Paget's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

PAGET’S DISEASE 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., 1960Paget’s Disease: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84147-0 1. Paget’s Disease-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 Paget’s disease. 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 PAGET’S DISEASE ...................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Paget’s Disease.............................................................................. 4 The National Library of Medicine: PubMed ................................................................................ 14 CHAPTER 2. NUTRITION AND PAGET’S DISEASE ............................................................................ 57 Overview...................................................................................................................................... 57 Finding Nutrition Studies on Paget’s Disease ............................................................................ 57 Federal Resources on Nutrition ................................................................................................... 63 Additional Web Resources ........................................................................................................... 64 CHAPTER 3. ALTERNATIVE MEDICINE AND PAGET’S DISEASE ...................................................... 65 Overview...................................................................................................................................... 65 National Center for Complementary and Alternative Medicine.................................................. 65 Additional Web Resources ........................................................................................................... 70 General References ....................................................................................................................... 71 CHAPTER 4. CLINICAL TRIALS AND PAGET’S DISEASE .................................................................. 73 Overview...................................................................................................................................... 73 Recent Trials on Paget’s Disease ................................................................................................. 73 Keeping Current on Clinical Trials ............................................................................................. 74 CHAPTER 5. BOOKS ON PAGET’S DISEASE ...................................................................................... 77 Overview...................................................................................................................................... 77 Book Summaries: Online Booksellers........................................................................................... 77 The National Library of Medicine Book Index ............................................................................. 78 Chapters on Paget’s Disease ........................................................................................................ 79 CHAPTER 6. MULTIMEDIA ON PAGET’S DISEASE ........................................................................... 81 Overview...................................................................................................................................... 81 Bibliography: Multimedia on Paget’s Disease ............................................................................. 81 CHAPTER 7. PERIODICALS AND NEWS ON PAGET’S DISEASE ........................................................ 83 Overview...................................................................................................................................... 83 News Services and Press Releases................................................................................................ 83 Newsletter Articles ...................................................................................................................... 85 Academic Periodicals covering Paget’s Disease ........................................................................... 86 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................... 87 Overview...................................................................................................................................... 87 U.S. Pharmacopeia....................................................................................................................... 87 Commercial Databases ................................................................................................................. 88 Researching Orphan Drugs ......................................................................................................... 89 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 93 Overview...................................................................................................................................... 93 NIH Guidelines............................................................................................................................ 93 NIH Databases............................................................................................................................. 95 Other Commercial Databases....................................................................................................... 97 APPENDIX B. PATIENT RESOURCES ................................................................................................. 99 Overview...................................................................................................................................... 99 Patient Guideline Sources............................................................................................................ 99 Associations and Paget’s Disease............................................................................................... 111 Finding Associations.................................................................................................................. 111 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 113 Overview.................................................................................................................................... 113 Preparation................................................................................................................................. 113

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Finding a Local Medical Library................................................................................................ 113 Medical Libraries in the U.S. and Canada ................................................................................. 113 ONLINE GLOSSARIES................................................................................................................ 119 Online Dictionary Directories ................................................................................................... 121 PAGET’S DISEASE DICTIONARY ........................................................................................... 123 INDEX .............................................................................................................................................. 167

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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 Paget’s disease 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 Paget’s disease, 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 Paget’s disease, 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 Paget’s disease. 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 Paget’s disease, 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 Paget’s disease. 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 PAGET’S DISEASE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Paget’s disease.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and Paget’s disease, 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 “Paget’s disease” (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: •

Dental, Visual, Auditory and Olfactory Complications in Paget's Disease of Bone Source: Journal of the American Geriatrics Society. 43(12): 1384-1391. December 1995. Summary: This article reports on a study undertaken to determine the prevalence of dental problems in people with Paget's disease and in a control population without Paget's disease. The researchers examine the relationship of localization of bony involvement of Paget's disease with the prevalence of dental, auditory, visual, and smell changes. Each subject (n=498), randomly generated from the mailing list of the Paget Foundation, was sent two questionnaires, one for themselves and one for an unaffected spouse or similar-aged friend (the controls). All subjects were asked about their socioeconomic status, chronic medical conditions, self-rating of their general physical and dental health, the number of teeth present, and the presence of dental, auditory, visual, and olfactory problems. Results show that patients with Paget's disease assessed

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their oral health to be poorer than the controls. Those patients with Paget's disease of bone involving facial or maxillo-mandibular parts of the skeleton have a higher prevalence of change in hearing, sight, smell, and dental problems. 1 figure. 5 tables. 43 references. (AA-M).

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

Project Title: A PILOT TRIAL OF IV PAMIDRONATE FOR LOW BACK PAIN Principal Investigator & Institution: Pappagallo, Marco; Beth Israel Medical Ctr (New York) 1St Ave at 16Th St New York, Ny 10003 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2006 Summary: (provided by the applicant): We have been motivated to propose an openlabel, dose-escalation, clinical pilot trial of Pamidronate infusions for the relief of chronic low-back pain by: (1) human studies that have demonstrated the analgesic effect of Pamidronate for cancer and non-cancer bone pain; (2) animal studies that have demonstrated the analgesic effect of this drug for pain unrelated to bone pathology; and (3) the impressive relief of non-malignant, chronic low-back pain among our patients treated with Pamidronate. Chronic low-back pain affects large segments of populations throughout the world, and is responsible for large costs in the form of suffering, lost workdays, and medical treatment. While Pamidronate infusions relieve bone pain related to Metastatic cancer, Paget's Disease, Ankylosing Spondylitis, and inflammatory bone and articular conditions, there have been no clinical trials of Pamidronate for chronic, mechanical low-back pain. The study participants will be 40 patients who have not had back surgery, and who have chronic, mechanical low-back pain associated with disc degeneration. Consistent with the success we have observed in patients with and without Osteoporosis, study participants will include individuals with and without Osteoporosis. They will be equally divided among five treatment groups (N=8 per group), who will receive between one and five 90 mg. Pamidronate infusions, respectively. There will be a one-month interval between infusions, and a 24-week follow-up period after the last infusion. Nightly, participants will electronically

2

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

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complete the Brief Pain Inventory (BPI). In addition, the research coordinator will administer the BPI, weekly, via telephone. The primary objective of the pilot is to determine the optimal dose of Pamidronate for a Phase III trial by comparing the different doses with respect to their tolerability and safety profiles, including their effect on bone remodeling. Very little is known about the effects of Pamidronate in individuals with normal bone turnover. Secondary aims include the determination of the duration of follow-up for the Phase 111 trial, and the assessment of the relationships of (1) pain intensity changes to baseline bone scan results, (2) changes in performance on the Simmonds Physical Performance Battery for Patients with Low-Back Pain, to the number of Pamidronate infusions and to changes in pain intensity scores, and (3) patient satisfaction to treatment regimen. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CALCITONIN RECEPTOR GENE EXPRESSION Principal Investigator & Institution: Goldring, Steven R.; Professor; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 01-MAY-1994; Project End 30-APR-2003 Summary: Our initial application proposed to study the mechanism of action and regulation of the calcitonin receptor (CTR) gene. Although the ultimate goal was to use this information to gain insights into the control of osteoclast differentiation and function, we have broadened the scope our studies to include investigation of the regulation and mechanism of action of the CTR in organs and tissues not directly involved in mineral ion homeostasis. We have established that the human CTR gene encodes multiple CTR isoforms that are functionally distinct and are expressed in a tissue- and cell-specific fashion. These observations have provided insights into the diversity of the biological activities of calcitonin (CT). In the competing renewal, we will continue to focus attention on the osteoclast CTR, but will also investigate the receptor in other CT-responsive tissues. The Aims are as follow: 1. Utilize the reverse transcriptase/polymerase chain reaction (RT-PCR) and cloning techniques to complete the sequencing and characterization of the structural properties of the human CTR isoforms. The corresponding genomic structure will be identified and the tissue and cellspecific distribution of the isoforms established using in situ hybridization, Northern blot analysis and RNase protection. 2. Complete the characterization of cells in specific bone lesions, e.g. Paget's disease of bone and other granulomatous diseases and tumors in which the phenotype of the giant cells and their relationship to osteoclasts is not well established. This will help to define the phenotypic relationship between bone resorbing cells in physiological and pathological remodeling and identify the structural features of the osteoclast-associated CTR. 3. Because the CTR family of receptors exhibit structural features that are different from other members of the G protein-coupled receptor superfamily, the structure/function relationships for these receptors are of particular interest. We propose to utilize the different CTR cDNAs presently available, as well as additional CTR isoforms that we have recently identified, to define the unique signaling properties and binding kinetics of the human CTR isoforms. 4. In the final Specific Aim, we propose to clone and characterize the human CTR gene and to define the specific and potentially unique regulatory sequences responsible for expression of the CTR in osteclasts and other CTR-expressing cells and tissues. Constructs of the CTR 5'-region containing the putative promoter sequences of the CTR gene will be linked to reporter gene(s) and screened for the capacity to induce CTR expression using transfection in human mononuclear cell lines or other cell types that constitutively express the CTR

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Paget’s Disease

(e.g. kidney). This will define the structural basis of CTR gene regulation and permit identification of potentially unique factors that regulate the CTR. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CHEMOTHERAPY FOR HUNTINGTON'S DISEASE Principal Investigator & Institution: Hersch, Steven M.; Associate Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 15-APR-2003; Project End 31-MAR-2008 Summary: Transcriptional modulation is a promising approach to neuroprotection in Huntington's disease (HD). Our preliminary data indicates that transcriptionally active compounds like histone deacetylase (HDAC) inhibitors and aureolic acid antibiotics including mithramycin are among the most promising potential treatments available for HD. Phenylbutyrate is the HDAC inhibitor most developed for human use and with the best evidence for brain bioavailability. Mithramycin is used to treat Paget's disease, several types of malignancy, and hypercalcemia of malignancy and has the greatest efficacy in HD transgenic mice to date. The safety, tolerability, and efficacy of these agents is completely unknown in HD or other neuro-degenerative disorders. This project will test the feasibility of these medications in HD in large scale trials of efficacy. In aim one, we will examine whether phenylbutyrate is safe and tolerable for use in HD patients and whether it can improve any symptoms or biological markers of HD. A randomized double-blind placebo-controlled long-term safety and tolerability trial of phenylbutyrate in HD patients will be performed. We will assess the impact of phenylbutyrate treatment on: standardized clinical ratings of motor function, cognition, behavior, and functional capacity. We will also examine In vivo markers of neurodegeneration and transcriptional modulation including proton magnetic resonance spectroscopy for lactate and NAA, and peripheral markers of transcriptional modulation, histone acetylation, and phenylbutyrate activity. In aim two, we will examine whether mithramycin is safe and tolerable in long-term use in HD patients and whether it can improve any symptoms or biological markers of HD. Following an open label dose-ranging trial in which a maximally tolerated dose will be determined, subjects will be randomized into a double-blind placebo controlled safety and tolerability trial of mithramycin using intermittent infusion. We will also assess the impact of mithramycin treatment on; standardized clinical ratings of motor function, cognition, behavior, and functional capacity. We will examine In vivo markers of neurodegeneration including proton magnetic resonance spectroscopy of the basal ganglia and cortex, and peripheral markers of mithramycin activity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COMPARISON OF A LOOSE IMPLANT AND IMPLANT WITH WEAR DEBRIS IN A RAT MODEL Principal Investigator & Institution: Smith, Richard A.; University of Tennessee Health Sci Ctr Memphis, Tn 38163 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2006 Summary: Asceptic loosening is the most common cause of problems leading to hip revision. This loosening may be due to micromotion, accumulation of particle debris or a combination of both leading to osteolysis (aggressive bone resorption around the implant) and eventual implant failure. Bisphosphonates are compounds that reduce bone resorption by causing ostoeclast apoptosis thereby reducing the life span of the osteoporosis and Paget's disease. We propose to test a bisphosphonate, pamidronate, in

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our osteolytic rat model as a possible anti-osteolytic compound. All rats will have a titanium pin implant with associated LPS exposed particles dispersed in gelatin inserted through a intercondylar drill hole into the distal femur on one side. Rats will be divided into 5 groups (10 rats each). Group one will receive no bisphosphonate, groups 2-4 will receive 100 mu1 IP infections of 0.1 mg/ml and 10.0 mg/ml every other day for ten days after surgery and group 5 will receive a one time dose of 30 mg/kg body weight mixed with gelatin that is placed inside the defect at the time of the surgery. After six weeks the animals will be sacrificed. Initial and six week radiographs, histology and histomorphometry will be used to assess the outcome of the animals. Gap sizes between the bone and implant will be measured and means compared using an ANOVA and multiple range tests. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECT OF ANTIRESORPTIVES IN PATIENTS W/ PAGETS DISEASE Principal Investigator & Institution: Bruder, Jan; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2001 Summary: Paget's is a disorder of bone remodeling. The process is initiated by an increase in osteoclast mediated bone resorption followed by an abundance of new but abnormal bone formation. This study will determine the number of osteoclast precursors, the level of IL-6 and the presence or absence of measles virus nucleocapsid mRNA in the peripheral blood from patients with Paget's disease at the start of their scheduled treatment with the antiresorptive bisphosphonate alendronate and at the completion of the 6 month treatment. The number of osteoclast precursors and the IL-6 levels will be correlated with the activity of the disease as determined by the levels of serum and urine markers of bone resorption and formation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: IMPAIRMENTS AND BONE REMODELING IN AGING PAGETS PATIENTS Principal Investigator & Institution: Lyles, Kenneth W.; Professor; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001; Project Start 01-DEC-2000; Project End 30-NOV-2001 Summary: Purpose: The purpose of this study is to determine if pamidroante will improve mobility impairments, functional status, pain, and psychosocial performance in patients with Paget's disease of bone. Methods: In order to determine if pamidronate will improve mobility impairments, functional status, pain, and psychosocial performance, we propose to use a randomized, double-blind, placebo-controlled trial in which 66 patients with active Paget's disease of femur, tibia, and/or acetabular portion of the ilium will be treated (pamidronate or placebo) and then followed for 6 months. All patients who enter the trial must have documented impairments in mobility, defined as an abnormal mobility measure (ten foot walk time, 360 degree turn, mobility skills protocol score, or 6 minute walk distance) and bone resorption or formation markers that are at least twice the normal level. When patients who have Paget's disease enter the study, they will have baseline measures performed and then be randomized to receive pamidronate 90mg intravenously over six hours or placebo. Measurements will be made at one, three and six months post therapy. Changes in mobility impairments will be assessed by measuring changes in ten foot walk time, (primary response variable), mobility skills protocol score, steps to make a 360 degree turn, or six minute

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walk distance. Changes in functional status impairments will be assessed with the Functional Status Questionnaire (FSQ). The primary response variable for functional status will be the instrumental activities of daily living scale of the FSQ. Changes in pain will be assessed by the West Haven Pain Inventory. Changes in impairments in psychosocial performance will be measured with the Rosenberg Self-Esteem Scale, the Beck Depression Scale and the Hopkins Symptom Checklist 90 Revised. Changes in bone remodeling activity will be followed by measuring serum alkaline phosphatase levels and urinary hydroxyproline and N-Telepeptide excretion. Results: Patients continue to be actively recruited and enrolled in this trial. Over the past year on the GCRC twenty-six patients were evaluated who were potential candidates for the study. Of the twenty-six, six were enrolled and two more have been offered a chance to participate in the study but have not yet been consented. We have treated the six patients with pamidronate, a second generation bisphosphonate, and shown improvement in mobility and functional status impairments as well as bone remodeling activity. Significance: Paget's disease of bone is a chronic skeletal disease that affects elderly people and is characterized by areas of increased skeletal remodeling which can lead to pain, deformity, secondary arthritis, fractures and rarely malignant degeneration. Several studies suggest that Paget's disease affects 1.8-5% of people over 60 years of age and 10% of people at 90 years of age. Improved therapy will enhance the ability of these patients to function in normal life activities. Future plans: Since the trial was started, two new bisphosphonates have been approved by the FDA to treat Paget's disease of bone: Alendronate (Fosamax) and Risedronate (Actonel). Both of these drugs are oral preparations and some patients have wished to receive oral medication rather than an intravenous preparation. More importantly, these drugs give many patients sustained biochemical and clinical remissions of their Paget's disease lasting 24 to 36 months. This means that many of the patients referred for evaluation of their Paget's disease do not need treatment of their disease as frequently as we had initially planned for this study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ISOLATION OSTEOSARCOMA

OF

GENES

FOR

PAGET

DISEASE

AND

Principal Investigator & Institution: Leach, Robin J.; Director of Cytogenetics and Genetics Re; Cellular & Structural Biology; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2001; Project Start 01-JAN-1998; Project End 31-DEC-2002 Summary: (Adapted from the Applicant's Abstract): Paget disease of the bone is a common bone disease characterized by abnormal osteoclasts which are large, overactive, multinucleated and contain paramyxovirus-like nuclear inclusions. It is a relatively common disorder, with an estimated incidence of 3% in individuals over the age of 40. In the majority of patients, Paget disease is asymptomatic. The 5% of patients with symptoms have bone pain and a wide range of complications including increased fractures, deafness and neurological complications. The most devastating complication of Paget disease is malignant transformation of the bone. Although these transformations are rare, they contribute significantly to the morbidity and mortality of this disorder. The most frequent type of malignant transformation associated with Paget disease is osteosarcoma. In addition, Paget patients with osteosarcoma have a much worse prognosis than patients with osteosarcoma de novo. Osteosarcomas are believed to result from a series of genetic alterations which transform the osteoblast to a malignant state. Strong evidence that an important tumor suppressor gene involved in

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the regulation of the osteoblast lies on chromosome 18 has recently been generated (Dr. Marc Hansen's laboratory). Furthermore, the applicant (Dr. Leach) has generated genetic evidence that there is a locus for Paget disease in the same region of chromosome 18. Thus, the correlation between Paget disease and osteosarcoma has a strong molecular basis. It is hypothesized that this osteosarcoma tumor suppressor gene and the Paget predisposition gene are the same gene, or two tightly linked genes (i.e., a contiguous gene syndrome). The goal of this research is to identify this gene (or these genes) on chromosome 18 and begin to determine their role in both of these disorders. This proposal is part of an Interactive Research Project Grant (IRPG) developed to achieve this goal. Dr. Hansen's laboratory will utilize mitotic mapping methods in osteosarcomas, while Dr. Leach's laboratory will use meiotic mapping with numerous Paget disease kindreds. Identification of this gene (or these genes) is an important step towards the development of treatment for osteosarcoma and Paget disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LOCATING NOVEL PAGET'S LOCI BY TUMOR ALLELOTYPING Principal Investigator & Institution: Hansen, Marc F.; Professor of Medicine, Genetics and Deve; None; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 28-FEB-2005 Summary: (Verbatim from the Applicant): Paget's Disease of bone is the second most common metabolic disease of bone after osteoporosis. It results in rapid bone formation, altering the strength and shape of the bone. Predisposition to Paget's Disease has been linked in some families to chromosome 1 8q. However, recent evidence has shown that predisposition to Paget's Disease is genetically heterogeneous and that two or more loci must be involved in familial Paget's Disease predisposition. Osteosarcoma is a rare but serious complication of Paget's Disease. Our laboratory has identified an association between Paget's Disease and osteosarcoma. Analysis of both sporadic osteosarcomas and osteosarcomas from patients with Paget's Disease revealed that these tumors undergo tumor-specific loss of constitutional heterozygosity (LoH) in a region that is tightly linked to predisposition to Paget's Disease. This suggests that some of the genes that are involved in tumongenesis of osteosarcomas may also be involved in predisposition to Paget's Disease. There are three goals for this proposal. The first is to identify additional genes that predispose to Paget's Disease. We propose to take advantage of our unique collection of pagetic osteosarcomas to allelotype the entire genomes of normal, pagetoid bone, and tumor samples from patients with pagetic osteosarcoma to identify regions that may harbor novel tumor suppressor loci involved in either the pagetic or tumongenic process. These candidate regions can then be tested for linkage to familial Paget's Disease in chromosome 18q-unlinked Paget's families to determine if any of these novel tumor suppressor genes may represent additional Paget's predisposition loci. It is possible that we will not find genes involved in predisposition to Paget's Disease by this method. In this worst-case scenario, we will still realize our second goal, which is to characterize the genetic events that take place in pagetic osteosarcoma and to compare them to the genetic events that take place in sporadic osteosarcoma. This will allow us to determine whether these two diseases share common genetic origins. Further, by including pagetoid bone in our analysis we will be able to realize our third goal, which is to determine whether there are genes which act in a tumor suppressor-like fashion in the onset of sporadic Paget's Disease. Together, these analyses will allow us to examine both the predisposition to familial

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Paget's Disease, as well as to characterize the molecular genetics of pagetic osteosarcoma and sporadic Paget's Disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR BASIS OF OTOPATHOLOGY Principal Investigator & Institution: Mckenna, Michael J.; Associate Professor; Massachusetts Eye and Ear Infirmary 243 Charles St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 01-AUG-1997; Project End 14-JUL-2003 Summary: Two specific aims were delineated: First, morphological, immunohistochemical, and molecular genetic evidence suggest that measles virus is present in otosclerotic lesions. Paramyxoviruses have been implicated in other osseous dysplasias (e.g. Paget's disease). The investigators plan to search for measles virus RNA in otosclerotic temporal bones. The applicant wi draw upon the extensive archival collection at the Massachusetts Eye and Ear Infirmary (MEEI) which includes 205 sets of otosclerotic temporal bones. Recently, the osteogenesis imperfecta (OI) associated gene COL 1A1 has been implicated in otosclerosis. The hypothesis is that otosclerosis represents a minor variant of OI and possesses a similar dysfunction in type 1 collagen. They have in hand samples from 220 individuals from 65 families with otosclerosis. The second line of investigation involves mtDNA mutations associated with presbycusis. The MEEI archival temporal bone collection contains 142 sets of temporal bones with various types of presbycusis (28 sensory, 70 neural, 44 strial). Comprehensive audiological profiles are available. Sensorineural hearing loss is present in virtually all known varieties of mitochondrial dysfunction. Mitochondrial mutations appear to accumulate with advancing age. The investigators plan to search for a variety of point mutations as well as sequential deletions in mtDNA obtained from their archival collection. Collection of audiological data from patients with known mitochondrial mutatio will also be undertaken. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NIH OSTEOPOROSIS & RELATED BONE DISEASES RESOURCE CENTER Principal Investigator & Institution: Dawson-Hughes, Bess V.; Professor of Medicine; National Osteoporosis Foundation 1232 22Nd St Nw Washington, Dc 20037 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 31-AUG-2003 Summary: (Taken from the Application) In 1993, Congress issued a mandate to increase awareness and knowledge about osteoporosis and related bone diseases. In response, the leading national nonprofit organizations in the field, the National Osteoporosis Foundation (NOF), The Paget Foundation (PF), and the Osteogenesis Imperfecta Foundation (OIF), were selected to establish the first national resource center in the field. In 1997, with 28 million Americans diagnosed or at risk for osteoporosis, 1.5 million painful fractures, $14 billion in health care costs, and millions affected by Paget's disease, osteogenesis imperfecta, and other related bone diseases, Congress renewed the Center's mandate. NOF and its collaborating partners propose to broaden and expand the reach of the current NIH Osteoporosis and Related Bone Diseases National Resource Center. Aim 1 focuses on strengthening the Center's infrastructure and broadening its services. Under the guidance of an Advisory Council, specific tasks include expanding the acquisition of research information and inquiry services; promoting the Center to physician and public audiences through exhibits, public service announcements and other means; and widely disseminating information via Web sites and other electronic

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methods, a speaker's bureau, and print publications such as bibliographies, fact sheets, and an expanded newsletter, to medical professionals, managed care organizations, and underserved and at-risk populations, including youth, men, and Hispanic and Asian American women. Aim 2 focuses on developing partnerships to create and evaluate a model education program to enhance bone health and reduce future risk of osteoporosis among a key group---adolescent females. The program will be based on a Centersponsored communications study of the delivery of health promotion messages to this audience. Aim 3 is intended to expand awareness and use of research data. Specific efforts include supporting the National Osteoporosis Data Group, collecting and disseminating definitive statistics on bone diseases and on conditions co-morbid with osteoporosis, and preparing summary reports. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROGRAM PROJECT GRANT-PATHOBIOLOGY OF PAGET'S DISEASE Principal Investigator & Institution: Roodman, G David.; Professor; Medicine; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2003; Project Start 29-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Significance: Paget's disease is the second most common bone disease, affecting 2-3 million people in the United States. It is the most exaggerated example of bone remodeling, where increased osteoclastic bone absorption is followed by exuberant new bone formation that is of poor quality. Although Paget's disease was first described more than 100 years ago, and a potential viral etiology for Paget's disease suggested nearly 30 years ago, little is known about its pathogenesis and the role that a virus may play in Paget's disease. Thus, a P01 grant that focuses on the underlying pathophysiology of Paget's disease has important implications on all areas of bone research. Approach: This P01 application represents a concerted approach to understand the pathogenesis of Paget's disease and brings together investigators of diverse expertise to address this important problem. The P01 will employ molecular biological, cell biological, and transgenic animal approaches to understand the underlying pathophysiology of Paget's disease and the role measles virus (MV) plays in Paget's disease. The overall goals of the program project are to: 1) determine the function of the measles virus nucleocapsid gene (MVNP) in Paget's disease using structure/function, and in vivo experiments testing a recombinant MV which contains the MVNP gene derived from a Paget's patient; 2) develop an in vivo model of Paget's disease using targeted expression of the MVNP gene and the mutant p62 gene linked to familial Paget's disease to OCL in vivo. Currently no animal model of Paget's disease exists, which has severely hampered progress in understanding the pathophysiology of the disease or the roles of specific factors or genes in this process. 3) determine the mechanisms responsible for the constitutive expression of high levels of RANKL in pagetic lesions; and 4) assess the importance of VDR responsive gene expression in development of the pagetic phenotype in osteoclasts (OCL), the mechanisms responsible for the enhanced 1,25 dihydroxy vitamin D3 responsivity of OCL precursors in Paget's disease, and the effects of overexpressing coactivators of VDR, such as TAF(II)17, in OCL in vivo; and Innovation: This P01 application employs novel transgenic mouse models and recombinant MV to test the role of the MVNP gene, and genes induced by MVNP in the development of Paget's disease. Environment: This P01 application involves investigators with expertise in molecular biology, cell biology, gene transcription, histomorphometry and transgenic approaches. These investigators work in an outstanding university that has large numbers of funded investigators interested

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in bone biology and clinical trials for bone diseases. The knowledge gained from this P01 grant will offer important insights for normal bone cell biology especially for understanding the paracrine regulation of osteoblasts by OCLs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RANK-ASSOCIATED FORMATION

INHIBITOR

(RAIN)

IN

OSTEOCLAST

Principal Investigator & Institution: Darnay, Bryant G.; Bioimmunotherapy; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 29-MAR-2008 Summary: (provided by applicant): Receptor activator of NF-kappaB (RANK) and its ligand (RANKL, also known as TRANCE/ODF/OPGL) are essential mediators of osteoclastogenesis and have been implicated in various diseases, which include rheumatoid arthritis, osteoporosis, giant cell tumor of bone, Paget's disease, metastatic breast cancer, multiple myeloma, and familial expansile osteolysis. Osteoprotegerin (OPG, also known as OCIF/TR1) is a soluble, decoy receptor that inhibits RANKL from binding to its cell surface receptor RANK. Activation of signaling pathways by RANK is mediated through its interaction with tumor necrosis factor receptor-associated factors (TRAFs). Mice deleted of RANKL, RANK, or TRAF6 lack osteoclasts and develop severe osteopetrosis while mice lacking OPG develop osteoporosis. Thus, RANKL and OPG are the governing factors that regulate normal bone homeostasis. The cytoplasmic domain of RANK interacts with TRAF1, 2, 3, 5, and 6, and our laboratory described the distinct regions of RANK that interact with TRAF2, 5, and 6. In an effort to identify other factors that interact with the cytoplasmic domain of RANK, we used a yeast two-hybrid approach and identified a novel protein, which we termed RAIN, for RANK-Associated Inhibitor, for its ability to inhibit RANKL-mediated osteoclast formation Both mouse and human cDNAs were cloned and contain an open reading frame of 241 and 242 residues, respectively. RAIN is a novel protein with no identifiable domains or motifs. RAIN coprecipitates with endogenous RANK in RAW264.7 (RAW) cells. Furthermore, RAIN interacts with TRAF2, TRAF5, and TRAF6 in RAW cells. To understand the function of RAIN, RAW cells stably expressing RAIN did not interfere with early RANKL signaling such as NF-kappaB, JNK, ERK, or p38 MAPK activation. However, RAIN expressing cells did not form multinucleated osteoclasts when stimulated with RANKL, although the cells were TRAP+ and the cell cycle inhibitor p27 was upregulated. Thus, it appears RAIN acts as a negative regulator of the fusion event during osteoclast differentiation. In support of this model, we established RAW cells stably expressing anti-sense RAIN. Surprisingly, we observed increased osteoclast number, which was observed as early as day 2. Additionally, RANKL treatment of RAW cells caused induction of RAIN mRNA and protein, which begins on day 2 and continues through day 5. Biochemical evidence suggests that RAIN may function by sequestering or preventing F-actin polymerizatio. Thus, we have identified a novel protein that interacts with RANK and TRAFs, and presumably controls the formation multi-nucleated osteoclasts. We propose to extend these studies to further our understanding of RAIN's function in osteoclastogenesis by pursing the following specific aims: (1) define the molecular interactions of RAIN and TRAFs; (2) determine the biochemical proteins of RAIN with respect to actin polymerization; and (3) determine the physiological role of RAIN by targeted gene disruption and transgenic mice expressing RAIN. The identification of RAIN and it function in controlling osteoclast formation will provide new insights into the mechanism of osteoclast formation and may provide a novel target for the development of pharmaceutical agents

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aimed at preventing unwanted bone destruction associated with metabolic bone disorders and cancers associated with osteolytic lesions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REGULATION OF OSTEOCLASTIC BONE RESORPTION Principal Investigator & Institution: Baron, Roland E.; Orthopedics and Rehabilitation; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 01-AUG-1977; Project End 31-DEC-2002 Summary: The research described in this application is aimed at understanding of the molecular mechanisms by which bone resorption is regulated. Bone resorption is performed by the osteoclast and acidification of the extracellular bone resorbing compartment constitutes one of the major physiological constraint on the osteoclast. Agents that regulate the differentiation and/or function of the osteoclast affect, albeit not exclusively, the ion transporters and attachment molecules involved in the acidification process. Investigation f the mechanisms by which peptide and steroid hormones affect these processes will therefore help refine our understanding of their regulation. Furthermore, to try to elucidate the mechanisms in which the non-receptor tyrosine kinase c-src is involved and so critically needed for normal osteoclast function may open new avenues for therapeutic intervention. The overall aim of this proposal is to further characterize the specific isoforms of the ion transporters involved in osteoclast-mediated acidification and the mechanisms by which their expression and/or function in bone resorption are regulated. This will include examples of the three main regulatory pathways, i.e., steroid hormones, peptide hormones and the tyrosine kinase signal transduction pathway. This proposal will address the following specific aims: (1) Further analyze the mechanisms by which the peptide hormone calcitonin regulates the processes of acidification by kidney cells and osteoclasts and compare them to the action of PTHrP 107-111 and RGD-containing peptides; (2) Further elucidate the mechanisms by which c-src regulates the function of the osteoclast and, possibly, some of the processes involved in acidification. (3) Further analyze the role of the steroid hormones 1,25- dihydroxyvitamin D3 and estrogens in the regulation of the expression of the various genes required for acidification by the osteoclast; This research program is particularly relevant to health related issues since a detailed analysis of the molecular mechanisms of bone resorption and its regulation can provide more specific and, thereby, more efficient, means to regulate these processes in vivo, whether to therapeutically activate osteoclasts in diseases involving a reduced rate of bone resorption (osteopetrosis, growth deficiencies for instance) or to inactivate osteoclasts in diseases involving an increased bone resorption (osteoporosis, osteoarthritis, periodontal disease, Paget's disease, etc.). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: STUDIES OF METABOLIC BONE DISEASE Principal Investigator & Institution: Avioli, Louis V.; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2001 Summary: Adults and children with generalized skeletal abnormalities or abnormalities in mineral metabolism have been studied. Included were metabolic, radiographic, genetic and pathological studies to define the pathogenesis of a variety of disorders of bone and mineral metabolism, particularly osteoporosis, osteomalacia and Paget's disease. Several new disorders have been characterized.

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

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

A case of giant extramammary Paget's disease of the genital area with squamous-cell carcinoma. Author(s): Tanabe H, Kishigawa T, Sayama S, Tanaka T. Source: Dermatology (Basel, Switzerland). 2001; 202(3): 249-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11385233&dopt=Abstract

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A case of McCune-Albright syndrome mimicking Paget's disease of bone. Author(s): Palanduz S, Cefle K, Ozturk S, Tanakol R, Tascioglu C, Koldas T, Erten NB, Karan MA. Source: Bone. 1999 February; 24(2): 157-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9951787&dopt=Abstract

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A case of metastatic extramammary Paget's disease that responded to combination chemotherapy. Author(s): Yamazaki N, Yamamoto A, Wada T, Ishikawa M, Moriya Y, Nakanishi Y. Source: The Journal of Dermatology. 1999 May; 26(5): 311-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10380432&dopt=Abstract

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A clinical approach to diagnosis and management of Paget's disease of bone. Author(s): Lyles KW, Siris ES, Singer FR, Meunier PJ. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2001 August; 16(8): 1379-87. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11499860&dopt=Abstract

3

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 comparison of in situ hybridisation, reverse transcriptase-polymerase chain reaction (RT-PCR) and in situ-RT-PCR for the detection of canine distemper virus RNA in Paget's disease. Author(s): Hoyland JA, Dixon JA, Berry JL, Davies M, Selby PL, Mee AP. Source: Journal of Virological Methods. 2003 May; 109(2): 253-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12711070&dopt=Abstract

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A negative search for a paramyxoviral etiology of Paget's disease of bone: molecular, immunological, and ultrastructural studies in UK patients. Author(s): Helfrich MH, Hobson RP, Grabowski PS, Zurbriggen A, Cosby SL, Dickson GR, Fraser WD, Ooi CG, Selby PL, Crisp AJ, Wallace RG, Kahn S, Ralston SH. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2000 December; 15(12): 2315-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11127197&dopt=Abstract

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A novel tumour marker RCAS1 in a case of extramammary Paget's disease. Author(s): Enjoji M, Noguchi K, Watanabe H, Yoshida Y, Kotoh K, Nakashima M, Watanabe T, Nakamuta M, Nawata H. Source: Clinical and Experimental Dermatology. 2003 March; 28(2): 211-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12653716&dopt=Abstract

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A patient with Paget's disease of bone treated with etidronate disodium. Author(s): Koga K, Kawasaki K, Kohno S, Yamada K, Itoh T, Nonaka K. Source: Kurume Med J. 1998; 45(4): 345-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9914722&dopt=Abstract

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A randomized, double-blind comparison of risedronate and etidronate in the treatment of Paget's disease of bone. Paget's Risedronate/Etidronate Study Group. Author(s): Miller PD, Brown JP, Siris ES, Hoseyni MS, Axelrod DW, Bekker PJ. Source: The American Journal of Medicine. 1999 May; 106(5): 513-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10335722&dopt=Abstract

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Absence of measles virus and canine distemper virus transcripts in long-term bone marrow cultures from patients with Paget's disease of bone. Author(s): Ooi CG, Walsh CA, Gallagher JA, Fraser WD. Source: Bone. 2000 September; 27(3): 417-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10962354&dopt=Abstract

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Acute ischemia of the lower limb. An unusual complication of Paget's disease of bone. Author(s): Manuel-Rimbau E, Julia J, Lozano P, Gomez FT. Source: The Journal of Cardiovascular Surgery. 1999 April; 40(2): 275-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10350117&dopt=Abstract

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Alendronate in the treatment of Paget's disease of bone. Author(s): Reid IR, Siris E. Source: Int J Clin Pract Suppl. 1999 April; 101: 62-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12669742&dopt=Abstract

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An atypical presentation of Paget's disease in an immunocompromised individual. A case report. Author(s): Sanders W, Bertolo S, Wunder JS, Kandel R, White L, Cialdella L, Ferracini R. Source: Chir Organi Mov. 1999 October-December; 84(4): 375-9. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11569005&dopt=Abstract

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Ankylosing spondylitis and rheumatoid arthritis in a patient with Paget's disease. Differential effects of indomethacin, D-penicillamine, or gold sodium thiomalate in the respective arthritides. Author(s): Alarcon-Segovia D, Martinez-Cordero E. Source: Archives of Internal Medicine. 1985 October; 145(10): 1915-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3929708&dopt=Abstract

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Anorectal miscellany: pilonidal disease, anal cancer, Bowen's and Paget's diseases, foreign bodies, and hidradenitis suppurativa. Author(s): Billingham RP. Source: Primary Care. 1999 March; 26(1): 171-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9922300&dopt=Abstract

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Are paramyxoviruses involved in Paget's disease? A negative view. Author(s): Ralston SH, Helfrich MH. Source: Bone. 1999 May; 24(5 Suppl): 17S-18S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10321920&dopt=Abstract

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Arthritis in Paget's disease of bone. Author(s): Altman RD. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 85-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510220&dopt=Abstract

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Artifact of cold lesions on skull SPECT of a patient with Paget's disease secondary to pixel overflow. Author(s): Shih WJ, Pulmano C, Han JK. Source: Clinical Nuclear Medicine. 1999 May; 24(5): 372-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10232489&dopt=Abstract

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Assessment of cardiac function by echocardiography in Paget's disease of bone. Author(s): Morales-Piga AA, Moya JL, Bachiller FJ, Munoz-Malo MT, Benavides J, Abraira V. Source: Clin Exp Rheumatol. 2000 January-February; 18(1): 31-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10728441&dopt=Abstract

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Atypical familial Paget's disease of bone. Author(s): Pande KC, Ashford RU, Dey A, Kayan K, McCloskey EV, Kanis JA. Source: Joint, Bone, Spine : Revue Du Rhumatisme. 2001 May; 68(3): 257-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11394627&dopt=Abstract

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Basal cell carcinoma within vulvar Paget's disease. Author(s): Ishizawa T, Mitsuhashi Y, Sugiki H, Hashimoto H, Kondo S. Source: Dermatology (Basel, Switzerland). 1998; 197(4): 388-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9873182&dopt=Abstract

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Beneficial effects of aminohexane diphosphonate in patients with Paget's disease of bone resistant to sodium etidronate. Author(s): Delmas PD, Chapuy MC, Edouard C, Meunier PJ. Source: The American Journal of Medicine. 1987 August; 83(2): 276-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3113247&dopt=Abstract

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Benign mucinous metaplasia of the penis. A lesion resembling extramammary Paget's disease. Author(s): Val-Bernal JF, Hernandez-Nieto E. Source: Journal of Cutaneous Pathology. 2000 February; 27(2): 76-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10678702&dopt=Abstract

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Benign tumefactive soft tissue extension from Paget's disease of bone simulating malignancy. Author(s): McNairn JD, Damron TA, Landas SK, Ambrose JL. Source: Skeletal Radiology. 2001 March; 30(3): 157-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11357454&dopt=Abstract

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Bilateral Paget's disease of the breast. Author(s): Markopoulos C, Gogas H, Sampalis F, Kyriakou B. Source: Eur J Gynaecol Oncol. 1997; 18(6): 495-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9443019&dopt=Abstract

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Bilateral scrotal extramammary Paget's disease in a Chinese man. Author(s): Kageyama N, Izumi AK. Source: International Journal of Dermatology. 1997 September; 36(9): 695-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9352414&dopt=Abstract

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Bile duct cancer associated with extramammary Paget's disease. Author(s): Nakano S, Narita R, Tabaru A, Ogami Y, Otsuki M. Source: The American Journal of Gastroenterology. 1995 March; 90(3): 507-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7872301&dopt=Abstract

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Biochemical and radiologic improvement in Paget's disease of bone treated with alendronate: a randomized, placebo-controlled trial. Author(s): Reid IR, Nicholson GC, Weinstein RS, Hosking DJ, Cundy T, Kotowicz MA, Murphy WA Jr, Yeap S, Dufresne S, Lombardi A, Musliner TA, Thompson DE, Yates AJ. Source: The American Journal of Medicine. 1996 October; 101(4): 341-8. Erratum In: Am J Med 1997 March; 102(3): 322. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8873503&dopt=Abstract

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Biochemical markers of bone turnover in Paget's disease of bone. Author(s): Delmas PD. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 66-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510216&dopt=Abstract

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Biochemical markers of bone turnover in Paget's disease of bone. Author(s): Eastell R. Source: Bone. 1999 May; 24(5 Suppl): 49S-50S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10321928&dopt=Abstract

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Biological and radiological responses to oral etidronate and tiludronate in Paget's disease of bone. Author(s): Devogelaer JP, Malghem J, Stasse P, Nagant de Deuxchaisnes C. Source: Bone. 1997 March; 20(3): 259-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9071477&dopt=Abstract

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Bisphosphonate resistance in Paget's disease of bone. Author(s): Joshua F, Epstein M, Major G. Source: Arthritis and Rheumatism. 2003 August; 48(8): 2321-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12905487&dopt=Abstract

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Bisphosphonate space measurement and dosage requirement for intravenous clodronate treatment of Paget's disease. Author(s): Rutland M, Wattie D, Que L, Hassan IM, Cundy T. Source: Calcified Tissue International. 2002 February; 70(2): 99-102. Epub 2001 December 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11870415&dopt=Abstract

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Bisphosphonate therapy for Paget's disease in a patient with hypoparathyroidism: profound hypocalcemia, rapid response, and prolonged remission. Author(s): Stuckey BG, Lim EM, Kent GN, Ward LC, Gutteridge DH. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2001 September; 16(9): 1719-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11547843&dopt=Abstract

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Bladder herniation within the inguinal canal simulating Paget's disease. Author(s): Sorenson SM, Gentili A. Source: Clinical Nuclear Medicine. 2001 October; 26(10): 864-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11564928&dopt=Abstract

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Bone alkaline phosphatase in Paget's disease. Author(s): Deftos LJ, Wolfert RL, Hill CS. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 1991 November; 23(11): 559-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1816067&dopt=Abstract

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Bone marrow mononuclear cells from patients with Paget's disease contain measles virus nucleocapsid messenger ribonucleic acid that has mutations in a specific region of the sequence. Author(s): Reddy SV, Singer FR, Roodman GD. Source: The Journal of Clinical Endocrinology and Metabolism. 1995 July; 80(7): 2108-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7608263&dopt=Abstract

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Bone pathologic correlation of multimodality imaging in Paget's disease. Author(s): Bahk YW, Park YH, Chung SK, Chi JG. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1995 August; 36(8): 1421-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7629588&dopt=Abstract

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Bone scintigraphy in Paget's disease treated with combined calcitonin and diphosphonate (EHDP). Author(s): Vellenga CJ, Pauwels EK, Bijvoet OL, Hosking DJ, Frijlink WB. Source: Metab Bone Dis Relat Res. 1982; 4(2): 103-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6815413&dopt=Abstract

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Breast filariasis mimicking Paget's disease. Author(s): Prasoon D. Source: Acta Cytol. 1998 March-April; 42(2): 452-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9568162&dopt=Abstract

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Calcitonin treatment in osteoectasia with hyperphosphatasia (juvenile Paget's disease): radiographic changes after treatment. Author(s): Tuysuz B, Mercimek S, Ungur S, Deniz M. Source: Pediatric Radiology. 1999 November; 29(11): 838-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10552064&dopt=Abstract

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Carbon dioxide laser treatment of extramammary Paget's disease guided by photodynamic diagnosis. Author(s): Becker-Wegerich PM, Fritsch C, Schulte KW, Megahed M, Neuse W, Goerz G, Stahl W, Ruzicka T. Source: The British Journal of Dermatology. 1998 January; 138(1): 169-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9536242&dopt=Abstract

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Carcinoma of areola and nipple of the breast: Paget's disease versus carcinoma in situ. Author(s): Underwood LJ, Green WS. Source: Archives of Dermatology. 1965 April; 91(4): 407-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9626095&dopt=Abstract

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Caring for the patient with Paget's disease of the bone. Author(s): Lewis T, Tesh AS, Lyles KW. Source: The Nurse Practitioner. 1999 July; 24(7): 50, 53, 57-8 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10412170&dopt=Abstract

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Cell biology of Paget's disease. Author(s): Reddy SV, Menaa C, Singer FR, Demulder A, Roodman GD. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 3-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510206&dopt=Abstract

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Changes in bone mineral density in patients with Paget's disease treated with risedronate. Author(s): Patel S, Pearson D, Bhallah A, Maslanka W, White DA, Hosking DJ. Source: Annals of the Rheumatic Diseases. 1997 July; 56(7): 405-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9486001&dopt=Abstract

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Charnley low-friction arthroplasty for Paget's disease of the hip. Author(s): Sochart DH, Porter ML. Source: The Journal of Arthroplasty. 2000 February; 15(2): 210-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10708088&dopt=Abstract

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Chondrosarcoma as a complicating factor in Paget's disease of bone. Author(s): Brandolini F, Bacchini P, Moscato M, Bertoni F. Source: Skeletal Radiology. 1997 August; 26(8): 497-500. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9297756&dopt=Abstract

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Clinically inapparent invasive vulvar carcinoma in an area of persistent Paget's disease: a case report. Author(s): Awtrey CS, Marshall DS, Soslow RA, Chi DS. Source: Gynecologic Oncology. 2003 March; 88(3): 440-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648600&dopt=Abstract

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Clodronate treatment reduces serum levels of interleukin-6 soluble receptor in Paget's disease of bone. Author(s): Rendina D, Postiglione L, Vuotto P, Numis FG, Di Domenico G, Viceconti R, Mossetti G, Nunziata V. Source: Clin Exp Rheumatol. 2002 May-June; 20(3): 359-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12102472&dopt=Abstract

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Coccygeal fracture and Paget's disease presenting as acute cauda equina syndrome. Author(s): Davis DP, Bruffey JD, Rosen P. Source: The Journal of Emergency Medicine. 1999 March-April; 17(2): 251-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10195481&dopt=Abstract

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Common mechanisms of osteosarcoma and Paget's disease. Author(s): Hansen MF, Nellissery MJ, Bhatia P. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 39-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510212&dopt=Abstract

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Comparison of mohs micrographic surgery and wide excision for extramammary Paget's disease. Author(s): O'Connor WJ, Lim KK, Zalla MJ, Gagnot M, Otley CC, Nguyen TH, Roenigk RK. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2003 July; 29(7): 723-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828695&dopt=Abstract

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Comparison of the efficacy and bioequivalence of two oral formulations of tiludronate in the treatment of Paget's disease of bone. Author(s): Morales-Piga A, Del Pino J, Rapado A, Diaz-Curiel M, Pallares M, GonzalezMacias J. Source: Clinical Therapeutics. 1997 September-October; 19(5): 963-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9385484&dopt=Abstract

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Consensus statement on the modern therapy of Paget's disease of bone from a Western Osteoporosis Alliance symposium. Biannual Foothills Meeting on Osteoporosis, Calgary, Alberta, Canada, September 9-10, 2000. Author(s): Drake WM, Kendler DL, Brown JP. Source: Clinical Therapeutics. 2001 April; 23(4): 620-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11354395&dopt=Abstract

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Controlled study of the prevalence of radiological osteoarthritis in clinically unrecognised juxta-articular Paget's disease. Author(s): Helliwell PS, Porter G. Source: Annals of the Rheumatic Diseases. 1999 December; 58(12): 762-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10577963&dopt=Abstract

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Cranial epidural hematoma in Paget's disease of the bone. Author(s): Martinez-Lage JF, Saez V, Requena L, Martinez-Barba E, Poza M. Source: Intensive Care Medicine. 2000 October; 26(10): 1582-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11126280&dopt=Abstract

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Cultured Paget cells derived from the involved skin of a patient with extramammary Paget's disease had an extended life span. Author(s): Mori O, Karashima T, Matsuo K, Hashimoto T, Katagata Y. Source: The Journal of Dermatology. 2000 January; 27(1): 60-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10692829&dopt=Abstract

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Cytokeratin 7 staining in mammary and extramammary Paget's disease. Author(s): Smith KJ, Tuur S, Corvette D, Lupton GP, Skelton HG. Source: Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc. 1997 November; 10(11): 1069-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9388055&dopt=Abstract

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Cytology of extramammary Paget's disease of the vulva. A case report. Author(s): Castellano Megias VM, Ibarrola de Andres C, Martinez Parra D, Lara Lara I, Perez Palacios C, Conde Zurita JM. Source: Acta Cytol. 2002 November-December; 46(6): 1153-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12462099&dopt=Abstract

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Decreased beta-isomerization of the C-terminal telopeptide of type I collagen alpha 1 chain in Paget's disease of bone. Author(s): Garnero P, Fledelius C, Gineyts E, Serre CM, Vignot E, Delmas PD. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1997 September; 12(9): 1407-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9286756&dopt=Abstract

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Demonstration of characteristic skin surface contours of extramammary Paget's disease and parapsoriasis en plaque by image analysis of negative impression replicas. Author(s): Kikuchi K, Aiba S, O'Goshi K, Yanai M, Takahashi M, Kasai H, Tagami H. Source: Journal of Dermatological Science. 2002 October; 30(1): 20-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12354416&dopt=Abstract

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Depigmented genital extramammary Paget's disease: a possible histogenetic link to Toker's clear cells and clear cell papulosis. Author(s): Chen YH, Wong TW, Lee JY. Source: Journal of Cutaneous Pathology. 2001 February; 28(2): 105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11168760&dopt=Abstract

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Depigmented macula as an initial manifestation of extramammary Paget's disease. Author(s): Sawamura D, Ishikawa H, Murai T, Hashimoto I, Yotsuyanagi T. Source: The Journal of Dermatology. 1996 June; 23(6): 429-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8708159&dopt=Abstract

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Detection of canine distemper virus in 100% of Paget's disease samples by in situreverse transcriptase-polymerase chain reaction. Author(s): Mee AP, Dixon JA, Hoyland JA, Davies M, Selby PL, Mawer EB. Source: Bone. 1998 August; 23(2): 171-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9701477&dopt=Abstract

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Diagnosis and treatment of Paget's disease of bone. Author(s): Schneider D, Hofmann MT, Peterson JA. Source: American Family Physician. 2002 May 15; 65(10): 2069-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12046775&dopt=Abstract

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Diagnosis of malignant change in Paget's disease by Tl-201. Author(s): Colarinha P, Fonseca AT, Salgado L, Vieira MR. Source: Clinical Nuclear Medicine. 1996 April; 21(4): 299-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8925612&dopt=Abstract

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Differential effects of bisphosphonate on Paget's disease and metastatic prostatic carcinoma-bone scan findings. Author(s): Lau WF, Hicks R, Binns D. Source: Clinical Nuclear Medicine. 2001 April; 26(4): 347-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11290899&dopt=Abstract

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Differential expression of mucin genes in mammary and extramammary Paget's disease. Author(s): Kuan SF, Montag AG, Hart J, Krausz T, Recant W. Source: The American Journal of Surgical Pathology. 2001 December; 25(12): 1469-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11717535&dopt=Abstract

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Digital subtraction angiography demonstration of bone hypervascularity in Paget's disease. Author(s): Loneragan R. Source: Australasian Radiology. 1999 May; 43(2): 260-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10901914&dopt=Abstract

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Discussion: Newer bisphosphonates in the treatment of Paget's disease of bone: where we are and where we want to go. Author(s): Grauer A, Bone H, McCloskey EV, McClung M, Gutteridge DH, Lyles KW, Mautalen C, Rodan G, Wallach S. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 74-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510218&dopt=Abstract

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Disodium pamidronate has beneficial effect in Paget's disease of bone. Author(s): Chakravarty K, Merry P, Scott DG. Source: Bmj (Clinical Research Ed.). 1996 June 8; 312(7044): 1476-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8664641&dopt=Abstract

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DNA ploidy and expression of p53 and C-erbB-2 in extramammary Paget's disease of the vulva. Author(s): Scheistroen M, Trope C, Kaern J, Pettersen EO, Alfsen GC, Nesland JM. Source: Gynecologic Oncology. 1997 January; 64(1): 88-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8995553&dopt=Abstract

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Docetaxel induced durable response in advanced extramammary Paget's disease: a case report. Author(s): Oguchi S, Kaneko M, Uhara H, Saida T. Source: The Journal of Dermatology. 2002 January; 29(1): 33-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11837572&dopt=Abstract

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Does Paget's disease really have a viral aetiology? Author(s): Ralston SH, Hobson RP, Pennington TH, Helfrich MH. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1997 May; 12(5): 863-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9144355&dopt=Abstract

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Dogs and Paget's disease. Author(s): Anderson DC, O'Driscoll JB. Source: Lancet. 1986 January 4; 1(8471): 41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2867281&dopt=Abstract

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Dogs and Paget's disease. Author(s): Barker DJ, Detheridge FM. Source: Lancet. 1985 November 30; 2(8466): 1245. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2866320&dopt=Abstract

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Domain-specific mutations in sequestosome 1 (SQSTM1) cause familial and sporadic Paget's disease. Author(s): Hocking LJ, Lucas GJ, Daroszewska A, Mangion J, Olavesen M, Cundy T, Nicholson GC, Ward L, Bennett ST, Wuyts W, Van Hul W, Ralston SH. Source: Human Molecular Genetics. 2002 October 15; 11(22): 2735-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12374763&dopt=Abstract

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Double involvement of extramammary Paget's disease in the genitalia and axilla. Author(s): Inui S, Fukuhara S, Asada H, Tadokoro T, Yoshikawa K, Itami S. Source: The Journal of Dermatology. 2000 June; 27(6): 409-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10920590&dopt=Abstract

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Ductal eccrine carcinoma presenting as a Paget's disease-like lesion of the breast. Author(s): Park BW, Kim SI, Lee KS, Yang WI. Source: The Breast Journal. 2001 September-October; 7(5): 358-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11906447&dopt=Abstract

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Ectopic extramammary Paget's disease arising on the cheek. Author(s): Chilukuri S, Page R, Reed JA, Friedman J, Orengo I. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2002 May; 28(5): 430-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12030879&dopt=Abstract

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Effect of surgical menopause and Paget's disease of bone on the isomerization of type I collagen carboxyterminal telopeptide: evolution after antiresorptive therapy. Author(s): Peris P, Alvarez L, Monegal A, Guanabens N, Duran M, Echevarria M, Ros I, Ballesta AM, Munoz-Gomez J. Source: Journal of Bone and Mineral Metabolism. 2002; 20(2): 116-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11862534&dopt=Abstract

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Effective short term treatment of Paget's disease with oral etidronate. Author(s): Preston CJ, Yates AJ, Beneton MN, Russell RG, Gray RE, Smith R, Kanis JA. Source: British Medical Journal (Clinical Research Ed.). 1986 January 11; 292(6513): 79-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3080099&dopt=Abstract

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European origin of patients with Paget's disease of bone in the Buenos Aires area. Author(s): Gomez Acotto C, Mautalen CA. Source: European Journal of Epidemiology. 2001; 17(5): 409-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11855572&dopt=Abstract

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Evaluation of the role of RANK and OPG genes in Paget's disease of bone. Author(s): Wuyts W, Van Wesenbeeck L, Morales-Piga A, Ralston S, Hocking L, Vanhoenacker F, Westhovens R, Verbruggen L, Anderson D, Hughes A, Van Hul W. Source: Bone. 2001 January; 28(1): 104-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11165949&dopt=Abstract

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Evidence of geographic variation in the occurrence of Paget's disease. Author(s): Armas JB, Pimentel F, Guyer PB, Cooper C, Pye SR, O'Neill TW. Source: Bone. 2002 April; 30(4): 649-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11934660&dopt=Abstract

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Experience with sodium etidronate in the treatment of symptomatic Paget's disease of bone. Author(s): Bourke J, Murphy M, Fennelly JJ. Source: Ir Med J. 1985 October; 78(10): 300. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3934108&dopt=Abstract

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Expression of mucin core proteins in extramammary Paget's disease. Author(s): Yoshii N, Kitajima S, Yonezawa S, Matsukita S, Setoyama M, Kanzaki T. Source: Pathology International. 2002 May-June; 52(5-6): 390-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12100522&dopt=Abstract

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Extramammary Paget's disease and occult hypernephroma. Author(s): Chanda JJ. Source: Journal of the American Academy of Dermatology. 1985 December; 13(6): 10535. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3001159&dopt=Abstract

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Extramammary Paget's disease found by abnormal vulvar brush sampling. Author(s): Yu BK, Lai CR, Yen MS, Tou NF, Chao KC, Yuan CC. Source: Eur J Gynaecol Oncol. 2002; 23(1): 35-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11878287&dopt=Abstract

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Extramammary Paget's disease of penis and scrotum. Author(s): van Randenborgh H, Paul R, Nahrig J, Egelhof P, Hartung R. Source: The Journal of Urology. 2002 December; 168(6): 2540-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12441964&dopt=Abstract

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Extramammary Paget's disease of scrotum. Author(s): Ng LG, Yip SK, Tan PH. Source: Urology. 2001 July; 58(1): 105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11445493&dopt=Abstract

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Extramammary Paget's disease of the penis and scrotum: excision, reconstruction and evaluation of occult malignancy. Author(s): Park S, Grossfeld GD, McAninch JW, Santucci R. Source: The Journal of Urology. 2001 December; 166(6): 2112-6; Discussion 2117. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11696717&dopt=Abstract

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Extramammary Paget's disease of the vulva. Author(s): Tjalma WA. Source: Journal of the American College of Surgeons. 2003 October; 197(4): 701-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14522345&dopt=Abstract

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Extramammary Paget's disease with superimposed herpes simplex virus infection: immunohistochemical comparison with cases of the two respective diseases. Author(s): Yamamoto O, Yasuda H. Source: The British Journal of Dermatology. 2003 June; 148(6): 1258-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828759&dopt=Abstract

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Extramammary Paget's disease. Author(s): Powell JL. Source: Journal of the American College of Surgeons. 2003 May; 196(5): 824; Author Reply 824-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742220&dopt=Abstract

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Extramammary Paget's disease. Author(s): Adamson T. Source: Dermatology Nursing / Dermatology Nurses' Association. 2002 August; 14(4): 280. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240507&dopt=Abstract

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Extramammary Paget's disease: outcome of radiotherapy with curative intent. Author(s): Luk NM, Yu KH, Yeung WK, Choi CL, Teo ML. Source: Clinical and Experimental Dermatology. 2003 July; 28(4): 360-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823291&dopt=Abstract

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Extramammary Paget's disease: prognosis and relationship to internal malignancy. Author(s): Chanda JJ. Source: Journal of the American Academy of Dermatology. 1985 December; 13(6): 100914. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3001158&dopt=Abstract

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Extramammary Paget's disease: role of radiation therapy. Author(s): Guerrieri M, Back MF. Source: Australasian Radiology. 2002 June; 46(2): 204-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12060165&dopt=Abstract

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Factors associated with self-rated health in patients with Paget's disease of bone. Author(s): Gold DT, Burchett BM, Shipp KM, Pieper CF, Lyles KW. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 99-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510224&dopt=Abstract

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Failure after customized curved femoral stems in total hip arthroplasty for Paget's disease. Author(s): Dunlop DJ, Donnachie NJ, Treacy RB. Source: The Journal of Arthroplasty. 2000 April; 15(3): 398-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10794240&dopt=Abstract

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Failure of carbon dioxide laser treatment in three patients with penoscrotal extramammary Paget's disease. Author(s): Puppala S. Source: Bju International. 2001 December; 88(9): 986-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11851630&dopt=Abstract

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Failure of carbon dioxide laser treatment in three patients with penoscrotal extramammary Paget's disease. Author(s): Choi JB, Yoon ES, Yoon DK, Kim DS, Kim JJ, Cho JH. Source: Bju International. 2001 August; 88(3): 297-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11488749&dopt=Abstract

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Failure to detect human papillomavirus DNA in extramammary Paget's disease. Author(s): Snow SN, Desouky S, Lo JS, Kurtycz D. Source: Cancer. 1992 January 1; 69(1): 249-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1309305&dopt=Abstract

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Failure to detect paramyxovirus sequences in Paget's disease of bone using the polymerase chain reaction. Author(s): Ralston SH, Digiovine FS, Gallacher SJ, Boyle IT, Duff GW. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1991 November; 6(11): 1243-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1805546&dopt=Abstract

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Familial Kaposi's sarcoma and Paget's disease of bone. Author(s): Hale LR, Kelly JW. Source: The Australasian Journal of Dermatology. 1998 November; 39(4): 241-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9838721&dopt=Abstract

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Familial Paget's disease of bone: nonlinkage to the PDB1 and PDB2 loci on chromosomes 6p and 18q in a large pedigree. Author(s): Good D, Busfield F, Duffy D, Lovelock PK, Kesting JB, Cameron DP, Shaw JT. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2001 January; 16(1): 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11149487&dopt=Abstract

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Familial Paget's disease of bone: patterns of inheritance and frequency of linkage to chromosome 18q. Author(s): Hocking L, Slee F, Haslam SI, Cundy T, Nicholson G, van Hul W, Ralston SH. Source: Bone. 2000 June; 26(6): 577-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10831928&dopt=Abstract

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Fibroepithelioma-like changes occurring in perianal Paget's disease with rectal mucinous carcinoma: case report and review of 49 cases of extramammary Paget's disease. Author(s): Ishida-Yamamoto A, Sato K, Wada T, Takahashi H, Toyota N, Shibaki T, Yamazaki K, Tokusashi Y, Miyokawa N, Iizuka H. Source: Journal of Cutaneous Pathology. 2002 March; 29(3): 185-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11972718&dopt=Abstract

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Flow cytometric DNA analysis of extramammary Paget's disease of the vulva. Author(s): Cotton J, Kotylo PK, Michael H, Roth LM, Sutton GP. Source: International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists. 1995 October; 14(4): 324-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8598335&dopt=Abstract

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Fluorine-18-FDG PET in Paget's disease of bone. Author(s): Cook GJ, Maisey MN, Fogelman I. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1997 September; 38(9): 1495-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9293817&dopt=Abstract

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Focal osteolysis as a complication of therapy for Paget's disease: case report. Author(s): Zander DR, Lander P, Begin LR, Hadjipavlou AG. Source: Canadian Association of Radiologists Journal = Journal L'association Canadienne Des Radiologistes. 1998 April; 49(2): 102-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9561012&dopt=Abstract

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Fourteen cases of sarcomatous degeneration in Paget's disease. Author(s): Jattiot F, Goupille P, Azais I, Roulot B, Alcalay M, Jeannou J, Bontoux D, Valat JP. Source: The Journal of Rheumatology. 1999 January; 26(1): 150-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9918257&dopt=Abstract

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Fractionation of Paget cells in extramammary Paget's disease. Author(s): Mori O, Hachisuka H, Nakano S, Sasai Y. Source: Archives of Dermatological Research. 1993; 285(8): 502-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8274038&dopt=Abstract

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Fracture risk among patients with Paget's disease: a population-based cohort study. Author(s): Melton LJ 3rd, Tiegs RD, Atkinson EJ, O'Fallon WM. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2000 November; 15(11): 2123-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11092393&dopt=Abstract

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Fractures in Paget's disease. Author(s): Gigliotti S, Giuzio E, De Durante C. Source: Chir Organi Mov. 1990 October-December; 75(4): 331-6. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2098219&dopt=Abstract

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Frequency and characteristics of familial aggregation of Paget's disease of bone. Author(s): Morales-Piga AA, Rey-Rey JS, Corres-Gonzalez J, Garcia-Sagredo JM, LopezAbente G. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1995 April; 10(4): 663-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7610939&dopt=Abstract

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Frequency and diagnostic value of the virus-like filamentous intranuclear inclusions in giant cell tumor of bone, not associated with Paget's disease. A study of 43 cases. Author(s): Abelanet R, Daudet-Monsac M, Laoussadi S, Forest M, Vacher-Lavenu MC. Source: Virchows Arch a Pathol Anat Histopathol. 1986; 410(1): 65-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3097954&dopt=Abstract

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Functional and mobility impairments associated with Paget's disease of bone. Author(s): Lyles KW, Lammers JE, Shipp KM, Sherman L, Pieper CF, Martinez S, Gold DT. Source: Journal of the American Geriatrics Society. 1995 May; 43(5): 502-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7730531&dopt=Abstract

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Gallium scanning in Paget's disease of bone: effect of calcitonin. Author(s): Waxman AD, McKee D, Siemsen JK, Singer FR. Source: Ajr. American Journal of Roentgenology. 1980 February; 134(2): 303-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6766237&dopt=Abstract

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Gallium-67 citrate localization in osteoclast nuclei of Paget's disease of bone. Author(s): Mills BG, Masuoka LS, Graham CC Jr, Singer FR, Waxman AD. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1988 June; 29(6): 1083-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3163726&dopt=Abstract

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Genital Paget's disease and urinary tract malignancy. Author(s): Powell FC, Bjornsson J, Doyle JA, Cooper AJ. Source: Journal of the American Academy of Dermatology. 1985 July; 13(1): 84-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2993379&dopt=Abstract

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Genital Paget's disease with clear cells in the epidermis of the axilla. Author(s): Makino T, Nakamura S, Nakayama H, Mihara M. Source: Journal of Cutaneous Pathology. 1998 November; 25(10): 568-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9870678&dopt=Abstract

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Genital Paget's disease: a histological study of the tumor margin. Author(s): Sano Y, Sakuma H, Hara T, Saeki H, Sugawara M, Tasaki M, Sato S, Ito I. Source: The Journal of Dermatology. 1987 June; 14(3): 279-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2822787&dopt=Abstract

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Genital Paget's disease: a transmission-, scanning-, and immuno-electron microscopic study. Author(s): Miyamoto T, Mihara M, Ishihara M, Hagari Y, Shimao S. Source: The Journal of Dermatology. 1988 June; 15(3): 224-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2846666&dopt=Abstract

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Geriatrics photo quiz. Paget's disease: skeletal deformity with or without pain. Author(s): Gross JS, Shua-Haim JR. Source: Geriatrics. 1996 June; 51(6): 19, 50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8647471&dopt=Abstract

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Giant cell lesions complicating Paget's disease of bone and their response to calcitonin therapy. Author(s): Penfold CN, Evans BT. Source: The British Journal of Oral & Maxillofacial Surgery. 1993 August; 31(4): 267. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8399049&dopt=Abstract

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Giant cell reparative granuloma of Paget's disease of bone: a unique clinical entity. Author(s): Upchurch KS, Simon LS, Schiller AL, Rosenthal DI, Campion EW, Krane SM. Source: Annals of Internal Medicine. 1983 January; 98(1): 35-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6848040&dopt=Abstract

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Giant cell tumor arising in Paget's disease of bone. Recurrences after 36 years. Author(s): Singer FR, Mills BG. Source: Clinical Orthopaedics and Related Research. 1993 August; (293): 293-301. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8339495&dopt=Abstract

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Giant cell tumor in Paget's disease of bone: familial and geographic clustering. Author(s): Jacobs TP, Michelsen J, Polay JS, D'Adamo AC, Canfield RE. Source: Cancer. 1979 August; 44(2): 742-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=476580&dopt=Abstract

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Giant cell tumor with viral-like intranuclear inclusions associated with Paget's disease. Author(s): Mirra JM, Bauer FC, Grant TT. Source: Clinical Orthopaedics and Related Research. 1981 July-August; (158): 243-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7273521&dopt=Abstract

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Giant cell tumour in a vertebra affected by Paget's disease of bone. Author(s): Donati U, Martucci E. Source: Ital J Orthop Traumatol. 1979 August; 5(2): 253-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=548519&dopt=Abstract

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Giant cell tumours in mandible and spine: a rare complication of Paget's disease of bone. Author(s): Bhambhani M, Lamberty BG, Clements MR, Skingle SJ, Crisp AJ. Source: Annals of the Rheumatic Diseases. 1992 December; 51(12): 1335-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1485818&dopt=Abstract

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Giant-cell tumor in soft parts in a patient with osseous Paget's disease: diagnosis by fine-needle aspiration. Author(s): Galed-Placed I, Garcia-Ureta E, Sanchez-Blas M, Lago-Novoa M. Source: Diagnostic Cytopathology. 1998 November; 19(5): 352-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9812229&dopt=Abstract

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Glandular extramammary Paget's disease. Author(s): Matsuo S, Penneys NS. Source: Archives of Dermatology. 1985 June; 121(6): 716-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2988460&dopt=Abstract

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Goals of treatment for Paget's disease of bone. Author(s): Siris ES. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 49-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510214&dopt=Abstract

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Gross cystic disease fluid protein-15 reactivity in extramammary Paget's disease with and without associated internal malignancy. Author(s): Kohler S, Smoller BR. Source: The American Journal of Dermatopathology. 1996 April; 18(2): 118-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8739985&dopt=Abstract

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Gross vertebral collapse associated with long-term disodium etidronate treatment for pelvic Paget's disease. Author(s): MacGowan JR, Pringle J, Morris VH, Stamp TC. Source: Skeletal Radiology. 2000 May; 29(5): 279-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10883448&dopt=Abstract

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Guidelines on the management of Paget's disease of bone. Author(s): Selby PL, Davie MW, Ralston SH, Stone MD; Bone and Tooth Society of Great Britain; National Association for the Relief of Paget's Disease. Source: Bone. 2002 September; 31(3): 366-73. Erratum In: Bone. 2002 Sep; 31(3): 437. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12231408&dopt=Abstract

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Healed Paget's disease of the nipple. Author(s): Masters RK, Robertson JF, Blamey RW. Source: Lancet. 1993 January 23; 341(8839): 253. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8093545&dopt=Abstract

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Hearing loss as a complication of Paget's disease of bone. Author(s): Monsell EM, Cody DD, Bone HG, Divine GW. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 92-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510222&dopt=Abstract

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Hearing loss in Paget's disease of bone: evidence of auditory nerve integrity. Author(s): Monsell EM, Bone HG, Cody DD, Jacobson GP, Newman CW, Patel SC, Divine GW. Source: The American Journal of Otology. 1995 January; 16(1): 27-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8579174&dopt=Abstract

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Hearing loss in Paget's disease of bone: the relationship between pure-tone thresholds and mineral density of the cochlear capsule. Author(s): Monsell EM, Cody DD, Bone HG, Divine GW, Windham JP, Jacobson GP, Newman CW, Patel SC. Source: Hearing Research. 1995 March; 83(1-2): 114-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7607977&dopt=Abstract

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Hemangiosarcoma complicating Paget's disease of the bone. Author(s): Chen KT. Source: Journal of Surgical Oncology. 1985 March; 28(3): 187-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4038765&dopt=Abstract

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Hemifacial spasm associated with Paget's disease of bone: good response to calcitonin. Author(s): Fernandez JM, Mederer S, Alvarez-Sabin J, Segura A, Codina A. Source: Neurology. 1991 August; 41(8): 1322-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1866030&dopt=Abstract

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High resolution computed tomography: Part 6. Craniofacial Paget's disease and fibrous dysplasia. Author(s): Swartz JD, Vanderslice RB, Korsvik H, Saluk PH, Popky GL, Marlowe FI, Wolfson RJ. Source: Head Neck Surg. 1985 September-October; 8(1): 40-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4066367&dopt=Abstract

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High-dose pamidronate in the management of resistant Paget's disease. Author(s): Cundy T, Wattie D, King AR. Source: Calcified Tissue International. 1996 January; 58(1): 6-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8825232&dopt=Abstract

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Hip arthroplasty in coxarthrosis secondary to Paget's disease. Author(s): Calderoni P, Ferruzzi A, Andreoli I, Gualtieri G. Source: Chir Organi Mov. 2002 January-March; 87(1): 43-8. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12198949&dopt=Abstract

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Hip arthroplasty in patients with Paget's disease. Author(s): Lewallen DG. Source: Clinical Orthopaedics and Related Research. 1999 December; (369): 243-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10611879&dopt=Abstract

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Histochemical analysis of sialomucin in Paget cells of mammary and extramammary Paget's disease. Author(s): Inokuchi K, Sasai Y. Source: Acta Histochemica. 1992; 92(2): 216-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1379408&dopt=Abstract

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HLA polymorphisms in Paget's disease of bone. Author(s): Gordon MT, Cartwright EJ, Mercer S, Anderson DC, Sharpe PT. Source: Seminars in Arthritis and Rheumatism. 1994 February; 23(4): 229. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8009233&dopt=Abstract

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HLA-D antigens and Paget's disease of bone. Author(s): Foldes J, Shamir S, Brautbar C, Schermann L, Menczel J. Source: Clinical Orthopaedics and Related Research. 1991 May; (266): 301-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2019065&dopt=Abstract

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Human papilloma virus DNA: a factor in the pathogenesis of mammary Paget's disease? Author(s): Czerwenka K, Heuss F, Hosmann JW, Manavi M, Lu Y, Jelincic D, Kubista E. Source: Breast Cancer Research and Treatment. 1996; 41(1): 51-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8932876&dopt=Abstract

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Hydrocephalic parkinsonism due to Paget's disease of bone: dramatic improvement following ventriculoperitoneal shunt and temporary levodopa/carbidopa therapy. Author(s): Ikeda K, Kinoshita M, Aoki K, Tomatsuri A. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1997 March; 12(2): 241-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9087985&dopt=Abstract

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Hydrocephalus and headaches in Paget's disease of the skull: complete relief by ventriculo-atrial shunt. Author(s): Hausser C, Ouaknine GE, Sylvestre J. Source: The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques. 1984 February; 11(1): 69-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6704797&dopt=Abstract

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Hydroxyapatite-coated total hip replacement in Paget's disease: 20 patients followed for 4-8 years. Author(s): Kirsh G, Kligman M, Roffman M. Source: Acta Orthopaedica Scandinavica. 2001 April; 72(2): 127-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11372942&dopt=Abstract

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Hypercalcaemia in Paget's disease of bone. Author(s): Hamilton DV, Hedges JR. Source: The Practitioner. 1981 August; 225(1358): 1179-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7323014&dopt=Abstract

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Hyperparathyroidism in Paget's disease of bone. Author(s): Gay JD, Poznanski WJ. Source: Clinical and Investigative Medicine. Medecine Clinique Et Experimentale. 1983; 6(2): 97-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6309450&dopt=Abstract

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Hyperphosphatasemia in an adult. Clinical, roentgenographic, and histomorphometric findings and comparison to classical Paget's disease. Author(s): Einhorn TA, Vigorita VJ, Teitcher JB. Source: Clinical Orthopaedics and Related Research. 1986 March; (204): 253-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3514034&dopt=Abstract

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Ibandronate treatment in Paget's disease of bone. Author(s): Grauer A, Heichel S, Knaus J, Dosch E, Ziegler R. Source: Bone. 1999 May; 24(5 Suppl): 87S-89S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10321936&dopt=Abstract

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Images and diagnoses. Patient 1: Paget's disease. Patient 2: nipple eczma. Author(s): Fitz-Henley M. Source: The West Indian Medical Journal. 2002 June; 51(2): 122, 132-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12232935&dopt=Abstract

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Images in clinical medicine. Paget's disease of bone. Author(s): Simcic KJ, Moreno AJ. Source: The New England Journal of Medicine. 1996 January 18; 334(3): 161. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8531972&dopt=Abstract

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Images in clinical medicine. Paget's disease of bone. Author(s): Thomas P, Howarth D. Source: The New England Journal of Medicine. 1996 January 18; 334(3): 160. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8531971&dopt=Abstract

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Immunohistochemical analysis of human milk fat globulin expression in extramammary Paget's disease. Author(s): Ohnishi T, Watanabe S. Source: Clinical and Experimental Dermatology. 2001 March; 26(2): 192-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11298114&dopt=Abstract

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Immunohistochemical detection of erbB-4 expression in extramammary Paget's disease. Author(s): Imakado S, Satomi H, Otsuka F. Source: Acta Dermato-Venereologica. 1999 March; 79(2): 172. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10228651&dopt=Abstract

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Immunohistochemical features of Paget's disease of the vulva with and without adenocarcinoma. Author(s): Olson DJ, Fujimura M, Swanson P, Okagaki T. Source: International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists. 1991; 10(3): 285-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1655667&dopt=Abstract

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Incidence and natural history of Paget's disease of bone in England and Wales. Author(s): van Staa TP, Selby P, Leufkens HG, Lyles K, Sprafka JM, Cooper C. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2002 March; 17(3): 465-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11878305&dopt=Abstract

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Incidental detection of lumbar Paget's disease by bone densitometry. Author(s): Vasireddy S, Halsey JP. Source: Rheumatology (Oxford, England). 2001 December; 40(12): 1424-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11752523&dopt=Abstract

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Increased accumulation of Tl-201 in monostotic Paget's disease of the patella: evaluation with quantitative analysis. Author(s): Abamor E, Kitapci MT, Cila E, Gokcora N, Uluoglu O. Source: Clinical Nuclear Medicine. 2001 July; 26(7): 615-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11416743&dopt=Abstract

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Indications for lymph node dissection in the treatment of extramammary Paget's disease. Author(s): Tsutsumida A, Yamamoto Y, Minakawa H, Yoshida T, Kokubu I, Sugihara T. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2003 January; 29(1): 21-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534507&dopt=Abstract

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Indium-111-leukocyte and technetium-99m-sulfur colloid uptake in Paget's disease. Author(s): Elgazzar AH, Yeung HW, Webner PJ. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1996 May; 37(5): 858-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8965163&dopt=Abstract

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Inheritance of osteosarcoma and Paget's disease of bone: a familial loss of heterozygosity study. Author(s): McNairn JD, Damron TA, Landas SK, Ambrose JL, Shrimpton AE. Source: The Journal of Molecular Diagnostics : Jmd. 2001 November; 3(4): 171-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11687601&dopt=Abstract

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Interleukin 6. A potential autocrine/paracrine factor in Paget's disease of bone. Author(s): Roodman GD, Kurihara N, Ohsaki Y, Kukita A, Hosking D, Demulder A, Smith JF, Singer FR. Source: The Journal of Clinical Investigation. 1992 January; 89(1): 46-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1729280&dopt=Abstract

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Internal auditory canal enlargement in Paget's disease appearing as bilateral acoustic neuromas. Author(s): Crain MR, Dolan KD. Source: The Annals of Otology, Rhinology, and Laryngology. 1990 October; 99(10 Pt 1): 833-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2221740&dopt=Abstract

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Intradiscal invasion of Paget's disease of the spine. Author(s): Lander P, Hadjipavlou A. Source: Spine. 1991 January; 16(1): 46-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1825894&dopt=Abstract

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Intranasal and intramuscular human calcitonin in female osteoporosis and in Paget's disease of bones: a pilot study. Author(s): Pontiroli AE, Pajetta E, Calderara A, Alberetto M, Pozza G, Manganelli V, Resmini G, Tessari L, Maresca V. Source: J Endocrinol Invest. 1991 January; 14(1): 47-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1646250&dopt=Abstract

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Intraosseous meningioma--a mimicry of Paget's disease? Author(s): Jayaraj K, Martinez S, Freeman A, Lyles KW. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2001 June; 16(6): 1154-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11393793&dopt=Abstract

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Intravenously administered pamidronate in the treatment of Paget's disease of bone. Author(s): Tucci JR, Bontha S. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2001 November-December; 7(6): 423-9. Erratum In: Endocr Pract 2002 January-February; 8(1): 78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11747277&dopt=Abstract

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Is clinical expressiveness of Paget's disease of bone decreasing? Author(s): Morales-Piga AA, Bachiller-Corral FJ, Abraira V, Beltran J, Rapado A. Source: Bone. 2002 February; 30(2): 399-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11856648&dopt=Abstract

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Juvenile Paget's disease--a case report. Author(s): Saraf SK, Gupta SK. Source: Australasian Radiology. 1989 May; 33(2): 189-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2673185&dopt=Abstract

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Juxta-acetabular synovial cyst in a patient with Paget's disease. Author(s): Miller MD, Kraft TA, Greendyke SD, Trick LW, Smith DK. Source: Orthopedics. 1995 March; 18(3): 293-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7761322&dopt=Abstract

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Juxtapapillary choroidal neovascular membrane in a patient with Paget's disease and lattice corneal dystrophy. Author(s): Boehme JD, Litwak AB. Source: J Am Optom Assoc. 1989 August; 60(8): 612-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2477432&dopt=Abstract

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Keratinocyte induced chemotaxis in the pathogenesis of Paget's disease of the breast. Author(s): de Potter CR, Eeckhout I, Schelfhout AM, Geerts ML, Roels HJ. Source: Histopathology. 1994 April; 24(4): 349-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7519165&dopt=Abstract

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Klinefelter's syndrome associated with breast carcinoma and Paget's disease of the nipple. Author(s): Moshakis V, Fordyce MJ, Griffiths JD. Source: Clin Oncol. 1983 September; 9(3): 257-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6311473&dopt=Abstract

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Lack of progesterone receptor expression in extramammary Paget's disease. Author(s): Imakado S, Satomi H, Ishii Y, Aiyoshi Y, Otsuka F. Source: Acta Dermato-Venereologica. 1999 September; 79(5): 399. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10494730&dopt=Abstract

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Leiomyoma as a rare differential diagnosis of Paget's disease of the nipple. Author(s): Haier J, Haensch W, Schon M. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1997 May; 76(5): 490-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9197458&dopt=Abstract

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Limited value of the NKI/C3-antibody for the differential diagnosis of Paget's disease of the nipple and intra-epidermal malignant melanoma. Author(s): Biesterfeld S, Kusche M, Viereck E, Fuzesi L. Source: Histopathology. 1996 March; 28(3): 269-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8729049&dopt=Abstract

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Localized Paget's disease with mucocele in the sphenoid sinus. Author(s): Lee KS, Rhee CS, Lee CH, Min YG. Source: Otolaryngology and Head and Neck Surgery. 2001 March; 124(3): 338-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11241004&dopt=Abstract

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Long-term follow-up of therapy with intermittent etidronate disodium in Paget's disease of bone. Author(s): Altman RD. Source: The American Journal of Medicine. 1985 November; 79(5): 583-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3933343&dopt=Abstract

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Long-term outcome of patients with perianal Paget's disease. Author(s): Marchesa P, Fazio VW, Oliart S, Goldblum JR, Lavery IC, Milsom JW. Source: Annals of Surgical Oncology : the Official Journal of the Society of Surgical Oncology. 1997 September; 4(6): 475-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9309336&dopt=Abstract

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Long-term outcome of perianal Paget's disease. Author(s): McCarter MD, Quan SH, Busam K, Paty PP, Wong D, Guillem JG. Source: Diseases of the Colon and Rectum. 2003 May; 46(5): 612-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792436&dopt=Abstract

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Long-term trends in the incidence of Paget's disease of bone. Author(s): Tiegs RD, Lohse CM, Wollan PC, Melton LJ. Source: Bone. 2000 September; 27(3): 423-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10962355&dopt=Abstract

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Low rates of Paget's disease of bone and osteosarcoma in elderly Japanese. Author(s): Ishikawa Y, Tsukuma H, Miller RW. Source: Lancet. 1996 June 1; 347(9014): 1559. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8684133&dopt=Abstract

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Low serum magnesium concentration in Paget's disease of bone (osteitis deformans). Author(s): Taylor WH. Source: Annals of Clinical Biochemistry. 1985 November; 22 ( Pt 6): 591-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4073791&dopt=Abstract

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Low specificity of cytokeratin 20 in the diagnosis of extramammary Paget's disease. Author(s): Wu ML, Guitart J. Source: The British Journal of Dermatology. 2000 March; 142(3): 569. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10777264&dopt=Abstract

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Low-dose mitomycin C, etoposide, and cisplatin for invasive vulvar Paget's disease. Author(s): Watanabe Y, Hoshiai H, Ueda H, Nakai H, Obata K, Noda K. Source: International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society. 2002 May-June; 12(3): 304-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12060453&dopt=Abstract

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Lymphoma arising in Paget's disease. Author(s): Yu T, Squires F, Mammone J, DiMarcangelo M. Source: Skeletal Radiology. 1997 December; 26(12): 729-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9453108&dopt=Abstract

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Magnetic resonance appearance of uncomplicated Paget's disease of bone. Author(s): Vande Berg BC, Malghem J, Lecouvet FE, Maldague B. Source: Seminars in Musculoskeletal Radiology. 2001; 5(1): 69-77. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11371337&dopt=Abstract

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Magnetic resonance imaging presentation of lytic Paget's disease of the cervical spine. Author(s): Sprecher S, Steinberg R, Lichtenstein D, Witt KM, Barginear M. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2002 November; 17(11): 1929-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12412798&dopt=Abstract

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Male Paget's disease of the breast. Author(s): Hayes R, Cummings B, Miller RA, Guha AK. Source: Journal of Cutaneous Medicine and Surgery. 2000 October; 4(4): 208-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11231200&dopt=Abstract

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Mammary and extramammary Paget's disease. Author(s): Lloyd J, Flanagan AM. Source: Journal of Clinical Pathology. 2000 October; 53(10): 742-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11064666&dopt=Abstract

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Metastatic in-situ perianal Paget's disease. Author(s): Khoubehi B, Schofield A, Leslie M, Slevin ML, Talbot IC, Northover JM. Source: Journal of the Royal Society of Medicine. 2001 March; 94(3): 137-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11285798&dopt=Abstract

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Monostotic Paget's Disease of a cervical vertebra: differential diagnosis with F-18 FDG positron emission tomography using a coincidence technique and with Tc-99m dicarboxypropane diphosphonate. Author(s): Schmid RA, Schwenzer K, Weiss M, Rock C, Rink FJ, Hahn K, Dresel S. Source: Clinical Nuclear Medicine. 2002 July; 27(7): 537-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12072790&dopt=Abstract

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MR imaging of pseudosarcoma in Paget's disease of bone: a report of two cases. Author(s): Tins BJ, Davies AM, Mangham DC. Source: Skeletal Radiology. 2001 March; 30(3): 161-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11357455&dopt=Abstract

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MRI of Paget's disease of bone. Author(s): Whitten CR, Saifuddin A. Source: Clinical Radiology. 2003 October; 58(10): 763-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14521884&dopt=Abstract

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Multifocal osteogenic sarcoma in Paget's disease. Author(s): Vuillemin-Bodaghi V, Parlier-Cuau C, Cywiner-Golenzer C, Quillard A, Kaplan G, Laredo JD. Source: Skeletal Radiology. 2000 June; 29(6): 349-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10929418&dopt=Abstract

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Mutation screening of the TNFRSF11A gene encoding receptor activator of NF kappa B (RANK) in familial and sporadic Paget's disease of bone and osteosarcoma. Author(s): Sparks AB, Peterson SN, Bell C, Loftus BJ, Hocking L, Cahill DP, Frassica FJ, Streeten EA, Levine MA, Fraser CM, Adams MD, Broder S, Venter JC, Kinzler KW, Vogelstein B, Ralston SH. Source: Calcified Tissue International. 2001 March; 68(3): 151-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11351498&dopt=Abstract

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Natural history of untreated Paget's disease of the tibia. Author(s): Siris ES, Feldman F. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1997 April; 12(4): 691-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9101382&dopt=Abstract

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Nd: YAG laser treatment of extramammary Paget's disease of the penis and scrotum. Author(s): Weese D, Murphy J, Zimmern PE. Source: J Urol (Paris). 1993; 99(5): 269-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8163850&dopt=Abstract

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Nerve growth factor (NGF) is present in human placenta and semen, but undetectable in normal and Paget's disease blood: measurements with an anti-mouse-NGF enzyme immunoassay using a recombinant human NGF reference. Author(s): Heinrich G, Meyer TE. Source: Biochemical and Biophysical Research Communications. 1988 August 30; 155(1): 482-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3046616&dopt=Abstract

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Neurological complications of Paget's disease of bone. Author(s): Chakravorty NK. Source: Br J Clin Pract. 1985 September; 39(9): 335-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4063128&dopt=Abstract

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New drugs for Paget's disease. Author(s): Anderson DC, Buckler HM, Cantrill JA. Source: Lancet. 1986 June 21; 1(8495): 1442. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2872541&dopt=Abstract

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New modes of administration of salmon calcitonin in Paget's disease. Nasal spray and suppository. Author(s): Nagant de Deuxchaisnes C, Devogelaer JP, Huaux JP, Dufour JP, Esselinckx W, Engelbeen JP, Stasse P, Hermans P, de Buisseret JP. Source: Clinical Orthopaedics and Related Research. 1987 April; (217): 56-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3549096&dopt=Abstract

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Nineteen-year radiographic follow-up of untreated Paget's disease of bone. Author(s): Shier CK, Ellis BI, Tennyson G, Kleerekoper M. Source: Henry Ford Hosp Med J. 1986; 34(2): 127-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3759491&dopt=Abstract

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Nipple adenoma: a differential diagnosis for Paget's disease. Author(s): Healy CE, Dijkstra B, Walsh M, Hill AD, Murphy J. Source: The Breast Journal. 2003 July-August; 9(4): 325-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12846871&dopt=Abstract

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Normal carboxylation of circulating osteocalcin (bone Gla-protein) in Paget's disease of bone. Author(s): Merle B, Delmas PD. Source: Bone Miner. 1990 November; 11(2): 237-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2176559&dopt=Abstract

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Normotensive renal failure in a patient with systemic sclerosis and p-antineutrophil cytoplasmic autoantibodies which developed into Paget's disease of bone after immunosuppressive therapy. Author(s): Villaverde V, Balsa A, Cabezas JA, Fernandez-Prada M, Torre A, Mola EM. Source: Rheumatology (Oxford, England). 1999 February; 38(2): 190-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10342639&dopt=Abstract

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Osseo-integration in Paget's disease: the bone-anchored hearing aid in the rehabilitation of Pagetic deafness. Author(s): Uppal HS, D'Souza AR, Proops DW. Source: The Journal of Laryngology and Otology. 2001 November; 115(11): 903-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11779307&dopt=Abstract

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Osteoclasts in Paget's disease of bone. Author(s): Ganly P, Beard M. Source: British Journal of Haematology. 2001 May; 113(2): 259. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11380387&dopt=Abstract

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Osteolytic Paget's disease. Recognition and risks of biopsy. Author(s): Eisman JA, Martin TJ. Source: The Journal of Bone and Joint Surgery. American Volume. 1986 January; 68(1): 112-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3941112&dopt=Abstract

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Osteomyelitis mimicking Paget's disease or a pagetoid phenomenon: a case report. Author(s): Akande OO, Lawoyin JO, Kolude B. Source: Afr J Med Med Sci. 2001 March-June; 30(1-2): 137-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14510170&dopt=Abstract

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Osteoprotegerin deficiency and juvenile Paget's disease. Author(s): Hofbauer LC, Schoppet M. Source: The New England Journal of Medicine. 2002 November 14; 347(20): 1622-3; Author Reply 1622-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12432053&dopt=Abstract

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Osteoprotegerin deficiency and juvenile Paget's disease. Author(s): Whyte MP, Obrecht SE, Finnegan PM, Jones JL, Podgornik MN, McAlister WH, Mumm S. Source: The New England Journal of Medicine. 2002 July 18; 347(3): 175-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12124406&dopt=Abstract

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Osteosarcoma arising in Paget's disease of the mandible. Author(s): Cheng YS, Wright JM, Walstad WR, Finn MD. Source: Oral Oncology. 2002 December; 38(8): 785-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12570058&dopt=Abstract

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Outcome of uncemented hip arthroplasty components in patients with Paget's disease. Author(s): Parvizi J, Schall DM, Lewallen DG, Sim FH. Source: Clinical Orthopaedics and Related Research. 2002 October; (403): 127-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12360018&dopt=Abstract

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Overexpression of p53 is correlated with stromal invasion in extramammary Paget's disease of the vulva. Author(s): Zhang C, Zhang P, Sung CJ, Lawrence WD. Source: Human Pathology. 2003 September; 34(9): 880-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14562283&dopt=Abstract

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Overexpression of transforming growth factor-beta3 immunohistochemical staining in extramammary Paget's disease, but downregulated expression in Bowen's disease. Author(s): Kawakami T, Soma Y, Mizoguchi M, Saito R. Source: International Journal of Dermatology. 2001 April; 40(4): 262-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11454082&dopt=Abstract

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Paget's disease and fibrous dysplasia. Author(s): Hullar TE, Lustig LR. Source: Otolaryngologic Clinics of North America. 2003 August; 36(4): 707-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14567061&dopt=Abstract

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Paget's disease complicated by hydrocephalus and syringomyelia. Author(s): Raubenheimer PJ, Taylor AG, Soule SG. Source: British Journal of Neurosurgery. 2002 October; 16(5): 513-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12498500&dopt=Abstract

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Paget's disease of bone. Author(s): Whitehouse RW. Source: Seminars in Musculoskeletal Radiology. 2002 December; 6(4): 313-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12541188&dopt=Abstract

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Paget's Disease of the Bone. Author(s): Swann G. Source: The Journal of Audiovisual Media in Medicine. 2003 June; 26(2): 80-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893574&dopt=Abstract

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Paget's disease of the breast. Simple method of cytological diagnosis. Author(s): Dutra FR. Source: Jama : the Journal of the American Medical Association. 1966 March 7; 195(10): 873-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608188&dopt=Abstract

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Paget's disease of the male breast: an unusual case of dermal invasion. Author(s): Chao C, Edwards MJ, Wolfson S, Sewell C, Edwards D, McMasters KM. Source: The Breast Journal. 2003 May-June; 9(3): 254. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752641&dopt=Abstract

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Paget's disease of the spine: unusual features and complications. Author(s): Saifuddin A, Hassan A. Source: Clinical Radiology. 2003 February; 58(2): 102-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623038&dopt=Abstract

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Pemphigus vulgaris mimicking Paget's disease of the breast. Author(s): Guyton DP, Sloan Stakleff K, Regula E. Source: The Breast Journal. 2003 July-August; 9(4): 319-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12846869&dopt=Abstract

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Penoscrotal extramammary Paget's disease: a review of 33 cases in a 20-year experience. Author(s): Lai YL, Yang WG, Tsay PK, Swei H, Chuang SS, Wen CJ. Source: Plastic and Reconstructive Surgery. 2003 September 15; 112(4): 1017-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12973217&dopt=Abstract

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Prognosis and management of extramammary Paget's disease and the association with secondary malignancies. Author(s): Pierie JP, Choudry U, Muzikansky A, Finkelstein DM, Ott MJ. Source: Journal of the American College of Surgeons. 2003 January; 196(1): 45-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517548&dopt=Abstract

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Quantification of skeletal kinetic indices in Paget's disease using dynamic 18Ffluoride positron emission tomography. Author(s): Cook GJ, Blake GM, Marsden PK, Cronin B, Fogelman I. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2002 May; 17(5): 854-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12009016&dopt=Abstract

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Quantitative bone scintigraphy in Paget's disease treated with APD. Author(s): Vellenga CJ, Pauwels EK, Bijvoet OL, Harinck HI, Frijlink WB. Source: The British Journal of Radiology. 1985 December; 58(696): 1165-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3842627&dopt=Abstract

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Quantitative bone scintigraphy in the management of monostotic Paget's disease of bone. Author(s): Patel S, Pearson D, Hosking DJ. Source: Arthritis and Rheumatism. 1995 October; 38(10): 1506-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7575701&dopt=Abstract

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Quantitative evaluation of bone scintigraphy in the assessment of Paget's disease activity. Author(s): Pons F, Alvarez L, Peris P, Guanabens N, Vidal-Sicart S, Monegal A, Pavia J, Ballesta AM, Munos-Gomez J, Herranz R. Source: Nuclear Medicine Communications. 1999 June; 20(6): 525-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10451864&dopt=Abstract

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Questions & answers. I'm a 79-year-old man with spinal stenosis. I was recently diagnosed with Paget's disease. Are these conditions related, and what are the best treatments? Author(s): Kippel J. Source: Health News. 2003 October; 9(10): 16. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14619778&dopt=Abstract

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Quiz. Osteoectasia with hyperphosphotasia (juvenile Paget's disease). Author(s): Di Gennaro GL, Pascarella R, Mignani G, Libri R. Source: Chir Organi Mov. 1999 April-June; 84(2): 211-5. English, Italian. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11569082&dopt=Abstract

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Radiologic case study. Insufficiency fracture of the acetabular roof in Paget's disease. Author(s): Adkins MC, Sundaram M. Source: Orthopedics. 2001 October; 24(10): 945, 1019-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11688771&dopt=Abstract

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Radiologic case study. Paget's disease with a pathologic fracture. Author(s): White RA, Burd T, Greene W, Griffiths HJ. Source: Orthopedics. 2002 April; 25(4): 388, 446-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12002208&dopt=Abstract

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Radiotherapy for genital extramammary Paget's disease in situ. Author(s): Moreno-Arias GA, Conill C, Castells-Mas A, Arenas M, Grimalt R. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 June; 27(6): 587-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11442599&dopt=Abstract

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Radiotherapy for perianal Paget's disease. Author(s): Brown RS, Lankester KJ, McCormack M, Power DA, Spittle MF. Source: Clin Oncol (R Coll Radiol). 2002 August; 14(4): 272-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12206637&dopt=Abstract

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Rapid osteolysis after revision hip arthroplasty in Paget's disease. Author(s): Oakley AP, Matheson JA. Source: The Journal of Arthroplasty. 2003 February; 18(2): 204-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629612&dopt=Abstract

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RCAS1 antigen is highly expressed in extramammary Paget's disease and in advanced stage squamous cell carcinoma of the skin. Author(s): Takahashi H, Iizuka H, Nakashima M, Wada T, Asano K, Ishida-Yamamoto A, Watanabe T. Source: Journal of Dermatological Science. 2001 June; 26(2): 140-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11378331&dopt=Abstract

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Recurrent Paget's disease of the vulva in a myocutaneous flap: case report and review of the literature. Author(s): Tjalma WA, Cooremans ID, Jeuris W, Van Marck EA, Monaghan JM. Source: Eur J Gynaecol Oncol. 2001; 22(1): 13-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11321485&dopt=Abstract

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Reversible dementia in Paget's disease. Author(s): Chitnavis BP. Source: Journal of the Royal Society of Medicine. 2001 March; 94(3): 157-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11285808&dopt=Abstract

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Reversible dementia in Paget's disease. Author(s): Martin AJ. Source: Journal of the Royal Society of Medicine. 2001 January; 94(1): 53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11220076&dopt=Abstract

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Reversible dementia in Paget's disease. Author(s): Chan YP, Shui KK, Lewis RR, Kinirons MT. Source: Journal of the Royal Society of Medicine. 2000 November; 93(11): 595-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198695&dopt=Abstract

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Sentinel lymph node navigation surgery in Paget's disease of the vulva. Author(s): Kudo G, Toyama H, Hasegawa K, Kuroda M, Hattori H, Ishiguro M, Kato M, Sawai T, Ejiri K, Minami K, Udagawa Y, Katada K. Source: Clinical Nuclear Medicine. 2002 December; 27(12): 909-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607882&dopt=Abstract

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Serrated adenocarcinoma of the rectum associated with perianal Paget's disease: a case report. Author(s): Makinen JM, Makinen MJ, Karttunen TJ. Source: Histopathology. 2002 August; 41(2): 177-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12147102&dopt=Abstract

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Serum osteoprotegerin and its ligand in Paget's disease of bone: relationship to disease activity and effect of treatment with bisphosphonates. Author(s): Alvarez L, Peris P, Guanabens N, Vidal S, Ros I, Pons F, Filella X, Monegal A, Munoz-Gomez J, Ballesta AM. Source: Arthritis and Rheumatism. 2003 March; 48(3): 824-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12632438&dopt=Abstract

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Short-term intravenous therapy with Neridronate in Paget's disease. Author(s): Adami S, Bevilacqua M, Broggini M, Filipponi P, Ortolani S, Palummeri E, Ulivieri F, Nannipieri F, Braga V. Source: Clin Exp Rheumatol. 2002 January-February; 20(1): 55-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11892710&dopt=Abstract

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Spinal epidural lipomatosis associated with Paget's disease of bone. Author(s): Koziarz P, Avruch L. Source: Neuroradiology. 2002 October; 44(10): 858-60. Epub 2002 August 27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12389138&dopt=Abstract

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Structure of the ubiquitin-associated domain of p62 (SQSTM1) and implications for mutations that cause Paget's disease of bone. Author(s): Ciani B, Layfield R, Cavey JR, Sheppard PW, Searle MS. Source: The Journal of Biological Chemistry. 2003 September 26; 278(39): 37409-12. Epub 2003 July 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12857745&dopt=Abstract

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Successful treatment of dysphagia in Paget's disease of the bone. Author(s): Varadarajulu S, Reddy S, Noone T, Payne KM. Source: Digestive Diseases and Sciences. 2002 September; 47(9): 2112-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353865&dopt=Abstract

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Successful treatment of extramammary Paget's disease with imiquimod. Author(s): Qian Z, Zeitoun NC, Shieh S, Helm T, Oseroff AR. Source: J Drugs Dermatol. 2003 January; 2(1): 73-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12852386&dopt=Abstract

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Successful treatment of recurrent extramammary Paget's disease of the vulva with topical imiquimod 5% cream. Author(s): Wang LC, Blanchard A, Judge DE, Lorincz AA, Medenica MM, Busbey S. Source: Journal of the American Academy of Dermatology. 2003 October; 49(4): 769-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14512941&dopt=Abstract

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Surgical treatment in Paget's disease of the breast. Author(s): Stanislawek A, Kurylcio L, Krasuska ME. Source: Ann Univ Mariae Curie Sklodowska [med]. 2002; 57(1): 444-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12898958&dopt=Abstract

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The current status of Paget's disease of the bone. Author(s): Keen RW. Source: Hosp Med. 2003 April; 64(4): 230-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12731136&dopt=Abstract

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The diagnosis of Paget's disease. Author(s): Pande I. Source: The Practitioner. 2001 September; 245(1626): 730-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11584586&dopt=Abstract

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The ectopic expression of gastric mucin in extramammary and mammary Paget's disease. Author(s): Kondo Y, Kashima K, Daa T, Fujiwara S, Nakayama I, Yokoyama S. Source: The American Journal of Surgical Pathology. 2002 May; 26(5): 617-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11979091&dopt=Abstract

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The influence of serum cytokines and growth factors on osteoclast formation in Paget's disease. Author(s): Neale SD, Schulze E, Smith R, Athanasou NA. Source: Qjm : Monthly Journal of the Association of Physicians. 2002 April; 95(4): 233-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11937650&dopt=Abstract

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The pro and con of measles virus in Paget's disease: con. Author(s): Rima BK, Gassen U, Helfrich MH, Ralston SH. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2002 December; 17(12): 2290-2; Author Reply 2293. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12469924&dopt=Abstract

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The renal clearance of free and peptide-bound deoxypyridinoline: response to pamidronate treatment of Paget's disease. Author(s): Naylor KE, Jackson B, Eastell R. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2003 April; 18(4): 658-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12674326&dopt=Abstract

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The role of p53 and Ki67 in Paget's disease of the vulva and the breast. Author(s): Ellis PE, Fong LF, Rolfe KJ, Crow JC, Reid WM, Davidson T, MacLean AB, Perrett CW. Source: Gynecologic Oncology. 2002 August; 86(2): 150-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12144821&dopt=Abstract

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The role of vascular endothelial growth factor-A (VEGF-A) and platelet-derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) in Paget's disease of the vulva and breast. Author(s): Ellis PE, Wong Te Fong LF, Rolfe KJ, Crow JC, Reid WM, Davidson T, MacLean AB, Perret CW. Source: Anticancer Res. 2002 March-April; 22(2A): 857-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12014662&dopt=Abstract

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Transfer of Paget's disease from one part of the skeleton to another as a result of autogenous bone-grafting: a case report. Author(s): Hamadouche M, Mathieu M, Topouchian V, de Pinieux G, Courpied JP. Source: The Journal of Bone and Joint Surgery. American Volume. 2002 November; 84A(11): 2056-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12429770&dopt=Abstract

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Treatment of primary limited cutaneous extramammary Paget's disease with topical imiquimod monotherapy: two case reports. Author(s): Zampogna JC, Flowers FP, Roth WI, Hassenein AM. Source: Journal of the American Academy of Dermatology. 2002 October; 47(4 Suppl): S229-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12271284&dopt=Abstract

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Ultrastructural features of giant cell tumors in Paget's disease. Author(s): Magitsky S, Lipton JF, Reidy J, Vigorita VJ, Bryk E. Source: Clinical Orthopaedics and Related Research. 2002 September; (402): 213-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218487&dopt=Abstract

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Uncemented total hip arthroplasty in Paget's disease of the hip: a report of 5 cases with 5-year follow-up. Author(s): Hozack WJ, Rushton SA, Carey C, Sakalkale D, Rothman RH. Source: The Journal of Arthroplasty. 1999 October; 14(7): 872-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10537266&dopt=Abstract

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Underlying pathology in mammary Paget's disease. Author(s): Yim JH, Wick MR, Philpott GW, Norton JA, Doherty GM. Source: Annals of Surgical Oncology : the Official Journal of the Society of Surgical Oncology. 1997 June; 4(4): 287-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9181226&dopt=Abstract

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Underpants-pattern erythema: a previously unrecognized cutaneous manifestation of extramammary Paget's disease of the genitalia with advanced metastatic spread. Author(s): Murata Y, Kumano K, Tani M. Source: Journal of the American Academy of Dermatology. 1999 June; 40(6 Pt 1): 949-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10365926&dopt=Abstract

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Unusual presentation of Paget's disease of the maxilla. Author(s): Woo TS, Schwartz HC. Source: The British Journal of Oral & Maxillofacial Surgery. 1995 April; 33(2): 98-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7772595&dopt=Abstract

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Unusual radiological features in Paget's disease of bone. Author(s): Moore TE, Kathol MH, el-Khoury GY, Walker CW, Gendall PW, Whitten CG. Source: Skeletal Radiology. 1994 May; 23(4): 257-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8059250&dopt=Abstract

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Update on the viral etiology of Paget's disease of bone. Author(s): Singer FR. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 29-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510210&dopt=Abstract

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Urinary excretion of glycosaminoglycans and hydroxyproline in Paget's disease of bone, compared with neoplastic invasion of bone. Author(s): Bower L, Manley G. Source: Journal of Clinical Pathology. 1981 October; 34(10): 1097-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7309892&dopt=Abstract

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Use of the bisphosphonate space in treatment and retreatment of Paget's disease. Author(s): Stone MD, Patel S, Hosking DJ. Source: Seminars in Arthritis and Rheumatism. 1994 February; 23(4): 278. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8009256&dopt=Abstract

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Usefulness of biochemical markers of bone turnover in assessing response to the treatment of Paget's disease. Author(s): Alvarez L, Guanabens N, Peris P, Vidal S, Ros I, Monegal A, Bedini JL, Deulofeu R, Pons F, Munoz-Gomez J, Ballesta AM. Source: Bone. 2001 November; 29(5): 447-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11704497&dopt=Abstract

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Variable disease severity associated with a Paget's disease predisposition gene. Author(s): Leach RJ, Singer FR, Cody JD, Roodman GD. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 October; 14 Suppl 2: 17-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510208&dopt=Abstract

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Variable efficacy of bone remodeling biochemical markers in the management of patients with Paget's disease of bone treated with tiludronate. Author(s): de la Piedra C, Rapado A, Diaz Diego EM, Diaz Martin MA, Aguirre C, Lopez Gavilanes E, Diaz Curiel M. Source: Calcified Tissue International. 1996 August; 59(2): 95-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8687976&dopt=Abstract

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Vascular steal mimicking compression myelopathy in Paget's disease of bone: rapid reversal with calcitonin and systemic steroids. Author(s): Yost JH, Spencer-Green G, Krant JD. Source: The Journal of Rheumatology. 1993 June; 20(6): 1064-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8350315&dopt=Abstract

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Viral behavior of paracrystalline inclusions in osteoclasts of Paget's disease of bone. Author(s): Abe S, Ohno T, Park P, Higaki S, Unno K, Tateishi A. Source: Ultrastructural Pathology. 1995 November-December; 19(6): 455-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8597199&dopt=Abstract

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Visualization of Paget's disease during somatostatin receptor scintigraphy. Author(s): Kang S, Mishkin FS. Source: Clinical Nuclear Medicine. 1999 November; 24(11): 900-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10551483&dopt=Abstract

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Vulval reconstruction using rectus abdominis musculocutaneous flap transfer with secondary liposuction in extramammary Paget's disease. Author(s): Hatoko M, Okazaki T, Tada H, Kuwahara M, Shiba A, Muramatsu T, Shirai T. Source: Annals of Plastic Surgery. 1997 February; 38(2): 179-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9043590&dopt=Abstract

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Vulvar Paget's disease and sweat gland carcinoma--report of a case and review of the literature. Author(s): Changchien CC, Hock-Liew E. Source: Changgeng Yi Xue Za Zhi. 1994 September; 17(3): 292-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7954012&dopt=Abstract

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Vulvar Paget's disease. Is immunocytochemistry helpful in assessing the surgical margins? Author(s): Ganjei P, Giraldo KA, Lampe B, Nadji M. Source: J Reprod Med. 1990 November; 35(11): 1002-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1703577&dopt=Abstract

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Vulvar Paget's disease: a clinicopathologic and immunohistochemical study of 19 cases. Author(s): Goldblum JR, Hart WR. Source: The American Journal of Surgical Pathology. 1997 October; 21(10): 1178-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9331290&dopt=Abstract

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Vulvar Paget's disease: review of the literature, considerations about histogenetic hypothesis and surgical approaches. Author(s): Tinari A, Pace S, Fambrini M, Eleuteri Serpieri D, Frega A. Source: Eur J Gynaecol Oncol. 2002; 23(6): 551-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556103&dopt=Abstract

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What is “resistance” in Paget's disease of bone? Author(s): Lyles KW. Source: Arthritis and Rheumatism. 2003 August; 48(8): 2097-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12905461&dopt=Abstract

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Whodunnit? (Paget's disease) Author(s): Jones RE Jr. Source: The American Journal of Dermatopathology. 1983 April; 5(2): 206-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6309032&dopt=Abstract

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Whole body retention of Tc-99m phosphate in Paget's disease of bone. Author(s): Hadjipavlou A, Lisbona R, Garbuz D, Abibtbol JJ. Source: Clinical Nuclear Medicine. 1991 June; 16(6): 435-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1868658&dopt=Abstract

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Whole-body and part-body turnover of 85Sr in Paget's disease. Author(s): Tothill P, Smith MA, Cohn SH. Source: Physics in Medicine and Biology. 1983 February; 28(2): 149-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6867104&dopt=Abstract

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Whole-body retention of 99mTc-MPD in Paget's disease. Author(s): Vattimo A, Cantalupi D, Righi G, Martini G, Nuti R, Turchetti V. Source: J Nucl Med Allied Sci. 1981 January-June; 25(1-2): 5-10. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6454766&dopt=Abstract

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Zoledronate in the treatment of Paget's disease. Author(s): Siris E. Source: Br J Clin Pract Suppl. 1996 September; 87: 19-20; Discussion 22. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8995014&dopt=Abstract

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CHAPTER 2. NUTRITION AND PAGET’S DISEASE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and Paget’s disease.

Finding Nutrition Studies on Paget’s Disease The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “Paget’s disease” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “Paget’s disease” (or a synonym): •

1,25-Dihydroxyvitamin D3 hypersensitivity of osteoclast precursors from patients with Paget's disease. Author(s): Department of Medicine/Hematology, University of Texas Health Science Center, San Antonio, USA. Source: Menaa, C Barsony, J Reddy, S V Cornish, J Cundy, T Roodman, G D J-BoneMiner-Res. 2000 February; 15(2): 228-36 0884-0431

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A review of Paget's disease: radiologic imaging, differential diagnosis, and treatment. Author(s): University of California Davis School of Medicine, Sacramento. Source: Greenspan, A Bull-Hosp-Jt-Dis-Orthop-Inst. 1991 Spring; 51(1): 22-33 0883-9344

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Alterations in vitamin D metabolites during treatment of Paget's disease of bone with calcitonin or etidronate. Author(s): Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Nedlands, Western Australia. Source: Devlin, R D Gutteridge, D H Prince, R L Retallack, R W Worth, G K J-BoneMiner-Res. 1990 November; 5(11): 1121-6 0884-0431

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An algorithmic approach to the treatment of Paget's disease of the spine. Author(s): Department of Surgery/Orthopaedics, University of Arizona, Tucson. Source: Smidt, W R Hadjipavlou, A G Lander, P Dzioba, R B Orthop-Revolume 1994 September; 23(9): 715-24 0094-6591

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Atypical multinucleated cells form in long-term marrow cultures from patients with Paget's disease. Author(s): Research Service, Audie Murphy Veterans Administration Hospital, San Antonio, Texas 78284. Source: Kukita, A Chenu, C McManus, L M Mundy, G R Roodman, G D J-Clin-Invest. 1990 April; 85(4): 1280-6 0021-9738

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Biochemical response to combination of disodium etidronate with calcitonin in Paget's disease. Author(s): Department of Medicine, University Hospital, Nottingham, UK. Source: O'Donoghue, D J Hosking, D J Bone. 1987; 8(4): 219-25 8756-3282

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Bisphosphonate therapy for Paget's disease in a patient with hypoparathyroidism: profound hypocalcemia, rapid response, and prolonged remission. Author(s): Keogh Institute for Medical Research, QEII Medical Center, Nedlands, Western Australia, Australia. Source: Stuckey, B G Lim, E M Kent, G N Ward, L C Gutteridge, D H J-Bone-Miner-Res. 2001 September; 16(9): 1719-23 0884-0431

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Calcitonin treatment in osteoectasia with hyperphosphatasia (juvenile Paget's disease): radiographic changes after treatment. Author(s): Division of Genetics and Teratology, Department of Paediatrics, Cerrahpasa Faculty of Medicine, University of Istanbul, Istanbul, Turkey. Source: Tuysuz, B Mercimek, S Ungur, S Deniz, M Pediatr-Radiol. 1999 November; 29(11): 838-41 0301-0449

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Cell biology of Paget's disease. Author(s): Department of Medicine/Hematology, University of Texas Health Science Center, San Antonio, Texas, USA. Source: Reddy, S V Menaa, C Singer, F R Demulder, A Roodman, G D J-Bone-Miner-Res. 1999 October; 14 Suppl 23-8 0884-0431

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Cellular immunodeficiency in Paget's disease of bone: changes induced by treatment with elcatonin. Author(s): Service of Internal Medicine (Unidad Metabolica), Fundacion Jimenez Diaz, Madrid, Spain. Source: Rapado, A Yague, M Diaz Curiel, M Ortiz, F Palomino, P de la Piedra, C Torres, R Peramo, B Lopez Gavilanes, E Calcif-Tissue-Int. 1991 December; 49(6): 436-7 0171967X

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Clinical efficacy of salmon calcitonin in Paget's disease of bone. Author(s): Bone Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048. Source: Singer, F R Calcif-Tissue-Int. 1991; 49 Suppl 2S7-8 0171-967X

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Clinical review 39: Paget's disease of bone. Author(s): Henry Ford Hospital, Detroit, Michigan 48202. Source: Bone, H G Kleerekoper, M J-Clin-Endocrinol-Metab. 1992 November; 75(5): 1179-82 0021-972X

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Clodronate treatment reduces serum levels of interleukin-6 soluble receptor in Paget's disease of bone. Author(s): Department of Clinical and Experimental Medicine, Federico II University Medical School, Naples, Italy. Source: Rendina, D Postiglione, L Vuotto, P Numis, F G Di Domenico, G Viceconti, R Mossetti, G Nunziata, V Clin-Exp-Rheumatol. 2002 May-June; 20(3): 359-64 0392-856X

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Correlation between serum osteocalcin and 24,25-dihydroxyvitamin D levels in Paget's disease of bone. Author(s): Unidad Metabolica, Fundacion Jimenez Diaz, Madrid, Spain. Source: Castro Errecaborde, N de la Piedra, C Rapado, A Alvarez Arroyo, M V Torres, R Traba, M L J-Clin-Endocrinol-Metab. 1991 February; 72(2): 462-6 0021-972X

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Critical evaluation of viral antigen data in Paget's disease of bone. Source: Mills, B G Singer, F R Clin-Orthopage 1987 April; (217): 16-25 0009-921X

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Diagnosis and treatment of Paget's disease of bone. Author(s): Department of Internal Medicine and the Muller Center for Senior Health, Abington Memorial Hospital, Pennsylvania 19001-3788, USA. Source: Schneider, Doron Hofmann, Mary T Peterson, Jeannette A Am-Fam-Physician. 2002 May 15; 65(10): 2069-72 0002-838X

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Docetaxel induced durable response in advanced extramammary Paget's disease: a case report. Author(s): Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan. Source: Oguchi, Shinji Kaneko, Miwako Uhara, Hisashi Saida, Toshiaki J-Dermatol. 2002 January; 29(1): 33-7 0385-2407

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Evaluation by using radionuclide uptake of bone in Paget's disease of bone: special reference to treatment with calcitonin. Author(s): Department of Radiology, Kyoto City Hospital, Japan. Source: Dokoh, S Fukunaga, M Yamamoto, I Torizuka, K Morita, R Radioisotopes. 1988 June; 37(6): 339-42 0033-8303

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Focal osteolysis as a complication of therapy for Paget's disease: case report. Author(s): Department of Pathology, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Que. Source: Zander, D R Lander, P Begin, L R Hadjipavlou, A G Can-Assoc-Radiol-J. 1998 April; 49(2): 102-4 0846-5371

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Formation of neutralizing antibodies during intranasal synthetic salmon calcitonin treatment of Paget's disease. Author(s): Department of Orthopedic Surgery, University of Zurich, Switzerland. Source: Levy, F Muff, R Dotti Sigrist, S Dambacher, M A Fischer, J A J-Clin-EndocrinolMetab. 1988 September; 67(3): 541-5 0021-972X

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Hemifacial spasm associated with Paget's disease of bone: good response to calcitonin. Author(s): Department of Clinical Neurophysiology, Ciudad Sanitaria Valle Hebron, Barcelona, Spain. Source: Fernandez, J M Mederer, S Alvarez Sabin, J Segura, A Codina, A Neurology. 1991 August; 41(8): 1322-3 0028-3878

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Human calcitonin for Paget's disease. Source: Anonymous Med-Lett-Drugs-Ther. 1987 May 8; 29(739): 47-8 0025-732X

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In vitro detection of neutralizing antibodies after treatment of Paget's disease of bone with nasal salmon calcitonin. Author(s): Department of Internal Medicine I, Endocrinology and Metabolism, University of Heidelberg. Source: Grauer, A Raue, F Schneider, H G Frank Raue, K Ziegler, R J-Bone-Miner-Res. 1990 April; 5(4): 387-91 0884-0431

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Influence of pharmacological doses of calcitonin on serum osteocalcin concentration in patients with Paget's disease of the bone. Author(s): Department of Internal Medicine, Eudokia Hospital, Rotterdam, The Netherlands. Source: Mulder, H Schop, C Koster, J C Acta-Endocrinol-(Copenh). 1989 June; 120(6): 721-3 0001-5598

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Intranasal and intramuscular human calcitonin in female osteoporosis and in Paget's disease of bones: a pilot study. Author(s): Clinica Medica, Universita di Milano, Italy. Source: Pontiroli, A E Pajetta, E Calderara, A Alberetto, M Pozza, G Manganelli, V Resmini, G Tessari, L Maresca, V J-Endocrinol-Invest. 1991 January; 14(1): 47-51 03914097

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Intranasal salmon calcitonin treatment of Paget's disease of bone. Results in nine patients. Author(s): Department of Radiology, Veterans Administration Medical Center, Martinez, California. Source: D'Agostino, H R Barnett, C A Zielinski, X J Gordan, G S Clin-Orthopage 1988 May; (230): 223-8 0009-921X

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Long-term elevation of 1,25-dihydroxyvitamin D after short-term intravenous administration of pamidronate (aminohydroxypropylidene bisphosphonate, APD) in Paget's disease of bone. Author(s): Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Nedlands, Western Australia. Source: Devlin, R D Retallack, R W Fenton, A J Grill, V Gutteridge, D H Kent, G N Prince, R L Worth, G K J-Bone-Miner-Res. 1994 January; 9(1): 81-5 0884-0431

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Measurement of bone mineral density by dual X-ray absorptiometry in Paget's disease before and after pamidronate treatment. Author(s): Service de Rhumatologie, CHU Rangueil, 1 avenue Jean-Poulhes, F-31403 Cedex 4, Toulouse, France.

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Source: Laroche, M Delpech, B Bernard, J Constantin, A Mazieres, B Calcif-Tissue-Int. 1999 September; 65(3): 188-91 0171-967X •

Medical treatment for Paget's disease of bone. Source: Bockman, R S Weinerman, S A Instr-Course-Lect. 1993; 42425-33 0065-6895

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Metastatic vulvar Paget's disease responding to combination chemotherapy: case report. Author(s): Department of Obstetrics and Gynecology, Gifu University School of Medicine. Source: Yokoyama, Y Mabuchi, M Kawabata, I Niwa, K Shimokawa, K Tamaya, T Jpn-JClin-Oncol. 1990 December; 20(4): 426-30 0368-2811

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New modes of administration of salmon calcitonin in Paget's disease. Nasal spray and suppository. Source: Nagant de Deuxchaisnes, C Devogelaer, J P Huaux, J P Dufour, J P Esselinckx, W Engelbeen, J P Stasse, P Hermans, P de Buisseret, J P Clin-Orthopage 1987 April; (217): 56-71 0009-921X

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Normal carboxylation of circulating osteocalcin (bone Gla-protein) in Paget's disease of bone. Author(s): INSERM Unit 234, Hopital E. Herriot, Lyon, France. Source: Merle, B Delmas, P D Bone-Miner. 1990 November; 11(2): 237-45 0169-6009

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One year's treatment of Paget's disease of bone by synthetic salmon calcitonin as a nasal spray. Author(s): Rheumatology, Physical Medicine and Rehabilitation Department, University of Liege, Belgium. Source: Reginster, J Y Jeugmans Huynen, A M Albert, A Denis, D Franchimont, P JBone-Miner-Res. 1988 June; 3(3): 249-52 0884-0431

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Optimizing the treatment of Paget's disease of bone. Source: Reginster, J Y Gennari, C Hosking, D J Ringe, J D Meunier, P J Rev-Rhum-EnglEd. 1997 April; 64(4): 207-9 1169-8446

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Osteoclast differentiation from circulating mononuclear precursors in Paget's disease is hypersensitive to 1,25-dihydroxyvitamin D(3) and RANKL. Author(s): Nuffield Department of Orthopaedic Surgery, University of Oxford, Oxford, UK. Source: Neale, S D Smith, R Wass, J A Athanasou, N A Bone. 2000 September; 27(3): 40916 8756-3282

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Paget's disease and fibrous dysplasia. Author(s): University of South Florida College of Medicine, Tampa. Source: Wallach, S Curr-Opin-Rheumatol. 1991 June; 3(3): 472-80 1040-8711

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Paget's disease of bone in older patients: UCLA grand rounds. Author(s): Geriatric Research, Education and Clinical Center, Sepulveda Veterans Administration Medical Center, CA 91343. Source: Rosenthal, M J Hartnell, J M Kaiser, F E Gharib, D Morley, J E J-Am-Geriatr-Soc. 1989 July; 37(7): 639-50 0002-8614

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Paget's disease of the bone. Author(s): Department of Geriatric Medicine and Gerontology, James H. Quillen College of Medicine, East Tennessee State University, Johnson City. Source: Hamdy, R C Clin-Geriatr-Med. 1994 November; 10(4): 719-35 0749-0690

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Pamidronate sodium and calcitonin-resistant Paget's disease. Immediate response in a patient. Author(s): Department of Medicine, University of Tennessee at Memphis 38163. Source: Drake, S Massie, J D Postlethwaite, A E Palmieri, G M Arch-Intern-Med. 1989 February; 149(2): 401-3 0003-9926

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Post-partum hypercalcemia in hereditary hyperphosphatasia (juvenile Paget's disease). Author(s): Ewen Downie Metabolic Unit, Alfred Hospital, Melbourne, Vic, Australia. Source: Chosich, N Long, F Wong, R Topliss, D J Stockigt, J R J-Endocrinol-Invest. 1991 Jul-August; 14(7): 591-7 0391-4097

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Prevention of appendicular bone loss in Paget's disease following treatment with intravenous pamidronate disodium. Author(s): Department of Diabetes and Endocrinology, Fremantle Hospital and Health Services, WA, Australia. Source: Stewart, G O Gutteridge, D H Price, R I Ward, L Retallack, R W Prince, R L Stuckey, B G Kent, G N Bhagat, C I Dhaliwal, S S Bone. 1999 February; 24(2): 139-44 8756-3282

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Procollagen-III peptide serum levels in Paget's disease of the bone. Source: Wilder Smith, C H Raue, F Holz Gottswinter, G Ziegler, R Klin-Wochenschr. 1987 February 16; 65(4): 174-8 0023-2173

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Radiologic case study. Paget's disease with a pathologic fracture. Author(s): Department of Orthopedics, University of Missouri, Columbia, USA. Source: White, R A Burd, T Greene, W Griffiths, H J Orthopedics. 2002 April; 25(4): 388, 446-8 0147-7447

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Risedronate, a highly effective oral agent in the treatment of patients with severe Paget's disease. Author(s): John Wayne Cancer Institute, Santa Monica, California 90404, USA. Source: Singer, F R Clemens, T L Eusebio, R A Bekker, P J J-Clin-Endocrinol-Metab. 1998 June; 83(6): 1906-10 0021-972X

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Spinal artery steal syndrome in Paget's disease of bone. Author(s): Department of Medicine, Instituto Nacional de Rehabilitacion, Buenos Aires, Argentina. Source: Porrini, A A Maldonado Cocco, J A Garcia Morteo, O Clin-Exp-Rheumatol. 1987 Oct-December; 5(4): 377-8 0392-856X

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Spinal cord compression in Paget's disease of bone with reference to sarcomatous degeneration and calcitonin treatment. Source: Gruszkiewicz, J Doron, Y Borovich, B Zaaroor, M Surg-Neurol. 1987 February; 27(2): 117-25 0090-3019

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Stabilization of hearing loss in Paget's disease with calcitonin and etidronate. Author(s): Division of Head and Neck Surgery, UCLA School of Medicine 90024. Source: Lando, M Hoover, L A Finerman, G Arch-Otolaryngol-Head-Neck-Surg. 1988 August; 114(8): 891-4 0886-4470

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Successful treatment of dysphagia in Paget's disease of the bone. Author(s): Digestive Disease Center, Medical University of South Carolina, Charleston 29425, USA. Source: Varadarajulu, S Reddy, S Noone, T Payne, K M Dig-Dis-Sci. 2002 September; 47(9): 2112-5 0163-2116

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The effect of 1 alpha-hydroxyvitamin D3 on the mineralization defect in disodium etidronate-treated Paget's disease--a double-blind randomized clinical study. Author(s): University Department of Medicine, Glasgow Royal Infirmary, Scotland. Source: Ralston, S H Boyce, B F Cowan, R A Fogelman, I Smith, M L Jenkins, A Boyle, I T J-Bone-Miner-Res. 1987 February; 2(1): 5-12 0884-0431

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The effect of nasal hCT on bone turnover in Paget's disease of bone--implications for the treatment of other metabolic bone diseases. Author(s): Department of Rheumatology and Endocrinology, University of Liege, Belgium. Source: Reginster, J Y Jeugmans Huynen, A M Wouters, M Sarlet, N McIntyre, H D Franchimont, P Br-J-Rheumatol. 1992 January; 31(1): 35-9 0263-7103

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Thirty cases of concurrent Paget's disease and primary hyperparathyroidism: sex distribution, histomorphometry, and prediction of the skeletal response to parathyroidectomy. Author(s): Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, 6009. Source: Gutteridge, D H Gruber, H E Kermode, D G Worth, G K Calcif-Tissue-Int. 1999 December; 65(6): 427-35 0171-967X

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Treatment of osteoporosis and Paget's disease. Author(s): Fremantle Hospital, Western Australia. Source: Stewart, G O Nicholson, G C Curr-Opin-Rheumatol. 1991 June; 3(3): 380-7 10408711

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Treatment of Paget's disease of bone with salmon calcitonin nasal spray. Author(s): Division of Endocrinology and Metabolism, Baylor College of Medicine, Houston, Texas. Source: Gagel, R F Logan, C Mallette, L E J-Am-Geriatr-Soc. 1988 November; 36(11): 1010-4 0002-8614

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Visual impairment in a case of juvenile Paget's disease with pseudoxanthoma elasticum: an eleven year follow up. Author(s): Department of Ophthalmology, Southern General Hospital, Victoria Infirmary, Glasgow, Scotland. Source: Sharif, K W Doig, W M Kinsella, F P J-Pediatr-Ophthalmol-Strabismus. 1989 Nov-December; 26(6): 299-302 0191-3913

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Vitamin D in Paget's disease of bone. Author(s): Unit of Metabolic Bone Diseases, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel. Source: Foldes, J Shamir, S Kidroni, G Menczel, J Clin-Orthopage 1989 June; (243): 275-9 0009-921X

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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CHAPTER 3. ALTERNATIVE MEDICINE AND PAGET’S DISEASE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to Paget’s disease. 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 Paget’s disease 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 “Paget’s disease” (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 Paget’s disease: •

360 degrees or 180 degrees for bone SPECT of the spine? Author(s): Tondeur M, Ham H. Source: Nuclear Medicine Communications. 1994 April; 15(4): 279-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8072741&dopt=Abstract

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A case of mammary Paget's disease without an underlying carcinoma: microscopic analysis of the DNA content in Paget cells. Author(s): Mori O, Hachisuka H, Nakano S, Maeyama Y, Sasai Y. Source: The Journal of Dermatology. 1994 March; 21(3): 160-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8014269&dopt=Abstract

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Angioid streaks associated with abetalipoproteinemia. Author(s): Gorin MB, Paul TO, Rader DJ.

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Source: Ophthalmic Genetics. 1994 September-December; 15(3-4): 151-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7749670&dopt=Abstract •

Bisphosphonate therapy for Paget's disease in a patient with hypoparathyroidism: profound hypocalcemia, rapid response, and prolonged remission. Author(s): Stuckey BG, Lim EM, Kent GN, Ward LC, Gutteridge DH. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2001 September; 16(9): 1719-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11547843&dopt=Abstract

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Bisphosphonates in prostate carcinoma. Author(s): Adami S. Source: Cancer. 1997 October 15; 80(8 Suppl): 1674-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9362435&dopt=Abstract

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Bone scintigraphy in metabolic bone disease. Author(s): Ryan PJ, Fogelman I. Source: Semin Nucl Med. 1997 July; 27(3): 291-305. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9224668&dopt=Abstract

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Cauda equina syndrome with pagetic vertebral fusion. Clinical recovery under calcium-vitamin D supplementation plus clodronate after apparent failure of pamidronate and acquired resistance to etidronate. Author(s): Eulry F, Poirier JM, Perard D, Bergamasco P, Lechevalier D, Magnin J. Source: Rev Rhum Engl Ed. 1997 July-September; 64(7-9): 495-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9338932&dopt=Abstract

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Cell cycle analyses of extramammary Paget's disease. Author(s): Mori O, Hachisuka H, Maeyama Y, Sasai Y. Source: Kurume Med J. 1993; 40(3): 129-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8139211&dopt=Abstract

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Chinese herbs and bone disease. Author(s): Hoshino J, Ubara Y, Tagami T, Sawa N, Yokota M, Katori H, Takemoto F, Mikami Y, Hara S, Hara S. Source: Intern Med. 2003 April; 42(4): 345-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729324&dopt=Abstract

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Chromium 51 EDTA/technetium 99m MDP plasma ratio to measure total skeletal function. Author(s): Nisbet AP, Edwards S, Lazarus CR, Malamitsi J, Maisey MN, Mashiter GD, Winn PJ.

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Source: The British Journal of Radiology. 1984 August; 57(680): 677-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6235885&dopt=Abstract •

Critical evaluation of viral antigen data in Paget's disease of bone. Author(s): Mills BG, Singer FR. Source: Clinical Orthopaedics and Related Research. 1987 April; (217): 16-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3549088&dopt=Abstract

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Demographics, assessment and management of pain in the elderly. Author(s): Davis MP, Srivastava M. Source: Drugs & Aging. 2003; 20(1): 23-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12513114&dopt=Abstract

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Docetaxel induced durable response in advanced extramammary Paget's disease: a case report. Author(s): Oguchi S, Kaneko M, Uhara H, Saida T. Source: The Journal of Dermatology. 2002 January; 29(1): 33-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11837572&dopt=Abstract

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Down-regulation of human osteoblast PTH/PTHrP receptor mRNA in end-stage renal failure. Author(s): Picton ML, Moore PR, Mawer EB, Houghton D, Freemont AJ, Hutchison AJ, Gokal R, Hoyland JA. Source: Kidney International. 2000 October; 58(4): 1440-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11012879&dopt=Abstract

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Expression of desmogleins in Paget cells of mammary and extramammary Paget's disease. Author(s): Mori O, Karashima T, Matsuo K, Hashimoto T. Source: Kurume Med J. 1997; 44(3): 185-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9339649&dopt=Abstract

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Fluoride kinetics of the axial skeleton measured in vivo with fluorine-18-fluoride PET. Author(s): Schiepers C, Nuyts J, Bormans G, Dequeker J, Bouillon R, Mortelmans L, Verbruggen A, De Roo M. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1997 December; 38(12): 1970-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9430479&dopt=Abstract

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Immunoradiometric assay for intact human osteocalcin(1-49) without cross-reactivity to breakdown products.

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Author(s): Colford JW, Lueddecke BA, Salvati M, Hanna D, Sailer D, Khosla S, Riggs BL, Langman CB. Source: Clinical Chemistry. 1999 April; 45(4): 526-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10102913&dopt=Abstract •

Ipriflavone: an important bone-building isoflavone. Author(s): Head KA. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 1999 February; 4(1): 10-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9988779&dopt=Abstract

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Ipriflavone: pharmacological properties and usefulness in postmenopausal osteoporosis. Author(s): Reginster JY. Source: Bone Miner. 1993 December; 23(3): 223-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8148667&dopt=Abstract

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Low-dose mitomycin C, etoposide, and cisplatin for invasive vulvar Paget's disease. Author(s): Watanabe Y, Hoshiai H, Ueda H, Nakai H, Obata K, Noda K. Source: International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society. 2002 May-June; 12(3): 304-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12060453&dopt=Abstract

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Metastatic eccrine porocarcinoma: response to docetaxel (Taxotere) chemotherapy. Author(s): Plunkett TA, Hanby AM, Miles DW, Rubens RD. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2001 March; 12(3): 411-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11332156&dopt=Abstract

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Metastatic vulvar Paget's disease responding to combination chemotherapy: case report. Author(s): Yokoyama Y, Mabuchi M, Kawabata I, Niwa K, Shimokawa K, Tamaya T. Source: Japanese Journal of Clinical Oncology. 1990 December; 20(4): 426-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2178199&dopt=Abstract

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Osteomalacia in Paget's disease treated with short term, high dose sodium etidronate. Author(s): Gibbs CJ, Aaron JE, Peacock M. Source: British Medical Journal (Clinical Research Ed.). 1986 May 10; 292(6530): 1227-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3085789&dopt=Abstract

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Paget's disease of bone--current thinking and management. Author(s): Hughes S, Peel-White AL, Peterson CK.

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Source: Journal of Manipulative and Physiological Therapeutics. 1992 May; 15(4): 242-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1321871&dopt=Abstract •

Parathyroid carcinoma: location of pelvic metastases by parathyroid hormone assay. Author(s): Murray TM, Patt NL, Muzaffar SA. Source: Can Med Assoc J. 1974 April 6; 110(7): 809-10 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4363399&dopt=Abstract

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Renal secretion of diphosphonates in rats. Author(s): Troehler U, Bonjour JP, Fleisch H. Source: Kidney International. 1975 July; 8(1): 6-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=240057&dopt=Abstract

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Secondary hyperparathyroidism associated with dichloromethane diphosphonate treatment of Paget's disease. Author(s): Harris ST, Neer RM, Segre GV, Petkau AJ, Tully GL 3rd, Daly M, Potts JT Jr. Source: The Journal of Clinical Endocrinology and Metabolism. 1982 December; 55(6): 1100-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6215419&dopt=Abstract

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Short-term treatment of Paget's disease of bone with ipriflavone. Author(s): Agnusdei D, Camporeale A, Gonnelli S, Gennari C, Baroni MC, Passeri M. Source: Bone Miner. 1992 October; 19 Suppl 1: S35-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1422319&dopt=Abstract

•

Structure-activity relationships of anthraquinones in some pathological conditions. Author(s): Friedmann CA. Source: Pharmacology. 1980; 20 Suppl 1: 113-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6445567&dopt=Abstract

•

The clinical measurement of skeletal blood flow. Author(s): Wootton R, Reeve J, Veall N. Source: Clin Sci Mol Med. 1976 April; 50(4): 261-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1261207&dopt=Abstract

•

The diphosphonate space: a useful quantitative index of disease activity in patients undergoing hydroxy methylene diphosphonate (HMDP) bone imaging for Paget's disease [corrected] Author(s): Evans A, Perkins A, Wastie M, Stone M, Hosking D.

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Source: European Journal of Nuclear Medicine. 1991; 18(9): 757-9. Erratum In: Eur J Nucl Med 1992; 19(2): 151. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1809266&dopt=Abstract •

The pathology of invasive breast cancer. A syllabus derived from findings of the National Surgical Adjuvant Breast Project (protocol no. 4). Author(s): Fisher ER, Gregorio RM, Fisher B, Redmond C, Vellios F, Sommers SC. Source: Cancer. 1975 July; 36(1): 1-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=173455&dopt=Abstract

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Tracer flows and 'difficult' organs. Author(s): Rutland MD. Source: Nuclear Medicine Communications. 1995 January; 16(1): 31-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7609932&dopt=Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to Paget’s disease; 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:

Alternative Medicine 71

•

General Overview Skin Cancer Source: Integrative Medicine Communications; www.drkoop.com

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Herbs and Supplements Bisphosphonate Derivatives Source: Integrative Medicine Communications; www.drkoop.com Bisphosphonates Source: Healthnotes, Inc.; www.healthnotes.com Risedronate Source: Healthnotes, Inc.; www.healthnotes.com

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

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CHAPTER 4. CLINICAL TRIALS AND PAGET’S DISEASE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning Paget’s disease.

Recent Trials on Paget’s Disease The following is a list of recent trials dedicated to Paget’s disease.5 Further information on a trial is available at the Web site indicated. •

Medroxyprogesterone in Treating Women With Breast Cancer Condition(s): Endometrial Cancer; stage I breast cancer; stage II breast cancer; intraductal breast carcinoma; lobular breast carcinoma in situ; Paget's disease of the breast Study Status: This study is currently recruiting patients. Sponsor(s): Southwest Oncology Group; National Cancer Institute (NCI); Cancer and Leukemia Group B Purpose - Excerpt: RATIONALE: It is not yet known whether medroxyprogesterone is effective in preventing endometrial disorder in patients with breast cancer who are taking tamoxifen. PURPOSE: Randomized phase III trial to study the effectiveness of medroxyprogesterone in preventing endometrial disorder in postmenopausal women who have ductal carcinoma in situ, lobular carcinoma in situ, Paget's disease of the nipple, stage I breast cancer, or stage II breast cancer and who are taking tamoxifen. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002920

5

These are listed at www.ClinicalTrials.gov.

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•

New bisphosphonate treatment for Paget's disease Condition(s): Paget's Disease of Bone Study Status: This study is currently recruiting patients. Sponsor(s): Novartis Pharmaceuticals Purpose - Excerpt: HORIZON TOP will study the effect of zoledronic acid given once as an iv infusion compared to 60 days of oral risedronate in patients with Paget's disease of bone. The effect will be demonstrated in the reduction of serum alkaline phosphatase (SAP). Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00051636

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “Paget’s disease” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 5. BOOKS ON PAGET’S DISEASE Overview This chapter provides bibliographic book references relating to Paget’s disease. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on Paget’s disease include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Human calcitonin and Paget's disease : proceedings of an international workshop, London, April 1976; ISBN: 3456805020; http://www.amazon.com/exec/obidos/ASIN/3456805020/icongroupinterna

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Paget's Disease of Bone (1991); ISBN: 0306309963; http://www.amazon.com/exec/obidos/ASIN/0306309963/icongroupinterna

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Paget's disease of bone by Hugh C. Barry; ISBN: 0443006512; http://www.amazon.com/exec/obidos/ASIN/0443006512/icongroupinterna

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Paget's Disease of Bone: Clinical Assessment, Present and Future Therapy by F.R. Singer; ISBN: 0444015590; http://www.amazon.com/exec/obidos/ASIN/0444015590/icongroupinterna

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Paget's Disease of the Bone by R. C. Hamdy (Author) (1981); ISBN: 0275913449; http://www.amazon.com/exec/obidos/ASIN/0275913449/icongroupinterna

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Pathophysiology & Treatment of Paget's Disease of Bone by John A. Kanis (1998); ISBN: 1853174637; http://www.amazon.com/exec/obidos/ASIN/1853174637/icongroupinterna

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The Molecular Biology of Paget's Disease by Paul T. Sharpe; ISBN: 3540612440; http://www.amazon.com/exec/obidos/ASIN/3540612440/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “Paget’s disease” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:6 •

A clinical and pathological study of malignancies of the nipple, exclusive of Paget's disease, but including a comparative study of papillomas of the nipple. Author: Congdon, Gordon Hall,; Year: 1954; [Minneapolis] 1954

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Diphosphonates and Paget's disease: proceedings of a symposium held at the University of York from 5-7 April 1981, sponsored by Brocades Author: Williams, N. J.; Year: 1981; London: Harvey; Blythe, [1981]

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Osteitis deformans; Paget's disease of the bone. Author: Dickson, Douglas Dwight,; Year: 1939; [Minneapolis, Minn.] 1939

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Paget's disease: an annotated bibliography, January 1990 Author: Harris, Cheryl.; Year: 1990; [Bethesda, Md.]: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, [1990]

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Paget's disease of bone: assessment and management Author: Hamdy, R. C.; Year: 1981; Eastbourne, East Sussex; New York: Praeger, 1981; ISBN: 0030591775

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Paget's disease of bone. Author: Barry, Hugh C. (Hugh Collis),; Year: 1969; Edinburgh, Livingstone, 1969; ISBN: 4006512
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Paget's disease of the male nipple and areola. Author: Rubenstein, Myer W.,; Year: 1929; [Minneapolis] 1929

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Paget's disease of the nipple and its relation to surface cancers and precancerous states in general. Author: Inglis, Keith.; Year: 1936; London, Oxford Univ. Press, 1936

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Paget's disease of the temporal bone. Author: Nager, George T. (George Theodore),; Year: 1975; [St. Louis, Annals Pub. Co.] 1975

6

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

Books

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Paget's disease, osteitis deformans of the jaws. Author: Funk, Edward Curtis,; Year: 1955; [Minneapolis] 1955

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Pathologic study of Paget's disease of the nipple. Author: Bennett, Warren Alfred,; Year: 1943; [Minneapolis] 1943

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Sarcoma in Paget's disease of bone. Author: Porretta, Charles Anthony,; Year: 1956; [Minneapolis] 1956

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The Aetiology of Paget's disease of bone: proceedings of a meeting held on 2nd December 1983 at the MRC Environmental Epidemiology Unit. Author: Pippard, Clare.; Year: 1984; Southampton: Southampton General Hospital, c1984; ISBN: 0903730103

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The molecular biology of Paget's disease Author: Sharpe, Paul T.; Year: 1996; New York: Chapman; Hall; Austin: R.G. Landes, c1996; ISBN: 0412107317 http://www.amazon.com/exec/obidos/ASIN/0412107317/icongroupinterna

Chapters on Paget’s Disease In order to find chapters that specifically relate to Paget’s disease, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and Paget’s disease using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “Paget’s disease” (or synonyms) into the “For these words:” box.

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CHAPTER 6. MULTIMEDIA ON PAGET’S DISEASE Overview In this chapter, we show you how to keep current on multimedia sources of information on Paget’s disease. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Bibliography: Multimedia on Paget’s Disease The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in Paget’s disease (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on Paget’s disease: •

Metabolic and endocrine disorders [slide]: radiologic evaluation of metabolic and endocrine disorders osteoporosis, rickets, and osteomalacia, hyperparathyroidism, Paget's disease, miscellaneous metabolic and endocrine disorders. Year: 1990; Format: Slide; New York, N.Y.: Gower Medical Pub., 1990

•

Paget's disease of bone [slide] Source: the American Academy of Orthopaedic Surgeons; Year: 1982; Format: Slide; [Chicago, Ill.]: The Academy, [1982]

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CHAPTER 7. PERIODICALS AND NEWS ON PAGET’S DISEASE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Paget’s disease.

News Services and Press Releases One of the simplest ways of tracking press releases on Paget’s disease 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 “Paget’s disease” (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 Paget’s disease. 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 “Paget’s disease” (or synonyms). The following was recently listed in this archive for Paget’s disease: •

Juvenile Paget's disease can result from osteoprotegerin deficiency Source: Reuters Medical News Date: July 18, 2002

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Paget's disease of the bone linked to more than one gene Source: Reuters Medical News Date: June 21, 2000

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Risedronate superior to etidronate for management of Paget's disease Source: Reuters Medical News Date: May 26, 1999

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FDA Approves Risedronate For Treating Paget's Disease Source: Reuters Medical News Date: April 03, 1998

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Conservative Therapy Effective For Paget's Disease Of The Breast Source: Reuters Medical News Date: September 15, 1997

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Exposure To Cattle, Pets Increases Risk Of Paget's Disease Of Bone Source: Reuters Medical News Date: May 27, 1997

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Animals Linked to Paget's Disease Source: Reuters Health eLine Date: April 29, 1997

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Oral Alendronate Reverses Osteolysis In Paget's Disease Source: Reuters Medical News Date: October 29, 1996

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Paget's Disease Caused By Osteoclast Hyperproliferation Source: Reuters Medical News Date: March 11, 1996 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

Periodicals and News

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Market Wire’s home page at http://www.marketwire.com/mw/home, type “Paget’s disease” (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 “Paget’s disease” (or synonyms). If you know the name of a company that is relevant to Paget’s disease, 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 “Paget’s disease” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “Paget’s disease” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on Paget’s disease: •

Skelid Now Available for the Treatment of Paget's Disease of Bone Source: Update. 19(2):1; Summer 1997. Contact: Paget Foundation, 120 Wall Street, 16th Floor, New York, NY 10005. (800) 23PAGET. Summary: This newsletter article for individuals with Paget's disease discusses a new drug, Skelid, for the treatment of this disease. This drug is a bisphosphonate and is indicated for individuals who have alkaline phosphatase levels that are twice the upper limit of normal, who are symptomatic, or who are at risk for future complications. Features of the drug discussed include its dosage level, interactions with other substances, medical effectiveness, and side effects.

•

Does Genetics Play a Role in Paget's Disease? Source: Update. 19(3):1,4; Fall 1997.

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Contact: Paget Foundation, 200 Varick Street, Suite 1004, New York, NY 10014-4810. (212) 229-1582. (800) 237-2438. (212) 229-1502 (fax). Summary: This newsletter article reviews studies that have investigated the role of genetic factors in Paget's disease. These studies provide evidence that genetics could have a role in this disease. The article also describes research involving the search for specific genes that could predispose an individual to Paget's disease. This research has led to the identification of a region of human chromosome 18 that may carry a predisposition gene for Paget's disease. Other evidence shows that the gene on chromosome 18 may not be the only gene that can cause this disease. In addition, other research is focusing on the relationship of the region of chromosome 18 that may carry a predisposition for Paget's disease and the presence of measle-like viruses in the bones of some individuals affected with Paget's disease.

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

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CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for Paget’s disease. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with Paget’s disease. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to Paget’s disease: Alendronate •

Systemic - U.S. Brands: Fosamax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202794.html

Calcitonin •

Systemic - U.S. Brands: Calcimar; Cibacalcin; Miacalcin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202106.html

Etidronate •

Systemic - U.S. Brands: Didronel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202233.html

Pamidronate •

Systemic - U.S. Brands: Aredia http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202662.html

Plicamycin •

Systemic - U.S. Brands: Mithracin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202467.html

Risedronate •

Systemic - U.S. Brands: Actonel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203554.html

Tiludronate •

Systemic - U.S. Brands: Skelid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203480.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

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PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to Paget’s disease by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “Paget’s disease” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for Paget’s disease: •

Calcitonin-human for injection (trade name: Cibacalcin) http://www.rarediseases.org/nord/search/nodd_full?code=602

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute7: •

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/

7

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

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

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

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

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

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

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

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

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

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

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

•

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

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

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

•

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.8 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:9 •

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

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

•

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

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

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

•

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

8 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). 9 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 Gateway10 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.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Paget’s disease” (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 5659 66 879 0 0 6604

HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 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.14 Simply search by “Paget’s disease” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

10

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

11

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). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14

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 Biologists15 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.16 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.17 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/.

15 Adapted 16

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. 17 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 Paget’s disease can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to Paget’s disease. 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 Paget’s disease. 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 “Paget’s disease”:

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Guides on Paget’s disease Paget's Disease of Bone http://www.nlm.nih.gov/medlineplus/pagetsdiseaseofbone.html

•

Other guides Ankylosing Spondylitis http://www.nlm.nih.gov/medlineplus/ankylosingspondylitis.html Bone Cancer http://www.nlm.nih.gov/medlineplus/bonecancer.html Bone Diseases http://www.nlm.nih.gov/medlineplus/bonediseases.html Breast Cancer http://www.nlm.nih.gov/medlineplus/breastcancer.html Osteogenesis Imperfecta http://www.nlm.nih.gov/medlineplus/osteogenesisimperfecta.html

Within the health topic page dedicated to Paget’s disease, the following was listed: •

General/Overviews Breast Cancer http://www.nlm.nih.gov/medlineplus/tutorials/breastcancernewloader.html What is Breast Cancer? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_is_breast_cancer_5. asp?sitearea=cri

•

Diagnosis/Symptoms Breast Implants: Do They Affect Breast Self-Exams? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00419 Breast Lump -- Biopsy http://www.nlm.nih.gov/medlineplus/tutorials/breastlumpsbiopsyloader.html Breast Self-Examination Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=WO00026 Can Breast Cancer Be Found Early? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_3x_can_breast_cancer_be_fo und_early_5.asp?sitearea=cri How Is Breast Cancer Diagnosed? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_3x_how_is_breast_cancer_di agnosed_5.asp?

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How is Breast Cancer Staged? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_3x_how_is_breast_cancer_st aged_5.asp?sitearea=cri Questions and Answers: Collecting Cells for Breast Cancer Biomarker Research Nipple Aspiration and Ductal Lavage Source: National Cancer Institute http://www.cancer.gov/newscenter/Lavage Ultrasound-Guided Breast Biopsy Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/interventional/breast_biopsy_us.htm Understanding Breast Changes: A Health Guide for All Women Source: National Cancer Institute http://www.cancer.gov/cancerinfo/understanding-breast-changes/ Understanding Tumor Markers for Breast and Colorectal Cancers Source: American Society of Clinical Oncology http://www.asco.org/ac/1%2C1003%2C_12-002214-00_18-009317-00_19-001000600_20-001%2C00.asp X-ray Guided Breast Biopsy Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/interventional/breast_biopsy_xr.htm •

Treatment Adjuvant Therapy for Breast Cancer: Questions and Answers Source: National Cancer Institute http://cis.nci.nih.gov/fact/7_20.htm Biological Therapies: Using the Immune System to Treat Cancer Source: National Cancer Institute http://cis.nci.nih.gov/fact/7_2.htm Biphosphonates for Breast Cancer Source: American Society of Clinical Oncology http://www.asco.org/ac/1%2C1003%2C_12-002214-00_18-0031017-00_19-003101800_20-001%2C00.asp Breast Cancer - Surgery http://www.nlm.nih.gov/medlineplus/tutorials/breastcancerloader.html Breast Cancer (PDQ): Treatment Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/treatment/breast/patient/ Breast Cancer and Pregnancy (PDQ) Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/treatment/breast-cancer-andpregnancy/patient/ FDA Clears New Device for Radiation Treatment for Breast Cancer Source: Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2002/ANS01150.html

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New Treatment Significantly Improves Long-Term Outlook for Breast Cancer Survivors Source: National Cancer Institute http://www.nih.gov/news/pr/oct2003/nci-09.htm Race, Age, Geography, Significantly Decrease Odds of Breast Reconstruction after Mastectomy Source: American Society of Plastic Surgeons http://www.plasticsurgery.org/news_room/press_releases/Race-Age-GeographySignificantly-Decrease-Odds-of-Breast-Reconstruction-After-Mastectomy.cfm Radiofrequency Catheter Ablation (RFA) Source: Society of Interventional Radiology http://www.sirweb.org/patPub/radiofrequencyAblation.shtml Tamoxifen: Questions and Answers Source: National Cancer Institute http://cis.nci.nih.gov/fact/7_16.htm Understanding Breast Cancer Treatments: A Guide For Patients Source: National Cancer Institute http://oesi.nci.nih.gov/aboutbc/ubc_treatment.html •

Nutrition Breast Cancer, Fruit and Vegetable Intake Link Questioned Source: American Cancer Society http://www.cancer.org/docroot/nws/content/nws_1_1x_breast_cancer__fruit_an d_vegetable_intake_link_questioned.asp

•

Coping Female Sexuality After Cancer: What You and Your Partner Need to Know Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=SA00071 Where to Seek Professional Help: Sexuality and Cancer Source: American Cancer Society http://www.cancer.org/docroot/mit/content/mit_7_2x_where_to_seek_professio nal_help_women.asp

•

Specific Conditions/Aspects Antiperspirants/Deodorants and Breast Cancer Source: National Cancer Institute http://cis.nci.nih.gov/fact/3_66.htm Breast Calcium Deposits (Calcifications) Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00049 Breast Cancer: Know Your Type Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00348

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Can Having an Abortion Cause or Contribute to Breast Cancer? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_6x_can_having_an_abortion_c ause_or_contribute_to_breast_cancer.asp?sitearea=cri Inflammatory Breast Cancer Source: National Cancer Institute http://cis.nci.nih.gov/fact/6_2.htm Known Health Effects for Women Prescribed DES (Diethylstilbestrol) While Pregnant Source: Centers for Disease Control and Prevention http://www.cdc.gov/DES/consumers/about/effects_women.html Oral Contraceptives and Cancer Risk Source: National Cancer Institute http://cis.nci.nih.gov/fact/3_13.htm Understanding Estrogen Receptors, Tamoxifen, and Raloxifene Source: National Cancer Institute http://press2.nci.nih.gov/sciencebehind/estrogen/estrogen01.htm What Breast Cancer Survivors Need to Know About Osteoporosis Source: Osteoporosis and Related Bone Diseases-National Resource Center http://www.osteo.org/newfile.asp?doc=r805i&doctitle=What%2BBreast%2BCance r%2BSurvivors%2BNeed%2Bto%2BKnow%2BAbout%2BOsteoporosis&doctype=HT ML%2BFact%2BSheet •

From the National Institutes of Health New Treatment Significantly Improves Long-Term Outlook for Breast Cancer Survivors Source: National Cancer Institute http://www.nih.gov/news/pr/oct2003/nci-09.htm NIHSeniorHealth: Breast Cancer Source: National Cancer Institute http://nihseniorhealth.gov/breastcancer/toc.html What You Need to Know about Breast Cancer Source: National Cancer Institute http://www.cancer.gov/cancerinfo/wyntk/breast

•

Latest News Ductal Lavage Not Reliable as Breast Cancer Screening Technique Source: 11/24/2003, American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Ductal_Lavage_Not_ Reliable_as_Breast_Cancer_Screening_Technique.asp Firm Will Sell Gene Test to Breast Cancer Patients Source: 12/07/2003, New York Times Syndicate http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_15009 .html

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Inadequate Treatment of Breast Cancer Deadly for Elderly Women Source: 11/04/2003, American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Inadequate_Treatmen t_of_Breast_Cancer_Deadly_for_Elderly_Women.asp Is Short Course, Partial Breast Radiation Safe? Source: 10/17/2003, American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Is_Short_Course_Parti al_Breast_Radiation_Safe.asp More News on Breast Cancer http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/alphanews_b.html#Br eastCancer New Scanner May Find Cancer Earlier Than Mammogram Source: 12/04/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14976 .html Radiation Key to Fight Ductal Breast Cancer Source: 12/04/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14975 .html •

Law and Policy Guidance and Summary of Actions on the Breast and Cervical Cancer Prevention and Treatment Act of 2000 Source: National Center for Chronic Disease Prevention and Health Promotion http://www.cdc.gov/cancer/nbccedp/law106-354.htm National Breast and Cervical Cancer Early Detection Program Source: Centers for Disease Control and Prevention http://www.cdc.gov/cancer/nbccedp/index.htm Women's Health and Cancer Rights Act Source: Centers for Medicare & Medicaid Services http://cms.hhs.gov/hipaa/hipaa1/content/whcra.asp

•

Men MEDLINEplus: Male Breast Cancer Source: National Library of Medicine http://www.nlm.nih.gov/medlineplus/malebreastcancer.html What Are the Risk Factors for Male Breast Cancer? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_2x_what_are_the_risk_factor s_for_male_breast_cancer_28.asp?sitearea=cri

•

Organizations American Cancer Society http://www.cancer.org/

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NABCO: National Alliance of Breast Cancer Organizations Source: National Alliance of Breast Cancer Organizations http://www.nabco.org/ National Cancer Institute http://www.cancer.gov/ Y-Me National Breast Cancer Organization http://www.y-me.org/ •

Pictures/Diagrams Atlas of the Body: The Breast -- Disorders Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZ3F9G56JC& sub_cat=326

•

Prevention/Screening Breast Cancer (PDQ): Prevention Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/prevention/breast/patient/ Breast Cancer (PDQ): Screening Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/screening/breast/patient/ Breast Cancer: Steps to Finding Breast Lumps Early Source: American Academy of Family Physicians http://familydoctor.org/018.xml MEDLINEplus: Mammography Source: National Library of Medicine http://www.nlm.nih.gov/medlineplus/mammography.html National Breast and Cervical Cancer Early Detection Program: Reducing Mortality Through Screening Source: National Center for Chronic Disease Prevention and Health Promotion http://www.cdc.gov/cancer/nbccedp/about.htm New Test May Spot Women at High Risk for Breast Cancer Source: American Cancer Society http://www.cancer.org/docroot/nws/content/nws_1_1x_new_test_may_spot_wo men_at_high_risk_for_breast_cancer.asp Preventive Mastectomy Source: National Cancer Institute http://cis.nci.nih.gov/fact/7_5.htm Protecting Your Health - Women Prescribed DES While Pregnant Source: Centers for Disease Control and Prevention http://www.cdc.gov/DES/consumers/do/protect_women.html U.S. Preventive Services Task Force: Breast Cancer - Screening Source: Agency for Healthcare Research and Quality http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm

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Updated Breast Cancer Screening Guidelines Released Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Updated_Breast_Canc er_Screening_Guidelines_Released.asp Using Medication to Prevent Breast Cancer: Recommendations from the United States Preventive Services Task Force Source: American College of Physicians http://www.annals.org/cgi/content/full/137/1/I-62 What Are the Risk Factors for Breast Cancer? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_2x_what_are_the_risk_factor s_for_breast_cancer_5.asp?sitearea=cri •

Research “Dose Dense” Chemotherapy Improves Survival in Breast Cancer Patients Compared to Conventional Chemotherapy Source: National Cancer Institute http://www.nih.gov/news/pr/dec2002/nci-12.htm Abortion, Miscarriage, and Breast Cancer Risk Source: National Cancer Institute http://cis.nci.nih.gov/fact/3_75.htm Breast Cancer and the Environment Studies Conducted and Supported by the National Cancer Institute Source: National Cancer Institute http://www.cancer.gov/newscenter/breastenvironment Breast Cancer Risk Among Young Women with Hodgkin Disease Source: National Cancer Institute http://www.cancer.gov/newscenter/pressreleases/HodgkinsBreast Brisk Walk to Cut Breast Cancer Risk Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_A_Brisk_Walk_to_Cu t_Breast_Cancer_Risk.asp Capecitabine-Docetaxel Combo Improves Survival in Advanced Breast Cancer Source: National Cancer Institute http://www.nci.nih.gov/ClinicalTrials/results/capecitabine-combo0602 Chemoprevention Source: National Cancer Institute http://cis.nci.nih.gov/fact/4_2.htm Chemotherapy in Women with Breast Cancer Source: American College of Physicians http://www.annals.org/cgi/content/full/138/2/I-16 Does Radiation for Breast Cancer Affect Lung Cancer Risk? Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Does_Radiation_for_ Breast_Cancer_Affect_Lung_Cancer_Risk.asp

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Donor Immune Cells Attack Metastatic Breast Cancer Source: National Cancer Institute http://www.nih.gov/news/pr/jun2003/nci-01.htm Ductal Lavage Not Reliable as Breast Cancer Screening Technique Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Ductal_Lavage_Not_ Reliable_as_Breast_Cancer_Screening_Technique.asp Herceptin (Trastuzumab): Questions and Answers Source: National Cancer Institute http://cis.nci.nih.gov/fact/7_45.htm Inadequate Treatment of Breast Cancer Deadly for Elderly Women Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Inadequate_Treatmen t_of_Breast_Cancer_Deadly_for_Elderly_Women.asp Is Pregnancy after Breast Cancer Safe? Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Is_Pregnancy_After_B reast_Cancer_Safe.asp Is Short Course, Partial Breast Radiation Safe? Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Is_Short_Course_Parti al_Breast_Radiation_Safe.asp Menopausal Hormone Use: Questions and Answers Source: National Cancer Institute http://www.cancer.gov/newscenter/estrogenplus NCI Study Estimates More Than 2 Million Women Could Benefit from Tamoxifen Source: National Cancer Institute http://www.cancer.gov/newscenter/pressreleases/2milliontamoxifen New Treatment Significantly Improves Long-Term Outlook for Breast Cancer Survivors Source: National Cancer Institute http://www.cancer.gov/newscenter/pressreleases/letrozole NHLBI Study Finds Moderate Physical Activity Promotes Weight Loss as well as Intense Exercise Source: National Cancer Institute, National Heart, Lung, and Blood Institute http://www.nih.gov/news/pr/sep2003/nhlbi-09.htm Proteomics Research Aids Cancer Diagnosis and Treatment Source: National Cancer Institute http://www.nih.gov/news/pr/apr2003/nci-09.htm Questions and Answers about the Electromagnetic Fields and Breast Cancer on Long Island Study Source: National Cancer Institute, National Institute of Environmental Health Sciences http://www.cancer.gov/newscenter/pressreleases/LIBCSPemfQandA

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Questions and Answers about the Study of Tamoxifen and Raloxifene (STAR) Source: National Cancer Institute http://cis.nci.nih.gov/fact/4_19.htm Race and Ethnicity Affect Breast Cancer Outcome Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Race_And_Ethnicity_ Affect_Breast_Cancer_Outcome.asp Study Confirms Breast Cancer Risk in Continuous Combined Hormone Therapy Risk Begins to Return to Normal After Women Stop Taking Hormones Source: National Institute of Child Health and Human Development http://www.nih.gov/news/pr/nov2002/nichd-29.htm Study Finds No Association Between Oral Contraceptive Use and Breast Cancer for Women 35 and Over Source: Centers for Disease Control and Prevention http://www.cdc.gov/od/oc/media/pressrel/r020626.htm Value of Radiation Confirmed in Early Breast Cancer Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Value_of_Radiation_ Confirmed_in_Early_Breast_Cancer.asp •

Statistics Breast Cancer Deaths on the Decline Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Breast_Cancer_Death s_on_the_Decline.asp Lifetime Probability of Breast Cancer in American Women Source: National Cancer Institute http://cis.nci.nih.gov/fact/5_6.htm What Are the Key Statistics for Breast Cancer? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_are_the_key_statist ics_for_breast_cancer_5.asp?sitearea=cri

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on Paget’s disease. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to

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http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Questions and Answers About Paget's Disease of the Bone Source: New York, NY: Paget Foundation. 1999. [7 p.]. Contact: Available from Paget Foundation. 120 Wall Street, Suite 1602, New York, NY 10005-4001. (212) 509-5335. Fax (212) 509-8492. E-mail: [email protected]. Website: www.paget.org. Price: Single copy free plus $2.00 shipping and handling. Summary: Paget's disease of bone is a chronic disorder that typically results in enlarged and deformed bones in one or more regions of the skeleton. Excessive bone breakdown and formation can cause the bone to weaken. This brochure, written in question and answer format, answers common questions about Paget's disease. Topics include the causes of the disease, the symptoms, how the diagnosis is established, the bones affected by Paget's disease, the relationship between Paget's disease and other problems (arthritis, osteoporosis, heart disease, diabetes, kidney diseases, hearing loss), the causes of pain in Paget's disease, complications of the nervous system, how Paget's disease affects the teeth, the role of diet and exercise, and treatment options, including drug therapy and surgery. One chart summarizes the administration, dosage, and cost of drugs that are approved in the U.S. for the treatment of Paget's disease (biphosphonates, calcitonin). The brochure briefly identifies the Paget Foundation, an organization that provides information and programs for consumers and medical professionals for bone disorders involving abnormal bone resorption, including Paget's disease of bone, primary hyperparathyroidism, fibrous dysplasia, osteopetrosis, and cancer metastatic to bone. 1 figure. 1 table.

•

Patient's Guide to Paget's Disease of Bone Source: New York, NY: Paget Foundation. 199x. 28 p. Contact: Available from Paget Foundation. 200 Varick Street, Suite 1004, New York, NY 10014-4810. (212) 229-1582; (800) 23-PAGET; FAX, (212) 229-1502. PRICE: $2.00 per copy for postage and handling; $21.00 for 25 copies; $39.00 for 50 copies. Summary: Paget's disease of bone, or osteitis deformans, is a chronic disorder which results in enlarged and deformed bones in one or more regions of the skeleton. This booklet reprints articles that were originally published in the newsletter of the Paget Foundation. Eleven articles are presented in four sections: general information about Paget's disease, diagnosis and treatment, complications of Paget's disease, and exercise. One article presents a summary of the dental/oral complications related to Paget's disease; the author focuses on the excessive loosening of teeth as a result of destruction of the supporting periodontal bone, tooth root resorption, or both.

•

Questions and Answers About Paget's Disease of Bone Source: New York, NY: The Paget's Disease Foundation, Inc. 1999. 8 p. Contact: Paget Foundation for Paget's Disease of Bone and Related Disorders. 120 Wall Street, Suite 1602, New York, NY 10005-4001. (800) 23-PAGET or (212) 509-5335. Fax (212) 509-8492. E-mail: [email protected]. Website: www.paget.org. PRICE: $2.00 postage and handling.

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Summary: This brochure provides answers to general questions concerning Paget 's disease, related medical conditions, the importance of diet and exercise, and treatment options. Questions answered define what PD is and its symptoms; explains who is at risk for getting the disease; describes its diagnosis; and discusses the relationship it has with other medical conditions such as arthritis, osteoporosis, heart disease, diabetes, kidney problems, and central nervous system complications. The brochure reveals there is no relationship between diet and PD, that exercise is important in maintaining skeletal health and is recommended, and that treatment of PD involves two classes of drugs, calcitonin and bisophosphonates , which suppress the abnormal bone cell activity associated with PD. Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Paget's Disease of Bone Summary: A consumer health information fact sheet that provides a definition of this musculoskeletal disease, along with information about causes, prevelance, symptoms, diagnosis and treatment. Source: NIH Osteoporosis and Related Bone Diseases~National Resource Center http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2264

•

Paget's Disease of the Breast: Questions and Answers Summary: This is a fact sheet about an uncommon type of breast cancer that is sometimes called mammary Paget's disease. Source: Cancer Information Service, National Cancer Institute http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7081 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 Paget’s disease. 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.

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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

Associations and Paget’s Disease The following is a list of associations that provide information on and resources relating to Paget’s disease: •

Paget Foundation for Paget's Disease of Bone and Related Disorders Telephone: (212) 509-5335 Toll-free: (800) 237-2438 Fax: (212) 509-8492 Email: [email protected] Web Site: http://www.paget.org Background: The Paget Foundation is a voluntary health agency devoted to serving people affected by Paget s Disease of Bone and certain other bone disorders, including primary hyperparathyroidism, fibrous dysplasia, osteopetrosis, and the complications of certain cancers of the skeleton. Established in 1978, it continues to provide affected individuals and their families with up-to-date information about these disorders. It also provides physician referrals, information to enhance public awareness of Paget s Disease of Bone and related disorders, and professional education for members of the medical community. Relevant area(s) of interest: Osteitis Deformans, Paget's Disease

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to Paget’s disease. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with Paget’s disease.

112 Paget’s Disease

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 Paget’s disease. 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 “Paget’s disease” (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 “Paget’s disease”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “Paget’s disease” (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 “Paget’s disease” (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.18

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

18

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)19: •

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/

19

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/

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

119

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Paget’s Disease Paget's disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000414.htm

•

Signs & Symptoms for Paget’s Disease Anemia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000560.htm Blindness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003040.htm Bone pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003180.htm Deafness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm

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Headache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Hearing loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Joint pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Joint stiffness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Neck pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003025.htm •

Diagnostics and Tests for Paget’s Disease ALP (alkaline phosphatase) isoenzyme Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003497.htm Bone scan Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003833.htm Bone X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003808.htm Breast biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003920.htm Calcitonin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003699.htm Calcium (ionized) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003486.htm CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Serum alkaline phosphatase Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003470.htm Serum calcium Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003477.htm

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Background Topics for Paget’s Disease Analgesics Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm Fractures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000001.htm

Online Glossaries 121

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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PAGET’S DISEASE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. ACE: Angiotensin-coverting enzyme. A drug used to decrease pressure inside blood vessels. [NIH]

Acetylgalactosamine: The N-acetyl derivative of galactosamine. [NIH] Acetylglucosamine: The N-acetyl derivative of glucosamine. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Actin: Essential component of the cell skeleton. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenoma: A benign epithelial tumor with a glandular organization. [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] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aetiology: Study of the causes of disease. [EU] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

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] Alendronate: A nonhormonal medication for the treatment of postmenopausal osteoporosis in women. This drug builds healthy bone, restoring some of the bone loss as a result of osteoporosis. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH]

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Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allium: A genus of liliaceous herbs containing onions (Allium cepa), garlic (Allium sativum), and others; many produce pungent, often bacteriostatic and physiologically active compounds and are used as food, condiment, and medicament, the latter in traditional medicine. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] 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] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Angiography: Radiography of blood vessels after injection of a contrast medium. [NIH] Angioid Streaks: Small breaks in the elastin-filled tissue of the retina. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers

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or other tissues are called xenograft models. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anthraquinones: An anthracene ring which contains two ketone moieties in any position. Can be substituted in any position except on the ketone groups. [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Apocrine Glands: Large, branched, specialized sweat glands that empty into the upper portion of a hair follicle instead of directly onto the skin. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Areola: The area of dark-colored skin on the breast that surrounds the nipple. [NIH] Aromatase: An enzyme which converts androgens to estrogens by desaturating ring A of the steroid. This enzyme complex is located in the endoplasmic reticulum of estrogenproducing cells including ovaries, placenta, testicular Sertoli and Leydig cells, adipose, and brain tissues. The enzyme complex has two components, one of which is the CYP19 gene product, the aromatase cytochrome P-450. The other component is NADPH-cytochrome P450 reductase which transfers reducing equivalents to P-450(arom). EC 1.14.13.-. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU]

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Arteries: The vessels carrying blood away from the heart. [NIH] Arthroplasty: Surgical reconstruction of a joint to relieve pain or restore motion. [NIH] Articular: Of or pertaining to a joint. [EU] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Auditory nerve: The eight cranial nerve; also called vestibulocochlear nerve or acoustic nerve. [NIH] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Axilla: The underarm or armpit. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits

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the growth or multiplication of bacteria. [EU] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] 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]

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] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH]

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Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists 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 metastases: Cancer that has spread from the original (primary) tumor to the bone. [NIH]

Bone Remodeling: The continuous turnover of bone matrix and mineral that involves first, an increase in resorption (osteoclastic activity) and later, reactive bone formation (osteoblastic activity). The process of bone remodeling takes place in the adult skeleton at discrete foci. The process ensures the mechanical integrity of the skeleton throughout life and plays an important role in calcium homeostasis. An imbalance in the regulation of bone remodeling's two contrasting events, bone resorption and bone formation, results in many of the metabolic bone diseases, such as osteoporosis. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [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] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can

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be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Capecitabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]

Capsid: The outer protein protective shell of a virus, which protects the viral nucleic acid. [NIH]

Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbidopa: A peripheral inhibitor of dopa decarboxylase. It is given in parkinsonism along with levodopa to inhibit the conversion of levodopa to dopamine in the periphery, thereby reducing the peripheral adverse effects, increasing the amount of levodopa that reaches the central nervous system, and reducing the dose needed. It has no antiparkinson actions when given alone. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Carcinoma in Situ: A malignant tumor that has not yet invaded the basement membrane of the epithelial cell of origin and has not spread to other tissues. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Cauda Equina: The lower part of the spinal cord consisting of the lumbar, sacral, and coccygeal nerve roots. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH]

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Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [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] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]

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] 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] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all

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human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Cicatricial: Ectropion due to scar tissue on the margins or the surrounding surfaces of the eyelids. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clodronate: A drug used as treatment for hypercalcemia (abnormally high levels of calcium in the blood) and for cancer that has spread to the bone (bone metastases). It may decrease pain, the risk of fractures, and the development of new bone metastases. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]

Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]

Cochlear: Of or pertaining to the cochlea. [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] 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]

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Combination chemotherapy: Treatment using more than one anticancer drug. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken

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from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Corneum: The superficial layer of the epidermis containing keratinized cells. [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 Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [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] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some nonleukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU]

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Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Deoxyribonucleic: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Deoxyribonucleic acid: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Dermatosis: Any skin disease, especially one not characterized by inflammation. [EU] Diagnostic procedure: A method used to identify a disease. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH]

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Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydroxy: AMPA/Kainate antagonist. [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] Diphosphonates: Organic compounds which contain P-C-P bonds, where P stands for phosphonates or phosphonic acids. These compounds affect calcium metabolism. They inhibit ectopic calcification and slow down bone resorption and bone turnover. Technetium complexes of diphosphonates have been used successfully as bone scanning agents. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissection: Cutting up of an organism for study. [NIH] 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] Distemper: A name for several highly contagious viral diseases of animals, especially canine distemper. In dogs, it is caused by the canine distemper virus (distemper virus, canine). It is characterized by a diphasic fever, leukopenia, gastrointestinal and respiratory inflammation and sometimes, neurologic complications. In cats it is known as feline panleukopenia. [NIH] Distemper Virus, Canine: A species of morbillivirus causing distemper in dogs, wolves, foxes, raccoons, and ferrets. [NIH] Docetaxel: An anticancer drug that belongs to the family of drugs called mitotic inhibitors. [NIH]

Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopa Decarboxylase: One of the aromatic-l-amino-acid decarboxylases, this enzyme is responsible for the conversion of dopa to dopamine. It is of clinical importance in the treatment of Parkinson's disease. EC 4.1.1.28. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH]

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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] Ductal carcinoma in situ: DCIS. Abnormal cells that involve only the lining of a duct. The cells have not spread outside the duct to other tissues in the breast. Also called intraductal carcinoma. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Ectopic: Pertaining to or characterized by ectopia. [EU] 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] Ejaculation: The release of semen through the penis during orgasm. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometrial disorder: Abnormal cell growth in the endometrium (the lining of the uterus). [NIH]

Endometrium: The layer of tissue that lines the uterus. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or

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biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. Also called squamous cell carcinoma. [NIH] 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] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Escalation: Progressive use of more harmful drugs. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Etidronate: A drug that belongs to the family of drugs called bisphosphonates. Bisphosphonates are used as treatment for hypercalcemia (abnormally high levels of calcium in the blood) and for cancer that has spread to the bone (bone metastases). [NIH] Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase

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of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [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] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Feline Panleukopenia: A highly contagious DNA virus infection of the cat family and of mink, characterized by fever, enteritis and bone marrow changes. It is also called feline ataxia, feline agranulocytosis, feline infectious enteritis, cat fever, cat plague, show fever. [NIH]

Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] 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] Filariasis: Infections with nematodes of the superfamily Filarioidea. The presence of living worms in the body is mainly asymptomatic but the death of adult worms leads to granulomatous inflammation and permanent fibrosis. Organisms of the genus Elaeophora infect wild elk and domestic sheep causing ischaemic necrosis of the brain, blindness, and dermatosis of the face. [NIH] Fine-needle aspiration: The removal of tissue or fluid with a needle for examination under a microscope. Also called needle biopsy. [NIH] Fistulas: An abnormal passage from one hollow structure of the body to another, or from a hollow structure to the surface, formed by an abscess, disease process, incomplete closure of a wound, or by a congenital anomaly. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of

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shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] 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] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [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] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giant Cell Tumors: Tumors of bone tissue or synovial or other soft tissue characterized by the presence of giant cells. The most common are giant cell tumor of tendon sheath and giant cell tumor of bone. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Gliosis: The production of a dense fibrous network of neuroglia; includes astrocytosis, which is a proliferation of astrocytes in the area of a degenerative lesion. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glycoprotein: A protein that has sugar molecules attached to it. [NIH]

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Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Gold Sodium Thiomalate: A variable mixture of the mono- and disodium salts of gold thiomalic acid used mainly for its anti-inflammatory action in the treatment of rheumatoid arthritis. It is most effective in active progressive rheumatoid arthritis and of little or no value in the presence of extensive deformities or in the treatment of other forms of arthritis. [NIH]

Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] 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] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Hearing aid: A miniature, portable sound amplifier for persons with impaired hearing, consisting of a microphone, audio amplifier, earphone, and battery. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH]

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Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Hidradenitis: The inflammation of a sweat gland (usually of the apocrine type). The condition can be idiopathic or occur as a result of or in association with another underlying condition. Neutrophilic eccrine hidradenitis is a relatively rare variant that has been reported in patients undergoing chemotherapy, usually for non-Hodgkin lymphomas or leukemic conditions. [NIH] Hidradenitis Suppurativa: A chronic suppurative and cicatricial disease of the apocrine glands occurring chiefly in the axillae in women and in the groin and anal regions in men. It is characterized by poral occlusion with secondary bacterial infection, evolving into abscesses which eventually rupture. As the disease becomes chronic, ulcers appear, sinus tracts enlarge, fistulas develop, and fibrosis and scarring become evident. Hormonal mechanisms are expected in its pathogenesis. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Histone Deacetylase: Hydrolyzes N-acetyl groups on histones. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Human papillomavirus: HPV. A virus that causes abnormal tissue growth (warts) and is often associated with some types of cancer. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [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] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of

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water. [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] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH]

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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] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [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] 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] Intraductal carcinoma: Abnormal cells that involve only the lining of a duct. The cells have

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not spread outside the duct to other tissues in the breast. Also called ductal carcinoma in situ. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ion Transport: The movement of ions across energy-transducing cell membranes. Transport can be active or passive. Passive ion transport (facilitated diffusion) derives its energy from the concentration gradient of the ion itself and allows the transport of a single solute in one direction (uniport). Active ion transport is usually coupled to an energy-yielding chemical or photochemical reaction such as ATP hydrolysis. This form of primary active transport is called an ion pump. Secondary active transport utilizes the voltage and ion gradients produced by the primary transport to drive the cotransport of other ions or molecules. These may be transported in the same (symport) or opposite (antiport) direction. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Joint Capsule: The sac enclosing a joint. It is composed of an outer fibrous articular capsule and an inner synovial membrane. [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] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [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

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colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Letrozole: An anticancer drug that belongs to the family of drugs called nonsteroidal aromatase inhibitors. Letrozole is used to decrease estrogen production and suppress the growth of estrogen-dependent tumors. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lichen Planus: An inflammatory, pruritic disease of the skin and mucous membranes, which can be either generalized or localized. It is characterized by distinctive purplish, flattopped papules having a predilection for the trunk and flexor surfaces. The lesions may be discrete or coalesce to form plaques. Histologically, there is a "saw-tooth" pattern of epidermal hyperplasia and vacuolar alteration of the basal layer of the epidermis along with an intense upper dermal inflammatory infiltrate composed predominantly of T-cells. Etiology is unknown. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] 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] Lobular carcinoma in situ: LCIS. Abnormal cells found in the lobules of the breast. This condition seldom becomes invasive cancer; however, having lobular carcinoma in situ increases one's risk of developing breast cancer in either breast. [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] Loss of Heterozygosity: The loss of one allele at a specific locus, caused by a deletion mutation; or loss of a chromosome from a chromosome pair. It is detected when heterozygous markers for a locus appear monomorphic because one of the alleles was deleted. When this occurs at a tumor suppressor gene locus where one of the alleles is

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already abnormal, it can result in neoplastic transformation. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Maculopapular: Both macular and papular, as an eruption consisting of both macules and papules; sometimes erroneously used to designate a papule that is only slightly elevated. [EU]

Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Mammary: Pertaining to the mamma, or breast. [EU] Mammography: Radiographic examination of the breast. [NIH] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Measles Virus: The type species of morbillivirus and the cause of the highly infectious human disease measles, which affects mostly children. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH]

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Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medroxyprogesterone: (6 alpha)-17-Hydroxy-6-methylpregn-4-ene-3,20-dione. A synthetic progestational hormone used in veterinary practice as an estrus regulator. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] 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] Meningioma: A type of tumor that occurs in the meninges, the membranes that cover and protect the brain and spinal cord. Meningiomas usually grow slowly. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Metaplasia: A condition in which there is a change of one adult cell type to another similar adult cell type. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] 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

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organisms, they are sometimes classified as microorganisms. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mitomycin: An antineoplastic antibiotic produced by Streptomyces caespitosus. It acts as a bi- or trifunctional alkylating agent causing cross-linking of DNA and inhibition of DNA synthesis. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mitotic inhibitors: Drugs that kill cancer cells by interfering with cell division (mitostis). [NIH]

Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Morbillivirus: A genus of the family Paramyxoviridae (subfamily Paramyxovirinae) where all the virions have hemagglutinin but not neuraminidase activity. All members produce both cytoplasmic and intranuclear inclusion bodies. MEASLES VIRUS is the type species. [NIH]

Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucinous carcinoma: A type of cancer that begins in cells that line certain internal organs, and produces mucin (the main component of mucus). [NIH] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH]

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Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle biopsy: The removal of tissue or fluid with a needle for examination under a microscope. Also called fine-needle aspiration. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuraminidase: An enzyme that catalyzes the hydrolysis of alpha-2,3, alpha-2,6-, and alpha-2,8-glycosidic linkages (at a decreasing rate, respectively) of terminal sialic residues in oligosaccharides, glycoproteins, glycolipids, colominic acid, and synthetic substrate. (From Enzyme Nomenclature, 1992) EC 3.2.1.18. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] 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] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by

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polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleocapsid: A protein-nucleic acid complex which forms part or all of a virion. It consists of a capsid plus enclosed nucleic acid. Depending on the virus, the nucleocapsid may correspond to a naked core or be surrounded by a membranous envelope. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Opacity: Degree of density (area most dense taken for reading). [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Ossicles: The hammer, anvil and stirrup, the small bones of the middle ear, which transmit the vibrations from the tympanic membrane to the oval window. [NIH] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Osteocalcin: Vitamin K-dependent calcium-binding protein synthesized by osteoblasts and found primarily in bone. Serum osteocalcin measurements provide a noninvasive specific marker of bone metabolism. The protein contains three residues of the amino acid gammacarboxyglutamic acid (GLA), which, in the presence of calcium, promotes binding to hydroxyapatite and subsequent accumulation in bone matrix. [NIH] Osteoclasts: A large multinuclear cell associated with the absorption and removal of bone. An odontoclast, also called cementoclast, is cytomorphologically the same as an osteoclast and is involved in cementum resorption. [NIH] Osteogenesis: The histogenesis of bone including ossification. It occurs continuously but particularly in the embryo and child and during fracture repair. [NIH] Osteogenesis Imperfecta: A collagen disorder resulting from defective biosynthesis of type I collagen and characterized by brittle, osteoporotic, and easily fractured bones. It may also present with blue sclerae, loose joints, and imperfect dentin formation. There are four major types, I-IV. [NIH] Osteogenic sarcoma: A malignant tumor of the bone. Also called osteosarcoma. [NIH] Osteolysis: Dissolution of bone that particularly involves the removal or loss of calcium. [NIH]

Osteolytic: Causing the breakdown of bone. [NIH] Osteomalacia: A condition marked by softening of the bones (due to impaired mineralization, with excess accumulation of osteoid), with pain, tenderness, muscular weakness, anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium. [EU]

Osteopetrosis: Excessive formation of dense trabecular bone leading to pathological fractures, osteitis, splenomegaly with infarct, anemia, and extramedullary hemopoiesis.

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[NIH]

Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Osteosarcoma: A cancer of the bone that affects primarily children and adolescents. Also called osteogenic sarcoma. [NIH] Otosclerosis: The formation of spongy bone in the labyrinth capsule. The ossicles can become fixed and unable to transmit sound vibrations, thereby causing deafness. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pamidronate: A drug that belongs to the family of drugs called bisphosphonates. Pamidronate is used as treatment for abnormally high levels of calcium in the blood. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH] Papillomavirus: A genus of Papovaviridae causing proliferation of the epithelium, which may lead to malignancy. A wide range of animals are infected including humans, chimpanzees, cattle, rabbits, dogs, and horses. [NIH] Paramyxovirus: A genus of the family Paramyxoviridae (subfamily Paramyxovirinae) where all the virions have both hemagglutinin and neuraminidase activities and encode a C protein. Human parainfluenza virus 1 is the type species. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]

Parapsoriasis: The term applied to a group of relatively uncommon inflammatory, maculopapular, scaly eruptions of unknown etiology and resistant to conventional treatment. Eruptions are both psoriatic and lichenoid in appearance, but the diseases are distinct from psoriasis, lichen planus, or other recognized dermatoses. Proposed nomenclature divides parapsoriasis into two distinct subgroups, pityriasis lichenoides and parapsoriasis en plaques (small- and large-plaque parapsoriasis). [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parathyroidectomy: Excision of one or both of the parathyroid glands. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU]

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Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Particle: A tiny mass of material. [EU] Patella: The flat, triangular bone situated at the anterior part of the knee. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] PDQ: Physician Data Query. PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information is available on the CancerNet Web site, and more specific information about PDQ can be found at http://cancernet.nci.nih.gov/pdq.html. [NIH] Pedigree: A record of one's ancestors, offspring, siblings, and their offspring that may be used to determine the pattern of certain genes or disease inheritance within a family. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillamine: 3-Mercapto-D-valine. The most characteristic degradation product of the penicillin antibiotics. It is used as an antirheumatic and as a chelating agent in Wilson's disease. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perianal: Located around the anus. [EU] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Peripheral blood: Blood circulating throughout the body. [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

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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] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phenylbutyrate: An anticancer drug that belongs to the family of drugs called differentiating agents. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphonic Acids: Inorganic or organic derivatives of phosphonic acid with the general formula ROP(OH)2. This includes phosphonates and phosphonic acid esters. The tautomeric form of this compound (P(OH)3) = phosphorous acids. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pityriasis: A name originally applied to a group of skin diseases characterized by the formation of fine, branny scales, but now used only with a modifier. [EU] Pityriasis Lichenoides: A subgroup of parapsoriasis itself divided into acute and chronic forms. The acute form is characterized by the abrupt onset of a generalized, reddish-brown, maculopapular eruption. Lesions may be vesicular, hemorrhagic, crusted, or necrotic. Histologically the disease is characterized by epidermal necrolysis. The chronic form shows milder skin changes with necrosis. An important variant of the chronic form is lymphomatoid papulosis. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH]

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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] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Ploidy: The number of sets of chromosomes in a cell or an organism. For example, haploid means one set and diploid means two sets. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's

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life when menstrual periods stop permanently; also called "change of life." [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Presbycusis: Progressive bilateral loss of hearing that occurs in the aged. Syn: senile deafness. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] 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] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH]

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Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] 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] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pseudoxanthoma: A rare disease of the skin characterized by the appearance of elevated yellowish papules or plaques, particularly on the neck, chest an abdomen and infrequently on the eyelids. [NIH] Pseudoxanthoma Elasticum: A rare, progressive inherited disorder resulting from extensive basophilic degeneration of elastic tissue, usually presenting after puberty and involving the skin, eye, and cardiovascular system. Characteristic manifestations are small, circumscribed yellowish patches at sites of considerable movement of the skin, angioid streaks in the retina, and a tendency towards hemorrhage and arterial insufficiency. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] 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] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH]

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Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] 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] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [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] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinae: A congenital notch or cleft of the retina, usually located inferiorly. [NIH]

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Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribonucleic acid: RNA. One of the two nucleic acids found in all cells. The other is deoxyribonucleic acid (DNA). Ribonucleic acid transfers genetic information from DNA to proteins produced by the cell. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Sclerae: A circular furrow between the sclerocorneal junction and the iris. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH] Sebaceous: Gland that secretes sebum. [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] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH]

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Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Distribution: The number of males and females in a given population. The distribution may refer to how many men or women or what proportion of either in the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine. [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] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] 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]

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

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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] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sperm: The fecundating fluid of the male. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Sphenoid: An unpaired cranial bone with a body containing the sphenoid sinus and forming the posterior part of the medial walls of the orbits. [NIH] Sphenoid Sinus: One of the paired paranasal sinuses, located in the body of the sphenoid bone and communicating with the highest meatus of the nasal cavity on the same side. [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 Stenosis: Narrowing of the spinal canal. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH]

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Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Sterile: Unable to produce children. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of

162 Paget’s Disease

homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Syncytium: A living nucleated tissue without apparent cellular structure; a tissue composed of a mass of nucleated protoplasm without cell boundaries. [NIH] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Cyst: A nodular, tumorlike lesion in or about a tendon sheath or joint capsule, especially of the hands, wrists, or feet. It is not a true cyst as it lacks an epithelial wall, and it does not communicate with the underlying synovial space. The lesion represents a focal accumulation of mucin in the dermis of the dorsal aspect of the distal phalanges or, less often, other portions of the extremities. [NIH] Syringomyelia: The presence in the spinal cord of elongated central fluid containing cavities surrounded by gliosis. [NIH] Systemic: Affecting the entire body. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Technetium: The first artificially produced element and a radioactive fission product of uranium. The stablest isotope has a mass number 99 and is used diagnostically as a radioactive imaging agent. Technetium has the atomic symbol Tc, atomic number 43, and atomic weight 98.91. [NIH] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thymidine: A chemical compound found in DNA. Also used as treatment for mucositis. [NIH]

Thymidine Phosphorylase: The enzyme catalyzing the transfer of 2-deoxy-D-ribose from thymidine to orthophosphate, thereby liberating thymidine. EC 2.4.2.4. [NIH]

Dictionary 163

Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] 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] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumor suppressor gene: Genes in the body that can suppress or block the development of cancer. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU]

164 Paget’s Disease

Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ubiquitin: A highly conserved 76 amino acid-protein found in all eukaryotic cells. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uranium: A radioactive element of the actinide series of metals. It has an atomic symbol U, atomic number 92, and atomic weight 238.03. U-235 is used as the fissionable fuel in nuclear weapons and as fuel in nuclear power reactors. [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys 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] 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] 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] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Valine: A branched-chain essential amino acid that has stimulant activity. It promotes muscle growth and tissue repair. It is a precursor in the penicillin biosynthetic pathway. [NIH]

Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricles: Fluid-filled cavities in the heart or brain. [NIH] Ventricular: Pertaining to a ventricle. [EU] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular

Dictionary 165

nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] 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] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virion: The infective system of a virus, composed of the viral genome, a protein core, and a protein coat called a capsid, which may be naked or enclosed in a lipoprotein envelope called the peplos. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] 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] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Vulva: The external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

167

INDEX A ACE, 102, 108, 123 Acetylgalactosamine, 123, 140 Acetylglucosamine, 123, 140 Acoustic, 39, 123, 126 Actin, 12, 123 Activities of Daily Living, 8, 123 Adenocarcinoma, 38, 50, 123 Adenoma, 44, 123 Adjuvant, 70, 101, 123, 139 Adrenal Cortex, 123, 155 Adverse Effect, 123, 129, 159 Aetiology, 25, 79, 123 Affinity, 123, 159 Agar, 123, 154 Agonist, 123, 135, 162 Alendronate, 7, 8, 16, 18, 84, 88, 123 Algorithms, 123, 127 Alkaline, 8, 19, 74, 85, 120, 124, 129, 162 Alkaline Phosphatase, 8, 19, 74, 85, 120, 124 Alleles, 124, 145 Allium, 31, 124 Alpha Particles, 124, 156 Alternative medicine, 65, 71, 84, 124, 132 Alveolar Process, 124, 157 Amino Acid Sequence, 124, 125 Amino Acids, 124, 152, 154, 156, 161, 164 Ammonia, 124, 161, 164 Anaesthesia, 124, 143 Anal, 16, 19, 39, 124, 137, 141 Analgesic, 4, 124 Analogous, 124, 163 Anatomical, 124, 126, 142, 158 Anemia, 119, 124, 148, 150 Angiography, 24, 124 Angioid Streaks, 124, 156 Animal model, 11, 124 Annealing, 125, 154 Anorexia, 125, 150 Anthraquinones, 69, 125 Antibiotic, 125, 148, 152 Antibodies, 60, 125, 126, 141, 146, 154, 157 Antibody, 40, 123, 125, 132, 133, 142, 143, 148, 156, 157, 160 Antigen, 49, 59, 67, 123, 125, 132, 139, 142, 143 Anti-inflammatory, 125, 140, 143

Antineoplastic, 125, 148, 154 Anus, 124, 125, 128, 152, 157 Apocrine Glands, 125, 141 Apoptosis, 6, 125 Areola, 20, 78, 125 Aromatase, 125, 145 Arterial, 125, 130, 156 Arteries, 125, 126, 128, 133, 147 Arthroplasty, 21, 28, 35, 46, 49, 53, 126 Articular, 4, 22, 126, 144, 150 Ascorbic Acid, 126, 142 Aspiration, 33, 101, 126, 138, 149 Assay, 67, 69, 126, 142 Asymptomatic, 8, 126, 138 Ataxia, 126, 138, 141 Atrial, 36, 126 Atrium, 126 Atypical, 16, 17, 58, 126 Auditory, 3, 34, 39, 126, 146 Auditory nerve, 34, 126, 146 Autacoids, 126, 143 Autoantibodies, 45, 126 Autoantigens, 126 Axilla, 25, 32, 126 B Back Pain, 4, 126 Bacteria, 125, 126, 134, 136, 147, 163, 164 Bacteriophage, 126, 154, 163 Bacteriostatic, 124, 126 Basal Ganglia, 6, 126, 127, 128, 142 Base, 127, 134, 144, 154, 162 Basement Membrane, 127, 129, 138 Benign, 17, 123, 127, 128, 140, 149, 151, 157, 165 Bilateral, 17, 18, 39, 127, 155 Bile, 18, 127, 138, 145, 161 Bioavailability, 6, 127 Biochemical, 8, 12, 18, 44, 54, 58, 124, 127, 150 Biological Markers, 6, 127 Biological therapy, 127, 140 Biopsy, 45, 100, 101, 120, 127, 138, 149 Biosynthesis, 127, 150 Biotechnology, 14, 78, 84, 95, 127 Bladder, 19, 127, 143, 155, 164 Blastocyst, 127, 153 Blood Coagulation, 127, 129 Blood pressure, 128, 148, 160

168 Paget’s Disease

Blood vessel, 123, 124, 128, 129, 136, 144, 146, 159, 160, 161, 162, 164 Blood-Brain Barrier, 128, 145 Blot, 5, 128 Body Fluids, 128, 136, 160 Bone Marrow, 15, 128, 138, 146, 148, 161 Bone metastases, 128, 131, 137 Bone Remodeling, 5, 7, 8, 11, 54, 128 Bone Resorption, 6, 7, 13, 109, 128, 135 Bone scan, 5, 24, 120, 128, 135 Bowel, 124, 128, 135 Bowel Movement, 128, 135 Brachytherapy, 128, 143, 156 Brain Neoplasms, 128, 141 Branch, 117, 128, 146, 152, 160, 162 Breakdown, 67, 109, 128, 139, 150 C Calcification, 128, 135 Calcium, 66, 102, 120, 128, 129, 131, 132, 135, 137, 142, 150, 151, 159, 162 Capecitabine, 106, 129 Capsid, 129, 150, 165 Capsules, 129, 139 Carbidopa, 36, 129 Carbon Dioxide, 29, 129, 153, 157 Carcinogenic, 129, 155, 161 Carcinoma in Situ, 20, 73, 129, 136, 144, 145 Cardiac, 17, 129, 137, 149, 161 Cardiovascular, 15, 129, 156 Cardiovascular System, 129, 156 Case report, 16, 21, 22, 24, 30, 40, 45, 49, 50, 52, 59, 61, 67, 68, 129, 131 Case series, 129, 131 Cauda Equina, 21, 129 Cell Cycle, 12, 129, 131, 138 Cell Death, 125, 130, 138, 139, 149 Cell Differentiation, 130, 159 Cell Division, 126, 129, 130, 138, 140, 148, 154 Cell membrane, 130, 134, 144, 153 Cell proliferation, 130, 159 Cell Survival, 130, 140 Central Nervous System, 110, 128, 129, 130, 139, 140, 141, 145 Central Nervous System Infections, 130, 140, 141 Cerebral, 126, 127, 128, 130, 137, 141, 162 Cerebral Infarction, 130, 141 Cerebrospinal, 130, 141, 159 Cerebrospinal fluid, 130, 141, 159 Cervical, 42, 43, 104, 105, 130

Cervix, 130 Character, 130, 134 Chemotaxis, 40, 130 Chemotherapy, 14, 61, 68, 106, 130, 132, 141 Cholesterol, 127, 130, 161, 162 Chromatin, 125, 130, 160 Chromosome, 9, 29, 86, 130, 140, 145 Chronic, 3, 4, 8, 104, 105, 109, 126, 131, 136, 141, 143, 144, 153, 156, 161, 165 Cicatricial, 131, 141 CIS, 101, 102, 103, 105, 106, 107, 108, 131 Cisplatin, 42, 68, 131 Clinical Medicine, 37, 131, 155 Clinical study, 63, 131 Clinical trial, 4, 12, 73, 74, 95, 131, 152, 156, 157 Clodronate, 19, 21, 59, 66, 131 Clone, 5, 131 Cloning, 5, 127, 131 Cochlea, 131 Cochlear, 34, 131, 164 Cofactor, 131, 156 Cognition, 6, 131 Collagen, 10, 23, 26, 127, 131, 138, 139, 150, 155 Collapse, 34, 128, 131 Combination chemotherapy, 14, 61, 68, 132 Complement, 132, 139 Complementary and alternative medicine, 65, 71, 132 Complementary medicine, 65, 132 Complete remission, 132, 157 Computational Biology, 95, 132 Computed tomography, 35, 132, 133 Computerized axial tomography, 132, 133 Computerized tomography, 132 Congestion, 133, 137 Connective Tissue, 126, 128, 131, 133, 138, 139, 146, 158 Consciousness, 124, 133, 134 Constitutional, 9, 133 Constriction, 133, 144 Contraindications, ii, 133 Conventional treatment, 133, 151 Corneum, 133, 137 Coronary, 133, 147 Coronary Thrombosis, 133, 147 Corpus, 133, 152, 155 Corpus Luteum, 133, 155 Cortex, 6, 123, 126, 133, 155

Index 169

Cranial, 22, 126, 133, 140, 143, 151, 153, 160, 164 Craniocerebral Trauma, 133, 140, 141 Curative, 28, 133, 158, 162 Cutaneous, 17, 23, 30, 32, 42, 52, 53, 133 Cyst, 40, 133, 162 Cysteine, 133, 161 Cytokines, 51, 133 Cytoplasm, 125, 130, 133, 140, 148 Cytotoxic, 134, 157, 159 Cytotoxicity, 131, 134 D Databases, Bibliographic, 95, 134 De novo, 8, 134 Decidua, 134, 153 Degenerative, 6, 134, 139, 150 Deletion, 125, 134, 145 Delivery of Health Care, 134, 140 Dementia, 49, 50, 134 Denaturation, 134, 154 Density, 20, 34, 60, 134, 150 Dental Caries, 134, 138 Deoxyribonucleic, 134, 158 Deoxyribonucleic acid, 134, 158 Depolarization, 134, 159 Dermal, 47, 134, 145 Dermatosis, 134, 138 Diagnostic procedure, 85, 134 Diffusion, 134, 144 Digestive system, 75, 135, 148 Digestive tract, 135, 159, 160 Dihydroxy, 11, 135 Dilation, 135, 141 Diphosphonates, 69, 78, 135 Diploid, 135, 154 Direct, iii, 87, 131, 135, 157 Dissection, 38, 135 Distal, 7, 135, 156, 162 Distemper, 15, 23, 135 Distemper Virus, Canine, 135 Docetaxel, 24, 59, 67, 68, 135 Dopa, 129, 135, 145 Dopa Decarboxylase, 129, 135 Dopamine, 129, 135, 145, 153 Dorsal, 135, 154, 162 Drive, ii, vi, 57, 135, 144 Drug Interactions, 88, 89, 136 Duct, 18, 136, 143, 158, 161 Ductal carcinoma in situ, 73, 136, 144 Dysphagia, 51, 62, 136 Dysplasia, 35, 46, 61, 109, 111, 136 Dystrophy, 40, 136

E Echocardiography, 17, 136 Ectopic, 25, 51, 135, 136 Efficacy, 6, 22, 54, 59, 136 Ejaculation, 136, 159 Elastin, 124, 131, 136 Electrolyte, 136, 160 Electrons, 127, 136, 144, 146, 156, 157 Elementary Particles, 136, 146, 149, 156 Embryo, 127, 130, 136, 143, 150 Endemic, 136, 160 Endometrial, 73, 136 Endometrial disorder, 73, 136 Endometrium, 134, 136, 147 Endothelial cell, 52, 128, 136 Endotoxin, 136, 163 End-stage renal, 67, 136 Environmental Exposure, 127, 136 Environmental Health, 94, 96, 107, 137 Enzymatic, 129, 132, 134, 137, 154 Enzyme, 44, 123, 124, 125, 127, 135, 137, 143, 144, 149, 154, 159, 162, 163, 165 Epidemic, 137, 160 Epidemiologic Studies, 127, 137 Epidermal, 40, 137, 145, 147, 153, 165 Epidermis, 32, 133, 137, 141, 145 Epidermoid carcinoma, 137, 160 Epidural, 22, 50, 137, 143 Epinephrine, 135, 137, 164 Epithelial, 123, 129, 134, 137, 151, 162 Erectile, 137, 152 Erythema, 53, 137 Erythrocytes, 124, 128, 137 Escalation, 4, 137 Esophagus, 135, 137, 161 Estrogen, 103, 125, 137, 145, 158, 162 Etidronate, 15, 17, 18, 26, 34, 41, 58, 62, 63, 66, 68, 84, 88, 137 Etoposide, 42, 68, 137 Eukaryotic Cells, 138, 142, 164 External-beam radiation, 138, 156 Extracellular, 13, 133, 138, 150, 160, 162 Extracellular Matrix, 133, 138, 150 Extravasation, 138, 140 F Facial, 4, 138, 146 Family Planning, 95, 138 Fat, 37, 128, 138, 145, 158, 160 Feline Panleukopenia, 135, 138 Femoral, 28, 138 Femur, 7, 138 Fetus, 138, 153, 164

170 Paget’s Disease

Fibroblasts, 138, 143 Fibrosis, 138, 141, 158 Filariasis, 20, 138 Fine-needle aspiration, 33, 138, 149 Fistulas, 138, 141 Fluorine, 30, 67, 138 Friction, 21, 138 G Gallbladder, 135, 138 Gamma Rays, 138, 156, 157 Ganglia, 6, 126, 127, 128, 139, 142, 149, 153 Gas, 124, 129, 134, 138, 139 Gastric, 51, 139 Gastrin, 139, 141 Gastrointestinal, 135, 137, 139, 160, 161 Gastrointestinal tract, 139, 160 Gelatin, 7, 139, 161 Gene, 5, 9, 10, 11, 12, 43, 54, 78, 84, 86, 103, 124, 125, 127, 139, 145, 163 Gene Expression, 11, 139 Genetic Engineering, 127, 131, 139 Genetic testing, 139, 154 Genetics, 8, 9, 10, 25, 58, 66, 85, 86, 139, 152 Genital, 14, 23, 31, 32, 49, 139, 165 Genotype, 139, 153 Gestation, 139, 153 Giant Cell Tumors, 53, 139 Giant Cells, 5, 139 Gland, 55, 123, 139, 141, 146, 151, 155, 158, 161, 163 Gliosis, 139, 162 Glomerular, 139, 157 Glycoprotein, 139, 163 Glycosaminoglycans, 54, 140 Gold Sodium Thiomalate, 16, 140 Gonadal, 140, 161 Governing Board, 140, 155 Grafting, 52, 140 Granulocytes, 140, 159, 165 Granuloma, 32, 140 Groin, 140, 141, 143 Growth, 13, 44, 46, 51, 52, 125, 126, 130, 136, 140, 141, 143, 145, 146, 149, 154, 160, 163, 164 Growth factors, 51, 140 H Hair follicles, 140, 165 Haploid, 140, 154 Headache, 120, 140, 141 Health Care Costs, 10, 140 Health Expenditures, 140

Health Promotion, 11, 104, 105, 140 Hearing aid, 45, 140 Hematoma, 22, 140 Hemorrhage, 133, 140, 141, 156, 161 Hereditary, 62, 141 Heredity, 139, 141 Herpes, 27, 141 Herpes Zoster, 141 Hidradenitis, 16, 141 Hidradenitis Suppurativa, 16, 141 Histology, 7, 141 Histone Deacetylase, 6, 141 Homeostasis, 5, 12, 128, 141 Hormone, 13, 19, 69, 107, 108, 127, 137, 139, 141, 147, 151, 155, 158, 159, 160, 163 Horny layer, 137, 141 Human papillomavirus, 29, 141 Hybrid, 12, 131, 141 Hybridomas, 141, 143 Hydrocephalus, 36, 46, 141, 143 Hydrolysis, 131, 141, 144, 149, 153, 154 Hydroxylysine, 131, 142 Hydroxyproline, 8, 54, 131, 142 Hypercalcemia, 6, 62, 131, 137, 142 Hypersensitivity, 58, 142, 158 Hypokinesia, 142, 151 Hypothalamus, 128, 142, 160 I Id, 64, 70, 100, 102, 111, 116, 118, 142 Idiopathic, 141, 142 Immune response, 123, 125, 126, 142, 161, 165 Immune system, 127, 142, 146, 164, 165 Immunoassay, 44, 142 Immunocompromised, 16, 142 Immunodeficiency, 59, 142 Immunologic, 142, 157 Immunosuppressive, 45, 142 Immunosuppressive therapy, 45, 142 Impairment, 63, 126, 142, 147 Implant radiation, 142, 143, 156 In situ, 5, 15, 20, 23, 49, 73, 142, 145 In Situ Hybridization, 5, 142 In vitro, 60, 142, 154 In vivo, 6, 11, 13, 67, 142 Incision, 143, 144 Incontinence, 141, 143 Indicative, 77, 143, 152, 164 Indomethacin, 16, 143 Induction, 12, 143 Infancy, 143, 158 Infarction, 130, 133, 141, 143, 147

Index 171

Infection, 27, 127, 138, 141, 142, 143, 146, 152, 158, 161, 165 Inflammation, 125, 134, 135, 138, 141, 143, 158, 160, 165 Infusion, 4, 6, 74, 143 Inguinal, 19, 143 Inorganic, 131, 143, 148, 153 Interleukin-6, 21, 59, 143 Intermittent, 6, 41, 143 Internal radiation, 143, 156 Interstitial, 128, 143, 157 Intracellular, 143, 159 Intracranial Hemorrhages, 141, 143 Intracranial Hypertension, 140, 141, 143 Intraductal carcinoma, 136, 143 Intramuscular, 39, 60, 144 Intravenous, 8, 19, 50, 60, 62, 143, 144 Invasive, 21, 42, 68, 70, 144, 145, 146 Involuntary, 144, 149, 160 Ion Transport, 13, 144 Ionizing, 124, 137, 144, 157 Ions, 127, 136, 144 Ischemia, 15, 144 Isoenzyme, 120, 144 J Joint, 17, 45, 52, 120, 126, 144, 150, 161, 162 Joint Capsule, 144, 162 K Kb, 94, 144 Kidney Disease, 75, 94, 109, 144 Kidney Failure, 136, 144 Kinetic, 47, 144 L Labyrinth, 131, 144, 151 Large Intestine, 135, 144, 157, 159 Latent, 145, 155 Lesion, 17, 25, 139, 140, 145, 162 Lethargy, 141, 145 Letrozole, 107, 145 Leukocytes, 128, 133, 140, 143, 145, 148, 163 Leukopenia, 135, 145 Levodopa, 36, 129, 135, 145 Library Services, 116, 145 Lichen Planus, 145, 151 Ligament, 145, 155 Linkage, 9, 29, 145 Lipomatosis, 50, 145 Liver, 127, 135, 138, 145, 164 Lobular carcinoma in situ, 73, 145 Localization, 3, 31, 145 Localized, 41, 134, 140, 143, 145, 154

Loss of Heterozygosity, 38, 145 Lumbar, 38, 126, 129, 146 Lymph, 38, 50, 130, 136, 146 Lymph node, 38, 50, 130, 146 Lymphatic, 143, 146 Lymphatic system, 146 Lymphocyte, 125, 146 Lymphoid, 125, 146 Lytic, 42, 146, 159 M Macula, 23, 146 Maculopapular, 146, 151, 153 Magnetic Resonance Imaging, 146 Magnetic Resonance Spectroscopy, 6, 146 Malignancy, 6, 17, 27, 28, 31, 33, 146, 151 Malignant, 4, 8, 23, 40, 123, 125, 128, 129, 146, 148, 149, 150, 157, 158 Malignant tumor, 129, 146, 148, 150 Mammary, 22, 24, 35, 36, 42, 51, 53, 65, 67, 110, 146, 162 Mammography, 105, 146 Mandible, 33, 46, 124, 146, 157 Measles Virus, 7, 10, 11, 15, 19, 52, 146 Meatus, 146, 160 Medial, 147, 160 Medicament, 124, 147, 161 MEDLINE, 95, 147 Medroxyprogesterone, 73, 147 Melanin, 147, 153, 164 Melanocytes, 147 Melanoma, 40, 147 Membrane, 40, 127, 129, 130, 132, 134, 138, 144, 147, 150, 153, 157, 159 Memory, 125, 134, 147 Meninges, 130, 133, 147 Meningioma, 39, 147 Menopause, 26, 147, 154 Menstrual Cycle, 147, 155 Menstruation, 134, 147 Mental Disorders, 75, 142, 147 Metaplasia, 17, 147 Metastasis, 147 Metastatic, 4, 12, 14, 24, 42, 53, 61, 68, 107, 109, 128, 147 Methionine, 147, 161 MI, 121, 147 Microbiology, 126, 147 Microorganism, 131, 147, 165 Mineralization, 63, 148, 150 Mitomycin, 42, 68, 148 Mitosis, 125, 148 Mitotic, 9, 135, 137, 148

172 Paget’s Disease

Mitotic inhibitors, 135, 148 Mobility, 7, 31, 148 Molecular, 9, 10, 11, 12, 13, 15, 25, 38, 78, 79, 95, 97, 127, 132, 148, 163 Molecule, 125, 127, 132, 141, 148, 154, 157, 159, 163 Monitor, 148, 149 Monoclonal, 141, 148, 156 Monocytes, 143, 145, 148 Mononuclear, 5, 19, 61, 140, 148, 163 Monotherapy, 52, 148 Morbillivirus, 135, 146, 148 Morphological, 10, 136, 147, 148 Motility, 143, 148 Mucinous, 17, 30, 148 Mucinous carcinoma, 30, 148 Mucositis, 148, 162 Mucus, 148 Multiple Myeloma, 12, 148 Muscular Dystrophies, 136, 148 Myocardium, 147, 149 N Nasal Cavity, 149, 151, 160 NCI, 1, 73, 74, 93, 101, 102, 103, 105, 106, 107, 108, 131, 149, 152 Necrosis, 12, 125, 130, 138, 143, 147, 149, 153, 163 Need, 3, 8, 79, 85, 89, 102, 103, 112, 149 Needle biopsy, 138, 149 Neoplasia, 149 Neoplasm, 149, 151, 158, 163 Neoplastic, 54, 141, 146, 149 Nephropathy, 144, 149 Nerve, 34, 44, 126, 129, 149, 155, 157, 158, 164 Nervous System, 109, 110, 128, 129, 130, 139, 140, 141, 145, 149, 152, 160, 161 Neural, 10, 149 Neuraminidase, 148, 149, 151 Neurologic, 135, 141, 149 Neurons, 139, 145, 149, 161, 165 Neutrons, 124, 149, 156 Nuclear, 8, 16, 19, 23, 24, 30, 31, 38, 43, 48, 50, 55, 56, 65, 67, 70, 127, 136, 138, 139, 149, 164 Nuclei, 31, 124, 136, 139, 146, 148, 149, 156, 165 Nucleic acid, 129, 142, 149, 150, 158 Nucleocapsid, 7, 11, 19, 150 Nucleus, 125, 126, 130, 133, 136, 138, 139, 148, 149, 150, 156, 161, 165

O Occult, 27, 150 Opacity, 134, 150 Oral Health, 4, 150 Ossicles, 150, 151 Ossification, 150, 158 Osteoarthritis, 13, 22, 150 Osteoblasts, 12, 150 Osteocalcin, 44, 59, 60, 61, 67, 150 Osteoclasts, 5, 8, 11, 12, 13, 45, 54, 150 Osteogenesis, 10, 100, 150 Osteogenesis Imperfecta, 10, 100, 150 Osteogenic sarcoma, 43, 150, 151 Osteolysis, 6, 12, 30, 49, 59, 84, 150 Osteolytic, 7, 13, 45, 150 Osteomalacia, 13, 68, 81, 150 Osteopetrosis, 12, 13, 109, 111, 150 Osteoporosis, 4, 6, 9, 10, 12, 13, 22, 39, 60, 63, 68, 81, 103, 109, 110, 123, 128, 151 Osteosarcoma, 8, 9, 21, 38, 41, 43, 46, 150, 151 Otosclerosis, 10, 151 Ovum, 133, 134, 139, 151, 155 P Palliative, 151, 162 Pamidronate, 4, 6, 7, 24, 35, 39, 52, 60, 62, 66, 88, 151 Pancreas, 135, 151, 160 Papilloma, 36, 151 Papillomavirus, 29, 141, 151 Paramyxovirus, 8, 29, 151 Paranasal Sinuses, 151, 160 Parapsoriasis, 23, 151, 153 Parathyroid, 69, 151, 158, 162 Parathyroid Glands, 151, 158 Parathyroid hormone, 69, 151 Parathyroidectomy, 63, 151 Parkinsonism, 36, 129, 145, 151 Partial remission, 152, 157 Particle, 6, 152, 163 Patella, 38, 152 Pathogenesis, 11, 13, 36, 40, 141, 152 Pathologic, 19, 48, 62, 79, 125, 127, 133, 142, 152, 156, 157 Pathologic fracture, 48, 62, 152 Pathologic Processes, 125, 152 Pathophysiology, 11, 78, 152 Patient Education, 108, 114, 116, 121, 152 Patient Satisfaction, 5, 152 PDQ, 101, 105, 152 Pedigree, 29, 152 Pelvic, 34, 69, 152, 155

Index 173

Penicillamine, 16, 152 Penicillin, 152, 164 Penis, 17, 27, 43, 136, 152 Peptide, 13, 52, 62, 152, 154, 156 Perianal, 30, 41, 42, 49, 50, 152 Periodontal disease, 13, 152 Peripheral blood, 7, 152 Peripheral Nervous System, 152, 160, 161 Pharmaceutical Preparations, 139, 153 Pharmacologic, 126, 153, 163 Phenotype, 5, 11, 127, 153 Phenylalanine, 153, 164 Phenylbutyrate, 6, 153 Phospholipases, 153, 159 Phospholipids, 138, 153 Phosphonic Acids, 135, 153 Phosphorus, 129, 151, 153 Physiologic, 123, 127, 135, 142, 147, 153, 157, 163 Physiology, 127, 153 Pigment, 147, 153 Pilot study, 39, 60, 153 Pityriasis, 151, 153 Pityriasis Lichenoides, 151, 153 Placenta, 44, 125, 153, 155 Plants, 129, 154, 158, 163 Plaque, 23, 151, 154 Plasma, 66, 125, 130, 139, 144, 148, 154, 159 Plasma cells, 125, 148, 154 Platelet Activation, 154, 159 Platinum, 131, 154 Ploidy, 24, 154 Podophyllotoxin, 137, 154 Point Mutation, 10, 154 Polymerase, 5, 15, 23, 29, 154 Polymerase Chain Reaction, 5, 15, 23, 29, 154 Polypeptide, 124, 131, 154, 160 Polysaccharide, 125, 154 Posterior, 124, 126, 135, 151, 154, 160 Postmenopausal, 68, 73, 123, 151, 154 Postsynaptic, 155, 159 Potentiation, 155, 159 Practice Guidelines, 96, 155 Precancerous, 78, 155 Precursor, 135, 137, 145, 153, 155, 163, 164 Predisposition, 9, 54, 86, 155 Premalignant, 155 Presbycusis, 10, 155 Prevalence, 3, 22, 155 Progesterone, 40, 155, 161

Progression, 124, 155 Progressive, 130, 134, 137, 140, 148, 149, 150, 154, 155, 156, 157, 163 Proline, 131, 142, 155 Promoter, 5, 155 Prostaglandins, 143, 155 Prostaglandins A, 143, 155 Prostate, 66, 155 Protein C, 124, 126, 150, 156, 164, 165 Protein S, 78, 127, 150, 156 Proteins, 12, 26, 124, 125, 128, 130, 131, 132, 133, 148, 152, 154, 156, 158, 159, 163 Proteinuria, 148, 156 Protocol, 7, 70, 156 Protons, 124, 144, 146, 156 Proximal, 135, 149, 156 Pseudoxanthoma, 63, 156 Pseudoxanthoma Elasticum, 63, 156 Psoriasis, 151, 156 Psychiatric, 127, 147, 156 Puberty, 156 Public Policy, 95, 156 R Radiation, 28, 101, 104, 106, 107, 108, 136, 137, 138, 142, 143, 144, 156, 157, 165 Radiation therapy, 28, 138, 143, 156 Radioactive, 128, 142, 143, 149, 156, 157, 162, 164 Radioimmunotherapy, 157 Radiolabeled, 156, 157 Radiological, 18, 22, 53, 101, 157 Radiology, 17, 20, 21, 24, 28, 34, 40, 42, 43, 46, 47, 48, 53, 59, 60, 67, 101, 102, 157 Radiotherapy, 28, 49, 128, 156, 157 Randomized, 6, 7, 15, 18, 63, 73, 136, 157 Receptor, 5, 12, 13, 21, 40, 43, 55, 59, 67, 125, 135, 157, 158, 159, 162 Recombinant, 11, 44, 157 Rectal, 30, 157 Rectum, 41, 50, 125, 128, 135, 139, 143, 144, 155, 157, 161 Refer, 1, 132, 141, 145, 146, 149, 157, 159 Regimen, 5, 136, 157, 158 Remission, 19, 58, 66, 132, 152, 157 Renal failure, 45, 67, 157 Resorption, 6, 7, 13, 109, 128, 135, 141, 150, 157 Respiration, 129, 148, 157 Retina, 124, 156, 157 Retinae, 146, 157 Retreatment, 54, 158 Rheumatism, 18, 35, 48, 50, 54, 55, 158

174 Paget’s Disease

Rheumatoid, 12, 16, 140, 158 Rheumatoid arthritis, 12, 16, 140, 158 Ribonucleic acid, 19, 158 Ribose, 158, 162 Rickets, 81, 158 Rigidity, 151, 154, 158 S Salivary, 135, 158 Salivary glands, 135, 158 Saponins, 158, 161 Sarcoma, 29, 43, 79, 150, 151, 158 Sclerae, 150, 158 Sclerosis, 45, 158 Screening, 43, 103, 105, 106, 107, 131, 152, 158 Scrotum, 27, 43, 158, 162 Sebaceous, 158, 165 Secretion, 69, 148, 158, 159 Selective estrogen receptor modulator, 158, 162 Self Care, 123, 158 Semen, 44, 136, 155, 159 Semisynthetic, 137, 159 Senile, 151, 155, 159 Sequencing, 5, 154, 159 Serologic, 142, 159 Serum, 7, 8, 21, 41, 50, 51, 59, 60, 62, 74, 120, 132, 150, 159, 163 Sex Distribution, 63, 159 Shunt, 36, 159 Side effect, 85, 87, 89, 123, 127, 159, 161, 163 Signal Transduction, 13, 159 Signs and Symptoms, 157, 159 Skeletal, 8, 13, 17, 21, 32, 34, 42, 43, 47, 53, 63, 66, 69, 110, 148, 159, 160 Skeleton, 4, 52, 67, 109, 111, 123, 128, 138, 144, 159 Skull, 16, 36, 133, 159, 162 Small intestine, 141, 159, 165 Smooth muscle, 126, 159, 160, 161 Sodium, 16, 17, 26, 62, 68, 140, 159, 161 Soft tissue, 17, 128, 139, 159, 160 Somatostatin, 55, 160 Spasm, 35, 60, 160, 162 Specialist, 112, 135, 160 Species, 135, 137, 141, 146, 148, 151, 160, 165 Specificity, 41, 123, 160 Sperm, 130, 160, 162 Spermatozoa, 159, 160 Sphenoid, 41, 151, 160

Sphenoid Sinus, 41, 160 Spinal cord, 62, 129, 130, 137, 147, 149, 152, 160, 162 Spinal Stenosis, 48, 160 Spinous, 137, 160 Splenomegaly, 150, 160 Spondylitis, 4, 16, 100, 160 Sporadic, 9, 25, 43, 160 Squamous, 14, 49, 137, 160, 161 Squamous cell carcinoma, 49, 137, 160 Squamous cells, 160, 161 Sterile, 151, 161 Steroid, 13, 125, 158, 161 Stomach, 135, 137, 139, 141, 159, 161 Strand, 154, 161 Stress, 155, 158, 161 Stroke, 75, 94, 161 Stromal, 46, 161 Subacute, 143, 161 Subclinical, 143, 161 Substance P, 158, 161 Sulfur, 38, 147, 161 Supplementation, 66, 161 Supportive care, 152, 161 Suppositories, 139, 161 Suppurative, 141, 161 Sweat, 55, 125, 141, 161 Sweat Glands, 125, 161 Symphysis, 155, 161 Symptomatic, 26, 85, 161 Synaptic, 159, 161 Syncytium, 139, 162 Synovial, 40, 139, 144, 162 Synovial Cyst, 40, 162 Syringomyelia, 46, 162 Systemic, 45, 54, 88, 128, 137, 143, 156, 162 T Tamoxifen, 73, 102, 103, 107, 108, 158, 162 Technetium, 38, 66, 135, 162 Telencephalon, 127, 162 Temporal, 10, 78, 146, 162 Testicles, 158, 162 Tetany, 151, 162 Therapeutics, 22, 69, 89, 162 Thermal, 149, 154, 162 Thigh, 138, 140, 162 Thoracic, 126, 162 Thorax, 146, 162 Thrombosis, 133, 147, 156, 161, 162 Thymidine, 52, 162 Thymidine Phosphorylase, 52, 162 Thyroid, 151, 163, 164

Index 175

Thyroid Gland, 151, 163 Tomography, 35, 43, 47, 132, 146, 163 Topical, 51, 52, 163 Toxic, iv, 134, 137, 154, 163 Toxicity, 136, 163 Toxicology, 96, 163 Toxins, 125, 143, 157, 163 Trace element, 138, 163 Transcriptase, 5, 15, 23, 163 Transduction, 13, 159, 163 Transfection, 5, 127, 163 Tremor, 151, 163 Tryptophan, 131, 163 Tumor Necrosis Factor, 12, 163 Tumor suppressor gene, 8, 9, 145, 163 Tumour, 15, 33, 163 Tyrosine, 13, 135, 164 U Ubiquitin, 50, 164 Unconscious, 142, 164 Uranium, 162, 164 Urea, 161, 164 Uremia, 144, 157, 164 Ureters, 164 Urethra, 152, 155, 164 Urinary, 8, 31, 54, 141, 143, 164 Urinary tract, 31, 164 Urine, 7, 127, 143, 156, 164 Uterus, 130, 133, 134, 136, 147, 155, 164 V Vaccine, 123, 156, 164 Vagina, 130, 147, 164, 165

Vaginal, 164, 165 Valine, 152, 164 Vascular, 52, 54, 143, 153, 163, 164 Vascular endothelial growth factor, 52, 164 Vein, 144, 149, 164 Venous, 130, 156, 164 Ventricles, 130, 141, 164 Ventricular, 141, 164 Vertebrae, 160, 164 Vertebral, 34, 66, 164 Vestibulocochlear Nerve, 126, 164 Veterinary Medicine, 95, 165 Villi, 141, 165 Viral, 11, 25, 33, 53, 54, 59, 67, 129, 135, 139, 163, 165 Virion, 150, 165 Vitro, 60, 142, 154, 165 Vivo, 6, 11, 13, 67, 142, 165 Vulgaris, 47, 165 Vulva, 22, 24, 27, 30, 38, 46, 49, 50, 51, 52, 165 W Warts, 141, 154, 165 White blood cell, 125, 145, 146, 148, 154, 165 X Xenograft, 125, 165 X-ray, 60, 101, 120, 132, 133, 139, 149, 156, 157, 165 Y Yeasts, 153, 165

176 Paget’s Disease