatch DA, Walter JS, Wheeler JS, Schlehahn L, Damaser MS. Source: The Journal of Urology. 1998 August; 160(2): 518-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9679921

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Hydrocephalus and myelomeningocele. Central nervous system infection. Author(s): Jasper PL, Merrill RE. Source: Am J Dis Child. 1965 December; 110(6): 652-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5844111

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Hydrocephalus in myelomeningocele. Author(s): Stein SC, Schut L. Source: Childs Brain. 1979; 5(4): 413-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=456113

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Hydrosyringomyelia and diastematomyelia detected by MRI in myelomeningocele. Author(s): Breningstall GN, Marker SM, Tubman DE. Source: Pediatric Neurology. 1992 July-August; 8(4): 267-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1388414

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Impaired mental capabilities and hand function in myelomeningocele patients. Author(s): Mazur JM, Aylward GP, Colliver J, Stacey J, Menelaus M. Source: Z Kinderchir. 1988 December; 43 Suppl 2: 24-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3213247

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Improvement in hindbrain herniation demonstrated by serial fetal magnetic resonance imaging following fetal surgery for myelomeningocele. Author(s): Sutton LN, Adzick NS, Bilaniuk LT, Johnson MP, Crombleholme TM, Flake AW. Source: Jama : the Journal of the American Medical Association. 1999 November 17; 282(19): 1826-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10573273

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In utero meconium exposure increases spinal cord necrosis in a rat model of myelomeningocele. Author(s): Correia-Pinto J, Reis JL, Hutchins GM, Baptista MJ, Estevao-Costa J, Flake AW, Leite-Moreira AF. Source: Journal of Pediatric Surgery. 2002 March; 37(3): 488-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11877673

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In utero repair of myelomeningocele: a comparison of endoscopy and hysterotomy. Author(s): Bruner JP, Tulipan NB, Richards WO, Walsh WF, Boehm FH, Vrabcak EK. Source: Fetal Diagnosis and Therapy. 2000 March-April; 15(2): 83-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10720871

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In utero repair of myelomeningocele: experimental pathophysiology, initial clinical experience, and outcomes. Author(s): Farmer DL, von Koch CS, Peacock WJ, Danielpour M, Gupta N, Lee H, Harrison MR. Source: Archives of Surgery (Chicago, Ill. : 1960). 2003 August; 138(8): 872-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12912746

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In vitro high-field magnetic resonance imaging-documented anatomy of a fetal myelomeningocele at 20 weeks' gestation. A contribution to the rationale of intrauterine surgical repair of spina bifida. Author(s): Beuls EA, Vanormelingen L, van Aalst J, Vandersteen M, Adriaensen P, Cornips EM, Vles HJ, Gelan J. Source: J Neurosurg Spine. 2003 March; 98(2): 210-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12650407

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Incidence of normal micturition in myelomeningocele patients. Author(s): Reiner I, Jones M, Donnell S, Rickwood AM. Source: Archives of Disease in Childhood. 1992 May; 67(5): 640-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1599305

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Incidence of seizures in patients with myelomeningocele: a multifactorial analysis. Author(s): Chadduck W, Adametz J. Source: Surgical Neurology. 1988 October; 30(4): 281-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3175838

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Increased intracranial pressure in myelomeningocele (MMC) patients never shunted: results of a prospective preliminary study. Author(s): Iborra J, Pages E, Cuxart A, Poca A, Sahuquillo J. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 2000 August; 38(8): 495-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10962610

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Increased intracranial pressure perinatally predicts early puberty in girls with myelomeningocele. Author(s): Dahl M, Proos LA, Ahlsten G, Tuvemo T, Gustafsson J. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1996 December; 6 Suppl 1: 41-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9008826

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Increased perinatal intracranial pressure and prediction of early puberty in girls with myelomeningocele. Author(s): Proos LA, Dahl M, Ahlsten G, Tuvemo T, Gustafsson J. Source: Archives of Disease in Childhood. 1996 July; 75(1): 42-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8813869

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Independent ambulators with high sacral myelomeningocele: the relation between walking kinematics and energy consumption. Author(s): Bare A, Vankoski SJ, Dias L, Danduran M, Boas S. Source: Developmental Medicine and Child Neurology. 2001 January; 43(1): 16-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11201417

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Infants with myelomeningocele: visual recognition memory and sensorimotor abilities. Author(s): Morrow JD, Wachs TD. Source: Developmental Medicine and Child Neurology. 1992 June; 34(6): 488-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1612208

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Initial experience with home therapeutic electrical stimulation for continence in the myelomeningocele population. Author(s): Balcom AH, Wiatrak M, Biefeld T, Rauen K, Langenstroer P. Source: The Journal of Urology. 1997 September; 158(3 Pt 2): 1272-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9258193

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Internal derotation osteotomy of the tibia: pre- and postoperative gait analysis in persons with high sacral myelomeningocele. Author(s): Dunteman RC, Vankoski SJ, Dias LS. Source: Journal of Pediatric Orthopedics. 2000 September-October; 20(5): 623-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11008742

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Intrauterine myelomeningocele repair reverses preexisting hindbrain herniation. Author(s): Tulipan N, Hernanz-Schulman M, Lowe LH, Bruner JP. Source: Pediatric Neurosurgery. 1999 September; 31(3): 137-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10708355

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Intrauterine myelomeningocele repair. Author(s): Tulipan N. Source: Clin Perinatol. 2003 September; 30(3): 521-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14533893

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Intrauterine myelomeningocele repair: effect on short-term complications of prematurity. Author(s): Hamdan AH, Walsh W, Bruner JP, Tulipan N. Source: Fetal Diagnosis and Therapy. 2004 January-February; 19(1): 83-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14646425

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Is sacral instrumentation mandatory to address pelvic obliquity in neuromuscular thoracolumbar scoliosis due to myelomeningocele? Author(s): Wild A, Haak H, Kumar M, Krauspe R. Source: Spine. 2001 July 15; 26(14): E325-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11462098

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Is tooth agenesis related to brainstem anomalies in myelomeningocele patients with Chiari II malformations? Author(s): Linderstrom A, Samuelsson L, Huggare J. Source: Acta Odontologica Scandinavica. 2002 December; 60(6): 337-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12512882

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Kyphectomy and segmental spinal instrumentation in young children with myelomeningocele kyphosis. Author(s): Huang TJ, Lubicky JP. Source: J Formos Med Assoc. 1994 June; 93(6): 503-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7858439

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Kyphectomy in children with myelomeningocele: a long-term outcome study. Author(s): Niall DM, Dowling FE, Fogarty EE, Moore DP, Goldberg C. Source: Journal of Pediatric Orthopedics. 2004 January-February; 24(1): 37-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14676532

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Kyphectomy using a surgical threadwire (T-saw) for kyphotic deformity in a child with myelomeningocele. Author(s): Miyamoto K, Shimizu K, Nozawa S, Sakaguchi Y, Toki M, Hosoe H. Source: Spine. 2003 May 15; 28(10): E187-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12768156

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Kyphosis deformity in myelomeningocele. Author(s): Sarwark JF. Source: The Orthopedic Clinics of North America. 1999 July; 30(3): 451-5, Viii-Ix. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10393766

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Kyphotic deformity in patients who have a myelomeningocele. Operative treatment and long-term follow-up. Author(s): Lintner SA, Lindseth RE. Source: The Journal of Bone and Joint Surgery. American Volume. 1994 September; 76(9): 1301-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8077259

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Language differences in young children with myelomeningocele and shunted hydrocephalus. Author(s): Vachha B, Adams R. Source: Pediatric Neurosurgery. 2003 October; 39(4): 184-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12944698

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Language sample analysis in children with myelomeningocele and shunted hydrocephalus. Author(s): Vachha B, Adams R. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2003 December; 13 Suppl 1: S36-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14986617

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Laryngeal palsy in association with myelomeningocele, hydrocephalus, and the arnold-chiari malformation. Author(s): Kirsch WM, Duncan BR, Black FO, Stears JC. Source: Journal of Neurosurgery. 1968 March; 28(3): 207-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4868501

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Late gestational intrauterine myelomeningocele repair does not improve lower extremity function. Author(s): Tubbs RS, Chambers MR, Smyth MD, Bartolucci AA, Bruner JP, Tulipan N, Oakes WJ. Source: Pediatric Neurosurgery. 2003 March; 38(3): 128-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12601237

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Late knee problems in myelomeningocele. Author(s): Williams JJ, Graham GP, Dunne KB, Menelaus MB. Source: Journal of Pediatric Orthopedics. 1993 November-December; 13(6): 701-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8245190

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Latex allergy in patients with myelomeningocele presenting for imaging studies of the urinary tract. Author(s): Zerin JM, McLaughlin K, Kerchner S. Source: Pediatric Radiology. 1996 July; 26(7): 450-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8662060

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Latex anaphylaxis during spinal surgery in children with myelomeningocele. Author(s): Banta JV, Bonanni C, Prebluda J. Source: Developmental Medicine and Child Neurology. 1993 June; 35(6): 543-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8504897

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Latex anaphylaxis during spinal surgery in children with myelomeningocele. Author(s): Banta J, Bonanni C, Prebluda J. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1992 December; 2 Suppl 1: 40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1489751

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Latissimus dorsi flap procedures to cover myelomeningocele in utero: a feasibility study in human fetuses. Author(s): Meuli-Simmen C, Meuli M, Adzick NS, Harrison MR. Source: Journal of Pediatric Surgery. 1997 August; 32(8): 1154-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9269961

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Lethal pulmonary hypoplasia after in-utero myelomeningocele repair. Author(s): Lu GC, Steinhauer J, Ramsey PS, Faye-Petersen O. Source: Obstetrics and Gynecology. 2001 October; 98(4): 698-701. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11576591

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Letter: Comments on urology section on myelomeningocele. Author(s): Lebowitz RL, Colodny AH. Source: Pediatrics. 1976 August; 58(2): 297-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=781611

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Life conditions of adolescents with myelomeningocele. Author(s): Borjeson MC, Lagergren J. Source: Developmental Medicine and Child Neurology. 1990 August; 32(8): 698-706. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2210084

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Lipomatous myelomeningocele, athyrotic hypothyroidism, and sensorineural deafness: a new form of syndromal deafness? Author(s): Peters HL, Bankier A. Source: Journal of Medical Genetics. 1998 November; 35(11): 948-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9832044

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Longevity of patients born with myelomeningocele. Author(s): Dillon CM, Davis BE, Duguay S, Seidel KD, Shurtleff DB. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 2000 December; 10 Suppl 1: 33-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11214830

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Longitudinal assessment of oxygen cost and velocity in children with myelomeningocele: comparison of the hip-knee-ankle-foot orthosis and the reciprocating gait orthosis. Author(s): Thomas SS, Buckon CE, Melchionni J, Magnusson M, Aiona MD. Source: Journal of Pediatric Orthopedics. 2001 November-December; 21(6): 798-803. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11675558

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Long-term efficacy of periurethral collagen injection for the treatment of urinary incontinence secondary to myelomeningocele. Author(s): Block CA, Cooper CS, Hawtrey CE. Source: The Journal of Urology. 2003 January; 169(1): 327-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12478183

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Long-term follow-up of Chiari pelvic osteotomy in myelomeningocele. Author(s): Mannor DA, Weinstein SL, Dietz FR. Source: Journal of Pediatric Orthopedics. 1996 November-December; 16(6): 769-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8906650

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Long-term intermittent catheterization: the experience of teenagers and young adults with myelomeningocele. Author(s): Lindehall B, Moller A, Hjalmas K, Jodal U. Source: The Journal of Urology. 1994 July; 152(1): 187-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8201663

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Long-term metabolic effects of urinary diversion: a comparison of myelomeningocele patients managed by clean intermittent catheterization and urinary diversion. Author(s): Koch MO, McDougal WS, Hall MC, Hill DE, Braren HV, Donofrio MN. Source: The Journal of Urology. 1992 May; 147(5): 1343-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1569680

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Long-term stability of hand-held dynamometric measurements in children who have myelomeningocele. Author(s): Effgen SK, Brown DA. Source: Physical Therapy. 1992 June; 72(6): 458-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1589465

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Management of hydrocephalus by endoscopic third ventriculostomy in patients with myelomeningocele. Author(s): Teo C, Jones R. Source: Pediatric Neurosurgery. 1996 August; 25(2): 57-63; Discussion 63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9075248

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Maternal-fetal surgery for treatment of myelomeningocele. Author(s): Lyerly AD, Mahowald MB. Source: Clin Perinatol. 2003 March; 30(1): 155-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12696793

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Measured and predicted total body water in children with myelomeningocele. Author(s): Littlewood RA, Trocki O, Cleghorn G. Source: Journal of Paediatrics and Child Health. 2003 May-June; 39(4): 278-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12755934

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Medical and social factors associated with cognitive outcome in individuals with myelomeningocele. Author(s): Bier JA, Morales Y, Liebling J, Geddes L, Kim E. Source: Developmental Medicine and Child Neurology. 1997 April; 39(4): 263-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9183267

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Medical stress, appraised stress, and the psychological adjustment of mothers of children with myelomeningocele. Author(s): Kronenberger WG, Thompson RJ Jr. Source: Journal of Developmental and Behavioral Pediatrics : Jdbp. 1992 December; 13(6): 405-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1469108

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Menarche and menstrual function in patients with myelomeningocele. Author(s): Furman L, Mortimer JC. Source: Developmental Medicine and Child Neurology. 1994 October; 36(10): 910-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7926323

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Motor adaptation in children with myelomeningocele: comparison to children with ADHD and healthy siblings. Author(s): Colvin AN, Yeates KO, Enrile BG, Coury DL. Source: Journal of the International Neuropsychological Society : Jins. 2003 May; 9(4): 642-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12755176

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Myelomeningocele and thick filum terminale with tethered cord appearing as a human tail. Case report. Author(s): Chakrabortty S, Oi S, Yoshida Y, Yamada H, Yamaguchi M, Tamaki N, Matsumoto S. Source: Journal of Neurosurgery. 1993 June; 78(6): 966-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8487080

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Myelomeningocele at the sacral level. Long-term outcomes in adults. Author(s): Brinker MR, Rosenfeld SR, Feiwell E, Granger SP, Mitchell DC, Rice JC. Source: The Journal of Bone and Joint Surgery. American Volume. 1994 September; 76(9): 1293-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8077258

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Myelomeningocele in a child with intrauterine exposure to efavirenz. Author(s): Fundaro C, Genovese O, Rendeli C, Tamburrini E, Salvaggio E. Source: Aids (London, England). 2002 January 25; 16(2): 299-300. Erratum In: Aids. 2002 July 5; 16(10): 1443. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11807320

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Myelomeningocele newborn management: time for parental decision. Author(s): Charney EB, Sutton LN, Bruce DA, Schut LB. Source: Z Kinderchir. 1983 December; 38(Suppl. Ii): 90-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11658519

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Myelomeningocele repair in utero. Author(s): Dias MS. Source: Pediatric Neurosurgery. 1999 February; 30(2): 108. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10325569

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Myelomeningocele repair: technical considerations and complications. 1988. Author(s): McCullough DC, Johnson DL. Source: Pediatric Neurosurgery. 1994; 21(1): 83-9; Discussion 90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7947317

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Myelomeningocele, dermal sinus tract, split cord malformation associated with extradural teratoma in a 30-month-Old girl. Author(s): Ozer H, Yuceer N. Source: Acta Neurochirurgica. 1999; 141(10): 1123-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10550661

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Myelomeningocele, spinal arteriovenous malformations and epidermal nevi syndrome: a possible rare association? Author(s): Chatkupt S, Ruzicka PO, Lastra CR. Source: Developmental Medicine and Child Neurology. 1993 August; 35(8): 737-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8335163

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Myelomeningocele. Author(s): Akar Z. Source: Surgical Neurology. 1995 February; 43(2): 113-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7892653

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Myelomeningocele: a review of the orthopaedic aspects of 206 patients treated from birth with no selection criteria. Author(s): Swank M, Dias L. Source: Developmental Medicine and Child Neurology. 1992 December; 34(12): 1047-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1451934

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Myelomeningocele: prenatal diagnosis, pathophysiology and management. Author(s): Adzick NS, Walsh DS. Source: Semin Pediatr Surg. 2003 August; 12(3): 168-74. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12961110

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Myelomeningocele: prenatal evaluation--comparison between transabdominal US and MR imaging. Author(s): Aaronson OS, Hernanz-Schulman M, Bruner JP, Reed GW, Tulipan NB. Source: Radiology. 2003 June; 227(3): 839-43. Epub 2003 April 24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12714679

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Myelomeningocele--still a challenge for the orthopaedic paediatric surgeon. Author(s): Correll J, Parsch K. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 2000 June; 9(3): 141-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10904898

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Natural history of knee contractures in myelomeningocele. Author(s): Wright JG, Menelaus MB, Broughton NS, Shurtleff D. Source: Journal of Pediatric Orthopedics. 1991 November-December; 11(6): 725-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1960195

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Neonatal kyphectomy in the patient with myelomeningocele. Author(s): Crawford AH, Strub WM, Lewis R, Gabriel KR, Billmire DA, Berger T, Crone K. Source: Spine. 2003 February 1; 28(3): 260-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12567028

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Neurogenic bladder dysfunction due to myelomeningocele: neonatal versus childhood treatment. Author(s): Wu HY, Baskin LS, Kogan BA. Source: The Journal of Urology. 1997 June; 157(6): 2295-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9146656

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Neurogenic bladder dysfunction in patients with myelomeningocele. Author(s): Madersbacher H. Source: Current Opinion in Urology. 2002 November; 12(6): 469-72. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12409874

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Neurological abnormalities, major orthopaedic deformities and ambulation analysis in a myelomeningocele population in Catalonia (Spain). Author(s): Iborra J, Pages E, Cuxart A. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 1999 May; 37(5): 351-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10369172

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Neuromuscular function and radioanatomical form of the myelomeningocele hip. Author(s): Bemmerl JG, Heimkes B. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 2000 January; 9(1): 34-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10647107

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No evidence for heterozygote advantage at MTHFR in patients with lumbosacral myelomeningocele or their relatives. Author(s): Rampersaud E, Brusato C, Melvin EC, Speer MC, Metcalf K; NTD Collaborative Group. Source: Genetics in Medicine : Official Journal of the American College of Medical Genetics. 2004 January-February; 6(1): 69-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14726815

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Nonsurgical management of threatened upper urinary tracts and incontinence in children with myelomeningocele. Author(s): Hernandez RD, Hurwitz RS, Foote JE, Zimmern PE, Leach GE. Source: The Journal of Urology. 1994 November; 152(5 Pt 1): 1582-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7933209

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Nordic children with myelomeningocele. Parents' assessments of the handicap and physicians' classifications of the disabilities. Author(s): Rasmussen F, Lie HR, Hagelsteen JH, Lagergren J, Borjeson MC, Lagerkvist B, Kohler L. Source: Acta Paediatrica (Oslo, Norway : 1992). 1993 March; 82(3): 276-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8495084

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Nordic children with myelomeningocele: the utilization of and satisfaction with health care and medical services. Author(s): Lie HR, Lagerkvist B, Rasmussen F, Hagelsteen J, Borjeson MC, Lagergren J, Kohler L. Source: Scand J Soc Med. 1995 December; 23(4): 258-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8919368

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Nutrition risk factors in children with myelomeningocele. Author(s): Jacobs RA, Blyler E, Baer MT. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1991 December; 1 Suppl 1: 22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1807376

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Nutritional survey of children and adolescents with myelomeningocele (MMC): overweight associated with reduced energy intake. Author(s): Fiore P, Picco P, Castagnola E, Palmieri A, Levato L, Gremmo M, Tramalloni R, Cama A. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1998 December; 8 Suppl 1: 34-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9926322

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Operative nuances of myelomeningocele closure. Author(s): Pitkethly DT. Source: Neurosurgery. 2003 June; 52(6): 1509; Author Reply 1510. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12800842

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Operative nuances of myelomeningocele closure. Author(s): Perry VL, Albright AL, Adelson PD. Source: Neurosurgery. 2002 September; 51(3): 719-23; Discussion 723-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12188950

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Orthopaedic care of children with myelomeningocele: a modern programme of rehabilitation. Author(s): Strach EH. Source: British Medical Journal. 1967 September 23; 3(568): 791-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5343060

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Orthopaedic management of myelomeningocele: general orthopaedic management. Author(s): Fisher LC 3rd, Purvis JM, Kendig RJ, Cooper K, Graves MD. Source: J Miss State Med Assoc. 1987 September; 28(9): 235-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3669075

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Orthopaedic management of myelomeningocele: specific orthopaedic procedures. Author(s): Graves MD, Kendig RJ, Fisher LC 3rd, Purvis JM, Cooper K. Source: J Miss State Med Assoc. 1987 November; 28(11): 299-303. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3694672

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Orthopedic and neurosurgical treatment of severe kyphosis in myelomeningocele. Author(s): Furderer S, Hopf C, Schwarz M, Voth D. Source: Neurosurgical Review. 1999; 22(1): 45-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10348207

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Orthopedic management in myelomeningocele. Author(s): Karol LA. Source: Neurosurg Clin N Am. 1995 April; 6(2): 259-68. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7620352

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Orthotic devices for ambulation in children with cerebral palsy and myelomeningocele. Author(s): Knutson LM, Clark DE. Source: Physical Therapy. 1991 December; 71(12): 947-60. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1946628

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Outcome following hindbrain decompression of symptomatic Chiari malformations in children previously treated with myelomeningocele closure and shunts. Author(s): Pollack IF, Pang D, Albright AL, Krieger D. Source: Journal of Neurosurgery. 1992 December; 77(6): 881-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1432130

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Parent and self-report ratings of executive function in adolescents with myelomeningocele and hydrocephalus. Author(s): Mahone EM, Zabel TA, Levey E, Verda M, Kinsman S. Source: Neuropsychology, Development, and Cognition. Section C, Child Neuropsychology : a Journal on Normal and Abnormal Development in Childhood and Adolescence. 2002 December; 8(4): 258-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12759823

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Parental opinions on treatment decisions for myelomeningocele infants: a descriptive study. Author(s): Jacobs RA, Negrete V, Johnson M, Korsch BM. Source: Z Kinderchir. 1989 December; 44(Suppl. I): 11-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11653902

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Pneumocephalus in a newborn with an open myelomeningocele. Author(s): Garonzik IM, Samdani AF, Carson BS, Avellino AM. Source: Pediatric Neurosurgery. 2001 December; 35(6): 334. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11786703

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Posterior spinal fusion in paralytic scoliosis and myelomeningocele. Author(s): Banit DM, Iwinski HJ Jr, Talwalkar V, Johnson M. Source: Journal of Pediatric Orthopedics. 2001 January-February; 21(1): 117-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11176365

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Postoperative sudden death in two adolescents with myelomeningocele and unrecognized arrhythmogenic right ventricular dysplasia. Author(s): Houfani B, Meyer P, Merckx J, Roure P, Padovani JP, Fontaine G, Carli P. Source: Anesthesiology. 2001 July; 95(1): 257-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11465566

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Prenatal spinal evaluation and functional outcome of patients born with myelomeningocele: information for improved prenatal counselling and outcome prediction. Author(s): Cochrane DD, Wilson RD, Steinbok P, Farquharson DF, Irwin B, Irvine B, Chambers K. Source: Fetal Diagnosis and Therapy. 1996 May-June; 11(3): 159-68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8739582

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Prescribing the reciprocal gait orthosis for myelomeningocele children: a different approach and clinical outcome. Author(s): Katz-Leurer M, Weber C, Smerling-Kerem J, Rottem H, Meyer S. Source: Pediatric Rehabilitation. 2004 April-June; 7(2): 105-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15204581

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Preservation of renal function in children with myelomeningocele managed with basic newborn evaluation and close followup. Author(s): Hopps CV, Kropp KA. Source: The Journal of Urology. 2003 January; 169(1): 305-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12478177

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Primary myelomeningocele closure and consequences. Author(s): Wagner W, Schwarz M, Perneczky A. Source: Current Opinion in Urology. 2002 November; 12(6): 465-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12409873

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Pulmonary dysfunction and reduced exercise capacity in patients with myelomeningocele. Author(s): Sherman MS, Kaplan JM, Effgen S, Campbell D, Dold F. Source: The Journal of Pediatrics. 1997 September; 131(3): 413-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9329418

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Quantitative evaluation of AFO use with myelomeningocele children. Author(s): Thomas SE, Mazur JM, Child ME, Supan TJ. Source: Z Kinderchir. 1989 December; 44 Suppl 1: 38-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2623961

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Radiation exposure in the myelomeningocele population. Author(s): Gaskill SJ, Marlin AE. Source: Pediatric Neurosurgery. 1998 February; 28(2): 63-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9693333

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Rapid tissue expansion in the treatment of myelomeningocele. Author(s): Mustoe TA, Gifford GH, Lach E. Source: Annals of Plastic Surgery. 1988 July; 21(1): 70-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3048186

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Reciprocating orthoses for children with myelomeningocele. A comparison of two types. Author(s): Phillips DL, Field RE, Broughton NS, Menelaus MB. Source: The Journal of Bone and Joint Surgery. British Volume. 1995 January; 77(1): 1103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7822365

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Reduced hindbrain herniation after intrauterine myelomeningocele repair: A report of four cases. Author(s): Tulipan N, Hernanz-Schulman M, Bruner JP. Source: Pediatric Neurosurgery. 1998 November; 29(5): 274-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9917546

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Relationship of CSF shunting and IQ in children with myelomeningocele: a retrospective analysis. Author(s): Mapstone TB, Rekate HL, Nulsen FE, Dixon MS Jr, Glaser N, Jaffe M. Source: Childs Brain. 1984; 11(2): 112-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6723425

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Renal size and function in patients with neuropathic bladder due to myelomeningocele: the role of growth hormone. Author(s): Del Gado R, Perrone L, Del Gaizo D, Sommantico M, Polidori G, Cioce F, Rambaldi PF, Sirigu A. Source: The Journal of Urology. 2003 November; 170(5): 1960-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14532832

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Repair of myelomeningocele. Author(s): Laurent JP, Cheek WR, Cech DA. Source: Journal of Neurosurgery. 1984 May; 60(5): 1117. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6716157

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Resting energy expenditure and body composition in children with myelomeningocele. Author(s): Littlewood RA, Trocki O, Shepherd RW, Shepherd K, Davies PS. Source: Pediatric Rehabilitation. 2003 January-March; 6(1): 31-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12745893

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Results of orthotic treatment in children with myelomeningocele. Author(s): Schiltenwolf M, Carstens C, Rohwedder J, Grundel E. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1991 December; 1 Suppl 1: 50-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1807395

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Rotational deformities of the lower limb in myelomeningocele. Evaluation and treatment. Author(s): Dias LS, Jasty MJ, Collins P. Source: The Journal of Bone and Joint Surgery. American Volume. 1984 February; 66(2): 215-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6693448

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Simultaneous repair of myelomeningocele and shunt insertion. Author(s): Machado HR, Santos de Oliveira R. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2004 February; 20(2): 107-9. Epub 2003 December 05. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14657994

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Skeletal maturity in myelomeningocele. Author(s): Feeley BT, Ip TC, Otsuka NY. Source: Journal of Pediatric Orthopedics. 2003 November-December; 23(6): 718-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14581773

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Soft-tissue coverage of the neural elements after myelomeningocele repair. Author(s): Seidel SB, Gardner PM, Howard PS. Source: Annals of Plastic Surgery. 1996 September; 37(3): 310-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8883731

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Spasticity in a child with myelomeningocele treated with continuous intrathecal baclofen. Author(s): Bergenheim AT, Wendelius M, Shahidi S, Larsson E. Source: Pediatric Neurosurgery. 2003 October; 39(4): 218-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12944705

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Spinal level of fetal myelomeningocele: does it influence ventricular size? Author(s): Babcook CJ, Drake CM, Goldstein RB. Source: Ajr. American Journal of Roentgenology. 1997 July; 169(1): 207-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9207526

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Spontaneous pneumocephalus associated with open myelomeningocele. Author(s): Odemis E, Aslan Y. Source: Indian Pediatrics. 2004 March; 41(3): 289-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15064523

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Supramalleolar osteotomy for ankle valgus in myelomeningocele. Author(s): Abraham E, Lubicky JP, Songer MN, Millar EA. Source: Journal of Pediatric Orthopedics. 1996 November-December; 16(6): 774-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8906651

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Surgical release of knee flexion contractures in myelomeningocele. Author(s): Marshall PD, Broughton NS, Menelaus MB, Graham HK. Source: The Journal of Bone and Joint Surgery. British Volume. 1996 November; 78(6): 912-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8951006

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Survival at 5 years of a cohort of newborn infants with myelomeningocele. Author(s): Worley G, Schuster JM, Oakes WJ. Source: Developmental Medicine and Child Neurology. 1996 September; 38(9): 816-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8810713

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Syringomyelia complicating myelomeningocele: review of the evidence. Author(s): Piatt JH Jr. Source: J Neurosurg Spine. 2004 February; 100(2): 101-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14758937

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Temporary perineal urethrostomy for external sphincter dilation in a male patient with high risk myelomeningocele. Author(s): Miller DC, Bloom DA, McGuire EJ, Park JM. Source: The Journal of Urology. 2003 October; 170(4 Pt 2): 1606-8; Discussion 1608-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14501673

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Tethered cord syndrome in low motor level children with myelomeningocele. Author(s): Sarwark JF, Weber DT, Gabrieli AP, McLone DG, Dias L. Source: Pediatric Neurosurgery. 1996 December; 25(6): 295-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9348149

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The effect of intrauterine myelomeningocele repair on the incidence of shuntdependent hydrocephalus. Author(s): Tulipan N, Sutton LN, Bruner JP, Cohen BM, Johnson M, Adzick NS. Source: Pediatric Neurosurgery. 2003 January; 38(1): 27-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12476024

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The immunohistochemical profile of the myelomeningocele placode: is the placode normal? Author(s): George TM, Cummings TJ. Source: Pediatric Neurosurgery. 2003 November; 39(5): 234-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14512686

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The influence of forearm crutches on pelvic and hip kinematics in children with myelomeningocele: don't throw away the crutches. Author(s): Vankoski S, Moore C, Statler KD, Sarwark JF, Dias L. Source: Developmental Medicine and Child Neurology. 1997 September; 39(9): 614-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9344054

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The initial treatment of meningocele and myelomeningocele lesions in adulthood: experiences with seven patients. Author(s): Akay KM, Gonul E, Ocal E, Timurkaynak E. Source: Neurosurgical Review. 2003 July; 26(3): 162-7. Epub 2002 June 18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12845543

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The progression of untreated lumbar kyphosis and the compensatory thoracic lordosis in myelomeningocele. Author(s): Doers T, Walker JL, van den Brink K, Stevens DB, Heavilon J. Source: Developmental Medicine and Child Neurology. 1997 May; 39(5): 326-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9236699

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The spinal cord lesion in human fetuses with myelomeningocele: implications for fetal surgery. Author(s): Meuli M, Meuli-Simmen C, Hutchins GM, Seller MJ, Harrison MR, Adzick NS. Source: Journal of Pediatric Surgery. 1997 March; 32(3): 448-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9094015

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The urological fate of young adults with myelomeningocele: a three decade follow-up study. Author(s): Peeker R, Damber JE, Hjalmas K, Sjodin JG, von Zweigbergk M. Source: European Urology. 1997; 32(2): 213-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9286656

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Upper body movement during walking in children with lumbo-sacral myelomeningocele. Author(s): Bartonek A, Saraste H, Eriksson M, Knutson L, Cresswell AG. Source: Gait & Posture. 2002 April; 15(2): 120-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11869905

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Ureteropelvic junction obstruction due to inflammatory pseudotumor masquerading as hydronephrosis because of a neuropathic bladder in a child with myelomeningocele. Author(s): Emley TE, Cain MP, Faught PR, Davis MM. Source: Urology. 2001 July; 58(1): 105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11445491

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Urethral dilation improves bladder compliance in children with myelomeningocele and high leak point pressures. Author(s): Bloom DA, Knechtel JM, McGuire EJ. Source: The Journal of Urology. 1990 August; 144(2 Pt 2): 430-3; Discussion 443-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2374216

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Urinary control in children with myelomeningocele. Author(s): Eckstein HB. Source: British Journal of Urology. 1968 April; 40(2): 191-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4871175

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Urinary infection, incontinence and clean intermittent catheterisation in myelomeningocele. Author(s): van Gool JD, de Jong TP. Source: Z Kinderchir. 1990 December; 45 Suppl 1: 10. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2293525

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Urinary problems in children with myelomeningocele. Author(s): Morales PA. Source: Archives of Physical Medicine and Rehabilitation. 1967 August; 48(8): 402-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4952532

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Urinary tract infection in children with myelomeningocele. Author(s): Cooper DG. Source: Archives of Disease in Childhood. 1967 October; 42(225): 521-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4862968

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Urological outcome of patients with cervical and upper thoracic myelomeningocele. Author(s): Perez LM, Wilbanks JT, Joseph DB, Oakes WJ. Source: The Journal of Urology. 2000 September; 164(3 Pt 2): 962-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10958717

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Urological problems after surgical treatment of scoliosis in children with myelomeningocele. Author(s): Boemers TM, Soorani-Lunsing IJ, de Jong TP, Pruijs HE. Source: The Journal of Urology. 1996 March; 155(3): 1066-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8583566

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Use of lumbar periosteal turnover flaps in myelomeningocele closure. Author(s): Fiala TG, Buchman SR, Muraszko KM. Source: Neurosurgery. 1996 September; 39(3): 522-5; Discussion 525-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8875482

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Vaginal delivery for myelomeningocele patients. Author(s): Hellbusch LC. Source: Nebr Med J. 1992 January; 77(1): 2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1549194

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Valgus knee stress in lumbosacral myelomeningocele: a gait-analysis evaluation. Author(s): Yngve DA. Source: Journal of Pediatric Orthopedics. 1999 March-April; 19(2): 275-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10088703

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Valgus knee stress in lumbosacral myelomeningocele: a gait-analysis evaluation. Author(s): Lim R, Dias L, Vankoski S, Moore C, Marinello M, Sarwark J. Source: Journal of Pediatric Orthopedics. 1998 July-August; 18(4): 428-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9661845

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Value of dynamometry in assessing upper extremity function in children with myelomeningocele. Author(s): Aronin PA, Kerrick R. Source: Pediatric Neurosurgery. 1995; 23(1): 7-12; Discussion 13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7495667

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Ventilator care in myelomeningocele children with abnormal neurologic control of breathing. Author(s): Jacobs RA. Source: Z Kinderchir. 1990 December; 45 Suppl 1: 38. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2293538

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Ventriculitis in newborns with myelomeningocele. Author(s): Charney EB, Melchionni JB, Antonucci DL. Source: Am J Dis Child. 1991 March; 145(3): 287-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2003476

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Ventriculo-peritoneal shunt pseudocyst causing ureteropelvic junction obstruction in a child with myelomeningocele and retrocaval ureter. Author(s): Piercy SL, Gregory JG, Young PH. Source: The Journal of Urology. 1984 August; 132(2): 345-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6737595

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Verbal learning and memory in children with myelomeningocele. Author(s): Yeates KO, Enrile BG, Loss N, Blumenstein E, Delis DC. Source: Journal of Pediatric Psychology. 1995 December; 20(6): 801-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8558379

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Vernix caseosa meningitis and laryngeal stridor in an infant with myelomeningocele. Case report. Author(s): Correa-Restrepo A, Robertson C, Rozdilsky B. Source: Journal of Neurosurgery. 1975 June; 42(6): 718-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1095695

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Vesicoureteral reflux in babies with myelomeningocele. Author(s): Magnus RV. Source: The Journal of Urology. 1975 July; 114(1): 122-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1095781

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Waardenburg syndrome and myelomeningocele in a family. Author(s): Chatkupt S, Chatkupt S, Johnson WG. Source: Journal of Medical Genetics. 1993 January; 30(1): 83-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8423616

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Walking training of the young child with myelomeningocele. Author(s): Cane FR. Source: Physiotherapy. 1969 August; 55(8): 322-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4895744

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When is a shunt no longer necessary? An investigation of 300 patients with hydrocephalus and myelomeningocele: 11-22 year follow up. Author(s): Lorber J, Pucholt V. Source: Z Kinderchir. 1981 December; 34(4): 327-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7331542

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CHAPTER 2. ALTERNATIVE MEDICINE AND MYELOMENINGOCELE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to myelomeningocele. 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 myelomeningocele 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 “myelomeningocele” (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 myelomeningocele: •

An extrarenal Wilms' tumor arising from a sacrococcygeal teratoma. Author(s): Tebbi K, Ragab AH, Ternberg JL, Vietti TJ. Source: Clinical Pediatrics. 1974 December; 13(12): 1019-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4373198

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Behavioral methods for teaching self-catheterization skills to anxious children with myelomeningocele. Author(s): Rickert VI, Ashcraft EW, Rickert CP, Thornsberry RG. Source: Archives of Physical Medicine and Rehabilitation. 1990 September; 71(10): 751-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2403283

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Biofeedback for neurogenic fecal incontinence: rectal sensation is a determinant of outcome. Author(s): Wald A. Source: Journal of Pediatric Gastroenterology and Nutrition. 1983 May; 2(2): 302-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6875754

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Biofeedback therapy for managing bowel incontinence caused by meningomyelocele. Author(s): Richardson K, Campbell MA, Brown MR, Masiulis B, Liptak GS. Source: Mcn. the American Journal of Maternal Child Nursing. 1985 NovemberDecember; 10(6): 388-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3932809

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Biofeedback training for patients with myelomeningocele and fecal incontinence. Author(s): Loening-Baucke V, Desch L, Wolraich M. Source: Developmental Medicine and Child Neurology. 1988 December; 30(6): 781-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3234607

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Biofeedback treatment of fecal incontinence in patients with myelomeningocele. Author(s): Whitehead WE, Parker LH, Masek BJ, Cataldo MF, Freeman JM. Source: Developmental Medicine and Child Neurology. 1981 June; 23(3): 313-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7250540

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Children with special needs in The Netherlands: impaired hearing, adolescent pregnancy, and myelomeningocele. Author(s): Verbrugge HP. Source: Pediatrics. 1990 December; 86(6 Pt 2): 1117-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2243751

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Community nursing needs of newborns with myelomeningocele and their families. Author(s): Moody BL. Source: Home Healthcare Nurse. 1993 January-February; 11(1): 29-39. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8449773

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Conservative management in neurogenic bladder dysfunction. Author(s): Aslan AR, Kogan BA. Source: Current Opinion in Urology. 2002 November; 12(6): 473-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12409875

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Endovesical electrotherapy in treatment of urinary incontinence in spina-bifida patients. Author(s): Nicholas JL, Eckstein HB.

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Source: Lancet. 1975 December 27; 2(7948): 1276-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=54798 •

Habilitation: application of a concept. Author(s): Bramadat IJ, Melvin CL. Source: Clinical Nurse Specialist Cns. 1987 Summer; 1(2): 76-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3647825

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Ineffectiveness of dietary folic acid supplementation on the incidence of lipomyelomeningocele: pathogenetic implications. Author(s): McNeely PD, Howes WJ. Source: J Neurosurg Spine. 2004 February; 100(2): 98-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14758936

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Intravesical transurethral electrotherapy in meningomyelocele patients. Author(s): Katona F, Berenyi M. Source: Acta Paediatr Acad Sci Hung. 1975; 16(3-4): 363-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=773096

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Maternal hyperthermia and neural-tube defects. Author(s): Halperin LR, Wilroy RS Jr. Source: Lancet. 1978 July 22; 2(8082): 212-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=78416

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Neurobiology of perceptual and motor timing in children with spina bifida in relation to cerebellar volume. Author(s): Dennis M, Edelstein K, Hetherington R, Copeland K, Frederick J, Blaser SE, Kramer LA, Drake JM, Brandt M, Fletcher JM. Source: Brain; a Journal of Neurology. 2004 June; 127(Pt 6): 1292-301. Epub 2004 April 06. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15069019

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Neuroprostheses in the management of incontinence in myelomeningocele patients. Author(s): Schmidt RA, Kogan BA, Tanagho EA. Source: The Journal of Urology. 1990 April; 143(4): 779-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2313806

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Nursing Mirror midwifery forum. 9. Kate's story. Author(s): Darling A. Source: Nurs Mirror. 1983 October 5; 157(14): Vi-Viii. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6556599

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On-line measurement of human CNS re-organization. Author(s): Schalow G. Source: Electromyogr Clin Neurophysiol. 2001 June; 41(4): 225-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11441640

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Oval-shaped cornea, lens duplication, and optic nerve hypoplasia associated with myelomeningocele. Author(s): Abou-Jaoude ES, Stevens JL, Katz NR. Source: Journal of Aapos : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus. 2000 December; 4(6): 377-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11124675

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Psychosocial and cultural factors associated with the management of spina bifida cystica in Nigeria. Author(s): Oyewole A, Adeloye A, Adeyokunnu AA. Source: Developmental Medicine and Child Neurology. 1985 August; 27(4): 498-503. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4029520

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Reconstruction of the anal sphincter by gracilis muscle transfer: the value of electromyography in the preoperative assessment and postoperative management of the patient. Author(s): Ben-Hur N, Gilai A, Golan J, Sagher U, Issac M. Source: British Journal of Plastic Surgery. 1980 April; 33(2): 156-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7388204

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Sacral anterior root stimulation: prerequisites and indications. Author(s): Madersbacher H, Fischer J. Source: Neurourology and Urodynamics. 1993; 12(5): 489-94. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8252055

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Severe neural tube defect syndrome from the Early Archaic of Florida. Author(s): Dickel DN, Doran GH. Source: American Journal of Physical Anthropology. 1989 November; 80(3): 325-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2686462

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Stooling problems in patients with myelomeningocele. Author(s): Younoszai MK. Source: Southern Medical Journal. 1992 July; 85(7): 718-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1631686

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Stress and coping in families of children with myelomeningocele. Author(s): Samuelson JJ, Foltz J, Foxall MJ.

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Source: Archives of Psychiatric Nursing. 1992 October; 6(5): 287-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1476456 •

Successful therapy in a child with a congenital peripheral medulloepithelioma and disruption of hindquarter development. Author(s): Bruggers CS, Welsh CT, Boyer RS, Byrne JL, Pysher TJ. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 1999 March-April; 21(2): 161-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10206465

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Tap water burns in handicapped children. Author(s): Feldman KW, Clarren SK, McLaughlin JF. Source: Pediatrics. 1981 April; 67(4): 560-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6454880

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Transrectal electrostimulation therapy for neuropathic bowel dysfunction in children with myelomeningocele. Author(s): Palmer LS, Richards I, Kaplan WE. Source: The Journal of Urology. 1997 April; 157(4): 1449-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9120978

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Transurethral electrical bladder stimulation: initial results. Author(s): Decter RM, Snyder P, Rosvanis TK. Source: The Journal of Urology. 1992 August; 148(2 Pt 2): 651-3; Discussion 654. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1640539

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Transurethral intravesical electrotherapy for neurogenic bladder dysfunction in children with myelodysplasia: a prospective, randomized clinical trial. Author(s): Boone TB, Roehrborn CG, Hurt G. Source: The Journal of Urology. 1992 August; 148(2 Pt 2): 550-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1640520

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Treatment of faecal incontinence in children with spina bifida by biofeedback and behavioural modification. Author(s): Pappo I, Meyer S, Winter S, Nissan S. Source: Z Kinderchir. 1988 December; 43 Suppl 2: 36-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3213249

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Treatment of fecal incontinence in children with spina bifida: comparison of biofeedback and behavior modification. Author(s): Whitehead WE, Parker L, Bosmajian L, Morrill-Corbin ED, Middaugh S, Garwood M, Cataldo MF, Freeman J.

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Source: Archives of Physical Medicine and Rehabilitation. 1986 April; 67(4): 218-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3964054 •

Treatment options for fecal incontinence. Author(s): Whitehead WE, Wald A, Norton NJ. Source: Diseases of the Colon and Rectum. 2001 January; 44(1): 131-42; Discussion 142-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11805574

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Urodynamic biofeedback treatment of urinary incontinence in children with myelomeningocele. Author(s): Killam PE, Jeffries JS, Varni JW. Source: Biofeedback Self Regul. 1985 June; 10(2): 161-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3914315

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Use of biofeedback in treatment of fecal incontinence in patients with meningomyelocele. Author(s): Wald A. Source: Pediatrics. 1981 July; 68(1): 45-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7243508

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

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

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

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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

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

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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

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HealthGate: http://www.tnp.com/

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

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

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

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The following is a specific Web list relating to myelomeningocele; 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 Urinary Tract Infection Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 3. DISSERTATIONS ON MYELOMENINGOCELE Overview In this chapter, we will give you a bibliography on recent dissertations relating to myelomeningocele. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “myelomeningocele” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on myelomeningocele, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Myelomeningocele ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to myelomeningocele. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Self concept change among adolescents with myelomeningocele in response to a summer camp experience by LUTKEMEIER, DAVID MICHAEL, EDD from UNIVERSITY OF CINCINNATI, 1979, 70 pages http://wwwlib.umi.com/dissertations/fullcit/8012239

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 4. PERIODICALS AND NEWS ON MYELOMENINGOCELE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover myelomeningocele.

News Services and Press Releases One of the simplest ways of tracking press releases on myelomeningocele is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “myelomeningocele” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to myelomeningocele. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “myelomeningocele” (or synonyms). The following was recently listed in this archive for myelomeningocele: •

In utero closure of myelomeningocele normalizes head-ventricle ratio Source: Reuters Medical News Date: February 07, 2000

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In utero myelomeningocele repair lowers incidence of hindbrain herniation in infants with spina bifida Source: Reuters Medical News Date: November 17, 1999 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “myelomeningocele” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “myelomeningocele” (or synonyms). If you know the name of a company that is relevant to myelomeningocele, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “myelomeningocele” (or synonyms).

Periodicals and News

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Academic Periodicals covering Myelomeningocele Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to myelomeningocele. In addition to these sources, you can search for articles covering myelomeningocele that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

71

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 Institute4: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

4

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.5 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:6 •

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

5

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). 6 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 Gateway7 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.8 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “myelomeningocele” (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 3011 28 13 1 10 3063

HSTAT9 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.10 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.11 Simply search by “myelomeningocele” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

7

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

8

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

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 Biologists12 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.13 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.14 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/.

12 Adapted 13

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. 14 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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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 myelomeningocele can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased 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 myelomeningocele. 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 myelomeningocele. 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 “myelomeningocele”:

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Degenerative Nerve Diseases http://www.nlm.nih.gov/medlineplus/degenerativenervediseases.html Developmental Disabilities http://www.nlm.nih.gov/medlineplus/developmentaldisabilities.html Head and Brain Malformations http://www.nlm.nih.gov/medlineplus/headandbrainmalformations.html Neural Tube Defects http://www.nlm.nih.gov/medlineplus/neuraltubedefects.html Spina Bifida http://www.nlm.nih.gov/medlineplus/spinabifida.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to myelomeningocele. 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. PEDBASE Similar to NORD, PEDBASE covers relatively rare disorders, limited mainly to pediatric conditions. PEDBASE was designed by Dr. Alan Gandy. To access the database, which is more oriented to researchers than patients, you can view the current list of health topics covered at the following Web site: http://www.icondata.com/health/pedbase/pedlynx.htm. 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

Patient Resources

•

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 myelomeningocele. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with myelomeningocele. 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 myelomeningocele. 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 “myelomeningocele” (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 “myelomeningocele”. Type the following hyperlink into

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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 “myelomeningocele” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “myelomeningocele” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.15

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

15

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)16: •

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/

16

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

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•

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

•

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

•

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

•

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/

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

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

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

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

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

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

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

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

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

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

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on myelomeningocele: •

Basic Guidelines for Myelomeningocele Myelomeningocele (children) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001558.htm

•

Signs & Symptoms for Myelomeningocele Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Lack of sensation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Lethargy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Loss of bladder or bowel control Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003142.htm

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Paralysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003190.htm Stiff neck Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm •

Diagnostics and Tests for Myelomeningocele Serum folate level Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003686.htm Spine CT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003787.htm Spine MRI Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003792.htm Spine X-rays Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003806.htm

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Nutrition for Myelomeningocele Fiber Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002470.htm Folate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002408.htm Folic acid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002408.htm

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Background Topics for Myelomeningocele Central nervous system Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002311.htm Dislocation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000014.htm Spina bifida - support group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002184.htm Support groups Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002150.htm

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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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MYELOMENINGOCELE 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] Accommodation: Adjustment, especially that of the eye for various distances. [EU] 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] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Agenesis: Lack of complete or normal development; congenital absence of an organ or part. [NIH]

Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH]

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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] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [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] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [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] Ankle: That part of the lower limb directly above the foot. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] 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] 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] Antioxidants: Naturally occurring or synthetic substances that inhibit or retard the oxidation of a substance to which it is added. They counteract the harmful and damaging effects of oxidation in animal tissues. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aqueous: Having to do with water. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arrhythmogenic: Producing or promoting arrhythmia. [EU] Arrhythmogenic Right Ventricular Dysplasia: A weakening of the right ventricle that results in the back up of blood in the venous system, liver, gastrointestinal tract, and

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extremities. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Artery: Vessel-carrying blood from the heart to various parts of the body. [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] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Auditory: Pertaining to the sense of hearing. [EU] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Baclofen: A GABA derivative that is a specific agonist at GABA-B receptors. It is used in the treatment of spasticity, especially that due to spinal cord damage. Its therapeutic effects result from actions at spinal and supraspinal sites, generally the reduction of excitatory transmission. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign prostatic hyperplasia: A benign (noncancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hypertrophy or BPH. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived

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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] Bladder Exstrophy: Congenital eversion of the urinary bladder. It is characterized by the absence of a portion of the lower abdominal wall and the anterior vesical wall, with eversion of the posterior vesical wall through the deficit. [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 Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Cells: Cells contained in the bone marrow including fat cells, stromal cells, megakaryocytes, and the immediate precursors of most blood cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Brain Diseases: Pathologic conditions affecting the brain, which is composed of the intracranial components of the central nervous system. This includes (but is not limited to) the cerebral cortex; intracranial white matter; basal ganglia; thalamus; hypothalamus; brain stem; and cerebellum. [NIH] Brain Neoplasms: Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Bulbar: Pertaining to a bulb; pertaining to or involving the medulla oblongata, as bulbar paralysis. [EU]

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Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [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] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [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]

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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] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Clinical 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] 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] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH]

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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] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [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] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Continence: The ability to hold in a bowel movement or urine. [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] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Callosum: Broad plate of dense myelinated fibers that reciprocally interconnect regions of the cortex in all lobes with corresponding regions of the opposite hemisphere. The corpus callosum is located deep in the longitudinal fissure. [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] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are

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measured to monitor kidney function. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Decubitus: An act of lying down; also the position assumed in lying down. [EU] Decubitus Ulcer: An ulceration caused by prolonged pressure in patients permitted to lie too still for a long period of time. The bony prominences of the body are the most frequently affected sites. The ulcer is caused by ischemia of the underlying structures of the skin, fat, and muscles as a result of the sustained and constant pressure. [NIH] Dehydroepiandrosterone: DHEA. A substance that is being studied as a cancer prevention drug. It belongs to the family of drugs called steroids. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Dermoid: A benign mixed tumor, usually congenital, containing teeth, hairs, skin glands, fibrous tissue, and other skin elements, rarely found in the limbal region of the eye and orbit. [NIH] Desmosine: 4-(4-Amino-4-carboxybutyl)-1-(5-amino-5-carboxypentyl)-3,5-bis(3-amino-3carboxypropyl)pyridinium. A rare amino acid found in elastin, formed by condensation of four molecules of lysine into a pyridinium ring. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dislocation: The displacement of any part, more especially of a bone. Called also luxation. [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] Diuretic: A drug that increases the production of urine. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the

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back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] 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] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Electrolytes: Substances that break up into ions (electrically charged particles) when they are dissolved in body fluids or water. Some examples are sodium, potassium, chloride, and calcium. Electrolytes are primarily responsible for the movement of nutrients into cells, and the movement of wastes out of cells. [NIH] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encephalocele: Cerebral tissue herniation through a congenital or acquired defect in the skull. The majority of congenital encephaloceles occur in the occipital or frontal regions. Clinical features include a protuberant mass that may be pulsatile. The quantity and location of protruding neural tissue determines the type and degree of neurologic deficit. Visual defects, psychomotor developmental delay, and persistent motor deficits frequently occur. [NIH]

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] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [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]

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Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epidural Space: Space between the dura mater and the walls of the vertebral canal. [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] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] 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] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extrarenal: Outside of the kidney. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [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] Fat: Total lipids including phospholipids. [NIH]

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Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetal Development: Morphologic and physiologic growth and development of the mammalian embryo or fetus. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibril: Most bacterial viruses have a hollow tail with specialized fibrils at its tip. The tail fibers attach to the cell wall of the host. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [NIH]

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Gait: Manner or style of walking. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene 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] Genital: Pertaining to the genitalia. [EU] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

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]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Handicap: A handicap occurs as a result of disability, but disability does not always constitute a handicap. A handicap may be said to exist when a disability causes a substantial

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and continuing reduction in a person's capacity to function socially and vocationally. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Heartbeat: One complete contraction of the heart. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterozygote: An individual having different alleles at one or more loci in homologous chromosome segments. [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] 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] Hydrocephalus: Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, intracranial hypertension; headache; lethargy; urinary incontinence; and ataxia (and in infants macrocephaly). This condition may be caused by obstruction of cerebrospinal fluid pathways due to neurologic abnormalities, intracranial hemorrhages; central nervous system infections; brain neoplasms; craniocerebral trauma; and other conditions. Impaired resorption of cerebrospinal fluid from the arachnoid villi results in a communicating form of hydrocephalus. Hydrocephalus ex-vacuo refers to ventricular dilation that occurs as a result of brain substance loss from cerebral infarction and other conditions. [NIH] Hydrochlorothiazide: A thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It has been used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism. [NIH] Hydronephrosis: Abnormal enlargement of a kidney, which may be caused by blockage of the ureter (such as by a kidney stone) or chronic kidney disease that prevents urine from draining into the bladder. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hygienic: Pertaining to hygiene, or conducive to health. [EU] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hyperreflexia: Exaggeration of reflexes. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH]

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Hypersensitivity, Immediate: Hypersensitivity reactions which occur within minutes of exposure to challenging antigen due to the release of histamine which follows the antigenantibody reaction and causes smooth muscle contraction and increased vascular permeability. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunology: The study of the body's immune system. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the

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microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] 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] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intracranial Hemorrhages: Bleeding within the intracranial cavity, including hemorrhages in the brain and within the cranial epidural, subdural, and subarachnoid spaces. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravesical: Within the bladder. [NIH] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] 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] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH]

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Kidney Pelvis: The flattened, funnel-shaped expansion connecting the ureter to the kidney calices. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Kyphosis: A deformity of the spine characterized by extensive flexion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngeal: Having to do with the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latex Allergy: Hypersensitivity to products containing processed natural rubber latex such as rubber gloves, condoms, catheters, dental dams, balloons, and sporting equipment. Both T-cell mediated (delayed hypersensitivity) and IgE antibody-mediated (immediate hypersensitivity) allergic responses are possible. Delayed hypersensitivity results from exposure to antioxidants present in the rubber; immediate hypersensitivity results from exposure to a latex protein. [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] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Lipomatosis: A disorder consisting of the accumulation of abnormal localized, or tumor-like fat in the tissues. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [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] 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] Lordosis: The anterior concavity in the curvature of the lumbar and cervical spine as viewed from the side. The term usually refers to abnormally increased curvature (hollow back, saddle back, swayback). It does not include lordosis as normal mating posture in certain animals ( = posture + sex behavior, animal). [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU]

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Luxation: The displacement of the particular surface of a bone from its normal joint, without fracture. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

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] Lysine: An essential amino acid. It is often added to animal feed. [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] Malformation: A morphologic developmental process. [EU]

defect

resulting

from

an

intrinsically

abnormal

Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Meconium: The thick green-to-black mucilaginous material found in the intestines of a fullterm fetus. It consists of secretions of the intestinal glands, bile pigments, fatty acids, amniotic fluid, and intrauterine debris. It constitutes the first stools passed by a newborn. [NIH]

Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] 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] Meningocele: A congenital or acquired protrusion of the meninges, unaccompanied by neural tissue, through a bony defect in the skull or vertebral column. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [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]

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Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micturition: The passage of urine; urination. [EU] Midwifery: The practice of assisting women in childbirth. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] 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] Mucilaginous: Pertaining to or secreting mucus. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelodysplasia: Abnormal bone marrow cells that may lead to myelogenous leukemia. [NIH]

Myelogenous: Produced by, or originating in, the bone marrow. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [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] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nephrectomy: Surgery to remove a kidney. Radical nephrectomy removes the kidney, the adrenal gland, nearby lymph nodes, and other surrounding tissue. Simple nephrectomy removes only the kidney. Partial nephrectomy removes the tumor but not the entire kidney. [NIH]

Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU]

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Neural tube defects: These defects include problems stemming from fetal development of the spinal cord, spine, brain, and skull, and include birth defects such as spina bifida, anencephaly, and encephalocele. Neural tube defects occur early in pregnancy at about 4 to 6 weeks, usually before a woman knows she is pregnant. Many babies with neural tube defects have difficulty walking and with bladder and bowel control. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oligohydramnios: Presence of less than 300 ml of amniotic fluid at term. Principal causes include malformations of fetal urinary tracts, intra-uterine growth retardation, high maternal blood pressure, nicotine poisoning, and prolonged pregnancy. [NIH] Opacity: Degree of density (area most dense taken for reading). [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 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] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a

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bony socket or orbit. [NIH] Orthopaedic: Pertaining to the correction of deformities of the musculoskeletal system; pertaining to orthopaedics. [EU] Osteotomy: The surgical cutting of a bone. [EU] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsies: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Panacea: A cure-all. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with spinal cord diseases, although brain diseases; peripheral nervous system diseases; neuromuscular diseases; and muscular diseases may also cause bilateral leg weakness. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] 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] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [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] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH]

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Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Pneumocephalus: Presence of air or gas within the intracranial cavity (e.g., epidural space, subdural space, intracerebral, etc.) which may result from traumatic injuries, fistulous tract formation, erosions of the skull from neoplasms or infection, neurosurgical procedures, and other conditions. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] 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] 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] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] 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

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health care and delivery. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prenatal Diagnosis: Determination of the nature of a pathological condition or disease in the postimplantation embryo, fetus, or pregnant female before birth. [NIH] Preoperative: Preceding an operation. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] 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] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] 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] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Prostatic Hyperplasia: Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells. [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] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] 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]

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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] Pupil: The aperture in the iris through which light passes. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radical prostatectomy: Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy and perineal prostatectomy. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Ramus: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [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] Randomized clinical trial: A study in which the participants are assigned by chance to

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separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reabsorption: 1. The act or process of absorbing again, as the selective absorption by the kidneys of substances (glucose, proteins, sodium, etc.) already secreted into the renal tubules, and their return to the circulating blood. 2. Resorption. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] 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] 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 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] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Retropubic prostatectomy: Surgery to remove the prostate through an incision made in the abdominal wall. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH]

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Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Scoliosis: A lateral curvature of the spine. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sex Behavior: Sexual activities of humans. [NIH] Sex Behavior, Animal: Sexual activities of animals. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] 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]

Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin Care: Maintenance of the hygienic state of the skin under optimal conditions of cleanliness and comfort. Effective in skin care are proper washing, bathing, cleansing, and the use of soaps, detergents, oils, etc. In various disease states, therapeutic and protective solutions and ointments are useful. The care of the skin is particularly important in various occupations, in exposure to sunlight, in neonates, and in decubitus ulcer. [NIH]

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Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Social Conditions: The state of society as it exists or in flux. While it usually refers to society as a whole in a specified geographical or political region, it is applicable also to restricted strata of a society. [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] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] 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] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spina bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Spina Bifida Cystica: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and

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inflammatory/autoimmune processes may affect the spinal cord. [NIH] Stabilization: The creation of a stable state. [EU] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Steady state: Dynamic equilibrium. [EU] 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] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Streptococcal: Caused by infection due to any species of streptococcus. [NIH] Streptococcal Infections: Infections with bacteria of the genus Streptococcus. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [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] Stress urinary: Leakage of urine caused by actions--such as coughing, laughing, sneezing, running, or lifting--that place pressure on the bladder from inside the body. Stress urinary incontinence can result from either a fallen bladder or weak sphincter muscles. [NIH] Stridor: The loud, harsh, vibrating sound produced by partial obstruction of the larynx or trachea. [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] Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Supraspinal: Above the spinal column or any spine. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Syrinx: A fistula. [NIH] Systemic: Affecting the entire body. [NIH] Talus: The second largest of the tarsal bones and occupies the middle and upper part of the tarsus. [NIH] Teratoma: A type of germ cell tumor that may contain several different types of tissue, such as hair, muscle, and bone. Teratomas occur most often in the ovaries in women, the testicles in men, and the tailbone in children. Not all teratomas are malignant. [NIH]

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Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Tibia: The second longest bone of the skeleton. It is located on the medial side of the lower leg, articulating with the fibula laterally, the talus distally, and the femur proximally. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Expansion: Process whereby tissue adjacent to a soft tissue defect is expanded by means of a subcutaneously implanted reservoir. The procedure is used in reconstructive surgery for injuries caused by trauma, burns, or ablative surgery. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transurethral: Performed through the urethra. [EU] Transurethral resection: Surgery performed with a special instrument inserted through the urethra. Also called TUR. [NIH] Transurethral Resection of Prostate: Resection of the prostate using a cystoscope passed through the urethra. [NIH]

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Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urodynamic: Measures of the bladder's ability to hold and release urine. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urologist: A doctor who specializes in diseases of the urinary organs in females and the urinary and sex organs in males. [NIH] Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes and the genital tract in the male. It includes the specialty of andrology which addresses both male genital diseases and male infertility. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventriculostomy: Surgical creation of an opening in a cerebral ventricle. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH]

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Vertebral: Of or pertaining to a vertebra. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] 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]

121

INDEX A Abdominal, 91, 94, 95, 111, 114 Accommodation, 8, 91 Adaptation, 39, 91 Adjustment, 39, 91 Adjuvant, 5, 91 Adolescence, 4, 44, 91 Adverse Effect, 91, 115 Agenesis, 15, 34, 91 Agonist, 91, 93, 109 Algorithms, 91, 94 Alleles, 91, 103 Allergen, 91, 115 Alpha Particles, 91, 113 Alternative medicine, 66, 91 Amino acid, 8, 92, 98, 102, 103, 107, 110, 111, 112, 118, 119 Amniotic Fluid, 92, 107, 109 Ampulla, 92, 99 Anal, 58, 92, 101, 106 Anaphylaxis, 36, 92 Anemia, 92, 101 Animal model, 8, 92 Ankle, 23, 37, 48, 92 Anomalies, 7, 34, 92 Anorectal, 22, 92 Antibody, 92, 96, 103, 104, 106, 108, 113, 115 Antigen, 92, 96, 103, 104, 115 Antioxidants, 92, 106 Anus, 92, 94, 99, 110, 114 Aorta, 92, 119 Aqueous, 92, 106 Arrhythmia, 92 Arrhythmogenic, 45, 92 Arrhythmogenic Right Ventricular Dysplasia, 45, 92 Arterial, 93, 104, 112 Arteries, 92, 93, 94, 97, 107 Arteriovenous, 40, 93 Artery, 93, 97 Ataxia, 93, 103 Atrium, 93, 119 Auditory, 15, 93, 100 Axonal, 7, 93 Axons, 93, 109, 114 B Baclofen, 47, 93

Bacteria, 92, 93, 101, 108, 117, 118, 119 Bacterial Physiology, 91, 93 Basement Membrane, 93, 100 Benign, 7, 13, 93, 94, 98, 103, 108, 113 Benign prostatic hyperplasia, 7, 93 Bilateral, 8, 93, 110 Bile, 93, 106, 107 Bile Pigments, 93, 107 Biochemical, 7, 91, 93 Biotechnology, 10, 66, 73, 93 Bladder Exstrophy, 28, 94 Blood pressure, 94, 104, 108, 109, 116 Blood vessel, 94, 95, 96, 116, 119 Body Composition, 47, 94 Body Mass Index, 94, 110 Bone Marrow, 94, 102, 104, 107, 108 Bone Marrow Cells, 94, 108 Bowel, 15, 56, 59, 87, 92, 94, 97, 99, 105, 109, 111, 117 Bowel Movement, 94, 97, 117 Brachytherapy, 94, 105, 113 Brain Diseases, 94, 110 Brain Neoplasms, 94, 103 Brain Stem, 94, 95 Bulbar, 5, 94 Burns, 29, 59, 95, 118 Burns, Electric, 95 C Case report, 9, 13, 21, 39, 52, 95 Catheterization, 4, 38, 55, 95, 105 Catheters, 4, 95, 104, 105, 106 Caudal, 95, 111 Cell, 6, 7, 91, 93, 95, 96, 100, 101, 102, 104, 105, 106, 107, 108, 109, 110, 111, 114, 117 Central Nervous System, 22, 28, 94, 95, 100, 102, 103, 109 Central Nervous System Infections, 95, 103 Cerebellar, 57, 93, 95 Cerebellum, 8, 9, 94, 95 Cerebral, 6, 44, 93, 94, 95, 99, 100, 101, 103, 119 Cerebral Palsy, 44, 95 Cerebrospinal, 95, 103, 115 Cerebrospinal fluid, 95, 103, 115 Cerebrum, 95 Cervical, 12, 16, 17, 51, 95, 106 Cervix, 95

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Cesarean Section, 8, 95 Chin, 95, 107 Chromosome, 96, 103 Chronic, 96, 98, 103, 104, 105, 117 Circulatory system, 96, 105 Clinical trial, 5, 6, 73, 96, 112, 113 Cloning, 94, 96 Collagen, 7, 8, 37, 92, 93, 96, 101, 112 Collapse, 92, 96 Complement, 96, 97, 115 Complementary and alternative medicine, 55, 61, 96 Complementary medicine, 55, 97 Compliance, 7, 8, 18, 50, 97 Computational Biology, 73, 97 Conception, 97, 101 Condoms, 97, 106 Connective Tissue, 94, 96, 97, 101, 102, 107 Continence, 3, 4, 9, 33, 97 Contraindications, ii, 97 Coordination, 95, 97 Cornea, 58, 97 Coronary, 97, 107 Coronary Thrombosis, 97, 107 Corpus, 15, 97, 120 Corpus Callosum, 15, 97 Cortex, 93, 94, 97, 100, 101 Cortical, 10, 97, 100, 115 Cranial, 6, 95, 97, 103, 105, 109, 111 Craniocerebral Trauma, 97, 103 Creatinine, 14, 97 Curative, 98, 118 D Decompression, 44, 98 Decompression Sickness, 98 Decubitus, 98, 115 Decubitus Ulcer, 98, 115 Dehydroepiandrosterone, 10, 98 Density, 14, 15, 94, 98, 109 Dermal, 40, 98 Dermoid, 13, 19, 98 Desmosine, 8, 98 Detergents, 98, 115 Diabetes Insipidus, 98, 103 Diagnostic procedure, 66, 98 Digestion, 93, 94, 98, 105, 106, 117 Dilation, 4, 24, 48, 50, 98, 103 Direct, iii, 98, 114 Dislocation, 20, 27, 88, 98 Distal, 93, 98 Diuretic, 98, 103 Dorsal, 98, 111

Drug Interactions, 99 Duct, 92, 95, 99 Duodenum, 93, 99, 117 Dura mater, 99, 100, 107, 110 E Edema, 99, 103, 105 Efficacy, 6, 8, 9, 22, 37, 99 Elastin, 96, 98, 99 Electrolytes, 93, 99, 103 Electromyography, 28, 58, 99 Electrons, 99, 113 Embryo, 99, 101, 112 Empirical, 21, 99 Encephalocele, 99, 109 Endoscope, 99 Endoscopic, 23, 38, 99 Endoscopy, 32, 99 Enema, 12, 99 Energy Intake, 43, 99 Environmental Health, 72, 74, 99 Enzymatic, 92, 96, 100, 114 Enzyme, 100, 102, 120 Epidermal, 40, 100 Epidermis, 100 Epidural, 100, 105, 111 Epidural Space, 100, 111 Epithelial, 100 Epithelial Cells, 100 Epithelium, 13, 93, 100, 105 Erythrocytes, 92, 94, 100, 115 Esophagus, 100, 114, 117 Evoke, 100, 117 Evoked Potentials, 15, 100 Excitatory, 93, 100, 102 External-beam radiation, 100, 113 Extracellular, 7, 8, 97, 100, 101, 116 Extracellular Matrix, 7, 8, 97, 100, 101 Extracellular Space, 100 Extrarenal, 55, 100 Extremity, 36, 51, 100 F Faecal, 59, 100 Family Planning, 73, 100 Fat, 94, 98, 100, 106, 110, 116 Fecal Incontinence, 56, 59, 60, 101, 104 Feces, 100, 101, 117 Femur, 24, 101, 118 Fetal Development, 101, 109 Fetus, 6, 95, 101, 107, 112, 119 Fibril, 8, 101 Fibroblasts, 7, 101 Fibrosis, 7, 14, 101

123

Fibula, 101, 118 Fissure, 97, 101 Fistula, 101, 117 Fixation, 101, 115 Flatus, 101, 102 Folate, 88, 101 Folic Acid, 57, 101 Forearm, 49, 94, 101 Fossa, 95, 101 G Gait, 12, 16, 23, 24, 27, 28, 34, 37, 45, 50, 51, 102 Gamma Rays, 102, 113 Ganglia, 93, 94, 102, 108, 111 Gas, 98, 101, 102, 111 Gastrin, 102, 103 Gastrointestinal, 17, 92, 102 Gastrointestinal tract, 92, 102 Gene, 6, 7, 8, 91, 94, 102 Gene Expression, 102 Gene Therapy, 6, 102 Genital, 102, 119 Gestation, 6, 8, 9, 32, 102, 110 Gestational, 28, 36, 102 Gland, 102, 107, 108, 112, 115, 117, 118 Glomerular, 102, 114 Glutamic Acid, 101, 102, 109, 112 Glycine, 92, 102, 109 Governing Board, 102, 111 Grasses, 101, 102 H Handicap, 42, 102 Headache, 103 Heartbeat, 103, 117 Hemoglobinopathies, 102, 103 Heredity, 102, 103 Heterozygote, 42, 103 Homologous, 91, 102, 103, 115 Hormone, 10, 21, 29, 46, 102, 103, 118 Hydrocephalus, 6, 8, 9, 11, 13, 21, 24, 25, 26, 30, 31, 35, 38, 44, 49, 53, 103, 105 Hydrochlorothiazide, 15, 103 Hydronephrosis, 4, 50, 103 Hydroxylysine, 96, 103 Hydroxyproline, 92, 96, 103 Hygienic, 103, 115 Hyperplasia, 7, 103 Hyperreflexia, 15, 22, 103 Hypersensitivity, 91, 92, 103, 104, 106, 115 Hypersensitivity, Immediate, 104 Hypertension, 103, 104, 105 Hyperthermia, 57, 104

Hypertrophy, 7, 93, 103, 104 Hypoplasia, 36, 58, 104 Hypothyroidism, 37, 104 Hysterotomy, 32, 95, 104 I Idiopathic, 19, 104 Immune response, 91, 92, 104, 115 Immunization, 104, 115 Immunology, 91, 104 Implant radiation, 104, 105, 113 In vitro, 7, 32, 102, 104 In vivo, 7, 102, 104 Incision, 5, 104, 105, 112, 114 Incontinence, 3, 4, 14, 37, 42, 50, 56, 57, 59, 60, 103, 104, 117 Infarction, 97, 103, 104, 107 Infection, 6, 31, 50, 61, 104, 107, 111, 117, 119 Infertility, 105, 119 Inflammation, 101, 105, 107, 110, 111, 117 Initiation, 105, 118 Intermittent, 4, 38, 50, 105 Internal radiation, 105, 113 Interstitial, 94, 100, 105, 114 Intestinal, 105, 107 Intestine, 94, 105, 106 Intracellular, 104, 105, 111 Intracranial Hemorrhages, 103, 105 Intracranial Hypertension, 103, 105 Intracranial Pressure, 33, 105 Intrathecal, 47, 105 Intravesical, 17, 57, 59, 105 Intubation, 95, 105 Invasive, 5, 105, 107 Involuntary, 101, 105, 108, 116 Iris, 97, 105, 113 K Kb, 72, 105 Kidney Disease, 72, 103, 105 Kidney Pelvis, 106, 119 Kidney stone, 103, 106 Kinetics, 8, 106 Kyphosis, 10, 17, 19, 34, 35, 43, 49, 106 L Large Intestine, 105, 106, 114, 116 Laryngeal, 35, 52, 106 Larynx, 106, 117, 118 Latex Allergy, 4, 106 Lens, 58, 106 Lesion, 17, 27, 49, 106 Lethargy, 87, 103, 104, 106 Leukemia, 102, 106, 108

124

Myelomeningocele

Lipomatosis, 13, 106 Liver, 91, 92, 93, 101, 106 Localization, 8, 106 Localized, 101, 104, 106, 111, 119 Longitudinal study, 10, 106 Lordosis, 49, 106 Lumbar, 12, 19, 23, 27, 31, 49, 51, 106 Luxation, 98, 107 Lymph, 95, 96, 107, 108 Lymph node, 95, 107, 108 Lymphatic, 105, 107 Lysine, 98, 103, 107 M Magnetic Resonance Imaging, 31, 32, 107 Malformation, 6, 9, 11, 13, 15, 35, 40, 107 Malignant, 94, 107, 108, 113, 117 Manifest, 93, 107 Meconium, 32, 107 Medial, 107, 109, 118 MEDLINE, 73, 107 Megaloblastic, 101, 107 Memory, 33, 52, 107 Meninges, 95, 97, 99, 107, 116 Meningitis, 52, 107 Meningocele, 49, 107 Mental, iv, 5, 8, 9, 31, 72, 74, 95, 104, 107, 112, 119 Mentors, 6, 107 MI, 89, 107 Microbiology, 91, 108 Microorganism, 108, 120 Micturition, 32, 108 Midwifery, 57, 108 Mitochondrial Swelling, 108 Mobility, 24, 108 Modification, 59, 92, 108, 113 Molecular, 6, 7, 73, 75, 94, 97, 108, 115, 118 Monitor, 98, 108, 109 Monoclonal, 108, 113 Mucilaginous, 107, 108 Muscular Diseases, 108, 110 Mydriatic, 98, 108 Myelodysplasia, 59, 108 Myelogenous, 108 Myocardium, 107, 108 N Necrosis, 32, 104, 107, 108 Neonatal, 9, 25, 41, 108 Neoplasms, 94, 108, 111, 113 Nephrectomy, 8, 108 Nerve, 6, 78, 93, 95, 108, 109, 111, 117

Nervous System, 26, 31, 47, 88, 95, 108, 109, 111 Neural, 15, 47, 57, 58, 78, 99, 107, 108, 109 Neural tube defects, 15, 109 Neurologic, 7, 51, 99, 103, 109 Neuromuscular, 34, 42, 109, 110 Neurotransmitter, 92, 102, 109 Neutrons, 91, 109, 113 Nicotine, 109 Nuclear, 99, 102, 108, 109, 114 Nuclei, 91, 99, 102, 107, 109, 112 Nursing Care, 4, 109 O Ointments, 109, 115, 116 Oligohydramnios, 8, 109 Opacity, 98, 109 Optic Chiasm, 109 Optic Nerve, 58, 109, 110, 114 Orbit, 98, 109 Orthopaedic, 27, 40, 41, 42, 43, 110 Osteotomy, 34, 37, 48, 110 Ovaries, 110, 115, 117 Overweight, 43, 110 Ovum, 102, 110 P Pachymeningitis, 107, 110 Paediatric, 11, 16, 27, 41, 42, 110 Palliative, 110, 118 Palsies, 6, 110 Palsy, 35, 110 Panacea, 26, 110 Paralysis, 88, 94, 110 Paraplegia, 11, 12, 13, 33, 41, 110 Parenteral, 99, 110 Pathologic, 7, 94, 97, 103, 110, 114, 116 Pathologies, 7, 110 Pathophysiology, 32, 40, 110 Pelvic, 34, 37, 49, 110, 112 Pelvis, 106, 110, 119 Peptide, 92, 110, 111, 112, 118 Perception, 3, 6, 29, 110 Perinatal, 33, 110 Perineal, 5, 48, 110, 113 Perineum, 110 Perioperative, 10, 111 Peripheral Nervous System, 109, 110, 111 Peripheral Nervous System Diseases, 110, 111 Peritoneal, 52, 111 Peritoneum, 111 Pharmacologic, 111, 118 Physiologic, 7, 8, 91, 101, 111, 114

125

Plants, 111, 118 Pneumocephalus, 44, 48, 111 Pneumonia, 97, 111 Poisoning, 109, 111 Polypeptide, 92, 96, 111 Posterior, 7, 44, 92, 93, 94, 95, 99, 105, 111 Postnatal, 8, 9, 25, 111 Postoperative, 12, 34, 45, 58, 111 Potassium, 99, 103, 111, 116 Practice Guidelines, 74, 111 Prenatal, 20, 27, 40, 41, 45, 99, 112 Prenatal Diagnosis, 40, 112 Preoperative, 58, 112 Prevalence, 30, 112 Progression, 49, 92, 112 Progressive, 108, 112, 114 Projection, 109, 112 Proline, 96, 103, 112 Prospective study, 4, 106, 112 Prostate, 5, 93, 112, 113, 114, 118 Prostatectomy, 5, 112, 113 Prostatic Hyperplasia, 112 Protein S, 94, 112 Proteins, 7, 92, 96, 110, 112, 114, 118 Protocol, 9, 112 Protons, 91, 112, 113 Psychic, 107, 112, 115 Puberty, 22, 33, 112 Public Policy, 73, 112 Pulmonary, 36, 45, 94, 113, 119 Pulmonary Artery, 94, 113, 119 Pupil, 97, 98, 108, 113 Q Quality of Life, 9, 113 R Race, 15, 113 Radiation, 5, 7, 46, 100, 102, 104, 105, 113, 120 Radiation therapy, 7, 100, 105, 113 Radical prostatectomy, 5, 113 Radioactive, 104, 105, 109, 113 Radiolabeled, 113 Radiological, 18, 113 Radiology, 16, 36, 41, 113 Radiotherapy, 94, 113 Ramus, 5, 113 Random Allocation, 113 Randomization, 9, 113 Randomized, 6, 8, 9, 59, 99, 113 Randomized clinical trial, 8, 9, 59, 113 Reabsorption, 103, 114 Receptor, 91, 92, 100, 114

Recombination, 102, 114 Rectal, 56, 114 Rectum, 60, 92, 94, 101, 102, 104, 106, 112, 114 Refer, 1, 96, 101, 106, 109, 114, 118 Reflux, 52, 114 Regimen, 99, 114 Renal failure, 4, 114 Resorption, 103, 114 Retina, 106, 109, 114 Retinal, 109, 114 Retinal Ganglion Cells, 109, 114 Retropubic, 112, 113, 114 Retropubic prostatectomy, 113, 114 Retrospective, 46, 114 Retroviral vector, 102, 114 Risk factor, 42, 112, 115 Rubber, 106, 115 S Scoliosis, 12, 15, 16, 17, 19, 34, 44, 51, 115 Screening, 96, 115 Secretion, 104, 115 Segmental, 34, 115 Segmentation, 115 Seizures, 32, 115 Sensitization, 30, 115 Sex Behavior, 106, 115 Sex Behavior, Animal, 106, 115 Sex Characteristics, 91, 112, 115 Shock, 92, 115, 119 Shunt, 6, 8, 9, 11, 17, 19, 26, 47, 49, 52, 53, 115 Side effect, 91, 115, 118 Skeleton, 101, 115, 116, 118 Skin Care, 4, 115 Skull, 97, 99, 105, 107, 109, 111, 116 Small intestine, 99, 103, 105, 116, 120 Smooth muscle, 7, 104, 108, 116 Sneezing, 116, 117 Soaps, 115, 116 Social Conditions, 16, 116 Social Environment, 113, 116 Sodium, 99, 103, 114, 116 Soft tissue, 94, 115, 116, 118 Soma, 116 Somatic, 12, 91, 111, 116 Specialist, 57, 79, 98, 116 Species, 108, 113, 116, 117, 120 Sphincter, 5, 14, 24, 48, 58, 106, 116, 117 Spina bifida, 3, 4, 9, 23, 29, 32, 57, 58, 59, 66, 88, 109, 116 Spina Bifida Cystica, 58, 116

126

Myelomeningocele

Spinal cord, 4, 11, 18, 19, 32, 49, 93, 94, 95, 99, 100, 105, 107, 108, 109, 110, 111, 116 Spinal Cord Diseases, 110, 116 Stabilization, 20, 117 Statistically significant, 3, 117 Steady state, 8, 117 Steroids, 98, 117 Stimulus, 7, 100, 117 Stomach, 91, 100, 102, 103, 114, 116, 117 Stool, 104, 106, 117 Streptococcal, 28, 117 Streptococcal Infections, 28, 117 Streptococcus, 117 Stress, 4, 7, 39, 51, 58, 115, 117, 119 Stress urinary, 4, 117 Stridor, 52, 117 Subacute, 104, 117 Subclinical, 104, 115, 117 Sudden death, 45, 117 Supplementation, 57, 117 Support group, 88, 117 Supraspinal, 93, 117 Symptomatic, 44, 117 Syrinx, 6, 117 Systemic, 92, 94, 104, 105, 113, 117 T Talus, 117, 118 Teratoma, 40, 55, 117 Testicles, 117, 118 Therapeutics, 118 Thoracic, 49, 51, 118 Thorax, 106, 118 Thyroid, 104, 118 Thyrotropin, 104, 118 Tibia, 34, 101, 118 Tissue Expansion, 46, 118 Tooth Preparation, 91, 118 Toxic, iv, 102, 109, 118 Toxicity, 99, 118 Toxicology, 74, 118 Toxin, 15, 22, 118 Trachea, 106, 117, 118 Transcription Factors, 7, 118 Transfection, 94, 102, 118 Translation, 92, 118

Transurethral, 5, 57, 59, 112, 118 Transurethral resection, 112, 118 Transurethral Resection of Prostate, 112, 118 Trauma, 27, 108, 118, 119 Tryptophan, 96, 119 U Uremia, 114, 119 Ureter, 52, 103, 106, 119 Urethra, 5, 93, 112, 118, 119 Urinary, 3, 4, 5, 9, 14, 28, 36, 37, 38, 42, 50, 56, 60, 61, 94, 103, 104, 109, 112, 114, 117, 119 Urinary tract, 4, 36, 42, 50, 109, 119 Urinary tract infection, 4, 50, 119 Urine, 93, 94, 97, 98, 103, 104, 106, 108, 117, 119 Urodynamic, 20, 60, 119 Urogenital, 7, 119 Urologist, 4, 119 Urticaria, 92, 119 Uterus, 95, 97, 104, 110, 119 V Vagina, 95, 104, 119 Valves, 7, 119 Vascular, 92, 104, 105, 116, 119 Vein, 93, 109, 119 Venous, 92, 93, 112, 119 Ventricle, 65, 92, 113, 119 Ventricular, 8, 9, 48, 103, 119 Ventriculostomy, 38, 119 Vertebrae, 116, 119 Vertebral, 100, 107, 116, 120 Veterinary Medicine, 73, 120 Villi, 103, 120 Viruses, 101, 108, 120 Viscera, 116, 120 Vitreous, 106, 114, 120 Vitro, 120 Vivo, 7, 120 W Wound Healing, 6, 120 X Xenograft, 92, 120 X-ray, 88, 102, 109, 113, 120

127

128

Myelomeningocele

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