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

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

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CHOLESTEATOMA 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., 1960Cholesteatoma: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00237-X 1. Cholesteatoma-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 cholesteatoma. 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 CHOLESTEATOMA ..................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Cholesteatoma ............................................................................... 6 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. NUTRITION AND CHOLESTEATOMA ........................................................................... 53 Overview...................................................................................................................................... 53 Finding Nutrition Studies on Cholesteatoma .............................................................................. 53 Federal Resources on Nutrition ................................................................................................... 54 Additional Web Resources ........................................................................................................... 54 CHAPTER 3. ALTERNATIVE MEDICINE AND CHOLESTEATOMA ..................................................... 57 Overview...................................................................................................................................... 57 National Center for Complementary and Alternative Medicine.................................................. 57 Additional Web Resources ........................................................................................................... 58 General References ....................................................................................................................... 59 CHAPTER 4. BOOKS ON CHOLESTEATOMA ..................................................................................... 61 Overview...................................................................................................................................... 61 Book Summaries: Federal Agencies.............................................................................................. 61 Book Summaries: Online Booksellers........................................................................................... 62 The National Library of Medicine Book Index ............................................................................. 63 Chapters on Cholesteatoma .......................................................................................................... 63 CHAPTER 5. MULTIMEDIA ON CHOLESTEATOMA .......................................................................... 65 Overview...................................................................................................................................... 65 Video Recordings ......................................................................................................................... 65 CHAPTER 6. PERIODICALS AND NEWS ON CHOLESTEATOMA ....................................................... 67 Overview...................................................................................................................................... 67 News Services and Press Releases................................................................................................ 67 Newsletter Articles ...................................................................................................................... 68 Academic Periodicals covering Cholesteatoma............................................................................. 69 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 73 Overview...................................................................................................................................... 73 NIH Guidelines............................................................................................................................ 73 NIH Databases............................................................................................................................. 75 Other Commercial Databases....................................................................................................... 77 APPENDIX B. PATIENT RESOURCES ................................................................................................. 79 Overview...................................................................................................................................... 79 Patient Guideline Sources............................................................................................................ 79 Finding Associations.................................................................................................................... 81 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 83 Overview...................................................................................................................................... 83 Preparation................................................................................................................................... 83 Finding a Local Medical Library.................................................................................................. 83 Medical Libraries in the U.S. and Canada ................................................................................... 83 ONLINE GLOSSARIES.................................................................................................................. 89 Online Dictionary Directories ..................................................................................................... 90 CHOLESTEATOMA DICTIONARY ........................................................................................... 93 INDEX .............................................................................................................................................. 123

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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 cholesteatoma 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 cholesteatoma, 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 cholesteatoma, 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 cholesteatoma. 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 cholesteatoma, 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 cholesteatoma. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON CHOLESTEATOMA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on cholesteatoma.

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

Chronic Otitis and Cholesteatoma Source: Current Opinion in Otolaryngology and Head and Neck Surgery. 1(1): 19-23. 1993. Summary: A number of recent clinical and laboratory studies have advanced the understanding of chronic otitis media (COM) with and without cholesteatoma. This review article summarizes recent research activities in this area. Topics covered include COM behind an intact tympanic membrane; the role of anaerobic bacteria in COM; new strategies for antimicrobial treatment of COM; the role of cytokines in the control of cellular events that occur during chronic middle ear inflammation; and fibroblasts derived from human cholesteatomas. The author notes that studies of the pathogenesis of COM have led to greater understanding of their bacteriologic management and the role of ventilating tubes in their prevention. 22 annotated references. (AA-M).

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Cholesteatoma

Hearing Results of Surgery for Acquired Cholesteatoma Source: ENT. Ear, Nose, and Throat Journal. 74(3): 160-164. March 1995. Summary: Chronic otitis media with cholesteatoma can lead to serious complications, such as labyrinthitis, meningitis, and brain abscess; therefore, it is a potentially lifethreatening disease that requires the aggressive approach of surgery. The primary goal of surgical treatment for cholesteatoma is to eradicate the disease and to prevent its recurrence. Hearing function in these patients is often worsened due to erosion of the ossicles by cholesteatoma or, if preoperatively normal or only moderately deteriorated, may be at risk during eradication of the disease. Although improvement or maintenance of hearing function is only a secondary goal of surgery, it is important especially in the patient's view. This article reports on a study undertaken to evaluate long-term hearing results of surgery for acquired cholesteatoma. Hearing results in 349 chronic ears with cholesteatoma were evaluated. The great majority of the patients underwent canal walldown mastoidectomy as a one-stage procedure. After a mean follow-up period of 7.3 years, 35 percent of the ears operated on showed hearing levels of 30 dB or better. Hearing improved in 30 percent, remained unchanged in 55 percent, and worsened in 15 percent. The mean hearing gain was only 5 dB. In 23 percent of ears with otherwise successful outcomes, the tympanum turned fibrotic, leading to poor hearing function. 4 tables. 4 references. (AA-M).

•

Causes of Failure of Combined Approach Tympanoplasty in the Treatment of Acquired Cholesteatomas of the Middle Ear and the Mastoid Source: Journal of Laryngology and Otology. 109(8): 710-712. August 1995. Summary: In this article, the author analyzes 40 case of failed combined approach tympanoplasty. The forty cases come from 141 patients (151 ears operated on) with acquired cholesteatoma of the middle ear and the mastoid. Failure was defined as a recurrence of the original condition, a residual cholesteatoma, or incomplete first stage removal. The most common cause of failure was adhesions between the facial ridge and the tympanic membrane, causing segmental attico-mastoid malaeration in 51.3 percent of cases follow-up continually. Other causes were: large dermoids, incomplete removal of squamous epithelium, and eustachian tube obstruction. Eustachian tube dysfunction did not appear to be a major cause of failure. 2 tables. 9 references. (AA-M).

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Pediatric Cholesteatoma: An Individualized, Single-Stage Approach Source: Otolaryngology-Head and Neck Surgery. 115(1): 107-114. July 1996. Summary: This article reports the authors' experience with a one-stage surgery technique used for pediatric cholesteatoma in 216 ears. Their technique is based on three main principles: the surgery is individualized; the goal of surgery is to completely remove cholesteatoma and related disease in one operation; and the reconstruction is performed to provide both good hearing and a dry, trouble-free ear. The incidence of recidivism was 10.2 percent and the rate achieved was 13.3 percent at 5 years and 24 percent at 10 years. Canal wall down surgery was the predominant procedure used. The incidence of intraoperative neurosensory hearing loss, vertigo, and facial nerve injury was extremely low. The postoperative cavity problems encountered were minimal. 3 figures. 3 tables. 27 references. (AA).

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Cholesteatomas Source: Pediatrics in Review. 20(4): 134-136. April 1999.

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Contact: Available from American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (800) 433-9016 (members) or (888) 227-1773 (nonmembers). Fax (847) 434-8000. Website: www.aap.org. Summary: This continuing education article for pediatricians reviews cholesteatomas, which are benign skin tumors that can occur in the middle ear and mastoid spaces. The article describes the classic location and appearance of congenital cholesteatomas; explains the two broad categories of cholesteatomas; describes how response to multiple courses of antibiotics should raise the index of suspicion for cholesteatoma; and discusses treatment options and prognosis. An otolaryngologist should be consulted if a cholesteatoma is suspected or if there is an unusual lesion in a child's ear. Surgery is always required and usually entails drilling out the lateral wall of the mastoid cavity of the skull behind the ear canal. Although cure may be difficult to achieve (recurrence rates approach 50 percent), a safe ear is almost always obtainable. 3 figures. 2 references. •

Cholesteatoma in Children Source: Pediatric Clinics in North America. 43(6): 1245-1252. December 1996. Summary: This review article considers cholesteatoma in children. Cholesteatoma refers to the presence of keratinizing squamous epithelium in the middle ear or mastoid space. These lesions are locally invasive and capable of causing destruction of the ossicles, cochlea, or semicircular canals. The author discusses the two types of cholesteatoma (congenital and acquired), including pathogenesis, presentation, evaluation, and management concepts. Cholesteatoma can develop as a complication of chronic otitis media (ear infection). The clinical presentation of children with cholesteatoma can be variable, ranging from an asymptomatic attic retraction pocket to a chronically draining ear associated with hearing loss and vertigo. Cholesteatoma is a surgical disease. The two primary goals of surgery are: eradication of the squamous epithelium and hearing preservation or restoration. Generally, a postauricular approach is required in children. The author briefly reviews the types of surgery possible. The author stresses the importance of close follow up of these children to prevent and control recurrent disease. 26 references. (AA-M).

•

Hearing Results of Surgery for Chronic Otitis Media Without Cholesteatoma Source: ENT. Ear, Nose, and Throat Journal. 74(3): 165-169. March 1995. Summary: While otologists are well aware of the potentially dangerous, even lifethreatening risks of chronic otitis media, patients often are mainly concerned about the hearing loss caused by this disease because other symptoms of chronic otitis media usually are minor or lacking. This article reports on a study that evaluated the hearing results of surgical treatment for chronic otitis media and its sequelae in 569 patients. Cases of cholesteatoma were excluded because of the special problems associated with this disease. The mean follow up period was 5.2 years. Ears with intact ossicular chain showed the best postoperative hearing function. Satisfactory hearing results were obtained in 68 percent of ears with eroded ossicles but intact stapes and in only 50 percent of ears with loss of stapes superstructure. Cases of sequelae to otitis showed better hearing results than cases of granulating otitis media. At last follow up examination, 72 percent of the whole series had hearing levels of 30 dB or better. 5 tables. 3 references. (AA-M).

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

Project Title: CELLULAR AND MOLECULAR BIOLOGY OF CHOLESTEATOMA Principal Investigator & Institution: Chole, Richard A.; Lindburg Professor and Head; Otolaryngology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 16-SEP-1985; Project End 30-NOV-2003 Summary: Aural cholesteatomas arise from the tympanic membrane as a sequela of otitis media. Cholesteatomas are progressive, epithelial lesions that destroy the bony structures of the middle and, sometimes, inner ear. Once established, cholesteatomas can only be mandated by surgical eradication and secondary middle ear reconstruction. The long-term objective of the Principal Investigator's research program is to understand the cellular mechanisms that lead to the development, progression, and bone destruction of cholesteatomas. Such an understanding may lead to strategies for the non-surgical prevention and management of this disease. The present application is designed to investigate the relationship of two important intercellular signaling molecules, interleukin-1 (IL-1) and nitric oxide (NO), to osteoclastic bone erosion in cholesteatoma. The specific aims of this application are: 1) to determine the expression of the interleukin family of cytokines (IL-1 alpha, IL-1 beta, and IL-1ra) in experimental cholesteatoma and also during osteoclast recruitment and activation induced by pressure in the gerbil bulla model of synchronous bone modeling; and 2) to investigate isoforms of nitric oxide synthase (NOS I, II, III) in the local control of osteoclasts in vitro and in vivo. There are two broad hypothesis, each focused on the isoforms of IL-1 and NOS. For Specific Aim1, hypothesis 1 will be tested: IL-1 isoforms are transcribed within bone lining cells and fibroblasts of the subepithelium subjacent to cholesteatoma and in the pressurized bulla and represent an early signal for the recruitment and activation of osteoclasts at a local site. Experimental gerbilline cholesteatoma, gerbilline pressurized bulla, PCS, cloning of PCR products, DNA sequencing, quantitative RTPCR, bone histomorphometry, and RNA in situ hybridization will be used to test this first hypothesis. For Specific Aim 2, hypothesis 2 will be tested: NO is produced by upregulation of NOS isoforms within bone lining cells and fibroblasts of the subepithelium subjacent to cholesteatoma and in the pressurized bulla. This leads to the

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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local elaboration of NO and the recruitment and activation of osteoclasts. Mouse calvarial organ culture (elemental calcium release and 45Ca release), gerbilline pressurized bulla, PCR, cloning of PCR products, DNA sequencing, quantitative RTPCR, bone histomorphometry, RNA in situ hybridization, and NADPH- diaphorase histochemistry will be used to test this second hypothesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CHARACTERIZATION OSTEOCLASTS

OF

NOS

I

SPLICE

VARIANTS

IN

Principal Investigator & Institution: Jung, Jae Y.; Otolaryngology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 01-FEB-2002 Summary: (provided by applicant): Chronic otitis media with and without cholesteatoma can lead to conductive as well as sensorineural hearing loss as the result of inflammatory bone resorption in the middle ear. Conductive hearing loss is commonly caused by erosion of the ossicles resulting from the inappropriate activation of osteoclasts. A number of factors regulate osteoclast development and activation including hormones, growth factors and cytokines. Recently, nitric oxide (NO) has been shown to play a role in osteoclast activation. NO is a short-lived neutral free radical gas synthesized from L-arginine by the enzyme nitric oxide synthase (NOS). The mechanism by which nitric oxide mediates osteoclast function is not well characterized and the three known isoforms may have opposing effects. In neurons, NOS I has extremely complex transcriptional and translational regulatory mechanisms involving multiple alternate splice variants, which are expressed in a stage and tissue specific manner. Preliminary results in our laboratory demonstrate NOS I-/ -osteolcasts have an in vitro and in vivo phenotype, suggesting NOS I plays an important role in osteoclast function and that this role may be mediated by a unique splice variant of this enzyme. The specific aims of this proposal are 1) to identify the alternate splice variant(s) expressed in osteoclasts and 2) to initiate the characterization of the translated NOS I protein. In addition to providing a understanding of the molecular mechanisms underlying cholesteatoma-induced bone resorption, the identification and characterization of unique transcriptional and translational NOS I regulatory mechanisms may facilitate the discovery of novel, osteoclast-specific pharmaceutical targets. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECTS REMODELING

OF

CYTOCHROME

P450

ON

ADAPTIVE

BONE

Principal Investigator & Institution: Young, Nwanmegha O.; Otolaryngology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 01-JAN-2002 Summary: Dr. Chole's laboratory is interested in the cellular and molecular mechanisms of localized bone remodeling in the middle ear. Bone in the middle ear is normally quiescent, but extensive remodeling can be induced by disease states like cholesteatoma. We are particularly interested in the modulatory role of signaling molecules such as nitric oxide and interleukin-1. Our preliminary data suggests that Cytochrome P450 may represent an alternate, or even preferred pathway to nitric oxide production in bone. Nitric oxide is an important regulator of osteoclast activity. This

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Cholesteatoma

proposal outlines studies to further elucidate the role of Cytochrome P450 in the modulation of nitric oxide signaling in bone. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISMS OF TISSUE DESTRUCTION IN CHOLESTEATOMA Principal Investigator & Institution: Faddis, Brian T.; Otolaryngology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 30-APR-2008 Summary: (provided by applicant): Cholesteatomas are epithelial tumor-like growths that arise from the tympanic membrane, typically as a sequela of chronic otitis media. The progressive nature of this lesion commonly results in the destruction of middle and inner ear structures via osteoclastic bone resorption. This destruction leads to hearing loss, vestibular dysfunction and intracranial complications. Current management of this disease is limited to surgical eradication, which must often be repeated. Chronic infection is another hallmark of the cholesteatoma and we have therefore been interested in the inflammatory signaling pathways that lead to osteoclast activation. We recently established a role for nitric oxide synthase 1 (NOS1 or neuronal NOS) in osteoclast activation. We now wish to explore this role further by identifying the mechanisms by which NOS1 is activated and the endogenous modulators that keep nitric oxide production in check. To this end, we have outlined the following specific aims. Specific Aim 1: To localize the cellular source(s) of NOSl that mediate osteoclast activity and to also localize potential endogenous modulators of NOSl. Specific Aim 2: To identify the mechanism of activation for NOSl and assess the efficiency by which various modulators can control nitric oxide production and ultimately the bone resorbing activity of osteoclasts in models of cholesteatoma. Neurons control NOSl activation by functionally linking it to the NMDA type of glutamate receptor. Interestingly, osteoclasts also have functional glutamate receptors, including the NMDA subtype, but their function is not well understood. Further, glutamate receptor antagonists inhibit the ability of the osteoclast to seal to the bone, a prerequisite to resorption activity. Osteoclasts from mice with targeted deletions of the NOS1 gene exhibit a similar phenotype. This coincidence offers intriguing evidence that these two observations are related and that osteoclasts may use the same mechanisms that neurons do to modulate NOS1 activation. These studies offer important insight into the control of osteoclast activity in cholesteatoma and may lead to the development of pharmacologic interventions that would replace the need for surgery in the treatment of this debilitating disease. 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 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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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 cholesteatoma, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “cholesteatoma” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for cholesteatoma (hyperlinks lead to article summaries): •

A case of giant cholesteatoma extending to the posterior fossa. Author(s): Uygur K, Ozlugedik S, Yasan H, Dursun G. Source: Kulak Burun Bogaz Ihtis Derg. 2003 June; 10(6): 237-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13679691

•

A murine model of cholesteatoma-induced bone resorption using autologous dermal implantation. Author(s): Sudhoff H, Liebehenz Y, Aschenbrenner J, Jung J, Hildmann H, Dazert S. Source: The Laryngoscope. 2003 June; 113(6): 1022-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782815

•

A new pathogenesis of mesotympanic (congenital) cholesteatoma. Author(s): Tos M. Source: The Laryngoscope. 2000 November; 110(11): 1890-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11081605

•

A scheme for challenging cholesteatoma in children. Author(s): Suzuki J, Iino Y. Source: International Journal of Pediatric Otorhinolaryngology. 1999 October 5; 49 Suppl 1: S91-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10577783

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A staging system for congenital cholesteatoma. Author(s): Potsic WP, Samadi DS, Marsh RR, Wetmore RF. Source: Archives of Otolaryngology--Head & Neck Surgery. 2002 September; 128(9): 1009-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12220203

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A systematic approach to interpretation of computed tomography scans prior to surgery of middle ear cholesteatoma. Author(s): Watts S, Flood LM, Clifford K. Source: The Journal of Laryngology and Otology. 2000 April; 114(4): 248-53. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10845037

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A tympanometric comparison of tympanoplasty with cartilage palisades or fascia after surgery for tensa cholesteatoma in children. Author(s): Uzun C, Caye-Thomasen P, Andersen J, Tos M. Source: The Laryngoscope. 2003 October; 113(10): 1751-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14520101

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Acquired and congenital cholesteatoma: determination of tumor necrosis factoralpha, intercellular adhesion molecule-1, interleukin-1-alpha and lymphocyte functional antigen-1 in the inflammatory process. Author(s): Akimoto R, Pawankar R, Yagi T, Baba S. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2000 September-October; 62(5): 257-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10965261

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Aggressiveness and quantification of epithelial proliferation of middle ear cholesteatoma by MIB1. Author(s): Mallet Y, Nouwen J, Lecomte-Houcke M, Desaulty A. Source: The Laryngoscope. 2003 February; 113(2): 328-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12567091

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Air-exposed tissue culture of human middle ear epithelium and meatal epidermis: a method to study the advancing front of cholesteatoma. Author(s): Albers-op t' Hof BM, Peek FA, Huisman MA, Grote JJ. Source: Acta Oto-Laryngologica. 2002 October; 122(7): 720-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12484648

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Alcaligenes xylosoxidans-associated infection in an infant with cholesteatoma. Author(s): Benaoudia F, Francois M, Brahimi N, Narcy P, Bingen E. Source: The Pediatric Infectious Disease Journal. 1995 July; 14(7): 637-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7567305

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Alteration of epidermal differentiation in middle ear cholesteatoma. Author(s): Stammberger M, Bujia J, Kastenbauer E. Source: The American Journal of Otology. 1995 July; 16(4): 527-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8588655

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Altered permeability barrier structure in cholesteatoma matrix. Author(s): Svane-Knudsen V, Halkier-Sorensen L, Rasmussen G, Ottosen PD. Source: Eur Arch Otorhinolaryngol. 2002 November;259(10):527-30. Epub 2002 June 28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12434186

Studies

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An in vitro growth study on cholesteatoma and normal skin. Author(s): Cheshire IM, Blight A, Proops DW. Source: Clinical Otolaryngology and Allied Sciences. 1995 October; 20(5): 453-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8582080

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Apoptosis in meatal skin, cholesteatoma and squamous cell carcinoma of the ear. Author(s): Ergun S, Carlsoo B, Zheng X. Source: Clinical Otolaryngology and Allied Sciences. 1999 August; 24(4): 280-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10472461

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Attic cholesteatoma with extension into the tympanum. Author(s): Pulec JL, Deguine C. Source: Ear, Nose, & Throat Journal. 2000 May; 79(5): 340. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10832195

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Audiologic presentation of cerebellopontine angle cholesteatoma. Author(s): Quaranta N, Chang P, Baguley DM, Moffat DA. Source: The Journal of Otolaryngology. 2003 August; 32(4): 217-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14587559

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Aural cholesteatoma: role of tumor necrosis factor-alpha in bone destruction. Author(s): Sastry KV, Sharma SC, Mann SB, Ganguly NK, Panda NK. Source: The American Journal of Otology. 1999 March; 20(2): 158-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10100515

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Autoclaving the ossicles provides safe autografts in cholesteatoma. Author(s): Miman MC, Aydin NE, Oncel S, Ozturan O, Erdem T. Source: Auris, Nasus, Larynx. 2002 April; 29(2): 133-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11893447

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Autograft ossiculoplasty in cholesteatoma surgery: is it feasible? Author(s): Ng SK, Yip WW, Suen M, Abdullah VJ, van Hasselt CA. Source: The Laryngoscope. 2003 May; 113(5): 843-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12792320

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Bacteriology of cholesteatoma: clinical significance. Author(s): Harker LA, Koontz FP. Source: Trans Am Acad Ophthalmol Otolaryngol. 1977 July-August; 84(4 Pt 1): Orl-6836. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=898521

12

Cholesteatoma

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Basement membrane in middle ear cholesteatoma. Immunohistochemical and ultrastructural observations. Author(s): Sudhoff H, Bujia J, Borkowshi G, Koc C, Holly A, Hildmann H, FisselerEckhoff A. Source: The Annals of Otology, Rhinology, and Laryngology. 1996 October; 105(10): 80410. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8865776

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Bezold's abscess arising with recurrent cholesteatoma 20 years after the first surgery: with a review of the 18 cases published in Japan since 1960. Author(s): Uchida Y, Ueda H, Nakashima T. Source: Auris, Nasus, Larynx. 2002 October; 29(4): 375-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12393045

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Bilateral cholesteatoma and habitual sniffing. Author(s): Tsuji K, Sone M, Kakibuchi M, Sakagami M. Source: Auris, Nasus, Larynx. 2002 April; 29(2): 111-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11893443

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Bilateral congenital aural cholesteatoma. Author(s): Fedok FG, Bellissimo JB, Wiegand DA. Source: Otolaryngology and Head and Neck Surgery. 1990 December; 103(6): 1028-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2126118

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Bilateral congenital cholesteatoma in branchio-oto-renal syndrome. Author(s): Worley GA, Vats A, Harcourt J, Albert DM. Source: The Journal of Laryngology and Otology. 1999 September; 113(9): 841-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10664690

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Bilateral congenital cholesteatoma. Author(s): Nishizaki K, Yamamoto S, Fukazawa M, Yuen K, Ohmichi T, Masuda Y. Source: International Journal of Pediatric Otorhinolaryngology. 1996 February; 34(3): 259-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8839077

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Bilateral congenital cholesteatoma: a cause or result of chronic otitis media with effusion? Author(s): Litman RS, Parisier SC, Hausman SA, Sher WH. Source: The American Journal of Otology. 1987 September; 8(5): 426-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3688201

Studies

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Bilateral occurrence of congenital middle ear cholesteatoma. Author(s): El-Bitar MA, Choi SS. Source: Otolaryngology and Head and Neck Surgery. 2002 November; 127(5): 480-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12447250

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Bilateral temporal bone cholesteatoma with an associated brain abscess. Author(s): O'Connor AF. Source: The Annals of Otology, Rhinology, and Laryngology. 1980 March-April; 89(2 Pt 1): 194-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7369653

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Biochemical study of cholesteatoma and cholesterol granuloma--occurrence of delta 7cholestenol in the tissues of cholesteatoma. Author(s): Hayashida T, Iwamori M, Kitsuwa T, Nagai Y, Nomura Y. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 1984; 46(5): 242-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6483382

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Biology of cholesteatoma. Author(s): Michaels L. Source: Otolaryngologic Clinics of North America. 1989 October; 22(5): 869-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2694066

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Blast injury and cholesteatoma. Author(s): Kronenberg J, Ben-Shoshan J, Modan M, Leventon G. Source: The American Journal of Otology. 1988 March; 9(2): 127-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3407744

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Bone destruction due to the rupture of a cholesteatoma sac: a pathogenesis of bone destruction in aural-cholesteatoma. Author(s): Kaneko Y, Yuasa R, Ise I, Iino Y, Shinkawa H, Rokugo M, Tomioka S, Shibahara Y. Source: The Laryngoscope. 1980 November; 90(11 Pt 1): 1865-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7432068

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Bone destruction mechanisms in chronic otitis media with cholesteatoma: specific production by cholesteatoma tissue in culture of bone-resorbing activity attributable to interleukin-1 alpha. Author(s): Kurihara A, Toshima M, Yuasa R, Takasaka T. Source: The Annals of Otology, Rhinology, and Laryngology. 1991 December; 100(12): 989-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1746847

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Bone resorption in chronic otitis media. A histological and ultrastructural study. II. Cholesteatoma. Author(s): Themsen J, Jorgensen MB, Bretlau P, Kristensen HK. Source: The Journal of Laryngology and Otology. 1974 October; 88(10): 983-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4470586

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Bone resorption in chronic otitis media. The role of cholesteatoma, a must or an adjunct? Author(s): Thomsen J, Bretlau P, Balslev Joorgensen M. Source: Clinical Otolaryngology and Allied Sciences. 1981 June; 6(3): 179-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7261454

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Bone resorption in human cholesteatoma: morphological study with scanning electron microscopy. Author(s): Uno Y, Saito R. Source: The Annals of Otology, Rhinology, and Laryngology. 1995 June; 104(6): 463-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7771720

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Bone SPECT in cholesteatoma assessment. Author(s): Ano T, Ciurana R, Figuerola E, Martinez de Virgala C, Reverter C, Risco J. Source: Acta Otorhinolaryngol Belg. 1997; 51(1): 35-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9105481

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Canal wall down tympanoplasty with canal reconstruction for middle-ear cholesteatoma: post-operative hearing, cholesteatoma recurrence, and status of reaeration of reconstructed middle-ear cavity. Author(s): Ikeda M, Yoshida S, Ikui A, Shigihara S. Source: The Journal of Laryngology and Otology. 2003 April; 117(4): 249-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12816211

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Cartilage palisade tympanoplasty in sinus and tensa retraction cholesteatoma. Author(s): Andersen J, Caye-Thomasen P, Tos M. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 November; 23(6): 825-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12438840

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Cholesteatoma epithelium is characterized by increased expression of Ki-67, p53 and p21, with minimal apoptosis. Author(s): Huisman MA, De Heer E, Grote JJ. Source: Acta Oto-Laryngologica. 2003 April; 123(3): 377-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12737294

Studies

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Cholesteatoma in children: histopathologic findings in middle ear ossicles. Author(s): Quaranta A, Bartoli R, Lozupone E, Resta L, Iurato S. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 1995 September-October; 57(5): 296-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8587786

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Cholesteatoma surgery with the canal-wall-down technique. Author(s): Wennmo C, Petersen H, Flisberg K. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 1996 January-February; 58(1): 39-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8718537

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Cholesteatoma surgery: the individualized technique. Author(s): Karmarkar S, Bhatia S, Saleh E, DeDonato G, Taibah A, Russo A, Sanna M. Source: The Annals of Otology, Rhinology, and Laryngology. 1995 August; 104(8): 591-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7639466

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Chorda tympani neuroma masquerading as cholesteatoma. Author(s): Hopkins C, Chau H, McGilligan JA. Source: The Journal of Laryngology and Otology. 2003 December; 117(12): 987-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14738613

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Chromosome 8 aneuploidy in acquired cholesteatoma. Author(s): Yildirim MS, Ozturk K, Acar H, Arbag H, Ulku CH. Source: Acta Oto-Laryngologica. 2003 April; 123(3): 372-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12737293

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Cochlear fistula in chronic otitis media with cholesteatoma. Author(s): Chao YH, Yun SH, Shin JO, Yoon JY, Lee DM. Source: The American Journal of Otology. 1996 January; 17(1): 15-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8694120

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Co-existing cholesteatoma and vestibular schwannoma. Author(s): Ogungbo B, Holliman D, Mendelow AD, Hill J. Source: The Journal of Laryngology and Otology. 2002 June; 116(6): 460-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12385362

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Comamonas testosteroni meningitis in a patient with recurrent cholesteatoma. Author(s): Arda B, Aydemir S, Yamazhan T, Hassan A, Tunger A, Serter D. Source: Apmis : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica. 2003 April; 111(4): 474-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12780521

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Concurrent intracranial and extracranial complications secondary to cholesteatoma: a case report. Author(s): Yeh SY, Cheng PW. Source: Otolaryngology and Head and Neck Surgery. 2003 January; 128(1): 163-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12574780

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Congenital cholesteatoma of the mastoid region. Author(s): Mevio E, Gorini E, Sbrocca M, Artesi L, Lenzi A, Lecce S, Mullace M. Source: Otolaryngology and Head and Neck Surgery. 2002 October; 127(4): 346-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12402016

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Congenital cholesteatoma of the tympanic membrane. Author(s): Kim SA, Haupert MS. Source: Otolaryngology and Head and Neck Surgery. 2002 October; 127(4): 359-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12402021

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Congenital cholesteatoma with spontaneous epidural abscess, sinus thrombosis and cutaneous fistula. Author(s): Gok A, Kanlikama M, Ozsarac C. Source: Neurosurgical Review. 1996; 19(3): 189-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8875509

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Congenital cholesteatoma. Author(s): Spingarn A. Source: Otolaryngology and Head and Neck Surgery. 1995 September; 113(3): 338. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7675506

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Congenital cholesteatoma. Author(s): Popli MB, Popli V. Source: Neurology India. 2003 June; 51(2): 292-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14571044

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Congenital middle ear cholesteatoma: need for early recognition--role of computed tomography scan. Author(s): El-Bitar MA, Choi SS, Emamian SA, Vezina LG. Source: International Journal of Pediatric Otorhinolaryngology. 2003 March; 67(3): 231-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12633921

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CT scanning of middle ear cholesteatoma: what does the surgeon want to know? Author(s): Yates PD, Flood LM, Banerjee A, Clifford K. Source: The British Journal of Radiology. 2002 October; 75(898): 847-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12381695

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Cytokeratin expression patterns by one- and two-dimensional electrophoresis in pars flaccida cholesteatoma and pars tensa cholesteatoma. Author(s): Kakoi H, Tamagawa Y, Kitamura K, Anniko M, Hiraide F, Kitajima Y. Source: Acta Oto-Laryngologica. 1995 November; 115(6): 804-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8749203

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Deafness and cholesteatoma complicating fracture of the mandibular condyle. Author(s): Langton SG, Saeed SR, Musgrove BT, Ramsden RT. Source: The British Journal of Oral & Maxillofacial Surgery. 1996 August; 34(4): 286-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8866061

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Delayed diagnosis and fate of congenital cholesteatoma (keratoma). Author(s): Grundfast KM, Ahuja GS, Parisier SC, Culver SM. Source: Archives of Otolaryngology--Head & Neck Surgery. 1995 August; 121(8): 903-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7619419

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Detection and management of childhood cholesteatoma. Author(s): De la Cruz A, Fayad JN. Source: Pediatric Annals. 1999 June; 28(6): 370-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10382196

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Detection of Chlamydia pneumoniae in cholesteatoma tissue: any pathogenetic role? Author(s): Ronchetti F, Ronchetti R, Guglielmi F, Chiappini I, Contini C, Filipo R, Santino I, Cerruto R, Bernardeschi D, Barbara M. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 May; 24(3): 353-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12806283

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Detection of postoperative residual cholesteatoma with delayed contrast-enhanced MR imaging: initial findings. Author(s): Williams MT, Ayache D, Alberti C, Heran F, Lafitte F, Elmaleh-Berges M, Piekarski JD. Source: European Radiology. 2003 January; 13(1): 169-74. Epub 2002 July 16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12541126

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Detection of recurrent cholesteatoma by computerized tomography after 'closed cavity' mastoid surgery. Author(s): Wake M, Robinson JM, Witcombe JB, Bazerbachi S, Stansbie JM, Phelps PD. Source: The Journal of Laryngology and Otology. 1992 May; 106(5): 393-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1613362

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Differentiation characteristics of cholesteatoma epithelium determined by expression of transglutaminase isoenzymes. Author(s): Chang CS, Jun BH, Song KY, Kim IG. Source: Journal of Korean Medical Science. 1999 December; 14(6): 665-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10642946

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Differentiation of nuclei during keratinization in middle ear cholesteatoma. DNA cytophotometry completed by computerized image analysis. Author(s): Broekaert D, Van Oostveldt P, Coucke P, Reyniers P, Kluyskens P, Gillis E. Source: Acta Oto-Laryngologica. 1988 January-February; 105(1-2): 90-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2449035

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Diffusion-weighted imaging for differentiating recurrent cholesteatoma from granulation tissue after mastoidectomy: case report. Author(s): Maheshwari S, Mukherji SK. Source: Ajnr. American Journal of Neuroradiology. 2002 May; 23(5): 847-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12006291

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Diffusion-weighted MR imaging of cholesteatoma in pediatric and adult patients who have undergone middle ear surgery. Author(s): Aikele P, Kittner T, Offergeld C, Kaftan H, Huttenbrink KB, Laniado M. Source: Ajr. American Journal of Roentgenology. 2003 July; 181(1): 261-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12818870

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Distribution of ABO blood groups in secretory otitis media and cholesteatoma. Author(s): Mortensen EH, Lildholdt T, Gammelgard NP, Christensen PH. Source: Clinical Otolaryngology and Allied Sciences. 1983 August; 8(4): 263-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6686090

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Dry central perforation with tympanosclerosis and cholesteatoma. Author(s): Pulec JL, Deguine C. Source: Ear, Nose, & Throat Journal. 2002 August; 81(8): 488. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12199160

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Duro-cutaneous fistula caused by a 'congenital' cholesteatoma. Author(s): Viani L, McCormick MS. Source: The Journal of Laryngology and Otology. 1990 March; 104(3): 241-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2341782

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Efficacy of mastoid cortex plasty for middle ear aeration in intact canal wall tympanoplasty for cholesteatoma. Author(s): Minoda R, Yanagihara N, Hinohira Y, Yumoto E. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 July; 23(4): 425-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12170139

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Efficacy of the 2-staged procedure in the management of cholesteatoma. Author(s): Ho SY, Kveton JF. Source: Archives of Otolaryngology--Head & Neck Surgery. 2003 May; 129(5): 541-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12759267

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Endoscope affects decision making in cholesteatoma surgery. Author(s): El-Meselaty K, Badr-El-Dine M, Mandour M, Mourad M, Darweesh R. Source: Otolaryngology and Head and Neck Surgery. 2003 November; 129(5): 490-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14595271

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Etiopathogenesis of cholesteatoma. Author(s): Olszewska E, Wagner M, Bernal-Sprekelsen M, Ebmeyer J, Dazert S, Hildmann H, Sudhoff H. Source: Eur Arch Otorhinolaryngol. 2004 January;261(1):6-24. Epub 2003 June 27. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12835944

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Evidence against neonatal aspiration of keratinizing epithelium as a cause of congenital cholesteatoma. Author(s): Bernal-Sprekelsen M, Sudhoff H, Hildmann H. Source: The Laryngoscope. 2003 March; 113(3): 449-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12616195

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Expression of a cathelicidin antimicrobial peptide is augmented in cholesteatoma. Author(s): Jung HH, Chae SW, Jung SK, Kim ST, Lee HM, Hwang SJ. Source: The Laryngoscope. 2003 March; 113(3): 432-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12616192

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Expression of a cell-cycle-associated nuclear antigen (MIB 1) in cholesteatoma and auditory meatal skin. Author(s): Sudhoff H, Bujia J, Fisseler-Eckhoff A, Holly A, Schulz-Flake C, Hildmann H. Source: The Laryngoscope. 1995 November; 105(11): 1227-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7475881

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Expression of beta-catenin in external auditory canal cholesteatoma (EACC). Author(s): Naim R, Riedel F, Bran G, Hormann K. Source: Biofactors (Oxford, England). 2003; 19(3-4): 189-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14757970

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Expression of beta-defensins in human middle ear cholesteatoma. Author(s): Park K, Moon SK, Choung YH, Choi HS. Source: Acta Oto-Laryngologica. 2003 January; 123(2): 236-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12701748

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Expression of bone morphogenetic protein-2 messenger ribonucleic acid in cholesteatoma fibroblasts. Author(s): Schmidt M, Schler G, Gruensfelder P, Hoppe F. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 May; 23(3): 267-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11981380

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Expression of epidermal growth factor receptor in human middle ear cholesteatoma. Author(s): Hsu YC, Ho KY, Chai CY, Lee KW, Wang LF, Wu SC, Kuo WR, Tsai SM. Source: Kaohsiung J Med Sci. 2003 October; 19(10): 497-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14620675

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Expression of epidermal growth factor, tumor necrosis factor-alpha, and interleukin1alpha in chronic otitis media with or without cholesteatoma. Author(s): Yetiser S, Satar B, Aydin N. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 September; 23(5): 647-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12218613

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Expression of hypoxia inducible factor 1 alpha and Von Hippel Lindau protein in human middle ear cholesteatoma. Author(s): Adunka O, Gstoettner W, Knecht R, Kierner AC. Source: The Laryngoscope. 2003 July; 113(7): 1210-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12838021

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Expression of messenger RNA for keratinocyte growth factor in human cholesteatoma. Author(s): Kojima H, Matsuhisa A, Shiwa M, Kamide Y, Nakamura M, Ohno T, Moriyama H. Source: Archives of Otolaryngology--Head & Neck Surgery. 1996 February; 122(2): 15760. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8630209

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Expression of the p53 and nm23 genes in cholesteatoma. Author(s): Bayazit YA, Bakir K, Kanlikama M, Ozer E, Mumbuc S, Disikirik I, Ucak R. Source: Acta Oto-Laryngologica. 2002 October; 122(7): 726-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12484649

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Expression of vascular endothelial growth factor in external auditory canal cholesteatoma. Author(s): Naim R, Riedel F, Hormann K. Source: International Journal of Molecular Medicine. 2003 May; 11(5): 555-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12684689

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Expressions of c-jun and p53 proteins in human middle ear cholesteatoma: relationship to keratinocyte proliferation, differentiation, and programmed cell death. Author(s): Shinoda H, Huang CC. Source: The Laryngoscope. 1995 November; 105(11): 1232-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7475882

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External auditory canal cholesteatoma: clinical and imaging spectrum. Author(s): Heilbrun ME, Salzman KL, Glastonbury CM, Harnsberger HR, Kennedy RJ, Shelton C. Source: Ajnr. American Journal of Neuroradiology. 2003 April; 24(4): 751-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12695217

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External canal cholesteatoma. Author(s): Dogru H, Korkmaz H. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 March; 23(2): 241-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11917891

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External ear canal cholesteatoma. Case report. Author(s): Hartley C, Birzgalis AR, Hartley RH, Lyons TJ, Farrington WT. Source: The Annals of Otology, Rhinology, and Laryngology. 1995 November; 104(11): 868-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8534026

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Facial nerve paralysis secondary to chronic otitis media without cholesteatoma. Author(s): Harker LA, Pignatari SS. Source: The American Journal of Otology. 1992 July; 13(4): 372-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1415504

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Facial paralysis associated with cholesteatoma unresponsive to surgical therapy. Author(s): Croxson G. Source: The American Journal of Otology. 1990 July; 11(4): 297-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2399953

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Facial paralysis: An unusual presentation of congenital cholesteatoma. Author(s): Melero GA, March AR, Aldrich I, Pinedo JT. Source: Otolaryngology and Head and Neck Surgery. 2000 April; 122(4): 615-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10740193

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Factors associated with recurrence of cholesteatoma. Author(s): Vartiainen E. Source: The Journal of Laryngology and Otology. 1995 July; 109(7): 590-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7561462

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Factors influencing the probability of residual cholesteatoma. Author(s): Gristwood RE, Venables WN. Source: The Annals of Otology, Rhinology, and Laryngology. 1990 February; 99(2 Pt 1): 120-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2301866

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Factors that affect the outcome of open-technique procedures performed in the treatment of cholesteatoma. Author(s): Ozgirgin ON, Aydin E, Ozcelik T, Ozluoglu LN. Source: Kulak Burun Bogaz Ihtis Derg. 2003 February; 10(2): 47-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12717056

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Fate of patients with bilateral cholesteatoma. Author(s): Vartiainen E. Source: American Journal of Otolaryngology. 1993 January-February; 14(1): 49-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8434720

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Fibrous dysplasia of the temporal bone and maxillofacial region associated with cholesteatoma of the middle ear. Author(s): Djeric D, Stefanovic P. Source: Auris, Nasus, Larynx. 1999 January; 26(1): 79-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10077260

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Findings in revision operations for failures after cholesteatoma surgery. Author(s): Vartiainen E, Virtaniemi J. Source: The American Journal of Otology. 1994 March; 15(2): 229-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8172307

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First branchial cleft sinus presenting with cholesteatoma and external auditory canal atresia. Author(s): Yalcin S, Karlidag T, Kaygusuz I, Demirbag E. Source: International Journal of Pediatric Otorhinolaryngology. 2003 July; 67(7): 811-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12791459

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First branchial cleft sinus presenting with cholesteatoma. Author(s): Lee S, Saleh HA, Abramovich S. Source: The Journal of Laryngology and Otology. 2000 March; 114(3): 210-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10829112

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First observations on treatment of cholesteatoma with (N-acetyl)cysteine. Author(s): Kluyskens P, Gillis E, Nsabumukunzi S. Source: Acta Oto-Laryngologica. 1979 March-April; 87(3-4): 362-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=443016

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Five years experience using the intact canal wall tympanoplasty with mastoidectomy for cholesteatoma: preliminary report. Author(s): Kinney SE. Source: The Laryngoscope. 1982 December; 92(12): 1395-400. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7176793

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Function of the Eustachian tube related to surgical management of acquired aural cholesteatoma in children. Author(s): Bluestone CD, Cantekin EI, Beery QC, Stool SE. Source: The Laryngoscope. 1978 July; 88(7 Pt 1): 1155-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=672348

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Functional characterization of middle ear mucosa residues in cholesteatoma samples. Author(s): Sudhoff H, Bujia J, Holly A, Kim C, Fisseler-Eckhoff A. Source: The American Journal of Otology. 1994 March; 15(2): 217-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8172304

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Functional evaluation of the patient with cholesteatoma. Author(s): Pratt LL, Murray J. Source: The Laryngoscope. 1973 June; 83(6): 871-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4711325

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Further research on solubilization of cholesteatoma keratins. Author(s): Kluyskens P, Gillis E, Broekaert D, Coucke P, Nsabumukunzi S, Reyniers P. Source: Acta Oto-Laryngologica. 1981 May-June; 91(5-6): 585-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6168164

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Further studies on a collagenase in middle ear cholesteatoma. Author(s): Abramson M, Gross J. Source: The Annals of Otology, Rhinology, and Laryngology. 1971 April; 80(2): 177-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4323841

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Gene expression analysis of human middle ear cholesteatoma using complementary DNA arrays. Author(s): Tokuriki M, Noda I, Saito T, Narita N, Sunaga H, Tsuzuki H, Ohtsubo T, Fujieda S, Saito H. Source: The Laryngoscope. 2003 May; 113(5): 808-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12792315

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Giant cholesteatoma of the external auditory canal. Author(s): Sapci T, Ugur G, Karavus A, Agrali N, Akbulut UG. Source: The Annals of Otology, Rhinology, and Laryngology. 1997 June; 106(6): 471-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9199605

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Giant cholesteatoma presenting as a postauricular mass. Author(s): Topaloglu I, Uguz MZ, Ardic FN. Source: Otolaryngology and Head and Neck Surgery. 1997 June; 116(6 Pt 1): 678-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9215383

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Giant congenital cholesteatoma. Author(s): Borgstein J, Martin F, Soda A. Source: The Annals of Otology, Rhinology, and Laryngology. 1993 August; 102(8 Pt 1): 646-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8352491

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Giant invasive cholesteatoma. Report of a case with cerebellar invasion. Author(s): Arkin CF, Millard M, Medeiros LJ. Source: Archives of Pathology & Laboratory Medicine. 1985 October; 109(10): 960-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3840009

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Grommet ventilation myringostomy with cholesteatoma. Author(s): Deguine C, Pulec JL. Source: Ear, Nose, & Throat Journal. 1999 December; 78(12): 884. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10624048

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Grommets and cholesteatoma in children. Author(s): Herdman R, Wright JL. Source: The Journal of Laryngology and Otology. 1988 November; 102(11): 1000-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3209932

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Growth rate and recurrence of residual epidermoid cholesteatoma after tympanoplasty. Author(s): Gristwood RE, Venables WN. Source: Clinical Otolaryngology and Allied Sciences. 1976; 1(2): 169-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1031660

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Has the increasing use of grommets influenced the frequency of surgery for cholesteatoma? Author(s): Padgham N, Mills R, Christmas H. Source: The Journal of Laryngology and Otology. 1989 November; 103(11): 1034-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2607198

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Hearing after surgery for cholesteatoma using various techniques. Author(s): Tos M, Lau T. Source: Auris, Nasus, Larynx. 1989; 16(2): 61-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2803117

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Hearing impairment in chronic otitis media with cholesteatoma. Author(s): Chao WY, Wu CC. Source: J Formos Med Assoc. 1994 October; 93(10): 866-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7749340

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Hearing preservation despite labyrinthectomy for resection of giant cholesteatoma with middle fossa extension. Author(s): Rapado F, Fergie N, Ramsden RT. Source: The Journal of Laryngology and Otology. 1998 May; 112(5): 472-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9747479

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Hearing results after cholesteatoma surgery: the Iowa experience. Author(s): Ragheb SM, Gantz BJ, McCabe BF. Source: The Laryngoscope. 1987 November; 97(11): 1254-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3669835

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Hearing results after tympanoplasty in elderly patients with middle ear cholesteatoma. Author(s): Nomura K, Iino Y, Hashimoto H, Suzuki JI, Kodera K. Source: Acta Oto-Laryngologica. 2001 December; 121(8): 919-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11813895

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Hearing results of canal wall reconstruction tympanoplasty for middle ear cholesteatoma in children. Author(s): Iino Y, Nagamine H, Sasaki Y, Kodera K. Source: International Journal of Pediatric Otorhinolaryngology. 2001 July 30; 60(1): 6572. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11434956

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Hearing results of surgery for acquired cholesteatoma. Author(s): Vartiainen E, Vartiainen J. Source: Ear, Nose, & Throat Journal. 1995 March; 74(3): 160-2, 164. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7729339

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Hearing results of surgery for chronic otitis media without cholesteatoma. Author(s): Vartiainen E, Vartiainen J. Source: Ear, Nose, & Throat Journal. 1995 March; 74(3): 165-6, 169. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7729340

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Heat shock proteins in middle ear cholesteatoma. Author(s): Shinoda H, Huang CC. Source: Otolaryngology and Head and Neck Surgery. 1996 January; 114(1): 77-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8570255

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Hemifacial spasm caused by cholesteatoma. Author(s): Davis WE, Luterman BF, Pulliam MW, Templer JW. Source: The American Journal of Otology. 1981 January; 2(3): 272-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7282899

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Hereditary congenital cholesteatoma. A variant of branchio-oto dysplasia. Author(s): Lipkin AF, Coker NJ, Jenkins HA. Source: Archives of Otolaryngology--Head & Neck Surgery. 1986 October; 112(10): 1097100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3755982

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Hereditary factors in chronic otitis with cholesteatoma. Author(s): Plester D. Source: Acta Otorhinolaryngol Belg. 1980; 34(1): 51-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7468194

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High levels of fibronectin in the stroma of aural cholesteatoma. Author(s): Schilling V, Holly A, Bujia J, Schulz P, Kastenbauer E. Source: American Journal of Otolaryngology. 1995 July-August; 16(4): 232-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7573742

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High resolution CT scanning for detection of cholesteatoma and complications in the postoperative ear. Author(s): Voorhees RL, Johnson DW, Lufkin RB, Hanafee W, Canalis R. Source: The Laryngoscope. 1983 May; 93(5): 589-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6843250

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Histochemical demonstration of mucin in lymphatic vessels of human middle ear cholesteatoma. Author(s): Nagai T, Suganuma T, Ide S, Morimitsu T. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1993; 250(4): 233-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8396397

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Histological changes of incus with cholesteatoma in the attic. Author(s): Subotic R, Femenic B. Source: Acta Oto-Laryngologica. 1991; 111(2): 358-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2068922

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Huge congenital cholesteatoma simulating an intracranial abscess. Author(s): Rapoport PB, Di Francesco RC, Mion O, Bento RF. Source: Otolaryngology and Head and Neck Surgery. 2000 July; 123(1 Pt 1): 148-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10889499

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Human leukocyte antigen-A, -B, -C tissue types in patients with middle ear cholesteatoma. Author(s): Felding JU, Pedersen CB, Lamm LU. Source: The Annals of Otology, Rhinology, and Laryngology. 1988 March-April; 97(2 Pt 1): 192-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3258487

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Hyperproliferation-associated keratin expression in human middle ear cholesteatoma. Author(s): Bujia J, Schilling V, Holly A, Stammberger M, Kastenbauer E. Source: Acta Oto-Laryngologica. 1993 May; 113(3): 364-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7685977

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Identification of proliferating keratinocytes in middle ear cholesteatoma using the monoclonal antibody Ki-67. Author(s): Bujia J, Holly A, Sudhoff H, Antoli-Candela F, Tapia MG, Kastenbauer E. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 1996 January-February; 58(1): 23-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8718533

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Images in clinical medicine. Cholesteatoma medial to an intact translucent tympanic membrane. Author(s): Todd NW. Source: The New England Journal of Medicine. 1994 November 17; 331(20): 1347. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7935704

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Imaging case study of the month. Congenital cholesteatoma isolated to the mastoid. Author(s): Luntz M, Telischi F, Bowen B, Ress B, Balkany T. Source: The Annals of Otology, Rhinology, and Laryngology. 1997 July; 106(7 Pt 1): 60810. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9228865

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Imaging quiz case 2. Osteoma of the mastoid antrum and cholesteatoma. Author(s): Ramirez-Camacho R, Vicente J, Ramon y Cajal S. Source: Archives of Otolaryngology--Head & Neck Surgery. 1999 March; 125(3): 349, 351-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10190811

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Immunohistochemical and histopathological features of keratosis obturans and cholesteatoma of the external auditory canal. Atypical keratosis obturans. Author(s): Kuczkowski J, Mikaszewski B, Narozny W. Source: The Journal of Laryngology and Otology. 2004 March; 118(3): 249-50; Author Reply 250-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15068533

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Immunohistochemical detection of proliferating cell nuclear antigen in middle ear cholesteatoma. Author(s): Bujia J, Sudhoff H, Holly A, Hildmann H, Kastenbauer E. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1996; 253(1-2): 21-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8932424

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Immunohistochemical investigations of cathepsin D activity in the structures of cholesteatoma. Author(s): Chodynicki S, Chyczewski L, Olszewska E. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2002 May; 8(5): Br184-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011767

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In vitro production of parathyroid hormone-related protein by cholesteatoma and normal skin. Author(s): Cheshire IM, Blight A, Ratcliffe WA, Proops DW. Source: Clinical Otolaryngology and Allied Sciences. 1995 October; 20(5): 448-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8582079

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Induction of matrix metalloproteinases in keratinocytes by cholesteatoma debris and granulation tissue extracts. Author(s): Schmidt M, Grunsfelder P, Hoppe F. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2000; 257(8): 425-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11073191

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Inner ear cholesteatoma: an embryologic aberration. Author(s): Spingarn AT, Selesnick SH, Minick CR. Source: Otolaryngology and Head and Neck Surgery. 1994 March; 110(3): 333-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8134146

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Intact canal wall mastoidectomy with tympanoplasty for cholesteatoma in children. Author(s): Dodson EE, Hashisaki GT, Hobgood TC, Lambert PR. Source: The Laryngoscope. 1998 July; 108(7): 977-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9665242

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Integrin expression in middle ear cholesteatoma. Author(s): Dallari S, Cavani A, Bergamini G, Girolomoni G. Source: Acta Oto-Laryngologica. 1994 March; 114(2): 188-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7515549

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Interleukin 1 (IL-1) and IL-1-receptor antagonist (IL-1-RA) in middle ear cholesteatoma: an analysis of protein production and biological activity. Author(s): Bujia J, Kim C, Ostos P, Sudhoff H, Kastenbauer E, Hultner L. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1996; 253(4-5): 252-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8737779

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Interleukin-6 and tumour necrosis factor alpha synthesized by cholesteatoma cells affect mucociliary function in the eustachian tube. Author(s): Kato A, Ohashi Y, Masamoto T, Sakamoto H, Uekawa M, Nakai Y. Source: Acta Otolaryngol Suppl. 1998; 538: 90-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9879407

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Intracranial cholesteatoma extending in the middle and posterior fossa. Author(s): Corriero G, Maiuri F, Giamundo A, Colella G. Source: Acta Neurol (Napoli). 1982 June; 4(3): 180-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7136883

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Intracranial extension of acquired aural cholesteatoma. Author(s): Horn KL. Source: The Laryngoscope. 2000 May; 110(5 Pt 1): 761-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10807355

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Intratympanic cholesteatoma. Author(s): Rappaport JM, Browning S, Davis NL. Source: The Journal of Otolaryngology. 1999 December; 28(6): 357-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10604168

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Involvement of interleukin-1 in middle ear cholesteatoma. Author(s): Shiwa M, Kojima H, Kamide Y, Moriyama H. Source: American Journal of Otolaryngology. 1995 September-October; 16(5): 319-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7503375

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Is chronic otitis media with cholesteatoma associated with neurosensory hearing loss? Author(s): Eisenman DJ, Parisier SC. Source: The American Journal of Otology. 1998 January; 19(1): 20-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9455942

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Isolation and characterization of trypsin-like and chymotrypsin-like proteinases from human cholesteatoma. Author(s): Hochstrasser K, Albrecht GJ, Gebhard W, Rasp G, Kastenbauer E. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1994; 251(1): 30-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8179864

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Keratinizing desquamative squamous metaplasia of the upper urinary tract: leukoplakia--cholesteatoma. Author(s): Hertle L, Androulakakis P. Source: The Journal of Urology. 1982 April; 127(4): 631-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7069821

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Keratinocyte differentiation in acquired cholesteatoma and perforated tympanic membranes. Author(s): Vennix PP, Kuijpers W, Peters TA, Tonnaer EL, Ramaekers FC. Source: Archives of Otolaryngology--Head & Neck Surgery. 1996 August; 122(8): 825-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8703383

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Keratinocyte growth factor and receptor mRNA expression in cholesteatoma of the middle ear. Author(s): Ishibashi T, Shinogami M, Kaga K, Fukaya T. Source: Acta Oto-Laryngologica. 1997 September; 117(5): 714-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9349868

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Keratosis obturans and external auditory canal cholesteatoma. Author(s): Piepergerdes MC, Kramer BM, Behnke EE. Source: The Laryngoscope. 1980 March; 90(3): 383-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7359960

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Kinetic analysis of cell proliferation using bromodeoxyuridine labeling and in situ detection of dying cells in the tympanic membrane and middle ear cholesteatoma. Author(s): Koba R, Yagi M, Tabe H, Kawabata I. Source: Arch Histol Cytol. 1996 October; 59(4): 339-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8937634

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Knowledge about cholesteatoma, from the first description to the modern histopathology. Author(s): Soldati D, Mudry A. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2001 November; 22(6): 723-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11698787

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Labyrinthine fistula as a complication of cholesteatoma. Author(s): Magliulo G, Terranova G, Varacalli S, Sepe C. Source: The American Journal of Otology. 1997 November; 18(6): 697-701. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9391663

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Labyrinthine fistulae caused by cholesteatoma. Improved bone conduction by treatment. Author(s): Kobayashi T, Sakurai T, Okitsu T, Yuasa R, Kawase T, Kusakari J, Takasaka T. Source: The American Journal of Otology. 1989 January; 10(1): 5-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2719088

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Labyrinthine fistulae in cholesteatoma. Author(s): Chiossone E. Source: Advances in Oto-Rhino-Laryngology. 1987; 37: 128-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3673802

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Laser-assisted tympanoplasty for preservation of the ossicular chain in cholesteatoma. Author(s): Nishizaki K, Yuen K, Ogawa T, Nomiya S, Okano M, Fukushima K. Source: American Journal of Otolaryngology. 2001 November-December; 22(6): 424-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11713730

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Late results after cholesteatoma surgery in early childhood. Author(s): Rigner P, Renvall U, Tjellstrom A. Source: International Journal of Pediatric Otorhinolaryngology. 1991 October; 22(3): 2138. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1752732

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Lateral sinus thrombosis and cervical abscess complicating cholesteatoma in children: case report and review. Author(s): Lubianca Neto JF, Saffer M, Rotta FT, Arrarte JL, Brinckmann CA, Ferreira P. Source: International Journal of Pediatric Otorhinolaryngology. 1998 January; 42(3): 2639. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9466230

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Lipopolysaccharide concentration and bone resorption in cholesteatoma. Author(s): Peek FA, Huisman MA, Berckmans RJ, Sturk A, Van Loon J, Grote JJ. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 September; 24(5): 709-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14501443

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Localization of filaggrin in human middle ear cholesteatoma. Author(s): Chao WY, Huang CC. Source: Acta Oto-Laryngologica. 1989 March-April; 107(3-4): 249-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2648749

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Localization of interleukin-1 in human cholesteatoma. Author(s): Ahn JM, Huang CC, Abramson M. Source: American Journal of Otolaryngology. 1990 March-April; 11(2): 71-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2188520

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Localization of matrix metalloproteinase 1 in cholesteatoma and deep meatal skin. Author(s): Banerjee AR, Jones JL, Birchall JP, Powe DG. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2001 September; 22(5): 579-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11568661

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Localization of proliferating cell nuclear antigen in aural cholesteatoma. Author(s): Uchida N, Ito S, Hirano M. Source: Kurume Med J. 1993; 40(4): 225-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7911858

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Localization of transforming growth factor-beta-expressing cells and comparison with major extracellular components in aural cholesteatoma. Author(s): Lang S, Schilling V, Wollenberg B, Mack B, Nerlich A. Source: The Annals of Otology, Rhinology, and Laryngology. 1997 August; 106(8): 66973. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9270431

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Localized cryptococcal infection combined with cholesteatoma of the ear. Author(s): Choo MJ, Yang SK, Jin HR, Lee OJ. Source: Otolaryngology and Head and Neck Surgery. 2002 April; 126(4): 453-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11997797

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Locations of primary cholesteatoma. Author(s): Cohen D. Source: The American Journal of Otology. 1987 January; 8(1): 61-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3565550

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Long-term observation after soft posterior meatal wall reconstruction in ears with cholesteatoma. Author(s): Hosoi H, Murata K, Kimura H, Tsuta Y. Source: The Journal of Laryngology and Otology. 1998 January; 112(1): 31-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9538442

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Long-term results of pediatric primary one-stage cholesteatoma surgery. Author(s): Silvola J, Palva T. Source: International Journal of Pediatric Otorhinolaryngology. 1999 May 5; 48(2): 101-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10375034

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Long-term results of surgery for childhood cholesteatoma. Author(s): Vartiainen E, Nuutinen J. Source: International Journal of Pediatric Otorhinolaryngology. 1992 November; 24(3): 201-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1399308

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Long-term results of treatment for children's cholesteatoma. Author(s): Schmid H, Dort JC, Fisch U. Source: The American Journal of Otology. 1991 March; 12(2): 83-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2053610

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Long-term results of various surgical treatments for cholesteatoma. Author(s): Gersdorff M, Vilain J. Source: Acta Otorhinolaryngol Belg. 1990; 44(4): 393-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2093283

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Lymphotoxin in human middle ear cholesteatoma. Author(s): Yan SD, Huang CC. Source: The Laryngoscope. 1991 April; 101(4 Pt 1): 411-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1680210

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Management of acquired cholesteatoma of the middle ear and the mastoid by combined approach tympanoplasty: a long-term view. Author(s): Kapur TR, Jayarmachandran S. Source: Clinical Otolaryngology and Allied Sciences. 1997 February; 22(1): 57-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9088682

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Management of anterior epitympanic cholesteatoma: expectations after epitympanic approach and canal wall reconstruction. Author(s): Duckert LG, Makielski KH, Helms J. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 January; 23(1): 8-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11773837

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Management of cholesteatoma: status of the canal wall. Author(s): Syms MJ, Luxford WM. Source: The Laryngoscope. 2003 March; 113(3): 443-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12616194

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Management of labyrinthine fistula in middle ear cholesteatoma. Author(s): Yen TC, Ho KY, Juan KH. Source: Kaohsiung J Med Sci. 1998 January; 14(1): 36-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9519688

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Management of labyrinthine fistulas in cholesteatoma. Author(s): Vanden Abeele D, Offeciers FE. Source: Acta Otorhinolaryngol Belg. 1993; 47(3): 311-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8213141

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Mastoid condition and clinical course of cholesteatoma. Author(s): Hasebe S, Takahashi H, Honjo I, Miura M, Tanabe M. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2001 MayJune; 63(3): 160-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11359094

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Mastoid obliteration with hydroxyapatite--the value of high resolution CT scanning in detecting recurrent cholesteatoma. Author(s): Yung MM, Karia KR. Source: Clinical Otolaryngology and Allied Sciences. 1997 December; 22(6): 553-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9466070

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Mastoid pneumatization in children with congenital cholesteatoma: an aspect of the formation of open-type and closed-type cholesteatoma. Author(s): Iino Y, Imamura Y, Hiraishi M, Yabe T, Suzuki J. Source: The Laryngoscope. 1998 July; 108(7): 1071-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9665259

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Mastoid volume and eustachian tube function in ears with cholesteatoma. Author(s): Lindeman P, Holmquist J. Source: The American Journal of Otology. 1987 January; 8(1): 5-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3565549

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Matrix metalloproteinase-1 in cholesteatoma, middle ear granulations and deep meatal skin: a comparative analysis. Author(s): Banerjee AR, James R, Narula AA, Lee RJ. Source: Clinical Otolaryngology and Allied Sciences. 1998 December; 23(6): 515-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9884804

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Matrix metalloproteinase-2 and matrix metalloproteinase-9 in cholesteatoma and deep meatal skin. Author(s): Banerjee AR, James R, Narula AA. Source: Clinical Otolaryngology and Allied Sciences. 1998 August; 23(4): 345-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9762497

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Mechanisms of cholesteatoma formation following stapedectomy. Author(s): Ferguson BJ, Gillespie CA, Kenan PD, Farmer JC Jr. Source: The American Journal of Otology. 1986 November; 7(6): 420-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3812643

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Mediation of signal transduction in keratinocytes of human middle ear cholesteatoma by ras protein. Author(s): Huang CC, Chen CT, Huang TS, Shinoda H. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1996; 253(7): 385-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8891480

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Microbiology of chronic suppurative otitis media with cholesteatoma. Author(s): Attallah MS. Source: Saudi Med J. 2000 October; 21(10): 924-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11369953

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Middle cranial fossa cholesteatoma following blast trauma. Author(s): Goldfarb A, Eliashar R, Gross M, Elidan J. Source: The Annals of Otology, Rhinology, and Laryngology. 2001 November; 110(11): 1084-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11713924

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Modification of combined-approach tympanoplasty in attic cholesteatoma. Author(s): Tos M. Source: Arch Otolaryngol. 1982 December; 108(12): 772-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7150070

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Modification of intact canal wall technique in the treatment of cholesteatoma. Author(s): Tos M. Source: Advances in Oto-Rhino-Laryngology. 1987; 37: 104-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3673796

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Modified Bondy's technique for epitympanic cholesteatoma. Author(s): Sanna M, Agarwal M, Khrais T, Di Trapani G. Source: The Laryngoscope. 2003 December; 113(12): 2218-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14660930

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Molecular biological diagnosis of congenital and acquired cholesteatoma on the basis of differences in telomere length. Author(s): Kojima H, Miyazaki H, Shiwa M, Tanaka Y, Moriyama H. Source: The Laryngoscope. 2001 May; 111(5): 867-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11359168

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Multifocal cholesteatoma of the external auditory canal following blast injury. Author(s): Wolf M, Megirov L, Kronenberg J. Source: The Annals of Otology, Rhinology, and Laryngology. 1999 March; 108(3): 269-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10086620

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N-acetylcysteine for cholesteatoma? Author(s): Altschuler EL. Source: The Journal of Otolaryngology. 2001 February; 30(1): 67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11770980

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Natural history of aural cholesteatoma. Author(s): Kimmelman CP, Schlosser WD. Source: Trans Pa Acad Ophthalmol Otolaryngol. 1979 Spring; 32(1): 47-51. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=473297

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Neurotologic treatment of acquired cholesteatoma. Author(s): Burggraaff B, Luxford WM, Doyle KJ. Source: The American Journal of Otology. 1995 July; 16(4): 480-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8588649

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Observation of the eustachian tube in pediatric cases with acquired cholesteatoma. Author(s): Yamashita K, Wang ZQ. Source: Advances in Oto-Rhino-Laryngology. 1987; 37: 39-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3673818

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One-stage revision surgery for pediatric cholesteatoma: long-term results and comparison with primary surgery. Author(s): Silvola J, Palva T. Source: International Journal of Pediatric Otorhinolaryngology. 2000 December 1; 56(2): 135-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11115686

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Open or closed tympanomastoidectomy for cholesteatoma in children. Author(s): Abramson M. Source: The American Journal of Otology. 1985 March; 6(2): 167-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3985133

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Open-type congenital cholesteatoma. Author(s): Takeda E, Yabe T, Suzuki J. Source: Advances in Oto-Rhino-Laryngology. 1997; 51: 29-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9017067

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Oral ciprofloxacin in the management of chronic suppurative otitis media without cholesteatoma in children: preliminary experience in 21 children. Author(s): Lang R, Goshen S, Raas-Rothschild A, Raz A, Ophir D, Wolach B, Berger I. Source: The Pediatric Infectious Disease Journal. 1992 November; 11(11): 925-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1454433

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Organic acids and anaerobic microorganisms in the contents of the cholesteatoma sac. Author(s): Iino Y, Hoshino E, Tomioka S, Takasaka T, Kaneko Y, Yuasa R. Source: The Annals of Otology, Rhinology, and Laryngology. 1983 January-February; 92(1 Pt 1): 91-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6337545

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Origin of congenital cholesteatoma from a normally occurring epidermoid rest in the developing middle ear. Author(s): Michaels L. Source: International Journal of Pediatric Otorhinolaryngology. 1988 February; 15(1): 5165. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3286554

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Ossicular erosion by cholesteatoma: investigation by scanning electron microscopy utilizing a new preparation technique. Author(s): Wong J, Stoney P, Hawke M. Source: The Journal of Otolaryngology. 1991 June; 20(3): 216-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1870172

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Ossicular reconstruction in ears with cholesteatoma. Author(s): Wehrs RE. Source: Otolaryngologic Clinics of North America. 1989 October; 22(5): 1003-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2616166

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Osteoclast stimulating and differentiating factors in human cholesteatoma. Author(s): Hamzei M, Ventriglia G, Hagnia M, Antonopolous A, Bernal-Sprekelsen M, Dazert S, Hildmann H, Sudhoff H. Source: The Laryngoscope. 2003 March; 113(3): 436-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12616193

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Osteoclasts in chronic otitis media, cholesteatoma, and otosclerosis. Author(s): Chole RA. Source: The Annals of Otology, Rhinology, and Laryngology. 1988 NovemberDecember; 97(6 Pt 1): 661-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3202569

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Osteoma with cholesteatoma in the external auditory canal. Author(s): Orita Y, Nishizaki K, Fukushima K, Akagi H, Ogawa T, Masuda Y, Fukazawa M, Mori Y. Source: International Journal of Pediatric Otorhinolaryngology. 1998 May 15; 43(3): 28993. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9663952

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Osteoplastic changes in attic cholesteatoma. Author(s): Hoshino T, Ishizaki H, Iwasaki S, Sakai T. Source: The Journal of Laryngology and Otology. 1995 August; 109(8): 703-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7561488

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Otoendoscopy for improved pediatric cholesteatoma removal. Author(s): Good GM, Isaacson G. Source: The Annals of Otology, Rhinology, and Laryngology. 1999 September; 108(9): 893-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10527282

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Otolaryngology quiz #5. Left ear cholesteatoma. Author(s): Estrem S. Source: Mo Med. 1995 June; 92(6): 277-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7643838

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Otological manifestations of thalassaemia intermedia: evidence of temporal bone involvement and report of a unique cholesteatoma-like lesion. Author(s): Sheikha A, Kameswaran M, Okafor BC, al-Saigh AA. Source: The Journal of Laryngology and Otology. 1992 April; 106(4): 316-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1613342

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Otomastoid cholesteatoma in children: histopathological findings. Author(s): Quaranta A, Resta L, Santangelo A. Source: International Journal of Pediatric Otorhinolaryngology. 1986 December; 12(2): 121-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3570678

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Outcome of residual cholesteatoma and hearing in mastoid surgery. Author(s): Roden D, Honrubia VF, Wiet R. Source: The Journal of Otolaryngology. 1996 June; 25(3): 178-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8783083

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Outpatient management of chronic suppurative otitis media without cholesteatoma in children. Author(s): Dagan R, Fliss DM, Einhorn M, Kraus M, Leiberman A. Source: The Pediatric Infectious Disease Journal. 1992 July; 11(7): 542-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1528644

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Overexpression of tenascin in cholesteatoma and external auditory meatal skin compared to retroauricular epidermis. Author(s): Schilling V, Lang S, Rasp G, Mack B, Nerlich A. Source: Acta Oto-Laryngologica. 1996 September; 116(5): 741-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8908253

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p53 Expression and keratinocyte hyperproliferation in middle ear cholesteatoma. Author(s): Motamed M, Powe D, Kendall C, Birchall JP, Banerjee AR. Source: Clinical Otolaryngology and Allied Sciences. 2002 December; 27(6): 505-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12472520

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Pars tensa perforation with cholesteatoma. Author(s): Pulec JL, Deguine C. Source: Ear, Nose, & Throat Journal. 1997 July; 76(7): 430. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9248132

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Pathogenesis of attic cholesteatoma: clinical and immunohistochemical support for combination of retraction theory and proliferation theory. Author(s): Sudhoff H, Tos M. Source: The American Journal of Otology. 2000 November; 21(6): 786-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11078064

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Pathogenesis of attic retraction pocket and cholesteatoma as studied by computed tomography. Author(s): Kobayashi T, Toshima M, Yaginuma Y, Ishidoya M, Suetake M, Takasaka T. Source: The American Journal of Otology. 1994 September; 15(5): 658-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8572068

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Pediatric one-stage cholesteatoma surgery: long term results. Author(s): Silvola J, Palva T. Source: International Journal of Pediatric Otorhinolaryngology. 1999 October 5; 49 Suppl 1: S87-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10577782

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Petrosal cholesteatoma: management considerations for minimizing morbidity. Author(s): Axon PR, Fergie N, Saeed SR, Temple RH, Ramsden RT. Source: The American Journal of Otology. 1999 July; 20(4): 505-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10431894

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Petrous apex arachnoid cyst: radiographic confusion with primary cholesteatoma. Author(s): Cheung SW, Broberg TG, Jackler RK. Source: The American Journal of Otology. 1995 September; 16(5): 690-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8588679

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Petrous apex cholesteatoma. Author(s): Profant M, Steno J. Source: Acta Oto-Laryngologica. 2000 March; 120(2): 164-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11603764

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Petrous bone cholesteatoma and facial paralysis. Author(s): Magliulo G, Terranova G, Sepe C, Cordeschi S, Cristofar P. Source: Clinical Otolaryngology and Allied Sciences. 1998 June; 23(3): 253-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9669076

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Positional vertigo as a first symptom of a cerebellopontine angle cholesteatoma: case report. Author(s): Beynon GJ, Baguley DM, Moffat DA, Irving RM. Source: Ear, Nose, & Throat Journal. 2000 July; 79(7): 508-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10935302

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Possible involvement of keratinocyte growth factor and its receptor in enhanced epithelial-cell proliferation and acquired recurrence of middle-ear cholesteatoma. Author(s): Yamamoto-Fukuda T, Aoki D, Hishikawa Y, Kobayashi T, Takahashi H, Koji T. Source: Laboratory Investigation; a Journal of Technical Methods and Pathology. 2003 January; 83(1): 123-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12533693

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Posterior and attic wall osteoplasty: hearing results and recurrence rates in cholesteatoma. Author(s): Babighian G. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 January; 23(1): 14-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11773838

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Postoperative results for cholesteatoma in children. Author(s): Mishiro Y, Sakagami M, Okumura S, Takeda N, Kubo T. Source: Auris, Nasus, Larynx. 2000 July; 27(3): 223-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10808109

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Preconditioning the tympanic membrane: identification of cholesteatoma prone ears? Author(s): Gaihede M, Kjaer D, Pedersen CB. Source: Acta Otolaryngol Suppl. 1997; 529: 40-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9288263

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Predictive risk factors of residual cholesteatoma in children: a study of 256 cases. Author(s): Roger G, Denoyelle F, Chauvin P, Schlegel-Stuhl N, Garabedian EN. Source: The American Journal of Otology. 1997 September; 18(5): 550-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9303150

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Preference for the closed technique in the management of cholesteatoma of the middle ear in children: a retrospective study of 215 consecutive patients treated over 10 years. Author(s): Darrouzet V, Duclos JY, Portmann D, Bebear JP. Source: The American Journal of Otology. 2000 July; 21(4): 474-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10912690

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Primary basal cell carcinoma of the middle ear presenting as recurrent cholesteatoma. Author(s): Lim V, Danner C, Colvin GB, Karpe L, Schaefer R, Dilday B, Farris P. Source: The American Journal of Otology. 1999 September; 20(5): 657-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10503590

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Prognostic factors of recidivism in pediatric cholesteatoma surgery. Author(s): Ahn SH, Oh SH, Chang SO, Kim CS. Source: International Journal of Pediatric Otorhinolaryngology. 2003 December; 67(12): 1325-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14643476

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Proliferation activity and apoptosis in granulation tissue and cholesteatoma in middle ear reoperations. Author(s): Durko M, Kaczmarczyk D. Source: Folia Morphol (Warsz). 2004 February; 63(1): 119-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15039916

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Pulsatile tinnitus as a rare presenting symptom of residual cholesteatoma. Author(s): Falcioni M, Taibah A, Rohit. Source: The Journal of Laryngology and Otology. 2004 February; 118(2): 165-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14979961

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Quantitative analysis of interleukin-1-alpha gene expression in middle ear cholesteatoma. Author(s): Bujia J, Kim C, Boyle D, Hammer C, Firestein G, Kastenbauer E. Source: The Laryngoscope. 1996 February; 106(2 Pt 1): 217-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8583857

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Questions regarding Bell's palsy: viral prodrome, type of onset of Bell's virus cholesteatoma. Author(s): Babiacki A. Source: The American Journal of Otology. 1990 January; 11(1): 50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2305860

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Radical revision mastoidectomy for chronic otitis media without cholesteatoma: the relevance of excenteration of all rest cells. Author(s): Rombout J, Pauw BK. Source: The Journal of Laryngology and Otology. 1999 August; 113(8): 710-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10748843

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Radiology quiz case 1. Cervical extension of an EAC cholesteatoma. Author(s): Carvalho DS, Edmonds JL, Money MK. Source: Archives of Otolaryngology--Head & Neck Surgery. 2002 September; 128(9): 1103, 1105-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12220222

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Recidivism in congenital cholesteatoma surgery. Author(s): Parisier SC, Weiss MH. Source: Ear, Nose, & Throat Journal. 1991 June; 70(6): 362-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1893884

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Recurrence of attic cholesteatoma: different methods of estimating recurrence rates. Author(s): Stangerup SE, Drozdziewicz D, Tos M, Hougaard-Jensen A. Source: Otolaryngology and Head and Neck Surgery. 2000 September; 123(3): 283-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10964308

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Results in resident cholesteatoma surgery: a review of 85 cases. Author(s): Blakley BW. Source: The Laryngoscope. 1987 May; 97(5): 643. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3573918

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Results in resident cholesteatoma surgery: a review of 85 cases. Author(s): Moss R, Lucente FE. Source: The Laryngoscope. 1987 February; 97(2): 212-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3807624

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Results of preservation of the posterior canal wall in cholesteatoma surgery as related to middle-ear aeration. Author(s): Sade J, Berco E, Fuchs C. Source: The Journal of Laryngology and Otology. 1986 December; 100(12): 1351-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3805876

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Retrograde mastoidectomy with canal wall reconstruction: a single-stage technique for cholesteatoma removal. Author(s): Dornhoffer JL. Source: The Annals of Otology, Rhinology, and Laryngology. 2000 November; 109(11): 1033-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11089994

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Risk factors for recurrent and residual cholesteatoma in children determined by second stage operation. Author(s): Iino Y, Imamura Y, Kojima C, Takegoshi S, Suzuki JI. Source: International Journal of Pediatric Otorhinolaryngology. 1998 November 15; 46(12): 57-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10190705

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Role of Bcl-xL protein in differentiation and apoptosis of human middle ear cholesteatoma epithelium. Author(s): Kojima H, Miyazaki H, Tanaka Y, Shiwa M, Koga T, Moriyama H. Source: Archives of Otolaryngology--Head & Neck Surgery. 1999 July; 125(7): 738-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10406309

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Roles of cytokines and cell cycle regulating substances in proliferation of cholesteatoma epithelium. Author(s): Tanaka Y, Kojima H, Miyazaki H, Koga T, Moriyama H. Source: The Laryngoscope. 1999 July; 109(7 Pt 1): 1102-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10401849

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Saddle blanket graft tympanoplasty and lateral attic wall reconstruction for defects produced by primary acquired cholesteatoma. Author(s): Luetje CM. Source: The Laryngoscope. 2001 August; 111(8): 1497-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11568591

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Selective indications for the management of extensive anterior epitympanic cholesteatoma via combined transmastoid/middle fossa approach. Author(s): Steward DL, Choo DI, Pensak ML. Source: The Laryngoscope. 2000 October; 110(10 Pt 1): 1660-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11037821

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Spontaneous cholesteatoma of the external auditory canal. Author(s): Pachoal JR, Maunsell RC. Source: Rev Laryngol Otol Rhinol (Bord). 2001; 122(4): 269-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11944622

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Spontaneous external auditory canal cholesteatoma complicated by rheumatoid arthritis--case report and review of the literature. Author(s): Sakamoto M, Kitahara N. Source: Auris, Nasus, Larynx. 2002 April; 29(2): 191-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11893456

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Staging and management of primary cerebellopontine cholesteatoma. Author(s): Moffat DA, Quaranta N, Baguley DM, Hardy DG, Chang P. Source: The Journal of Laryngology and Otology. 2002 May; 116(5): 340-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12080988

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Submucosal cholesteatoma in the middle ear: a histopathologic observation. Author(s): Cureoglu S, Schachern PA, Fulton S, Paparella MM. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 November; 24(6): 968-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14600487

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Supralabyrinthine approach to petrosal cholesteatoma. Author(s): Sheahan P, Walsh RM. Source: The Journal of Laryngology and Otology. 2003 July; 117(7): 558-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12901813

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Surgical strategy for cholesteatoma in children. Author(s): Ueda H, Nakashima T, Nakata S. Source: Auris, Nasus, Larynx. 2001 April; 28(2): 125-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11240319

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Surgical treatment of cholesteatoma in children. Author(s): Mutlu C, Khashaba A, Saleh E, Karmarkar S, Bhatia S, DeDonato G, Russo A, Sanna M. Source: Otolaryngology and Head and Neck Surgery. 1995 July; 113(1): 56-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7603723

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Surgical treatment of cholesteatoma in children. Author(s): Gocmen H, Kilic R, Ozdek A, Kizilkaya Z, Safak MA, Samim E. Source: International Journal of Pediatric Otorhinolaryngology. 2003 August; 67(8): 86772. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12880666

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Telomerase activity, telomere length, and apoptosis: a comparison between acquired cholesteatoma and squamous cell carcinoma. Author(s): Watabe-Rudolph M, Rudolph KL, Averbeck T, Buhr T, Lenarz T, Stover T. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 September; 23(5): 793-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12218637

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The clinical evaluations of pathophysiology for congenital middle ear cholesteatoma. Author(s): Yeo SW, Kim SW, Chang KH, Suh BD. Source: American Journal of Otolaryngology. 2001 May-June; 22(3): 184-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11351288

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The contralateral ear in patients with middle ear cholesteatoma after long-term follow-up. Author(s): Tsai TL, Lien CF, Guo YC. Source: J Chin Med Assoc. 2003 July; 66(7): 418-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14509404

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The feasibility of cartilage graft for mastoid obliteration in cholesteatoma surgery. Author(s): Chao WY. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2002 November; 65(11): 515-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12583514

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The incidence of facial nerve dehiscence at surgery for cholesteatoma. Author(s): Selesnick SH, Lynn-Macrae AG. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2001 March; 22(2): 129-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11300257

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The management of pediatric cholesteatoma. Author(s): Shohet JA, de Jong AL. Source: Otolaryngologic Clinics of North America. 2002 August; 35(4): 841-51. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12487085

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The natural history of congenital cholesteatoma. Author(s): Koltai PJ, Nelson M, Castellon RJ, Garabedian EN, Triglia JM, Roman S, Roger G. Source: Archives of Otolaryngology--Head & Neck Surgery. 2002 July; 128(7): 804-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12117340

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The use of middle ear endoscopy: has residual cholesteatoma been eliminated? Author(s): Yung MW. Source: The Journal of Laryngology and Otology. 2001 December; 115(12): 958-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11779323

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The value of pre-operative high resolution CT scans in cholesteatoma surgery. Author(s): Chee NW, Tan TY. Source: Singapore Med J. 2001 April; 42(4): 155-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11465314

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Transcanal atticoaditotomy and transcortical mastoidectomy for cholesteatoma: the Farrior-Olaizola technique revisited. Author(s): Reddy TN, Dutt SN, Shetty A, Maini S. Source: The Annals of Otology, Rhinology, and Laryngology. 2001 August; 110(8): 73945. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11510731

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Ultrastructural findings of the macula utriculi in a case of a petrous apex cholesteatoma: a comparison with findings in a patient with an acoustic neuroma. Author(s): Adachi M, Hoshino T, Mizuta K, Wu R. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1997; 254(5): 255-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9195152

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Ultrastructure of eustachian tube mucosa in chronic otitis media with cholesteatoma. Author(s): Chao WY, Chang SJ. Source: American Journal of Otolaryngology. 1996 May-June; 17(3): 161-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8827274

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Ultrastructure of the middle ear mucosa in patients with chronic otitus media with cholesteatoma. Author(s): Chao WY, Shen CL. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1996; 253(1-2): 56-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8932432

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Unusual cases of congenital cholesteatoma of the ear. Author(s): Rashad U, Hawthorne M, Kumar U, Welsh A. Source: The Journal of Laryngology and Otology. 1999 January; 113(1): 52-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10341920

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Unusual cholesteatoma shell: CT findings. Author(s): Nardis PF, Teramo M, Giunta S, Bellelli A. Source: Journal of Computer Assisted Tomography. 1988 November-December; 12(6): 1084-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3183121

•

Unusual MRI appearance of an intracranial cholesteatoma extension: the 'billiard pocket sign'. Author(s): Quaranta N, Chang P, Moffat DA. Source: Ear, Nose, & Throat Journal. 2002 September; 81(9): 645-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12353441

•

Upper urinary tract cholesteatoma misdiagnosed as a ureteral tumor. Author(s): Park WH, Kim HG, Choi YC, Kim JH, Kim JM. Source: The Journal of Urology. 2000 July; 164(1): 120-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10840438

•

Up-regulation of matrix metalloprotease-9 in middle ear cholesteatoma--correlations with growth factor expression in vivo? Author(s): Schmidt M, Grunsfelder P, Hoppe F. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2001 November; 258(9): 472-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11769995

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•

Ureteroscopic management of ureteral cholesteatoma. Author(s): Kirschenbaum AM, Cohen EL, Goldman HJ, Mitty HA, Train JS, Ribe JK. Source: Urology. 1986 November; 28(5): 397-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3787901

•

Using high resolution computed tomography to evaluate middle ear cleft aeration of postoperative cholesteatoma ears. Author(s): Lan MY, Lien CF, Liao WH. Source: J Chin Med Assoc. 2003 April; 66(4): 217-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854873

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Validating the excision of cholesteatoma. Author(s): Schuring AG. Source: Otolaryngologic Clinics of North America. 1989 October; 22(5): 1041-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2616167

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Validating the excision of cholesteatoma. Author(s): Schuring AG, Lippy WH. Source: Otolaryngology and Head and Neck Surgery. 1985 June; 93(3): 288-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3927221

•

Value of ear endoscopy in cholesteatoma surgery. Author(s): Badr-el-Dine M. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 September; 23(5): 631-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12218610

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Ventilation tubes and cholesteatoma in children. Author(s): Mortensen EH, Lildholdt T. Source: The Journal of Laryngology and Otology. 1984 January; 98(1): 27-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6537964

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Ventilation tubes and cholesteatoma. Author(s): Kinsella JB. Source: Ir Med J. 1996 November-December; 89(6): 223. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8996953

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•

Vestibular cholesteatoma in stapedectomy. Author(s): Dunkelberger JA. Source: Arch Otolaryngol. 1970 October; 92(4): 394-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5455582

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Vestibule exposure during surgery. Clinical observations in three cases of cholesteatoma. Author(s): Lapidot A, Mazzarella LA, Ratanaprasatporn S. Source: Arch Otolaryngol. 1970 July; 92(1): 24-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5422335

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Virtual endoscopic evaluation of labyrinthine fistulae resulting from cholesteatoma. Author(s): Briggs RD, Vrabec JT, Cavey ML, Johnson RF Jr. Source: The Laryngoscope. 2001 October; 111(10): 1828-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11801953

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Visualization of a retraction pocket/cholesteatoma: indications for use of the middle ear telescope in children. Author(s): Gonzalez C, Bluestone CD. Source: The Laryngoscope. 1986 January; 96(1): 109-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3941575

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What is the best method of treatment for labyrinthine fistulae caused by cholesteatoma? Author(s): Vartiainen E. Source: Clinical Otolaryngology and Allied Sciences. 1992 June; 17(3): 258-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1505095

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CHAPTER 2. NUTRITION AND CHOLESTEATOMA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and cholesteatoma.

Finding Nutrition Studies on Cholesteatoma 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 “cholesteatoma” (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 “cholesteatoma” (or a synonym): •

The effect of isotretinoin on propylene glycol-induced cholesteatoma in chinchilla middle ears. Author(s): Department of Otolaryngology--Head and Neck Surgery, University of Illinois College of Medicine, Chicago 60612. Source: Jove, M A Vassalli, L Raslan, W Applebaum, E L Am-J-Otolaryngol. 1990 JanFebruary; 11(1): 5-9 0196-0709

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

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

•

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

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

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

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

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

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

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

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

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

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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/

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. CHOLESTEATOMA

ALTERNATIVE

MEDICINE

AND

Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to cholesteatoma. 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 cholesteatoma 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 “cholesteatoma” (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 cholesteatoma: •

Common ear diseases: recognition and management. Author(s): Keim RJ. Source: Postgraduate Medicine. 1977 May; 61(5): 72-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=857250

•

Electron microscope study of bone lesion in cholesteatoma otitis. Author(s): Tanaka K, Terayama Y, Hirai T. Source: Arch Otorhinolaryngol. 1980; 226(1-2): 85-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7469923

•

Immunohistochemical study of cytokeratin expression in normal and pathologic middle ear mucosa of the rat. Author(s): Vennix PP, Kuijpers W, Tonnaer EL, Peters TA, Ramaekers FC.

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Source: The Annals of Otology, Rhinology, and Laryngology. 1990 December; 99(12): 998-1004. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1700893 •

Intra- and intersubject comparison of cochlear implant systems using the Esprit and the Tempo+ behind-the-ear speech processor. Author(s): Kompis M, Jenk M, Vischer MW, Seifert E, Hausler R. Source: International Journal of Audiology. 2002 December; 41(8): 555-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477176

•

Misdiagnosis complicating acupuncture. Author(s): Sasaki CT, Nagel RF, Otobo E, Kirchner JA. Source: Arch Otolaryngol. 1975 January; 101(1): 36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1119987

•

Otitis media in Greenland. Studies on historical, epidemiological, microbiological, and immunological aspects. Author(s): Homoe P. Source: Int J Circumpolar Health. 2001; 60 Suppl 2: 1-54. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11725622

•

Water contamination and swimming with the open mastoid cavity. Author(s): Bingham BJ, Chevretton E, Firman E. Source: Clinical Otolaryngology and Allied Sciences. 1988 October; 13(5): 347-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3243010

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/

•


•

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/

Alternative Medicine 59

•

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/

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

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CHAPTER 4. BOOKS ON CHOLESTEATOMA Overview This chapter provides bibliographic book references relating to cholesteatoma. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on cholesteatoma include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “cholesteatoma” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on cholesteatoma: •

Inner Ear Surgeries: Meant to Control Vertigo-Disequilibrium Source: Portland, OR: Vestibular Disorders Association (VEDA). 1996. 36 p. Contact: Available from Vestibular Disorders Association (VEDA). P.O. Box 4467, Portland, OR 97208-4467. (503) 229-7705. Fax (503) 229-8064. E-mail: [email protected]. Website: www.vestibular.org. PRICE: $10.00 plus shipping and handling. Order number B-5. Summary: This document from the Vestibular Disorders Association (VEDA) describes inner ear surgeries used to control vertigo or disequilibrium. The author stresses that most individuals who develop vestibular problems will never need to consider surgical treatment. The majority of those people will have either a spontaneous resolution of the symptoms or will respond satisfactorily to medical management such as dietary changes, vestibular rehabilitation, or medication. However, surgical procedures exist for

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many vestibular problems including acoustic neuroma, endolymphatic hydrops, Meniere's disease, vascular compression syndrome, benign paroxysmal positional vertigo (BPPV) and benign paroxysmal positional nystagmus (BPPN), cholesteatoma, perilymph fistula, and otosclerosis. The author notes that some of the procedures described in this document may also be meant to preserve or improve hearing; however, they have been included because of their intended control of vertigo or disequilibrium. Descriptions of surgical treatments include information about intended outcomes and possible bad outcomes. Procedures described include general surgery, such as mastoidectomy and tympanotomy; procedures for inner-ear problems, including labyrinthectomy, gentamicin ear treatment, vestibular nerve section, and PE (pneumatic equalization) tubes; procedures for problems other than Meniere's disease or endolymphatic hydrops, including perilymph fistula repair, posterior canal partitioning, microvascular decompression, stapedectomy, acoustic neuroma removal, and cholesteatoma removal; procedures some times used for Meniere's disease and endolymphatic hydrops, including endolymphatic sac decompression procedures and cochleosacculotomy; and procedures less often used for Meniere's disease or endolymphatic hydrops, including sacculotomy (tack procedure or Cody tack), cryosurgery, ultrasound surgery (done in Sweden), and cochlear dialysis. 36 references. •

Ear, Nose, and Throat Disorders Sourcebook Source: Detroit, MI: Omnigraphics, Inc. 1998. 576 p. Contact: Available from Omnigraphics, Inc. Penobscot Building, Detroit, MI 48226. (800) 234-1340. Fax (800) 875-1340. PRICE: $78.00. ISBN: 0780802063. Summary: This reference book provides information about some of the most common disorders of the ears, nose, and throat. The text describes diseases and their accompanying symptoms, as well as treatment options and current research initiatives. The book's 67 chapters are arranged in six parts: introduction, disorders of the inner and outer ear, vestibular disorders, disorders of the nose and sinuses, disorders of the throat, and cancers related to the ears, nose, and throat. Specific disorders and topics include otitis externa, otitis media, allergy, perforated eardrum, cholesteatoma, otosclerosis, tinnitus, hyperacusis, ear surgery, dizziness, BPPV (benign paraoxysmal positional vertigo), labyrinthitis, Meniere's disease, perilymph fistula, sinusitis, rhinitis, antihistamines, nosebleeds, smell and taste problems, sore throats, hoarseness, swallowing disorders, salivary glands, snoring, sleep apnea, spasmodic dysphonia, laryngeal diseases and disorders, smoking cessation, head and neck cancer, cancer of the oral cavity and upper throat, esophageal cancer, and oropharyngeal cancer. Simple line drawings illustrate some of the anatomical concepts discussed. The book also includes a glossary of terms and an annotated directory of organizational resources with addresses, telephone numbers, e-mail addresses, and web site locations.

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 “cholesteatoma” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “cholesteatoma” (or a synonym) in

Books

63

their titles. The following is indicative of the results you might find when searching for “cholesteatoma” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Microsurgery of Cholesteatoma of the Middle Ear by Zini; ISBN: 091279111X; http://www.amazon.com/exec/obidos/ASIN/091279111X/icongroupinterna

•

Surgical Treatment of Middle Ear Cholesteatoma (Advances in Oto-RhinoLaryngology, Vol 36) by M. Wayoff; ISBN: 3805544413; http://www.amazon.com/exec/obidos/ASIN/3805544413/icongroupinterna

•

Treatment of the Uncomplicated Aural Cholesteatoma (Continuing Education Program) by Andrew J. Miller, et al; ISBN: 1567720250; http://www.amazon.com/exec/obidos/ASIN/1567720250/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 “cholesteatoma” (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:5 •

Histology and histogenesis of cholesteatoma of the middle ear and mastoid. Author: Begley, Joseph Walter, 1922-; Year: 1950

•

Shinjushu no chiryo = Cholesteatoma therapeutic issues with an emphasis upon surgical treatment. Author: Yanagihara Naoaki; Year: 2003

Chapters on Cholesteatoma In order to find chapters that specifically relate to cholesteatoma, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and cholesteatoma 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 “cholesteatoma” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on cholesteatoma:

5

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

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Cholesteatoma

Chronic Otitis Media and Cholesteatoma Source: in Canalis, R.F. and Lambert, P.R., eds. Ear: Comprehensive Otology. Philadelphia, PA: Lippincott Williams and Wilkins. 2000. p. 409-431. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030. Fax (301) 223-2300. Website: www.lww.com. PRICE: $179.00 plus shipping and handling. ISBN: 078171558X. Summary: Chronic otitis media (COM) is an unresolved inflammatory process of the middle ear and mastoid. The disease nearly always is associated with tympanic membrane (eardrum) perforation and may be active when infection and otorrhea (drainage from the ear) are present or quiet when they are absent. Cholesteatoma is a tumor like lesion of the temporal bone, causing an ingrowth of skin which invades the middle ear and the mastoid spaces. This chapter on COM and cholesteatoma is from a textbook that offers complete coverage of the field of clinical otology (study of the ear). The book is oriented to serve both the otolaryngology resident as a practical learning tool and the practicing otolaryngologist as an updated reference source of clinical and basic information. In the section on COM, the authors discuss definition, etiology, bacteriology, pathology, sensorineural hearing loss, history and physical findings, audiologic examination, vestibular examination, radiographic evaluation, medical treatment, tuberculous otomastoiditis, nontuberculous mycobacteria and COM, and Wegener's granulomatosis. In the section on cholesteatoma, the authors cover definition, pathology and pathogenesis of acquired cholesteatoma, growth patterns of cholesteatoma, epitympanic cholesteatomas, posterior mesotympanic cholesteatomas, history and physical findings of acquired cholesteatoma, audiologic examination, radiographic evaluation, the medical management of cholesteatomas, cholesteatomas in children, and congenital cholesteatoma. T39 figures. 123 references.

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CHAPTER 5. MULTIMEDIA ON CHOLESTEATOMA Overview In this chapter, we show you how to keep current on multimedia sources of information on cholesteatoma. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on cholesteatoma is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “cholesteatoma” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “cholesteatoma” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on cholesteatoma: •

AAO-HNS Presents: Surgery of the Middle Ear Source: Alexandria, VA: American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). 1996. (videocassette). Contact: Available from American Academy of Otolaryngology-Head and Neck Surgery, Inc. (AAO-HNS). One Prince Street, Alexandria, VA 22314. (703) 836-4444. Fax (703) 683-5100. Website: www.entnet.org. PRICE: $175.00 for members; $250.00 for nonmembers; plus shipping and handling. Item Number OT-17. Summary: This patient education videotape explains how the middle ear can become infected and when surgery is necessary. The goals and risks of four major types of surgery (myringoplasty, tympanoplasty, cholesteatoma removal, and mastoidectomy) are discussed. The program also covers preparing for surgery, anesthesia, and discharge from the hospital, as well as the symptoms patients may have during recovery. Home recovery guidelines are given regarding strenuous activity, bandages, keeping the ear dry, and sneezing. The videotape is closed captioned. (AA-M).

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CHAPTER 6. PERIODICALS CHOLESTEATOMA

AND

NEWS

ON

Overview In this chapter, we suggest a number of news sources and present various periodicals that cover cholesteatoma.

News Services and Press Releases One of the simplest ways of tracking press releases on cholesteatoma 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 “cholesteatoma” (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 cholesteatoma. 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 “cholesteatoma” (or synonyms).

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “cholesteatoma” (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 “cholesteatoma” (or synonyms). If you know the name of a company that is relevant to cholesteatoma, 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 “cholesteatoma” (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

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69

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 “cholesteatoma” (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 cholesteatoma: •

Inner Ear Infections Source: Otoscope. 9(3): 1-3. Winter 1994. Contact: Available from Ear Foundation. 2000 Church Street, Box 111, Nashville, TN 37236. (800) 545-HEAR; (615) 329-7809; TTY (615) 329-7849. PRICE: Reprints are available for $25.00/200 copies. Summary: This newsletter article describes the physiology involved in inner ear infections. After a brief description of the evolutionary development of hearing and ear structure, the author discusses the defenses of the inner ear; how those defenses may be overcome; the anatomy of the ear; middle ear infections; complications of inner ear infection, including hearing loss, loss of balance function, and meningitis; chronic infections of the middle ear; cholesteatomas; and infections transmitted through the bloodstream to the inner ear. The author emphasizes the importance of preventive efforts and the medical and surgical management of causative ear infections.

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

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APPENDICES

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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 Institute6: •

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/

6

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 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:8 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

7

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). 8 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 Gateway9 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.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “cholesteatoma” (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 4506 38 10 1 6 4561

HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 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.13 Simply search by “cholesteatoma” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

9

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

10

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

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 Biologists14 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.15 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.16 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/.

14 Adapted 15

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. 16 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 cholesteatoma 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 cholesteatoma. 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 cholesteatoma. 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 “cholesteatoma”:

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

Cholesteatoma: A Serious Ear Condition Source: Alexandria, VA: American Academy of Otolaryngology-Head and Neck Surgery, Inc. 1997. [2 p.]. Contact: American Academy of Otolaryngology-Head and Neck Surgery, Inc. One Prince Street, Alexandria, VA 22314. (703) 836-4444. Fax (703) 683-5100. Website: www.entnet.org. PRICE: $20.00 for 100 (members); $25.00 for 100 (non-members). Summary: This pamphlet provides information to patients and the general public about cholesteatoma, which is an ingrowth of the skin of the eardrum. The document describes the etiology, symptoms, and treatments of cholesteatoma. Symptoms of cholesteatoma include ear pressure, hearing loss, dizziness, or facial muscle paralysis. 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 cholesteatoma. 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: •


•

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

•

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

•

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

•

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

•

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

•

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

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

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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 “cholesteatoma”. 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 “cholesteatoma” (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 “cholesteatoma” (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.17

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

17

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)18: •

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/

18

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Basic Guidelines for Cholesteatoma Cholesteatoma Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001050.htm

•

Signs & Symptoms for Cholesteatoma Deafness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Dizziness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm Drainage from the ear Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003042.htm Ear drainage Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003042.htm

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Ear pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003046.htm Facial paralysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003028.htm Hearing loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Numbness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Vertigo Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm •

Diagnostics and Tests for Cholesteatoma Caloric stimulation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003429.htm Cyst Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003240.htm Electronystagmography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003448.htm Erosion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003225.htm Otoscope Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003340.htm

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Background Topics for Cholesteatoma Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Inspection Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002388.htm

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

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

•

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

Online Glossaries 91

•

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

•

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

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CHOLESTEATOMA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abscess: A localized, circumscribed collection of pus. [NIH] Acetylcysteine: The N-acetyl derivative of cysteine. It is used as a mucolytic agent to reduce the viscosity of mucous secretions. It has also been shown to have antiviral effects in patients with HIV due to inhibition of viral stimulation by reactive oxygen intermediates. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adhesions: Pathological processes consisting of the union of the opposing surfaces of a wound. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alpha-helix: One of the secondary element of protein. [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] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [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] Ampulla: A sac-like enlargement of a canal or duct. [NIH]

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Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneuploidy: The chromosomal constitution of cells which deviate from the normal by the addition or subtraction of chromosomes or chromosome pairs. In a normally diploid cell the loss of a chromosome pair is termed nullisomy (symbol: 2N-2), the loss of a single chromosome is monosomy (symbol: 2N-1), the addition of a chromosome pair is tetrasomy (symbol: 2N+2), the addition of a single chromosome is trisomy (symbol: 2N+1). [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] 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] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Apnea: A transient absence of spontaneous respiration. [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] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH]

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Arterial: Pertaining to an artery or to the arteries. [EU] Articular: Of or pertaining to a joint. [EU] Aseptic: Free from infection or septic material; sterile. [EU] Aspiration: The act of inhaling. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atresia: Lack of a normal opening from the esophagus, intestines, or anus. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Attic: Portion of the tympanic cavity lying above the level of the tympanic membrane. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Aural: Pertaining to or perceived by the ear, as an aural stimulus. [EU] Autologous: Taken from an individual's own tissues, cells, or DNA. [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] Basal cell carcinoma: A type of skin cancer that arises from the basal cells, small round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Beta-Defensins: Defensins found mainly in epithelial cells. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bilateral: Affecting both the right and left side of body. [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] 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] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Groups: The classification systems (or schemes) of the different antigens located on erythrocytes.The antigens are the phenotypic expression of the genetic differences characteristic of specific blood groups. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a

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network of arteries, arterioles, capillaries, venules, and veins. [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 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] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Bromodeoxyuridine: A nucleoside that substitutes for thymidine in DNA and thus acts as an antimetabolite. It causes breaks in chromosomes and has been proposed as an antiviral and antineoplastic agent. It has been given orphan drug status for use in the treatment of primary brain tumors. [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] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [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] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell

Dictionary 97

division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell 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] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellopontine: Going from the cerebellum (the part of the brain responsible for coordinating movement) to the pons (part of the central nervous system located near the base of the brain.) [NIH] Cerebellopontine Angle: Junction between the cerebellum and the pons. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] 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] 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] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chymotrypsin: A serine endopeptidase secreted by the pancreas as its zymogen, chymotrypsinogen and carried in the pancreatic juice to the duodenum where it is activated by trypsin. It selectively cleaves aromatic amino acids on the carboxyl side. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciprofloxacin: A carboxyfluoroquinoline antimicrobial agent that is effective against a wide range of microorganisms. It has been successfully and safely used in the treatment of resistant respiratory, skin, bone, joint, gastrointestinal, urinary, and genital infections. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient.

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[NIH]

Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]

Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] 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] Colloidal: Of the nature of a colloid. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices

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are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corneum: The superficial layer of the epidermis containing keratinized cells. [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

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classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Cryosurgery: The use of freezing as a special surgical technique to destroy or excise tissue. [NIH]

Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cutaneous Fistula: An abnormal passage or communication leading from an internal organ to the surface of the body. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyst: A sac or capsule filled with fluid. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge 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] Cytophotometry: A method for the study of certain organic compounds within cells, in situ, by measuring the light intensities of the selectively stained areas of cytoplasm. The compounds studied and their locations in the cells are made to fluoresce and are observed under a microscope. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [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

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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] Diagnostic procedure: A method used to identify a disease. [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] 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] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [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] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dysphonia: Difficulty or pain in speaking; impairment of the voice. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Ear Diseases: Diseases of the ear, general or unspecified. [NIH] Eardrum: A thin, tense membrane forming the greater part of the outer wall of the tympanic cavity and separating it from the external auditory meatus; it constitutes the boundary between the external and middle ear. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endolymphatic Duct: Duct connecting the endolymphatic sac with the membranous labyrinth. [NIH] Endolymphatic Sac: The blind pouch at the end of the endolymphatic duct. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH]

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Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Enteropeptidase: A specialized proteolytic enzyme secreted by intestinal cells. It converts trypsinogen into its active form trypsin by removing the N-terminal peptide. EC 3.4.21.9. [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] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermal growth factor receptor: EGFR. The protein found on the surface of some cells and to which epidermal growth factor binds, causing the cells to divide. It is found at abnormally high levels on the surface of many types of cancer cells, so these cells may divide excessively in the presence of epidermal growth factor. Also known as ErbB1 or HER1. [NIH] 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] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Equalization: The reduction of frequency and/or phase distortion, or modification of gain and or phase versus frequency characteristics of a transducer, by the use of attenuation circuits whose loss or delay is a function of frequency. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH]

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Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Eustachian tube: The middle ear cavity is in communication with the back of the nose through the Eustachian tube, which is normally closed, but opens on swallowing, in order to maintain equal air pressure. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Facial: Of or pertaining to the face. [EU] Facial Expression: Observable changes of expression in the face in response to emotional stimuli. [NIH] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Facial Nerve Diseases: Diseases of the facial nerve or nuclei. Pontine disorders may affect the facial nuclei or nerve fascicle. The nerve may be involved intracranially, along its course through the petrous portion of the temporal bone, or along its extracranial course. Clinical manifestations include facial muscle weakness, loss of taste from the anterior tongue, hyperacusis, and decreased lacrimation. [NIH] Facial Paralysis: Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. Facial nerve diseases generally results in generalized hemifacial weakness. Neuromuscular junction diseases and muscular diseases may also cause facial paralysis or paresis. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fats: One of the three main classes of food and a source of energy in the body. Bile dissolves fats, and enzymes break them down. This process moves fats into cells. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen

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and other macromolecules. [NIH] Fibronectin: An adhesive glycoprotein. One form circulates in plasma, acting as an opsonin; another is a cell-surface protein which mediates cellular adhesive interactions. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flatus: Gas passed through the rectum. [NIH] Fossa: A cavity, depression, or pit. [NIH] Gamma-interferon: Interferon produced by T-lymphocytes in response to various mitogens and antigens. Gamma interferon appears to have potent antineoplastic, immunoregulatory and antiviral activity. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] 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] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulation Tissue: A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid cells, macrophages, and plasma cells. [NIH]

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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] 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] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Hammer: The largest of the three ossicles of the ear. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hoarseness: An unnaturally deep or rough quality of voice. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] 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] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperacusis: An abnormally disproportionate increase in the sensation of loudness in response to auditory stimuli of normal volume. Cochlear diseases; vestibulocochlear nerve diseases; facial nerve diseases; stapes surgery; and other disorders may be associated with this condition. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Illusion: A false interpretation of a genuine percept. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

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Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incus: One of three ossicles of the middle ear. It conducts sound vibrations from the malleus to the stapes. [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] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Intercellular Adhesion Molecule-1: A cell-surface ligand with a role in leukocyte adhesion and inflammation. Its production is induced by gamma-interferon and it is required for neutrophil migration into inflamed tissue. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result

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from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [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] Isoenzymes: One of various structurally related forms of an enzyme, each having the same mechanism but with differing chemical, physical, or immunological characteristics. [NIH] Isotretinoin: A topical dermatologic agent that is used in the treatment of acne vulgaris and several other skin diseases. The drug has teratogenic and other adverse effects. [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] Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH] Keratinocyte growth factor: A substance that stimulates the growth of epithelial cells that line the surface of the mouth and intestinal tract. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Keratosis: Any horny growth such as a wart or callus. [NIH] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Labyrinthine: A vestibular nystagmus resulting from stimulation, injury, or disease of the labyrinth. [NIH] Labyrinthitis: Inflammation of the inner ear. [NIH] Lacrimal: Pertaining to the tears. [EU] Laryngeal: Having to do with the larynx. [NIH] Laryngeal Diseases: General or unspecified disorders of the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukoplakia: A white patch that may develop on mucous membranes such as the cheek, gums, or tongue and may become cancerous. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH]

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Localized: Cancer which has not metastasized yet. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [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] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malleus: The largest of the auditory ossicles, and the one attached to the membrana tympani (tympanic membrane). Its club-shaped head articulates with the incus. [NIH] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mandibular Condyle: The posterior process on the ramus of the mandible composed of two parts: a superior part, the articular portion, and an inferior part, the condylar neck. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [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] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH]

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Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [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] Microbiological: Pertaining to microbiology : the science that deals with microorganisms, including algae, bacteria, fungi, protozoa and viruses. [EU] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone

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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] Monosomy: The condition in which one chromosome of a pair is missing. In a normally diploid cell it is represented symbolically as 2N-1. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] Mucolytic: Destroying or dissolving mucin; an agent that so acts : a mucopolysaccharide or glycoprotein, the chief constituent of mucus. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroma: A tumor that arises in nerve cells. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrophil: A type of white blood cell. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

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]

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Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nystagmus: An involuntary, rapid, rhythmic movement of the eyeball, which may be horizontal, vertical, rotatory, or mixed, i.e., of two varieties. [EU] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] 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] 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] 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] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Otitis Media with Effusion: Inflammation of the middle ear with a clear pale yellowcolored transudate. [NIH] Otolaryngologist: A doctor who specializes in treating diseases of the ear, nose, and throat. Also called an ENT doctor. [NIH] Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat. [NIH] Otology: The branch of medicine which deals with the diagnosis and treatment of the disorders and diseases of the ear. [NIH] Otorrhea: A discharge from the ear, especially a purulent one. [EU] 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] Outer ear: The pinna and external meatus of the ear. [NIH] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of

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increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Paralysis: Loss of ability to move all or part of the body. [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]

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] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] 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]

Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perilymph: The fluid contained within the space separating the membranous from the

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osseous labyrinth of the ear. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] 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] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [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] 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] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Pneumonia: Inflammation of the lungs. [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] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [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]

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Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [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] 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] Prone: Having the front portion of the body downwards. [NIH] Propylene Glycol: A clear, colorless, viscous organic solvent and diluent used in pharmaceutical preparations. [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] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Quiescent: Marked by a state of inactivity or repose. [EU] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Ramus: Most commonly used for branches of nerves, but applied also to other structures. [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] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH]

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Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [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] Resection: Removal of tissue or part or all of an organ by surgery. [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] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about. [NIH] Retinae: A congenital notch or cleft of the retina, usually located inferiorly. [NIH] Retraction: 1. The act of drawing back; the condition of being drawn back. 2. Distal movement of teeth, usually accomplished with an orthodontic appliance. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [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] Rhinitis: Inflammation of the mucous membrane of the nose. [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] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schwannoma: A tumor of the peripheral nervous system that begins in the nerve sheath (protective covering). It is almost always benign, but rare malignant schwannomas have been reported. [NIH]

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Scleroproteins: Simple proteins characterized by their insolubility and fibrous structure. Within the body, they perform a supportive or protective function. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Sequela: Any lesion or affection following or caused by an attack of disease. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] 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] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH]

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Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Snoring: Rough, noisy breathing during sleep, due to vibration of the uvula and soft palate. [NIH]

Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] 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] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spiral Lamina: The bony plate which extends outwards from the modiolus. It is part of the structure which divides trhe cochlea into sections. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH]

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Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Squamous Epithelium: Tissue in an organ such as the esophagus. Consists of layers of flat, scaly cells. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Sterile: Unable to produce children. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [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] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Systemic: Affecting the entire body. [NIH] Telomere: A terminal section of a chromosome which has a specialized structure and which is involved in chromosomal replication and stability. Its length is believed to be a few hundred base pairs. [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] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU]

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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] 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]

Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] 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] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] 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] 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

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analogous to bacterial transformation. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trisomy: The possession of a third chromosome of any one type in an otherwise diploid cell. [NIH]

Trypsin: A serine endopeptidase that is formed from trypsinogen in the pancreas. It is converted into its active form by enteropeptidase in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. [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] 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] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Tympani: The part of the cochlea below the spiral lamina. [NIH] Tympanic membrane: A thin, tense membrane forming the greater part of the outer wall of the tympanic cavity and separating it from the external auditory meatus; it constitutes the boundary between the external and middle ear. [NIH] Tympanum: 1. Loosely, the tympanic membrane (membrana tympani). 2. The tympanic cavity (cavitas tympanica). [EU] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [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] Uvula: Uvula palatinae; specifically, the tongue-like process which projects from the middle of the posterior edge of the soft palate. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

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]

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Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibular Nerve: The vestibular part of the 8th cranial nerve (vestibulocochlear nerve). The vestibular nerve fibers arise from neurons of Scarpa's ganglion and project peripherally to vestibular hair cells and centrally to the vestibular nuclei of the brain stem. These fibers mediate the sense of balance and head position. [NIH] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Wart: A raised growth on the surface of the skin or other organ. [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]

122

Cholesteatoma

Wound Healing: Restoration of integrity to traumatized tissue. [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] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

123

INDEX A Abscess, 4, 12, 13, 16, 28, 33, 93 Acetylcysteine, 38, 93 Acne, 93, 107 Acne Vulgaris, 93, 107 Acoustic, 48, 62, 93, 121 Adaptability, 93, 97 Adhesions, 4, 93 Adverse Effect, 93, 107, 116 Afferent, 93, 103 Airway, 93, 117 Algorithms, 93, 95 Alkaline, 93, 96, 119 Alpha-helix, 93, 107 Alternative medicine, 68, 93 Alveolar Process, 93, 115 Alveoli, 93, 121 Amino Acids, 93, 97, 112, 113, 114, 116 Ampulla, 93, 102 Anaerobic, 3, 39, 94 Anatomical, 62, 94, 101, 106 Anesthesia, 65, 93, 94 Aneuploidy, 15, 94 Antibacterial, 94, 117 Antibiotic, 94, 117 Antibodies, 94, 113 Antibody, 28, 94, 98, 100, 106, 109 Antigen, 10, 20, 28, 29, 33, 94, 98, 105, 106 Antimetabolite, 94, 96 Antimicrobial, 3, 20, 94, 97 Antineoplastic, 94, 96, 104 Antiviral, 93, 94, 96, 104 Anus, 94, 95, 106 Apnea, 94 Apoptosis, 11, 14, 43, 45, 47, 94 Arginine, 7, 94, 110, 120 Arterial, 95, 114 Articular, 95, 108 Aseptic, 95, 111 Aspiration, 19, 95 Asymptomatic, 5, 95 Atresia, 23, 95 Attenuation, 95, 102 Attic, 5, 11, 28, 37, 40, 41, 42, 44, 46, 95 Auditory, 20, 21, 23, 24, 29, 32, 38, 40, 41, 46, 95, 101, 105, 108, 120 Aural, 6, 11, 12, 13, 24, 27, 30, 33, 34, 38, 63, 95

Autologous, 9, 95 B Bacteria, 3, 94, 95, 102, 109, 117, 119, 120 Basal cell carcinoma, 43, 95 Basal cells, 95 Base, 95, 97, 107, 118 Benign, 5, 62, 95, 104, 110, 115 Beta-Defensins, 20, 95 Bewilderment, 95, 99 Bilateral, 12, 13, 23, 95, 112 Biological therapy, 95, 105 Biotechnology, 8, 63, 68, 75, 95 Bladder, 95, 120 Blood Coagulation, 95, 96 Blood Groups, 18, 95 Blood vessel, 95, 96, 102, 107, 109, 112, 117, 119, 120, 121 Bone Marrow, 96, 108, 110 Bone Remodeling, 7, 96 Bone Resorption, 7, 8, 9, 33, 96 Bone scan, 96, 115 Bradykinin, 96, 110 Brain Stem, 96, 97, 121 Bromodeoxyuridine, 32, 96 C Calcium, 7, 96, 98, 108, 112, 116, 119 Callus, 96, 107 Carcinoma, 96 Case report, 16, 18, 22, 33, 42, 96 Caudal, 96, 113 Cell Cycle, 45, 96 Cell Death, 21, 94, 97, 110 Cell Differentiation, 97, 116 Cell Division, 95, 97, 105, 109 Cell proliferation, 32, 42, 97, 116 Cell Survival, 97, 105 Cerebellar, 25, 97 Cerebellopontine, 11, 42, 46, 97 Cerebellopontine Angle, 11, 42, 97 Cerebellum, 97, 113 Cerebral, 96, 97, 103 Cerebral Cortex, 97, 103 Cervical, 33, 44, 97 Cervix, 97 Cholesterol, 13, 97 Chromatin, 94, 97, 108 Chromosomal, 94, 97, 118 Chromosome, 15, 94, 97, 110, 118, 120

124

Cholesteatoma

Chymotrypsin, 31, 97 Ciliary, 97, 110 Ciprofloxacin, 39, 97 Clinical Medicine, 28, 97 Clinical trial, 6, 75, 98 Cloning, 6, 95, 98 Cochlea, 5, 98, 106, 117, 120 Cochlear, 15, 58, 62, 98, 105, 119, 121 Cochlear Diseases, 98, 119 Cofactor, 98, 114 Collagen, 98, 103, 108, 113 Collapse, 98, 117 Colloidal, 98, 101 Complement, 98, 99, 104 Complementary and alternative medicine, 57, 59, 98 Complementary medicine, 57, 99 Computational Biology, 75, 99 Computed tomography, 9, 17, 41, 50, 99, 115 Computerized axial tomography, 99, 115 Computerized tomography, 18, 99 Conduction, 32, 99 Confusion, 42, 99, 101 Connective Tissue, 96, 98, 99, 104, 108, 109 Contamination, 58, 99 Contraindications, ii, 99 Contralateral, 47, 99 Cornea, 99, 118 Corneum, 99, 102 Cortex, 19, 99 Cranial, 37, 97, 99, 103, 106, 112, 113, 121 Craniocerebral Trauma, 99, 119 Cryosurgery, 62, 100 Curative, 100, 119 Cutaneous, 16, 19, 100 Cutaneous Fistula, 16, 19, 100 Cyclic, 100, 105, 110 Cyst, 42, 90, 100 Cysteine, 23, 93, 100 Cystine, 100 Cytokines, 3, 6, 7, 45, 100 Cytophotometry, 18, 100 Cytoplasm, 94, 100, 105, 108, 110 Cytotoxic, 100, 116 D Decompression, 62, 100 Decompression Sickness, 100 Deletion, 94, 100 Dendrites, 100, 110 Deoxyribonucleic, 100, 115 Deoxyribonucleic acid, 100, 115

Depolarization, 100, 116 Diagnostic procedure, 68, 101 Digestive tract, 101, 117, 118 Diploid, 94, 101, 110, 120 Direct, iii, 97, 101, 114 Discrete, 96, 101 Disorientation, 99, 100, 101 Dizziness, 62, 80, 89, 101, 121 Dorsal, 101, 113 Drug Interactions, 101 Duct, 93, 101, 115 Duodenum, 97, 101, 102, 112, 118 Dura mater, 101, 109, 111 Dysphonia, 62, 101 Dysplasia, 23, 27, 101 E Ear Diseases, 57, 101 Eardrum, 62, 64, 80, 101 Efferent, 101, 103 Electrophoresis, 17, 101 Enamel, 101, 107 Endocrine Glands, 101, 112 Endogenous, 8, 101 Endolymphatic Duct, 101 Endolymphatic Sac, 62, 101 Endoscope, 19, 101, 102 Endoscopic, 51, 102 Endoscopy, 48, 50, 102 Endothelium, 102, 110 Endothelium-derived, 102, 110 Endotoxin, 102, 120 Enteropeptidase, 102, 120 Environmental Health, 74, 76, 102 Enzymatic, 96, 98, 102 Enzyme, 7, 102, 105, 107, 116, 121, 122 Epidemiological, 58, 102 Epidermal, 10, 20, 102, 107 Epidermal Growth Factor, 20, 102 Epidermal growth factor receptor, 20, 102 Epidermis, 10, 41, 95, 99, 102, 105, 107 Epidermoid carcinoma, 102, 118 Epidural, 16, 102 Epithelial, 6, 8, 10, 42, 95, 102, 107 Epithelial Cells, 95, 102, 107 Epithelium, 5, 6, 10, 14, 18, 19, 45, 102 Equalization, 62, 102 Erythrocytes, 95, 96, 102 Esophageal, 62, 103 Esophagus, 95, 101, 103, 118 Eukaryotic Cells, 103, 106 Eustachian tube, 4, 24, 30, 36, 38, 49, 103 Exogenous, 101, 103

125

Extracellular, 34, 99, 103, 108, 119 Extracellular Matrix, 99, 103, 108 Extracellular Matrix Proteins, 103, 108 F Facial, 4, 22, 42, 48, 80, 90, 103, 105, 108 Facial Expression, 103 Facial Nerve, 4, 48, 103, 105 Facial Nerve Diseases, 103, 105 Facial Paralysis, 42, 103 Family Planning, 75, 103 Fats, 97, 103 Fibroblasts, 3, 6, 20, 103 Fibronectin, 27, 104 Fistula, 15, 32, 35, 62, 104 Flatus, 104 Fossa, 9, 26, 30, 37, 46, 97, 104 G Gamma-interferon, 104, 106 Ganglion, 104, 121 Gas, 7, 100, 104, 110, 115, 121 Gas exchange, 104, 115, 121 Gastric, 102, 104 Gastrointestinal, 96, 97, 104 Gene, 8, 24, 44, 63, 95, 104 Gene Expression, 44, 104 Genetic Engineering, 95, 98, 104 Genital, 16, 97, 104 Genotype, 104, 113 Gland, 104, 108, 112, 116, 118, 119 Glutamate, 8, 104 Glycoprotein, 104, 110, 120 Governing Board, 104, 114 Graft, 46, 47, 104 Grafting, 104, 106 Granulation Tissue, 18, 29, 43, 104 Granulocytes, 105, 116, 121 Granuloma, 13, 105 Growth factors, 7, 105 Guanylate Cyclase, 105, 110 H Habitual, 12, 105 Hair Cells, 105, 121 Hammer, 44, 105, 111 Heredity, 93, 104, 105 Hoarseness, 62, 105 Homeostasis, 96, 105 Hormone, 105, 115, 116, 119 Horny layer, 102, 105 Hybrid, 105 Hybridization, 7, 105 Hydrolysis, 105, 113, 120 Hyperacusis, 62, 103, 105

Hypersensitivity, 105, 115 Hypoxia, 21, 105 I Illusion, 105, 121 Immune response, 94, 105, 121 Impairment, 26, 95, 101, 106 Implantation, 9, 106 In situ, 6, 32, 100, 106 In Situ Hybridization, 6, 106 In vitro, 6, 7, 11, 29, 106, 119 In vivo, 6, 7, 49, 106 Incision, 106, 107 Incus, 28, 106, 108 Infection, 5, 8, 10, 34, 64, 69, 95, 97, 106, 108, 115, 118, 121 Inflammation, 3, 93, 97, 106, 107, 109, 111, 113, 115 Inner ear, 6, 8, 30, 61, 69, 98, 106, 107 Innervation, 103, 106 Insight, 8, 106 Intercellular Adhesion Molecule-1, 10, 106 Interleukin-1, 6, 7, 10, 13, 20, 31, 33, 44, 106 Interleukin-2, 106 Intestinal, 102, 106, 107 Intestines, 95, 101, 104, 106, 116 Intracellular, 106, 110, 116 Intracranial Hypertension, 106, 119 Invasive, 5, 25, 107, 108 Involuntary, 107, 111, 117 Isoenzymes, 18, 107 Isotretinoin, 54, 107 K Kb, 74, 107 Keratin, 28, 107 Keratinocyte growth factor, 21, 31, 42, 107 Keratinocytes, 28, 29, 37, 107 Keratosis, 29, 32, 107 L Labyrinth, 98, 101, 106, 107, 111, 113, 116, 121 Labyrinthine, 32, 35, 51, 107 Labyrinthitis, 4, 62, 107 Lacrimal, 103, 107 Laryngeal, 62, 107 Laryngeal Diseases, 62, 107 Larynx, 11, 12, 23, 25, 43, 46, 47, 107 Lesion, 5, 8, 40, 57, 64, 105, 107, 116, 120 Leukoplakia, 31, 107 Liver, 107, 115 Liver scan, 107, 115 Localized, 7, 34, 93, 106, 108, 120

126

Cholesteatoma

Lymph, 97, 102, 108, 118 Lymph node, 97, 108 Lymphatic, 27, 102, 106, 108, 109, 117, 119 Lymphocytes, 94, 104, 106, 108, 117, 119, 121 Lymphoid, 94, 104, 108 Lysine, 108, 120 M Macrophage, 106, 108 Macula, 48, 108 Magnetic Resonance Imaging, 108, 115 Malignant, 94, 108, 110, 115 Malleus, 106, 108 Mandible, 93, 108, 115 Mandibular Condyle, 17, 108 Matrix metalloproteinase, 29, 33, 36, 108 Meatus, 101, 108, 111, 120 Medial, 28, 108 Mediate, 8, 108, 121 Medical Records, 108, 115 MEDLINE, 75, 108 Membrane, 12, 98, 101, 103, 107, 109, 110, 115, 116, 120 Meninges, 99, 101, 109 Meningitis, 4, 16, 69, 109 Mental, iv, 6, 74, 76, 97, 99, 101, 109, 114 Mesenchymal, 102, 109 Metaplasia, 31, 109 Metastasis, 108, 109 Microbiological, 58, 109 Microbiology, 37, 109 Microorganism, 98, 109, 121 Microscopy, 14, 39, 109 Migration, 106, 109 Mitochondrial Swelling, 109, 110 Mitosis, 94, 109 Modeling, 6, 109 Modification, 37, 102, 104, 109 Molecular, 7, 21, 37, 75, 77, 94, 95, 99, 109, 120 Molecule, 94, 95, 98, 102, 105, 109, 111, 114, 116 Monitor, 29, 109, 110 Monoclonal, 28, 109 Monocytes, 106, 109 Mononuclear, 105, 109, 110, 120 Monosomy, 94, 110 Morphological, 14, 110 Mucociliary, 30, 110, 116 Mucolytic, 93, 110 Mucosa, 24, 49, 57, 110 Mucus, 110

Muscular Diseases, 103, 110 N Necrosis, 30, 94, 110 Neonatal, 19, 110 Neoplasm, 110, 120 Nervous System, 93, 97, 101, 104, 105, 110, 113 Neuroma, 15, 48, 62, 110 Neuronal, 8, 110 Neurons, 7, 8, 100, 110, 118, 121 Neurotransmitter, 96, 104, 110, 116 Neutrophil, 106, 110 Nitric Oxide, 6, 7, 8, 110 Nuclear, 20, 29, 33, 103, 104, 110 Nuclei, 18, 103, 104, 108, 109, 111, 121 Nucleic acid, 105, 106, 111, 115 Nucleic Acid Hybridization, 105, 111 Nucleus, 94, 97, 100, 103, 108, 110, 111, 121 Nystagmus, 62, 107, 111 O Organ Culture, 7, 111, 119 Ossicles, 4, 5, 7, 11, 15, 105, 106, 108, 111 Osteoclasts, 6, 7, 8, 39, 111 Osteoporosis, 96, 111 Otitis Media with Effusion, 12, 111 Otolaryngologist, 5, 64, 111 Otorrhea, 64, 111 Otosclerosis, 39, 62, 111 Outer ear, 62, 111 P Pachymeningitis, 109, 111 Palate, 111, 117, 120 Palliative, 111, 119 Palsy, 44, 111 Pancreas, 97, 112, 120 Pancreatic, 97, 112 Pancreatic Juice, 97, 112 Paralysis, 22, 80, 90, 103, 112 Paranasal Sinuses, 112, 116 Parathyroid, 29, 112, 119 Parathyroid Glands, 112 Parathyroid hormone, 29, 112 Paresis, 103, 112 Paroxysmal, 62, 112 Patch, 107, 112 Pathologic, 57, 94, 105, 112, 115 Pathologic Processes, 94, 112 Pathophysiology, 47, 112 Patient Education, 65, 80, 84, 86, 91, 112 Peptide, 20, 102, 107, 112, 113, 114 Perforation, 19, 41, 64, 112 Perfusion, 105, 112

127

Perilymph, 62, 112 Peripheral Nervous System, 110, 111, 113, 115 Pharmaceutical Preparations, 113, 114 Pharmacologic, 8, 94, 113, 119 Phenotype, 7, 8, 113 Phospholipases, 113, 116 Phosphorus, 96, 112, 113 Physiologic, 113, 114, 115 Physiology, 69, 113 Plasma, 94, 104, 113 Plasma cells, 94, 104, 113 Platelet Activation, 113, 116 Platelet Aggregation, 110, 113 Platelets, 110, 113 Pleated, 107, 113 Pneumonia, 99, 113 Polypeptide, 98, 102, 105, 113, 122 Polysaccharide, 94, 113 Pons, 96, 97, 103, 113 Posterior, 9, 30, 34, 42, 45, 62, 64, 97, 101, 108, 111, 112, 113, 120 Postoperative, 4, 5, 18, 27, 43, 50, 114 Postsynaptic, 114, 116 Potentiates, 106, 114 Potentiation, 114, 116 Practice Guidelines, 76, 114 Progression, 6, 114 Progressive, 6, 8, 97, 110, 113, 114, 120 Prone, 43, 114 Propylene Glycol, 54, 114 Protein S, 63, 95, 114 Protozoa, 109, 114, 120 Psychiatry, 114, 121 Public Policy, 75, 114 Purulent, 111, 114 Q Quiescent, 7, 114 R Radiation, 114, 115, 122 Radioactive, 96, 106, 107, 110, 114, 115 Ramus, 108, 114 Receptor, 8, 30, 31, 42, 94, 114, 116 Rectum, 94, 101, 104, 114 Recurrence, 4, 5, 14, 22, 25, 42, 44, 114 Refer, 1, 98, 101, 108, 114, 121 Refraction, 115, 117 Remission, 114, 115 Resection, 26, 115 Resorption, 7, 8, 14, 96, 111, 115 Respiratory Physiology, 115, 121 Respiratory System, 110, 115

Retinae, 108, 115 Retraction, 5, 14, 41, 51, 115 Retrospective, 43, 115 Retrospective study, 43, 115 Rheumatoid, 46, 115 Rheumatoid arthritis, 46, 115 Rhinitis, 62, 115 Ribonucleic acid, 20, 115 Risk factor, 43, 45, 115 S Saliva, 115 Salivary, 62, 103, 115, 118 Salivary glands, 62, 103, 115 Scans, 9, 48, 115 Schwannoma, 15, 115 Scleroproteins, 107, 116 Screening, 98, 116 Secretion, 93, 102, 110, 116 Secretory, 18, 116 Segmental, 4, 116 Segmentation, 116 Seizures, 112, 116 Semicircular canal, 5, 106, 116 Sequela, 6, 8, 116 Sequencing, 6, 116 Serine, 97, 116, 120 Shock, 27, 116, 120 Side effect, 93, 95, 116, 119 Signal Transduction, 37, 116 Sinusitis, 62, 116 Skeletal, 110, 116, 117 Skeleton, 96, 116, 117 Skull, 5, 100, 117, 118 Sleep apnea, 62, 117 Small intestine, 101, 105, 106, 117, 120 Smoking Cessation, 62, 117 Smooth muscle, 110, 117 Sneezing, 65, 117 Snoring, 62, 117 Solvent, 114, 117 Sound wave, 99, 117 Spasm, 27, 117, 119 Spasmodic, 62, 117 Spatial disorientation, 101, 117 Specialist, 81, 117 Species, 105, 109, 117 Spectrum, 21, 117 Spinal cord, 96, 97, 101, 102, 104, 109, 110, 111, 113, 117 Spinous, 102, 107, 117 Spiral Lamina, 117, 120 Spleen, 108, 117

128

Cholesteatoma

Squamous, 4, 5, 11, 31, 47, 102, 118 Squamous cell carcinoma, 11, 47, 102, 118 Squamous cells, 118 Squamous Epithelium, 4, 5, 118 Staging, 9, 46, 115, 118 Sterile, 95, 112, 118 Stimulus, 95, 106, 118 Stomach, 101, 103, 104, 105, 106, 117, 118 Stress, 115, 118 Stroma, 27, 118 Subacute, 106, 116, 118 Subclinical, 106, 116, 118 Submaxillary, 102, 118 Suppurative, 37, 39, 41, 118 Synaptic, 110, 116, 118 Systemic, 106, 107, 118 T Telomere, 37, 47, 118 Temporal, 13, 23, 40, 64, 103, 108, 118 Teratogenic, 107, 118 Tetany, 112, 119 Therapeutics, 119 Thrombosis, 16, 33, 114, 119 Thymidine, 96, 119 Thymus, 108, 119 Thyroid, 112, 119 Thyroid Gland, 112, 119 Tinnitus, 44, 62, 111, 119, 121 Tissue Culture, 10, 119 Tomography, 49, 119 Topical, 107, 119 Toxic, iv, 119 Toxicity, 101, 119 Toxicology, 76, 119 Toxins, 94, 106, 119 Transduction, 116, 119 Transfection, 95, 119 Translational, 7, 120 Trauma, 37, 110, 120 Trisomy, 94, 120 Trypsin, 31, 97, 102, 120, 122 Tumor Necrosis Factor, 10, 11, 20, 120 Tumour, 30, 104, 120 Tunica, 110, 120 Tympani, 15, 108, 120

Tympanic membrane, 3, 4, 6, 8, 16, 28, 31, 32, 43, 64, 95, 108, 111, 120 Tympanum, 4, 11, 120 U Ulcer, 104, 120 Ureters, 120 Urethra, 120 Urinary, 31, 49, 97, 120 Urinary tract, 31, 49, 120 Urine, 95, 102, 120 Uterus, 97, 120 Uvula, 117, 120 V Vaccines, 120, 121 Vascular, 21, 62, 102, 104, 106, 110, 119, 120 Vascular endothelial growth factor, 21, 120 Vasodilators, 110, 121 Vein, 110, 121 Venous, 114, 121 Ventilation, 25, 50, 115, 121 Vertigo, 4, 5, 42, 61, 62, 90, 111, 121 Vestibular, 8, 15, 51, 61, 62, 64, 105, 107, 121 Vestibular Nerve, 62, 121 Vestibule, 51, 98, 106, 116, 121 Vestibulocochlear Nerve, 105, 119, 121 Vestibulocochlear Nerve Diseases, 105, 119, 121 Veterinary Medicine, 75, 121 Viral, 44, 93, 119, 121 Virus, 44, 104, 119, 121 Viscosity, 93, 121 Vitro, 121 Vivo, 121 W Wart, 107, 121 White blood cell, 94, 108, 110, 113, 121 Wound Healing, 108, 122 X X-ray, 99, 110, 115, 122 Y Yeasts, 113, 122 Z Zymogen, 97, 122

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