Clitoris: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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

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CLITORIS 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., 1960Clitoris: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84269-8 1. Clitoris-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 clitoris. 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 CLITORIS ................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Clitoris .......................................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 7 Academic Periodicals covering Clitoris........................................................................................ 18 CHAPTER 2. NUTRITION AND CLITORIS.......................................................................................... 19 Overview...................................................................................................................................... 19 Finding Nutrition Studies on Clitoris ......................................................................................... 19 Federal Resources on Nutrition ................................................................................................... 20 Additional Web Resources ........................................................................................................... 20 CHAPTER 3. PATENTS ON CLITORIS ................................................................................................ 23 Overview...................................................................................................................................... 23 Patents on Clitoris ....................................................................................................................... 23 Patent Applications on Clitoris.................................................................................................... 27 Keeping Current .......................................................................................................................... 28 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 31 Overview...................................................................................................................................... 31 NIH Guidelines............................................................................................................................ 31 NIH Databases............................................................................................................................. 33 Other Commercial Databases....................................................................................................... 35 APPENDIX B. PATIENT RESOURCES ................................................................................................. 37 Overview...................................................................................................................................... 37 Patient Guideline Sources............................................................................................................ 37 Finding Associations.................................................................................................................... 38 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 41 Overview...................................................................................................................................... 41 Preparation................................................................................................................................... 41 Finding a Local Medical Library.................................................................................................. 41 Medical Libraries in the U.S. and Canada ................................................................................... 41 ONLINE GLOSSARIES.................................................................................................................. 47 Online Dictionary Directories ..................................................................................................... 47 CLITORIS DICTIONARY.............................................................................................................. 49 INDEX ................................................................................................................................................ 73

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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 clitoris is indexed in search engines, such as www.google.com or others, a nonsystematic 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 clitoris, 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 clitoris, 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 clitoris. 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 clitoris, 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 clitoris. The Editors

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

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

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

Female Bladder Exstrophy Source: International Urogynecology Journal. 8(2): 98-104. 1997. Contact: Available from Springer-Verlag New York Inc. 175 Fifth Avenue, New York, NY 10010. (212) 460-1500. Fax (212) 473-6272. Summary: Bladder exstrophy is one of the most challenging congenital urinary tract abnormalities. Classic bladder exstrophy is a severe congenital abnormality characterized by a small bladder turned inside out through a defect in the lower abdominal wall. Apart from the open bladder, the patient also has various other abnormalities, including urogenital, musculoskeletal, and anorectal defects. The size of the exstrophic bladder varies from patient to patient. In the female, the clitoris is bifid and the vagina is anteriorly placed. In this article, various aspects of female bladder

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exstrophy are reviewed in detail, including incidence, etiology, anatomy, and clinical features, together with early, medium term, and long term surgical management. The aim is to achieve a functional bladder closure, although some patients are better off with a urinary diversion. Considering the complexity of the urogenital problems and the surgical management thereof, all patients require lifelong followup. In addition, psychosexual dysfunction may be a serious, although often overlooked, sequel in patients with major urogenital abnormalities, including bladder exstrophy. 1 figure. 1 table. 123 references. (AA-M).

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

Project Title: FEMALE PHYSIOLOGY

SEXUAL

AROUSAL:

CLITORAL

AND

VAGINAL

Principal Investigator & Institution: Traish, Abdulmaged M.; Professor; Urology; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2002; Project Start 15-SEP-2000; Project End 30-JUN-2004 Summary: (Adapted from the Applicant's Abstract): Female sexuality is an desire, arousal, orgasm or pain, are estimated to afflict 30-50 percent of women in the United States. These disorders may be chronic, progressive, age-related and adversely affect quality of life and interpersonal relationships. In particular, sexual arousal disorder, has been linked to age, menopause, hysterectomy and vascular risk factors. Overall clinical management of afflicted patients has been primarily psychologically and hormonallybased. There has been limited research attention to the physiologically or medicallybased conditions which adversely affect the female sexual arousal response. Recently, increasing numbers of afflicted women are utilizing "off-label" oral vasoactive agents for treatment of diminished genital swelling/lubrication responses in the absence of such physiologic and clinical trial data, suggesting demand for improved female sexual health care management. There is a need to broaden understanding of the pathophysiologic mechanisms of female sexual dysfunction. The overall goal of this proposal is to define the physiological mechanisms underlying the arousal component 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).

Studies

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of the female sexual response. Specifically, they will investigate the physiologic mechanisms of clitoral and vaginal smooth muscle contractility which contribute to clitoral and vaginal engorgement during genital swelling/lubrication responses. To accomplish this goal, they have developed several experimental systems including: I) an in vivo animal model to record physiologic and hemodynamic changes in the clitoris and vagina following pelvic nerve stimulation, ii) in vitro organ baths of clitoral and vaginal tissue to investigate mechanisms involved in the modulation of smooth muscle contractility and iii) primary cultures of human and animal clitoral and vaginal smooth muscle cells to examine signal transduction pathways underlying smooth muscle tone. The Specific Aims of this proposal are to investigate: 1) neurogenic mechanisms modulating clitoral and vaginal smooth muscle contractility, 2) signal transduction pathways by which alpha-adrenergic receptors, nitric oxide and VIP modulate smooth muscle function, 3) the activity, in vivo, of alpha-adrenergic antagonists, VIP and nitric oxide on clitoral and vaginal hemodynamic response to pelvic nerve stimulation and 4) the role of estrogens in modulating vaginal and clitoral smooth muscle function. These studies should lead to new and useful information concerning physiological and pathophysiological mechanisms in female sexual arousal and to potentially improve diagnostic and treatment strategies for women suffering from sexual dysfunction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PATTERNS OF BEHAVIORAL AND HORMONAL DEVELOPMENT Principal Investigator & Institution: Glickman, Stephen E.; Professor; Psychology; University of California Berkeley Berkeley, Ca 94720 Timing: Fiscal Year 2002; Project Start 01-JUN-1984; Project End 30-JUN-2007 Summary: (provided by applicant): The proposed research program is focused on an unusual mammal, the spotted hyena, as a route to understanding general mechanisms of sexual differentiation and development. The female spotted hyena has no external vagina. The clitoris has hypertrophied until it is the approximate size and shape of the male penis, and is traversed by a central urogenital canal. Female spotted hyenas urinate, mate and give birth through the clitoris. Contemporary understanding of sexual differentiation requires the presence of androgens during fetal life to explain the "masculine" phenotype observed at birth in both sexes. The present proposal, focused on differentiation of the urogenital system and the brain, is designed to examine the following hypotheses: (1) Differentiation and development of the external genitalia of the spotted hyena are driven, either by an androgen-independent process, or by "unusual" steroids (e.g., A and E2) activating the hyena Androgen Receptor (AR)). (2) Sex differences in clitoral/penile morphology observed at birth are the result of differential secretions of the fetal ovaries, testes or adrenals, acting on a background of placental T/E2 arriving via the umbilical vein. (3) Growth of the genitalia during postnatal life is modulated by the same growth factors that control general skeletal growth (i.e., IGF-1). (4) Sex differences in the brain are the result of sex differences in steroid hormones, such as those responsible for dimorphisms in the genitalia. In order to achieve these ends: (A) Dr. Michael McPhaul will extend his studies of the unusual binding properties of the hyena AR in fibroblast culture. In addition, a team of investigators will explore fetal urogenital development with a variety of techniques, including (B) transplantation of genital tissues from fetal hyenas into the renal capsule of nude mice; (C) examination of androgenic/estrogenic activity of fetal ovaries, testes and adrenals, including ICC studies of metabolic enzymes, and assays of gonadal secretions in vitro; and (D) examination of steroid receptors in the UG system during fetal life. (E) Studies of sex differences in the CNS, involving both Nissl stains and ICC

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for various neuropeptides, will examine fetal and adult tissues from the hyena CNS, including tissues derived from mature hyenas that were exposed to flutamide/finasteride in utero. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TESTOSTERONE MENOPAUSAL WOMENT

DOSE

RESPONSE

IN

SURGICALLY

Principal Investigator & Institution: Bhasin, Shalender; Professor and Chief; Charles R. Drew University of Med & Sci 1621 E 120Th St Los Angeles, Ca 90059 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2008 Summary: The clinical applications of testosterone in women are predicated upon the postulate that by appropriate selection of testosterone dose, clinically beneficial effects of testosterone on sexual, physical and neurocognitive functions can be dissociated from its virilizing side effects. However, we do not know whether the skin, hair, vocal cords, and clitoris differ in their testosterone sensitivity from sexual, cognitive, and physical functions. Therefore, the primary objective of this study is to establish testosterone doseresponse relationships in surgically menopausal women with low testosterone concentrations for a range of androgen-dependent outcomes, including sexual function, fat-free mass, thigh muscle strength and leg power, and several domains of neurocognitive function. The secondary objective is to determine the range of testosterone doses and concentrations that are associated with improvements in sexual, physical and neurocognitive functions and that can be safely administered to women without adverse effects on hair growth, voice, sebum production, clitoral size, and cardiovascular risk factors. In this randomized, double-blind, parallel-group study, surgically-menopausal women with low testosterone concentrations after a run-in period of transdermal estradiol for 3 months will be randomized to one of 4 groups to receive 0, 400, 1000, or 1600 uL testosterone gel daily for 6-months. These doses are expected to be associated with total testosterone concentrations of 20, 60, 120, and 180 ng/dL. The following outcomes will be assessed before and after 24-weeks of testosterone/placebo: sexual function, assessed by Brief Index of Sexual Functioning for Women, Derogatis Sexual Function Interview-Self Report, a sexual event log diary, and a Female Sexual Distress Scale; genital blood flow and sensation; mood by Psychological General Well Being Index; whole body and regional fat-free and fat mass by DEXA, deuterium water and sodium water dilution; and MRI scans of abdomen and thigh; leg press strength and leg power; physical function by Margaria power test, 400-m walk, and load carry test; and neurocognitive function by tests of spatial memory, spatial ability, logical memory, verbal (category and phonemic) fluency, immediate and delayed recall, digit and visual memory spans, spatial orientation, selective attention measure, and executive function. We will measure serum total and free testosterone, estradiol, DHT, SHBG, and FSH. For safety, we will evaluate hematocrit, liver enzymes, periodic breast and pelvic examination, hair growth by Ferriman and Galloway scale, sebuln production by Sebu-Tape, acne by Palatsi scale, clitoris size and index, changes in voice frequency, pitch range, and video images of vocal cords and digital speech records; plasma lipids, apolipoproteins and lipoprotein particles; inflammation sensitive markers; sleep apnea using Berlin's questionnaire; and insulin sensitivity by modified FSIVGT. These dose response data are crucial for the therapeutic applications of androgens in women, and will help determine whether by appropriate selection of testosterone dose, its beneficial effects can be dissociated from virilizing side effects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

Studies

7

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

A case of multiple intestinal atresias, brain anomalies, mental retardation, growth hormone deficiency and clitoris hypertrophy. Author(s): Guala A, Licardi G, Maghnie M, Minniti S, Danesino C. Source: Clinical Dysmorphology. 1998 July; 7(3): 209-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9689996&dopt=Abstract

•

A hair tourniquet resulting in strangulation and amputation of the clitoris. Author(s): Kuo JH, Smith LM, Berkowitz CD. Source: Obstetrics and Gynecology. 2002 May; 99(5 Pt 2): 939-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11975967&dopt=Abstract

•

A method of preserving the glans penis as a clitoris in sex conversion operations in male transsexuals. Author(s): Rubin SO. Source: Scandinavian Journal of Urology and Nephrology. 1980; 14(3): 215-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7193907&dopt=Abstract

•

A new and simplified method for concealing the hypertrophied clitoris. Author(s): Ansell JS, Rajfer J. Source: Journal of Pediatric Surgery. 1981 October; 16(5): 681-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7310599&dopt=Abstract

•

A pilonidal sinus of the clitoris? Author(s): Werker PM, Kon M. Source: Annals of Plastic Surgery. 1990 July; 25(1): 63-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2378499&dopt=Abstract

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

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•

A simple technic for shortening the clitoris without amputation. Author(s): Kaplan I. Source: Obstetrics and Gynecology. 1967 February; 29(2): 270-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6018178&dopt=Abstract

•

A solitary neurilemmoma of the clitoris. Author(s): Huang HJ, Yamabe T, Tagawa H. Source: Gynecologic Oncology. 1983 February; 15(1): 103-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6822362&dopt=Abstract

•

A solitary neurofibroma of the clitoris masquerading as intersex. Author(s): Ravikumar VR, Lakshmanan D. Source: Journal of Pediatric Surgery. 1983 October; 18(5): 617. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6644506&dopt=Abstract

•

Amebiasis of clitoris mimicking carcinoma. Author(s): Majmudar B, Chaiken ML, Lee KU. Source: Jama : the Journal of the American Medical Association. 1976 September 6; 236(10): 1145-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=181603&dopt=Abstract

•

Anatomical relationship between urethra and clitoris. Author(s): O'Connell HE, Hutson JM, Anderson CR, Plenter RJ. Source: The Journal of Urology. 1998 June; 159(6): 1892-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9598482&dopt=Abstract

•

Anatomical studies of the human clitoris. Author(s): Baskin LS, Erol A, Li YW, Liu WH, Kurzrock E, Cunha GR. Source: The Journal of Urology. 1999 September; 162(3 Pt 2): 1015-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10458423&dopt=Abstract

•

Angiokeratoma of the clitoris. Author(s): McNeely TB. Source: Archives of Pathology & Laboratory Medicine. 1992 August; 116(8): 880-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1497470&dopt=Abstract

•

Angiokeratoma of the clitoris: a subtype of angiokeratoma vulvae. Author(s): Yamazaki M, Hiruma M, Irie H, Ishibashi A. Source: The Journal of Dermatology. 1992 September; 19(9): 553-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1479114&dopt=Abstract

Studies

9

•

Bit-mapped imaging of somatosensory evoked potentials after stimulation of the posterior tibial nerves and dorsal nerve of the penis/clitoris. Author(s): Guerit JM, Opsomer RJ. Source: Electroencephalography and Clinical Neurophysiology. 1991 May-June; 80(3): 228-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1713154&dopt=Abstract

•

Carcinoma of stomach with a metastasis in the clitoris. Author(s): Ahmed W, Beasley WH. Source: J Pak Med Assoc. 1979 March; 29(3): 62-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=107350&dopt=Abstract

•

Carcinoma of the bladder with a metastasis in the clitoris. Author(s): Powell CS, Jones PA. Source: British Journal of Obstetrics and Gynaecology. 1983 April; 90(4): 380-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6838794&dopt=Abstract

•

Carcinoma of the clitoris: a histologic study with cytokeratin profile. Author(s): Czernobilsky B, Gat A, Evron R, Dgani R, Ben-Hur H, Lifschitz-Mercer B. Source: International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists. 1995 July; 14(3): 274-8. Erratum In: Int J Gynecol Pathol 1995 October; 14(4): 366. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8600082&dopt=Abstract

•

Clitoridectomy or plastic reduction of the clitoris in the adrenogenital syndrome. Author(s): Strohmenger P. Source: Monogr Paediatr. 1981; 12: 80-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7219425&dopt=Abstract

•

Clitoris and labia minora agenesis--an undescribed malformation. Author(s): Martinon-Torres F, Martinon-Sanchez JM, Martinon-Sanchez F. Source: Clinical Genetics. 2000 October; 58(4): 336-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11076061&dopt=Abstract

•

Clitoris tourniquet syndrome. Author(s): Press S, Schachner L, Paul P. Source: Pediatrics. 1980 November; 66(5): 781-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7432884&dopt=Abstract

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Clitorism at presentation of acute nonlymphocytic leukemia. Author(s): Williams DL, Bell BA, Ragab AH. Source: The Journal of Pediatrics. 1985 November; 107(5): 754-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3863907&dopt=Abstract

•

Comparison of the treatment results in the vulvar and clitoris squamous cell carcinoma. Author(s): Masak L, Hudakova G. Source: Neoplasma. 1998; 45(6): 377-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10210112&dopt=Abstract

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Congenital absence of clitoris. A case report. Author(s): Falk HC, Hyman AB. Source: Obstetrics and Gynecology. 1971 August; 38(2): 269-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5560111&dopt=Abstract

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Congenital hemangiopericytoma of the clitoris. Author(s): Brock JW 3rd, Morgan W, Anderson TL. Source: The Journal of Urology. 1995 February; 153(2): 468-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7815622&dopt=Abstract

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Congenital neoplasm of the clitoris. Author(s): Levard G, Podevin J, Levillain P, Podevin G. Source: The Journal of Urology. 1997 February; 157(2): 649. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8996391&dopt=Abstract

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Construction of a neoclitoris in male transsexuals. Author(s): Szalay L. Source: Plastic and Reconstructive Surgery. 1995 February; 95(2): 425. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7824637&dopt=Abstract

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Construction of a neoclitoris in male transsexuals. Author(s): Szalay L. Source: Plastic and Reconstructive Surgery. 1994 March; 93(3): 646-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8204166&dopt=Abstract

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Construction of a neovagina with preservation of the glans penis as a clitoris in male transsexuals. Author(s): Eldh J. Source: Plastic and Reconstructive Surgery. 1993 April; 91(5): 895-900; Discussion 901-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8460193&dopt=Abstract

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Cortical evoked potentials of the dorsal nerve of the clitoris and female sexual dysfunction in multiple sclerosis. Author(s): Yang CC, Bowen JR, Kraft GH, Uchio EM, Kromm BG. Source: The Journal of Urology. 2000 December; 164(6): 2010-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11061904&dopt=Abstract

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Duplex ultrasonography after prostaglandin E1 injection of the clitoris in a case of hyperreactio luteinalis. Author(s): Akkus E, Carrier S, Turzan C, Wang TN, Lue TF. Source: The Journal of Urology. 1995 April; 153(4): 1237-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7869513&dopt=Abstract

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Endodermal sinus tumor of the clitoris. Author(s): Castaldo TW, Petrilli ES, Ballon SC, Voet RL, Lagasse LD, Lubens R. Source: Gynecologic Oncology. 1980 June; 9(3): 376-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6155314&dopt=Abstract

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Epidermal cyst of the clitoris: a rare cause of clitorimegaly. Author(s): Schmidt A, Lang U, Kiess W. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1999 December; 87(2): 163-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10597967&dopt=Abstract

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Epidermal inclusion cysts of the clitoris as a complication of female circumcision and pharaonic infibulation. Author(s): Hanly MG, Ojeda VJ. Source: Cent Afr J Med. 1995 January; 41(1): 22-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7767932&dopt=Abstract

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Epithelioid hemangioendothelioma of the clitoris: a case report with immunohistochemical and ultrastructural findings. Author(s): Strayer SA, Yum MN, Sutton GP. Source: International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists. 1992 July; 11(3): 234-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1399230&dopt=Abstract

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Formation of neoclitoris from glans penis by reduction glansplasty with preservation of neurovascular bundle in male-to-female gender surgery: functional and cosmetic outcome. Author(s): Rehman J, Melman A. Source: The Journal of Urology. 1999 January; 161(1): 200-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10037398&dopt=Abstract

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Glomus tumor of the clitoris. Author(s): Jagadha V, Srinivasan K, Panchacharam P. Source: N Y State J Med. 1985 October; 85(10): 611. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3001604&dopt=Abstract

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Granular cell myoblastoma of the clitoris. Author(s): Doyle WF, Hutchison JR. Source: American Journal of Obstetrics and Gynecology. 1968 February 15; 100(4): 58990. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4295204&dopt=Abstract

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Granular cell tumor (Abrikossoff tumor) of the clitoris. Author(s): Ortiz-Hidalgo C, de la Vega G, Moreno-Collado C. Source: International Journal of Dermatology. 1997 December; 36(12): 935-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9466204&dopt=Abstract

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Granular cell tumor of the clitoris in pregnancy. Author(s): Degefu S, Dhurandhar HN, O'Quinn AG, Fuller PN. Source: Gynecologic Oncology. 1984 October; 19(2): 246-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6489836&dopt=Abstract

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Hair tourniquet syndrome of the clitoris. Author(s): Rich MA, Keating MA. Source: The Journal of Urology. 1999 July; 162(1): 190-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10379786&dopt=Abstract

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Hemangioma of clitoris, confused with adrenogenital syndrome: case report. Author(s): Kaufman-Friedman K. Source: Plastic and Reconstructive Surgery. 1978 September; 62(3): 452-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=693675&dopt=Abstract

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Histochemistry and cytochemistry of human skin. XXVI. alkaline phosphatase activity in the sensory nerve endings of the clitoris. Author(s): Giacometti L, Machida H. Source: Archives of Dermatology. 1965 April; 91(4): 377-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9626091&dopt=Abstract

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Immunohistochemical description of nitric oxide synthase isoforms in human clitoris. Author(s): Burnett AL, Calvin DC, Silver RI, Peppas DS, Docimo SG. Source: The Journal of Urology. 1997 July; 158(1): 75-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9186326&dopt=Abstract

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Immunohistochemical study of neuropeptide Y-containing nerve fibers in the human clitoris and penis. Author(s): Cocchia D, Rende M, Toesca A, Viola R, Stolfi VM. Source: Cell Biol Int Rep. 1990 October; 14(10): 865-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2265429&dopt=Abstract

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Immunohistochemical study of the corpora cavernosa of the human clitoris. Author(s): Toesca A, Stolfi VM, Cocchia D. Source: Journal of Anatomy. 1996 June; 188 ( Pt 3): 513-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8763468&dopt=Abstract

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Implantation dermoid of the clitoris. Author(s): Duvie SO. Source: Journal of the Royal College of Surgeons of Edinburgh. 1980 July; 25(4): 276-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7401006&dopt=Abstract

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Juvenile melanoma of clitoris. Author(s): Hulagu C, Erez S. Source: J Obstet Gynaecol Br Commonw. 1973 January; 80(1): 89-91. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4696566&dopt=Abstract

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Leiomyoma of the clitoris. Author(s): Stenchever MA, McDivitt RW, Fisher JA. Source: J Reprod Med. 1973 February; 10(2): 75-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4697434&dopt=Abstract

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Leiomyosarcoma of the clitoris: report of a case. Author(s): Yang FT, Lin CS, Ch'iu JK. Source: Chin Med J. 1965 August; 84(8): 553. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5865026&dopt=Abstract

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Locally aggressive granular cell tumor causing priapism of the crus of the clitoris. A light and ultrastructural study, with observations concerning the pathogenesis of fibrosis of the corpus cavernosum in priapism. Author(s): Slavin RE, Christie JD, Swedo J, Powell LC Jr. Source: The American Journal of Surgical Pathology. 1986 July; 10(7): 497-507. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3014914&dopt=Abstract

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Malignant rhabdoid tumor of the clitoris in an elderly patient: report of a case. Author(s): Haidopoulos D, Elsheikh A, Vlahos G, Sotiropoulou M, Rodolakis A, Voulgaris Z, Milingos S, Diakomanolis E. Source: Eur J Gynaecol Oncol. 2002; 23(5): 447-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12440823&dopt=Abstract

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Malignant schwannoma of the clitoris in a 1-year-old child. Author(s): Thomas WJ, Bevan HE, Hooper DG, Downey EJ. Source: Cancer. 1989 June 1; 63(11): 2216-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2720570&dopt=Abstract

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Nerve tumour of the clitoris. Report of a case and commentary. Author(s): Cheng WC. Source: J Obstet Gynaecol Br Commonw. 1966 December; 73(6): 1016-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5927774&dopt=Abstract

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Neurofibroma of the clitoris. A case report. Author(s): Nishimura K, Sugao H, Sato K, Okuyama A, Sonoda T. Source: Urologia Internationalis. 1991; 46(1): 109-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2024359&dopt=Abstract

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Neurofibromata of clitoris and labium majus simulating a penis and testicle. Author(s): Schepel SJ, Tolhurst DE. Source: British Journal of Plastic Surgery. 1981 April; 34(2): 221-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6786402&dopt=Abstract

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Neuroma of the clitoris after female genital cutting. Author(s): Fernandez-Aguilar S, Noel JC. Source: Obstetrics and Gynecology. 2003 May; 101(5 Pt 2): 1053-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738098&dopt=Abstract

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Neuroma of the clitoris. Author(s): Craven EM, Bresnahan K. Source: Del Med J. 1983; 55(6): 341-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6409681&dopt=Abstract

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Nevus lipomatosus cutaneous superficialis of the clitoris. Author(s): Hattori R, Kubo T, Yano K, Tanemura A, Yamaguchi Y, Itami S, Hosokawa K. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2003 October; 29(10): 1071-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12974709&dopt=Abstract

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Office gynecology: some facts about the clitoris. Author(s): Huffman JW. Source: Postgraduate Medicine. 1976 November; 60(5): 245-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=988587&dopt=Abstract

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Pelvic lymphadenectomy in women with carcinoma of the clitoris. Author(s): Piver MS, Xynos FP. Source: Obstetrics and Gynecology. 1977 May; 49(5): 592-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=850576&dopt=Abstract

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Peptidergic innervation of the human clitoris. Author(s): Hauser-Kronberger C, Cheung A, Hacker GW, Graf AH, Dietze O, Frick J. Source: Peptides. 1999; 20(5): 539-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10465504&dopt=Abstract

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Phimosis of the prepuce of the clitoris: indication for female circumcision. Author(s): McLintock DG. Source: Journal of the Royal Society of Medicine. 1985 March; 78(3): 257-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3973892&dopt=Abstract

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Pilonidal cyst arising in the clitoris. Author(s): Harris RE, Daly JW. Source: Syst Zool. 1967 March; 16(1): 281-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6040270&dopt=Abstract

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Post-circumcision epidermoid inclusion cysts of the clitoris. Author(s): Ofodile FA, Oluwasanmi JO. Source: Plastic and Reconstructive Surgery. 1979 April; 63(4): 485-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=570710&dopt=Abstract

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Priapism of the clitoris. Author(s): Monllor J, Tano F, Arteaga PR, Galbis F. Source: European Urology. 1996; 30(4): 521-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8977080&dopt=Abstract

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Priapism of the clitoris. Author(s): Lozano GB, Castaneda PF. Source: British Journal of Urology. 1981 August; 53(4): 390. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7196274&dopt=Abstract

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Priapism of the clitoris: a case report following trazodone use. Author(s): Pescatori ES, Engelman JC, Davis G, Goldstein I. Source: The Journal of Urology. 1993 June; 149(6): 1557-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8501813&dopt=Abstract

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Recession and relocation of the enlarged clitoris in congenital adrenogenital syndrome. Author(s): Seymour RJ, Kinch RA. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1966 October; 9(4): 365-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5923146&dopt=Abstract

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Reduction clitoroplasty in females with hypertrophied clitoris. Author(s): Randolph JG, Hung W. Source: Journal of Pediatric Surgery. 1970 April; 5(2): 224-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5419072&dopt=Abstract

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Rhabdomyosarcoma of the clitoris. Author(s): Bond SJ, Seibel N, Kapur S, Newman KD. Source: Cancer. 1994 April 1; 73(7): 1984-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8137226&dopt=Abstract

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Schwannoma of the clitoris. Author(s): Llaneza P, Fresno F, Ferrer J. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2002 May; 81(5): 471-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12027824&dopt=Abstract

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Sculpturing the neoclitoris in vaginoplasty for male-to-female transsexuals. Author(s): Hage JJ, Karim RB, Bloem JJ, Suliman HM, van Alphen M. Source: Plastic and Reconstructive Surgery. 1994 February; 93(2): 358-64; Discussion 365. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8310028&dopt=Abstract

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Sex-reassignment surgery male-to-female. Review, own results and report of a new technique using the glans penis as a pseudoclitoris. Author(s): Rubin SO. Source: Scand J Urol Nephrol Suppl. 1993; 154: 1-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8140401&dopt=Abstract

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Subtotal de-epithelialization and partial concealment of the glans clitoris: a modification to improve the cosmetic results of feminizing genitoplasty. Author(s): Bellinger MF. Source: The Journal of Urology. 1993 August; 150(2 Pt 2): 651-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8326615&dopt=Abstract

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Surgical treatment of carcinoma of the clitoris. Author(s): Eriksson E, Eldh J, Peterson LE. Source: Gynecologic Oncology. 1984 March; 17(3): 291-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6706229&dopt=Abstract

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The anterior vaginal wall as an organ for the transmission of active forces to the urethra and the clitoris. Author(s): Ingelman-Sundberg A. Source: International Urogynecology Journal and Pelvic Floor Dysfunction. 1997; 8(1): 50-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9260097&dopt=Abstract

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The male clitoris. Author(s): Sevely JL. Source: American Journal of Obstetrics and Gynecology. 1988 August; 159(2): 533-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3407714&dopt=Abstract

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The prevalence of phimosis of the clitoris in women presenting to the sexual dysfunction clinic: lack of correlation to disorders of desire, arousal and orgasm. Author(s): Munarriz R, Talakoub L, Kuohung W, Gioia M, Hoag L, Flaherty E, Min K, Choi S, Goldstein I. Source: Journal of Sex & Marital Therapy. 2002; 28 Suppl 1: 181-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11898701&dopt=Abstract

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The surgical management of the enlarged clitoris. Author(s): Allen LE, Hardy BE, Churchill BM. Source: The Journal of Urology. 1982 August; 128(2): 351-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7109108&dopt=Abstract

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The suspensory ligament of the clitoris: connective tissue supports of the erectile tissues of the female urogenital region. Author(s): Rees MA, O'Connell HE, Plenter RJ, Hutson JM. Source: Clinical Anatomy (New York, N.Y.). 2000; 13(6): 397-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11111889&dopt=Abstract

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Vaginal and phallic urethra with prominent clitoris in female pseudohermaphroditism. Author(s): Kounami T, Takeuchi H, Takayama H, Tomoyoshi T. Source: The Journal of Urology. 1986 October; 136(4): 915-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3761460&dopt=Abstract

Academic Periodicals covering Clitoris Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to clitoris. 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, visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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

Finding Nutrition Studies on Clitoris 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. Once you have entered 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 “clitoris” (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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Clitoris

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

Duplex ultrasonography after prostaglandin E1 injection of the clitoris in a case of hyperreactio luteinalis. Author(s): Department of Urology, University of California School of Medicine, San Francisco 94143-0738. Source: Akkus, E Carrier, S Turzan, C Wang, T N Lue, T F J-Urol. 1995 April; 153(4): 1237-8 0022-5347

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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CHAPTER 3. PATENTS ON CLITORIS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “clitoris” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on clitoris, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Clitoris By performing a patent search focusing on clitoris, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We

5Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on clitoris: •

Clitoral treatment devices and methods Inventor(s): Abrams; Jerome H. (St. Paul, MN), Hovland; Claire T. (Andover, MN), Olson; Curtis E. (St. Paul, MN) Assignee(s): Urometrics, Inc. (st. Paul, Mn) Patent Number: 6,464,653 Date filed: November 18, 1999 Abstract: Therapeutic devices and methods according to embodiments of the invention encourage or cause clitoral engorgement to assist in the treatment of female sexual dysfunction. A vacuum is created over the clitoris, or suction is applied to the clitoris, to create a negative pressure in the clitoris that is lower than the systolic blood pressure. This tends to promote engorgement of the clitoris with blood. Excerpt(s): The invention relates to devices and methods for treating female sexual dysfunction, and more particularly, to such devices and methods that promote blood flow to the genital region, specifically the clitoris of a female patient. The clitoris in the human female consists of a cylindrical, erectile organ composed of three parts: the outermost glans or head, the middle corpus or body, and the innermost crura. The glans of the clitoris is visualized as it emerges from the labia minora, which bifurcates to form the upper prepuce anteriorly and the lower frenulum posteriorly. The body of the clitoris consists of two paired corpora cavernosa of about 2.5 cm in length. The body extends under the skin at the corona to the crura. The two crura of the clitoris, formed from the separation of the most proximal portions of the corpora in the perineum, attach bilaterally to the undersurface of the symphysis pubis at the ischiopubic rami. A fibrous tunica albuginea ensheathes each corporal body made up of lacunar space sinusoids surrounded by trabecula of the vascular smooth muscle and collagen connective tissue. No retractor clitoridis muscle exists in humans as it does in other animals such as cattle and sheep, however a supporting suspensory ligament does hold the clitoris in the introital region. Web site: http://www.delphion.com/details?pn=US06464653__

•

Corporal tissue penile reconstruction Inventor(s): Atala; Anthony (Weston, MA) Assignee(s): Children's Medical Center Corporation (boston, Ma) Patent Number: 6,514,292 Date filed: November 21, 2000 Abstract: A prosthetic corporal cavernosal structure (PCCS) for use in penile reconstruction, for the correction of developmental defects, for postoperative reconstruction, and for reconstructive preprosthetic surgery. The prosthetic corporal cavernosal structure (PCCS) comprises live cells seeded onto pre-formed shaped structure which may be biodegradable. The live cells may comprise smooth muscle cells such as corporal cavernosal cells, and the prosthetic corporal cavernosal structure (PCCS) for use in reconstructive surgery may be constructed of polyglycolic acid. The implant structure is applicable to use for the regeneration and reconstruction or

Patents 25

augmentation of semirigid erectile members of the body such as the penis, and the clitoris. The prosthetic corporal cavernosal structure (PCCS) may be a composite prosthetic corporal cavernosal structure (PCCS) comprising additional anchoring and strengthening elements for anchoring or changing the structural strength of said composite prosthetic corporal cavernosal structure (PCCS). Excerpt(s): The invention is directed to methods and materials for the treatment of penile defects by employing an implant comprising corporal cavernosal tissue grown on a support, and in particular to methods and materials useful in the reconstruction of an erectile penis. The penis or phallus, is the male organ of copulation and of urinary excretion, comprising a root, body, and extremity, or glans penis. The structure of the penis consists of two parallel cylindrical bodies, the corpora cavernosa and beneath them the corpus spongiosum, through which the urethra passes. The root of the penis is attached to the descending portions of the pubic bone by the crura, the latter being the extremities of the corpora cavernosa. The urethra runs along the underside of the penis then rises to open at the expanded, cone-shaped tip, the glans penis, which fits like a cap over the end of the penis. The cavema, also called the cavernae, corporum, or cavernosorum penis referred to the caverns of corpora cavernosa of the penis or the dilatable spaces within the corpora cavernosa of the penis, which fill with blood and become distended with erection. Loose skin encloses the penis and also forms the retractable foreskin or prepuce. Corporal, corporeal and corporic are terms used to describe tissues which are derived from the corpora cavernosa or which can be developed, differentiated, or altered by natural or artificial means into corpora cavernosa tissue. A variety of congenital and acquired genitourinary tract abnormalities require surgical reconstruction and/or augmentation of the phallus. Surgeons approaching such diverse conditions as ambiguous genitalia, extrophy-epispadias complex, micropenis, aphallia, severe chordee, clubbed penis, concealed penis, double penis, webbed penis (penis palmatus), penis plastica, impotence, female to male genital reassignment, ventral hypospadias, and retracted phallus (in patients with spinal cord injury and traumatically or surgically acquired penile defects), encounter common difficulties presented by the lack of sufficient normal corporal tissue for satisfactory, functional phalloplasty (Woodhouse, C. R. J.: J. Urol., 152: 645, 1994; Atala, A et al. J. Urol., 150: 745, 1993). Web site: http://www.delphion.com/details?pn=US06514292__ •

Female stimulator comprising close-fitting clitoral suction chamber Inventor(s): Hockhalter; Robert (8126 W. Evergreen La., Frankfort, IL 60423) Assignee(s): None Reported Patent Number: 6,099,463 Date filed: August 3, 1998 Abstract: A female stimulation device is comprised of a tubular suction chamber sized for closely fitting around a clitoris. The suction chamber is connected to a variable partial vacuum source through a tubing. The partial vacuum source may be the mouth of a user or a mechanical device, such as a vacuum bulb or pump. The clitoris is drawn outwardly by the partial vacuum, so that it is engorged with blood to produce a sexually pleasurable sensation. The force of suction may be controlled by a check and suction release valve, which is also used to release the partial vacuum. The front end of the suction chamber is shaped to provide an air-tight but comfortable seal.

26

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Excerpt(s): This invention relates generally to sexual stimulation devices, specifically to a female stimulator. A variety of devices have been developed for stimulating the female genitalia during masturbation or foreplay. The most common is the vibrator, which works by applying pressure, friction, and vibration to the inside or outside of the genitalia. U.S. Pat. No. 4,033,338 to Igwebike (1977) shows a tubular device for insertion into a vagina, and cleaning its interior by suction produced with an internal motor. Being a cleaning device, it does not produce any pleasurable sensations. Web site: http://www.delphion.com/details?pn=US06099463__ •

Gum job Inventor(s): Tyler; John (2010 Helen St., Melbourne, FL 32901) Assignee(s): None Reported Patent Number: 6,244,269 Date filed: April 27, 1999 Abstract: A two piece pliable, edible, flavored mouthpiece to be worn by one consenting adult performing oral sexual activities such as cunnilingus and fellatio, and the like, on another consenting adult. The mouthpiece can be formed from pliable flavored edible materials such as but not limited to starch jellied candies, gelatin candy(i.e. Gummy Bears TM), starch gelatin, licorice, chewing gum, and the like. The mouth piece includes a top U-shaped single piece set for fitting about the front top and partial top side teeth of the wearer, and a bottom U-shaped single piece set for fitting about the front bottom and partial bottom side teeth of the wearer. The wearer clenching down customizes the fit of the mouthpiece therein and changes the sharp hard edges of the teeth to be soft and rounded. Each piece uses more material adjacent to between the front teeth, tapering to less material toward the back of the side teeth. Optionally, at least one of the top and bottom teeth members can have a half circular through hole, through a center portion of the front teeth section to allow a portion of another person's body part such as a tip portion of a person's tongue, nipple, toes, fingers, clitoris, penis, and/or body fluids to pass therethrough. Excerpt(s): This invention relates to sexual novelty products, and in particular to an edible, pliable mouthpiece worn over the front top and bottom teeth rows of a user performing oral sex. Oral sexual activities between consenting adults such as cunnilingus, fellatio, and the like, require one partner to actively utilize their mouth during the activity. Condoms and oral contraceptives/masks are popular types of devices that are used during these activities. However, the primary purpose of these prophylactic type devices are to prevent the spread of infectious sexually transmitted diseases such as AIDS, Herpes, and the like. See for example, U.S. Pat. Nos. 4,949,731 and 5,176,151 to Harding; U.S. Pat. No. 5,016,649 to Johnson; U.S. Pat. No. 5,409,016 to Bloodsaw and U.S. Pat. No. 5,582,187 to Hussey. All of these patents require an absolute shield between the consenting adult partners so that no bodily fluid is exchanged from one partner to the other partner. None of these patents allow the partners to be able to directly contact each other partner's body parts and body fluids between partners already knowing the other partner's health condition. All of these patents cover scenarios when there is a risk of passing a sexually transmitted disease. For example, long married partners would not have a desire for these devices when they wish to use an aid that enhances the oral sexual activity by not restricting contact between the partner's body parts and body fluids. Furthermore, these patents are limited to being formed from materials that while flexible are generally plastic in nature, and would not

Patents 27

be edible. Furthermore, many of these devices are pre-formed into exact shapes and dimensions, and will not conform to the different sized mouths and various sized teeth of various users. Furthermore, many of these devices while flexible donot provide a cushioned surface, and can be both uncomfortable and harmful to the soft human tissue that the devices contact. While the Harding '731 and '151 patents mention that flavor enhancers can be released in their devices, the Harding patents require the entire oral prophylactics be formed from material such as silicone, and the like, which are not normally dissolvable, nor edible to the person using these devices during oral sexual activities. Web site: http://www.delphion.com/details?pn=US06244269__

Patent Applications on Clitoris As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to clitoris: •

Devices and methods for treatment of incontinence Inventor(s): Abrams, Jerome H.; (St. Paul, MN), Hovland, Claire T.; (Andover, MN), Messina, Philip A.; (St. Paul, MN), Olson, Curtis E.; (St. Paul, MN), Robinson, Paul J.; (Mahtomedi, MN) Correspondence: Dicke, Billig & Czaja, P.A.; 701 Building, Suite 1250; 701 Fourth Avenue South; Minneapolis; MN; 55415; US Patent Application Number: 20020120219 Date filed: February 15, 2002 Abstract: Therapeutic devices and methods according to embodiments of the invention alleviate e.g. urinary incontinence in female and male patients. Suction or vacuum, for example, is applied to the genital region, clitoris or clitoral region, the external urethral orifice, and/or other designated areas, e.g. physically stimulating the sacral/pudendal nerves and/or nerve roots and alleviating incontinence. Such embodiments also can encourage or cause clitoral engorgement, or otherwise promote blood flow in the genital region. Vacuum or suction applied to e.g. the clitoris creates a negative pressure in the clitoris that is lower than the systolic blood pressure, tending to promote engorgement of the clitoris with blood. Aspects of the invention are applicable not only to treatment of urinary and fecal incontinence, but also to the treatment of female sexual dysfunction. Aspects of the invention are also applicable to treatment of male incontinence and male erectile dysfunction. Excerpt(s): This application is a Continuation-In-Part of U.S. patent application Ser. No. 09/442,803, filed Nov. 18, 1999, which is incorporated herein by reference; the subject matter of this application also is related to the subject matter of U.S. patent application Ser. No. 60/269,260, priority to which is claimed under 35 U.S.C.sctn. 119(e) and which is incorporated herein by reference. Further, the subject matter of this application is related to the subject matter of U.S. patent application Ser. No. 60/108,959, filed Nov. 18, 1998, and U.S. patent application Ser. No. 60/158,257, filed Oct. 6, 1999, all of which are

6

This has been a common practice outside the United States prior to December 2000.

28

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incorporated herein by reference. The invention relates to devices and methods for treating incontinence. More specifically, particular embodiments of the invention use a variable control vacuum and/or vibratory device or other device to apply suction or other force to the male or female genital region, e.g. the region of the female urethral opening, the clitoral region and/or the vaginal region, or the male penile region. Urinary incontinence is a significant clinical problem and a major source of disability and dependency. Although urinary incontinence is particularly prevalent in the elderly, it affects all age groups. Millions of male and female adult Americans suffer from urinary incontinence, including at least one-half of all nursing home residents. The monetary costs of managing urinary incontinence, and the psychological costs associated with the problem, are great. Fecal incontinence presents similar concerns. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with clitoris, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “clitoris” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on clitoris. You can also use this procedure to view pending patent applications concerning clitoris. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

29

APPENDICES

31

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

7

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

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•

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

•

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.8 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:9 •

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

•

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

•

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

•

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

•

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

•

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

•

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

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 9 See http://www.nlm.nih.gov/databases/databases.html. 8

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•

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

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The NLM Gateway10

The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “clitoris” (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. HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.14 Simply search by “clitoris” (or synonyms) at the following Web site: http://text.nlm.nih.gov. Coffee Break: Tutorials for Biologists15 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.16 Each report is about 400 words and is usually based on a discovery reported in one or

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x. The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 The HSTAT URL is http://hstat.nlm.nih.gov/. 14 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. 15 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 16 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. 10 11

Physician Resources

35

more articles from recently published, peer-reviewed literature.17 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

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

37

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 clitoris 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 clitoris. 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 clitoris. 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.

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You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to clitoris. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Patient Resources

39

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 “clitoris” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “clitoris”. 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 “clitoris” (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 “clitoris” (or a synonym) into the search box, and click “Submit Query.”

41

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

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.18

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

18

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)19: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

19

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

Finding Medical Libraries

43

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries

45

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

47

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

•

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

•

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

•

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

49

CLITORIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acute myelogenous leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute nonlymphocytic leukemia. [NIH] Acute myeloid leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myelogenous leukemia or acute nonlymphocytic leukemia. [NIH] Acute nonlymphocytic leukemia: A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute myelogenous leukemia. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenergic Antagonists: Drugs that bind to but do not activate adrenergic receptors. Adrenergic antagonists block the actions of the endogenous adrenergic transmitters epinephrine and norepinephrine. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH]

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Aged, 80 and Over: A person 80 years of age and older. [NIH] Agenesis: Lack of complete or normal development; congenital absence of an organ or part. [NIH]

Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Androgenic: Producing masculine characteristics. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Angiokeratoma: A vascular, horny neoplasm of the skin characterized by telangiectasis and secondary epithelial changes including acanthosis and hyperkeratosis. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apolipoproteins A: Lipoproteins found in human blood serum in the high-density and very-high-density lipoprotein fraction (HDL, VHDL). They consist of several different polypeptides, the most important of which are apolipoprotein A-I and A-II. They maintain the structural integrity of the HDL particles and are activators of lecithin:cholesterol acyltransferase (LCAT). Atherosclerotic patients show low apolipoprotein A levels and these apolipoproteins are either absent or present in extremely low plasma concentration in Tangier disease. [NIH]

Dictionary 51

Approximate: Approximal [EU] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Baths: The immersion or washing of the body or any of its parts in water or other medium for cleansing or medical treatment. It includes bathing for personal hygiene as well as for medical purposes with the addition of therapeutic agents, such as alkalines, antiseptics, oil, etc. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] 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] Bladder: The organ that stores urine. [NIH] Bladder Exstrophy: Congenital eversion of the urinary bladder. It is characterized by the absence of a portion of the lower abdominal wall and the anterior vesical wall, with eversion of the posterior vesical wall through the deficit. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a

52

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network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [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] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] 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 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]

Dictionary 53

Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Circumcision: Excision of the prepuce or part of it. [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] Clitoral: Pertaining to the clitoris. [EU] Coitus: Sexual intercourse. [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] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [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] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] 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

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tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Constriction: The act of constricting. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [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] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Copulation: Sexual contact of a male with a receptive female usually followed by emission of sperm. Limited to non-human species. For humans use coitus. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyproterone: An anti-androgen that, in the form of its acetate, also has progestational properties. It is used in the treatment of hypersexuality in males, as a palliative in prostatic carcinoma, and, in combination with estrogen, for the therapy of severe acne and hirsutism in females. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cytotoxic: Cell-killing. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Dermoid: A benign mixed tumor, usually congenital, containing teeth, hairs, skin glands, fibrous tissue, and other skin elements, rarely found in the limbal region of the eye and orbit. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] 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]

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Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] 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] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Duodenum: The first part of the small intestine. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [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] Enhancers: Transcriptional element in the virus genome. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [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] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epispadias: Congenital absence of the upper wall of the urethra. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with

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blood. [EU] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogens: A class of sex hormones associated with the development and maintenance of secondary female sex characteristics and control of the cyclical changes in the reproductive cycle. They are also required for pregnancy maintenance and have an anabolic effect on protein metabolism and water retention. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] 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] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Finasteride: An orally active testosterone 5-alpha-reductase inhibitor. It is used as a surgical alternative for treatment of benign prostatic hyperplasia. [NIH] Flatus: Gas passed through the rectum. [NIH] Flutamide: An antiandrogen with about the same potency as cyproterone in rodent and canine species. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] 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]

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Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Genes: Specific sequences of nucleotides along a molecule of DNA (or, in the case of some viruses, RNA) which represent the functional units of heredity. The majority of eukaryotic genes contain coding regions (codons) that are interrupted by non-coding regions (introns) and are therefore labeled split genes. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Granular Cell Tumor: Unusual tumor affecting any site of the body, but most often encountered in the head and neck. Considerable debate has surrounded the histogenesis of this neoplasm; however, it is considered to be a myoblastoma of, usually, a benign nature. It affects women more often than men. When it develops beneath the epidermis or mucous membrane, it can lead to proliferation of the squamous cells and mimic squamous cell carcinoma. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] 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] Gynecology: A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology. [NIH] Hemangiopericytoma: A type of cancer involving blood vessels and soft tissue. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [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] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H,

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atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperkeratosis: 1. Hypertrophy of the corneous layer of the skin. 2a. Any of various conditions marked by hyperkeratosis. 2b. A disease of cattle marked by thickening and wringling of the hide and formation of papillary outgrowths on the buccal mucous membranes, often accompanied by watery discharge from eyes and nose, diarrhoea, loss of condition, and abortion of pregnant animals, and now believed to result from ingestion of the chlorinated naphthalene of various lubricating oils. [EU] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypospadias: A developmental anomaly in the male in which the urethra opens on the underside of the penis or on the perineum. [NIH] Hysterectomy: Excision of the uterus. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immersion: The placing of a body or a part thereof into a liquid. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impotence: The inability to perform sexual intercourse. [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] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] 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

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signs of pain, heat, redness, swelling, and loss of function. [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] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interpersonal Relations: The reciprocal interaction of two or more persons. [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] Involuntary: Reaction occurring without intention or volition. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [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] 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] Leukemia: Cancer of blood-forming tissue. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Lipid: Fat. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH]

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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] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lubricants: Oily or slippery substances. [NIH] Lubrication: The application of a substance to diminish friction between two surfaces. It may refer to oils, greases, and similar substances for the lubrication of medical equipment but it can be used for the application of substances to tissue to reduce friction, such as lotions for skin and vaginal lubricants. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenectomy: A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer. Also called lymph node dissection. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malformation: A morphologic developmental process. [EU]

defect

resulting

from

an

intrinsically

abnormal

Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Masturbation: Sexual stimulation or gratification of the self. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH]

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Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] Neurofibroma: A fibrous tumor, usually benign, arising from the nerve sheath or the endoneurium. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH]

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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] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [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] 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] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [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] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue

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enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perineum: The area between the anus and the sex organs. [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] Phallic: Pertaining to the phallus, or penis. [EU] 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] 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] Phimosis: The inability to retract the foreskin over the glans penis due to tightness of the prepuce. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] 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] Pilonidal Sinus: A hair-containing cyst or sinus, occurring chiefly in the coccygeal region. [NIH]

Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the

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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] Pneumonia: Inflammation of the lungs. [NIH] Polyglycolic Acid: Poly(oxy(1-oxo-1,2-ethanediyl)). A biocompatible polymer used as a surgical suture material. [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] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Pregnancy Maintenance: Physiological mechanisms that sustain the state of pregnancy. [NIH]

Prepuce: A covering fold of skin; often used alone to designate the preputium penis. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Priapism: Persistent abnormal erection of the penis, usually without sexual desire, and accompanied by pain and tenderness. It is seen in diseases and injuries of the spinal cord, and may be caused by vesical calculus and certain injuries to the penis. [EU] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate

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the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychosexual: Pertaining to the mental aspects of sex. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] 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] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Renal capsule: The fibrous connective tissue that surrounds each kidney. [NIH]

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Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retractor: An instrument designed for pulling aside tissues to improve exposure at operation; an instrument for drawing back the edge of a wound. [NIH] Rhabdoid tumor: A malignant tumor of either the central nervous system (CNS) or the kidney. Malignant rhabdoid tumors of the CNS often have an abnormality of chromosome 22. These tumors usually occur in children younger than 2 years. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] 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] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary

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cancer. [NIH] Seminal vesicles: Glands that help produce semen. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [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] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] 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] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH]

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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] Sperm: The fecundating fluid of the male. [NIH] Sphincters: Any annular muscle closing an orifice. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] 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] 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]

Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strangulation: Extreme compression or constriction of the trachea or of any part. [NIH] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suspensory: Supporting a part. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [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

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homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Systolic blood pressure: The maximum pressure in the artery produced as the heart contracts and blood begins to flow. [NIH] Testicle: The male gonad where, in adult life, spermatozoa develop; the testis. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Tourniquet: A device, band or elastic tube applied temporarily to press upon an artery to stop bleeding; a device to compress a blood vessel in order to stop bleeding. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] 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] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] 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]

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Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [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] Urinate: To release urine from the bladder to the outside. [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] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urogenital Abnormalities: Congenital structural abnormalities of the urogenital system. [NIH]

Urogenital System: All the organs involved in reproduction and the formation and release of urine. It includes the kidneys, ureters, bladder, urethra, and the organs of reproduction ovaries, uterus, fallopian tubes, vagina, and clitoris in women and the testes, seminal vesicles, prostate, seminal ducts, and penis in men. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoactive: Exerting an effect upon the calibre of blood vessels. [EU] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venter: Belly. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some

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viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vocal cord: The vocal folds of the larynx. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

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INDEX A Abdomen, 6, 49, 59, 62, 68, 69 Abdominal, 3, 49, 51, 62 Acetylcholine, 49, 62 Acne, 6, 49, 54 Acute myelogenous leukemia, 49 Acute myeloid leukemia, 49 Acute nonlymphocytic leukemia, 10, 49 Adjuvant, 49, 57 Adrenergic, 5, 49, 55 Adrenergic Antagonists, 5, 49 Adverse Effect, 6, 49, 67 Affinity, 49, 67 Age Groups, 28, 49 Aged, 80 and Over, 49, 50 Agenesis, 9, 50 Airway, 50, 67 Alkaline, 12, 50, 52 Alkaline Phosphatase, 12, 50 Amino acid, 50, 51, 58, 62, 64, 65, 69 Amputation, 7, 8, 50 Anabolic, 50, 56 Anal, 50, 56 Androgenic, 5, 50 Androgens, 5, 6, 50 Anemia, 50, 57 Angiokeratoma, 8, 50 Animal model, 5, 50 Anomalies, 7, 50 Anorectal, 3, 50 Anus, 50, 59, 63 Apnea, 50 Apolipoproteins, 6, 50, 59 Apolipoproteins A, 6, 50 Approximate, 5, 51 Arachidonic Acid, 51, 64 Arginine, 51, 62 Arterial, 51, 53, 69 Arteries, 51, 52, 54, 60, 61 Artery, 51, 54, 69, 70 Auditory, 51, 56 Autoimmune disease, 51, 61 Axons, 51, 61, 64 B Bacteria, 51, 56, 69 Bacteriophage, 51, 69 Baths, 5, 51 Benign, 51, 54, 56, 57, 61, 66

Bile, 51, 56, 59, 68 Biological therapy, 51, 57 Bladder, 3, 9, 51, 58, 61, 65, 70 Bladder Exstrophy, 3, 51 Blood Cell Count, 51, 57 Blood pressure, 51, 67 Blood vessel, 51, 52, 53, 55, 57, 60, 67, 69, 70 Body Fluids, 26, 52, 67 Bone Marrow, 49, 52 Bone scan, 52, 66 Bradykinin, 52, 62 Branch, 52, 67, 69 C Calcium, 52, 67 Capsules, 52, 57 Carcinogenic, 52, 68 Carcinoma, 8, 9, 15, 17, 52, 54 Cardiac, 52, 55, 61, 68 Cardiovascular, 6, 52 Case report, 10, 11, 12, 14, 16, 52 Caudal, 52, 64 Cell, 12, 13, 51, 52, 53, 54, 55, 56, 57, 59, 61, 62, 63, 64, 65, 67, 69 Cell Differentiation, 52, 67 Cell Division, 51, 52, 57, 63 Cell proliferation, 52, 67 Cell Survival, 52, 57 Central Nervous System, 49, 53, 56, 61, 66 Centrifugation, 53, 57 Chin, 13, 53, 61 Cholesterol, 50, 51, 53, 59, 60, 68 Cholesterol Esters, 53, 59 Chromosome, 53, 66 Chronic, 4, 53 Chylomicrons, 53, 59 Circumcision, 11, 15, 53 Clinical trial, 4, 53, 55, 65 Clitoral, 5, 6, 24, 25, 27, 28, 53 Coitus, 53, 54 Collagen, 24, 50, 53, 57, 64 Collapse, 53, 67 Compress, 53, 69 Computed tomography, 53, 66 Cone, 25, 53, 68 Connective Tissue, 17, 24, 52, 53, 54, 56, 57, 60, 65 Connective Tissue Cells, 53, 54

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Constriction, 54, 68 Contractility, 5, 54 Contraindications, ii, 54 Coordination, 54, 61 Copulation, 25, 54 Coronary, 54, 61 Coronary Thrombosis, 54, 61 Corpus, 13, 24, 25, 54, 63, 64 Cortex, 54, 56, 64 Cutaneous, 14, 54 Cyclic, 54, 57, 62, 65 Cyproterone, 54, 56 Cyst, 11, 15, 54, 63 Cytotoxic, 54, 67 D Density, 50, 53, 54, 59 Depolarization, 54, 67 Dermis, 54, 69 Dermoid, 13, 54 Deuterium, 6, 54, 58 Diagnostic procedure, 23, 54 Digestion, 51, 54, 59, 68 Digestive tract, 54, 67, 68 Dilution, 6, 55 Direct, iii, 55, 65, 68 Dissection, 55, 60 Distal, 55, 64, 65 Dorsal, 9, 11, 55, 64 Double-blind, 6, 55 Duodenum, 51, 55, 68 E Elastic, 55, 69 Elastin, 53, 55 Electrolyte, 55, 67 Endocrinology, 55, 57 Endogenous, 49, 55 Endothelium, 55, 62 Endothelium-derived, 55, 62 Enhancers, 27, 55 Enzyme, 50, 55, 57, 65, 67, 71 Epidermis, 54, 55, 57, 59 Epidermoid carcinoma, 55, 68 Epinephrine, 49, 55, 62 Epispadias, 25, 55 Epithelial, 50, 55 Erectile, 17, 24, 25, 27, 55, 62 Erection, 25, 55, 64 Esophagus, 54, 56, 68 Estradiol, 6, 56 Estrogens, 5, 56 Evoked Potentials, 9, 11, 56 Extracellular, 53, 54, 56, 67

Extracellular Matrix, 53, 54, 56 Extremity, 25, 56, 66 F Fallopian tube, 56, 70 Fat, 6, 51, 52, 56, 59, 61, 66, 67 Fatty acids, 56, 64 Fecal Incontinence, 27, 56, 58 Feces, 56, 68 Fibrosis, 13, 56, 66 Finasteride, 6, 56 Flatus, 56 Flutamide, 6, 56 Fold, 56, 64 Friction, 26, 56, 60 G Gallbladder, 49, 56 Gas, 56, 58, 62, 68 Gastrin, 57 Gelatin, 26, 57, 68 Genes, 57, 63, 69 Genital, 4, 5, 6, 14, 24, 25, 27, 28, 57, 70 Genitourinary, 25, 57, 70 Genotype, 57, 63 Glucose, 57, 59, 66 Gonad, 57, 69 Gonadal, 5, 57, 68 Granular Cell Tumor, 13, 57 Granulocytes, 57, 67 Growth, 5, 6, 7, 50, 52, 57, 60, 61, 63, 66, 69 Growth factors, 5, 57 Guanylate Cyclase, 57, 62 Gynecology, 7, 8, 10, 11, 12, 14, 15, 17, 57 H Hemangiopericytoma, 10, 57 Hematocrit, 6, 51, 57 Hormone, 7, 55, 56, 57, 59, 64, 67, 69 Hydrogen, 54, 57, 61 Hydrophobic, 58, 59 Hydroxylysine, 53, 58 Hydroxyproline, 50, 53, 58 Hyperkeratosis, 50, 58 Hyperplasia, 56, 58 Hypertrophy, 7, 58 Hypospadias, 25, 58 Hysterectomy, 4, 58 I Id, 20, 58 Immersion, 51, 58 Impairment, 58, 61 Impotence, 25, 55, 58 In vitro, 5, 58 In vivo, 5, 58

Index 75

Incontinence, 27, 28, 58 Indicative, 58, 70 Induction, 50, 58 Infant, Newborn, 49, 58 Infarction, 54, 58, 61 Inflammation, 6, 49, 56, 58, 64 Innervation, 15, 59, 66, 69 Insulator, 59, 61 Insulin, 6, 59 Insulin-dependent diabetes mellitus, 59 Interpersonal Relations, 4, 59 Intestinal, 7, 59 Intestines, 49, 54, 56, 59 Intracellular, 59, 62, 65, 67 Involuntary, 56, 59, 61 J Joint, 59, 68 K Keratin, 59, 66 L Larynx, 59, 69, 71 Leukemia, 59 Libido, 50, 59 Library Services, 59 Ligament, 17, 24, 56, 59, 65 Lipid, 50, 59, 61 Lipoprotein, 6, 50, 59, 60 Liver, 6, 49, 51, 56, 59, 60, 66 Liver scan, 60, 66 Low-density lipoprotein, 59, 60 Lubricants, 60 Lubrication, 4, 60 Lumbar, 60, 66, 69 Lymph, 55, 60 Lymph node, 60 Lymphadenectomy, 15, 60 M Magnetic Resonance Imaging, 60, 66 Malformation, 9, 60 Malignant, 14, 60, 61, 66 Malignant tumor, 60, 66 Masturbation, 26, 60 Medial, 60, 69 Melanocytes, 60 Melanoma, 13, 60 Membrane, 54, 56, 57, 59, 60, 63, 67 Memory, 6, 60 Menopause, 4, 60 Menstruation, 60 Mental, iv, 4, 7, 53, 60, 61, 65 Mental Retardation, 7, 61 Metastasis, 9, 61

MI, 47, 61 Modification, 17, 50, 61, 65 Molecule, 55, 57, 61, 65, 67, 70 Morphology, 5, 61 Multiple sclerosis, 11, 61 Myelin, 61 Myocardium, 61 N Need, 3, 4, 61 Neoplasm, 10, 50, 57, 61, 69 Nerve, 5, 9, 11, 12, 13, 14, 27, 49, 51, 53, 59, 61, 64, 66, 68, 69, 70 Nerve Endings, 12, 61 Nerve Fibers, 13, 61, 69 Nervous System, 53, 61, 62, 63 Neuroeffector Junction, 61 Neurofibroma, 8, 14, 61 Neurogenic, 5, 61 Neurons, 61, 62, 68 Neuropeptide, 13, 62 Neurotransmitter, 49, 50, 52, 62, 67 Nitric Oxide, 5, 12, 62 Nitrogen, 50, 62, 69 Norepinephrine, 49, 62 Nucleus, 54, 62 O Orbit, 54, 62 Orgasm, 4, 17, 62 Ovaries, 5, 62, 67, 70 Ovary, 56, 57, 62 P Pancreas, 49, 59, 62 Patch, 62, 69 Pathogenesis, 13, 62 Pelvic, 5, 6, 15, 17, 62, 65 Pelvis, 49, 60, 62, 70 Penis, 5, 7, 9, 10, 11, 13, 14, 16, 25, 26, 58, 62, 63, 64, 70 Perception, 53, 63 Perineum, 24, 58, 63 Peripheral Nervous System, 62, 63, 64, 66 Phallic, 18, 63 Pharmaceutical Preparations, 57, 63 Phenotype, 5, 63 Phimosis, 15, 17, 63 Phospholipases, 63, 67 Phospholipids, 56, 59, 63 Physiologic, 4, 60, 63, 64, 65 Physiology, 55, 57, 63 Pilonidal Sinus, 7, 63 Pitch, 6, 63 Placenta, 56, 63, 64

76

Clitoris

Plants, 57, 61, 62, 63, 66 Plasma, 6, 50, 53, 57, 63 Platelet Activation, 63, 67 Platelet Aggregation, 62, 64 Platelets, 62, 64 Pneumonia, 54, 64 Polyglycolic Acid, 24, 64 Posterior, 9, 50, 51, 55, 62, 64 Postnatal, 5, 64 Postoperative, 24, 64 Postsynaptic, 61, 64, 67 Potentiation, 64, 67 Pregnancy Maintenance, 56, 64 Prepuce, 15, 24, 25, 53, 63, 64 Presynaptic, 61, 62, 64 Presynaptic Terminals, 61, 64 Prevalence, 17, 64 Priapism, 13, 15, 16, 64 Progesterone, 64, 68 Progression, 50, 64 Progressive, 4, 52, 57, 63, 64, 69 Proline, 53, 58, 64 Prostaglandin, 11, 20, 64 Prostaglandins A, 65 Prostate, 65, 70 Protein C, 50, 51, 59, 65 Proteins, 50, 53, 59, 61, 62, 63, 65, 67 Proximal, 24, 55, 64, 65 Psychic, 59, 61, 65 Psychosexual, 4, 65 Q Quality of Life, 4, 65 R Radiation, 65, 66, 71 Radioactive, 52, 58, 60, 65, 66 Randomized, 6, 65 Receptor, 5, 53, 56, 65, 67 Rectum, 50, 54, 56, 58, 65, 68 Reductase, 56, 65 Refer, 1, 60, 65 Regeneration, 24, 65 Renal capsule, 5, 65 Retinal, 53, 66 Retractor, 24, 66 Rhabdoid tumor, 14, 66 Risk factor, 4, 6, 66 S Saponins, 66, 68 Scans, 6, 66 Schwannoma, 14, 16, 66 Sciatic Nerve, 66, 69 Sclerosis, 61, 66

Screening, 53, 66 Sebaceous, 54, 66 Sebaceous gland, 54, 66 Sebum, 6, 66 Secondary tumor, 61, 66 Seminal vesicles, 67, 70 Serum, 6, 50, 60, 67 Sex Characteristics, 50, 56, 67, 69 Sexually Transmitted Diseases, 26, 67 Side effect, 6, 49, 51, 67 Signal Transduction, 5, 67 Skeletal, 5, 50, 67 Skeleton, 59, 65, 67 Sleep apnea, 6, 67 Small intestine, 53, 55, 57, 59, 67 Smooth muscle, 5, 24, 54, 67 Social Environment, 65, 67 Sodium, 6, 67 Soft tissue, 52, 57, 67 Specialist, 67 Species, 54, 55, 56, 68, 69, 71 Sperm, 50, 53, 54, 68 Sphincters, 56, 68 Spinal cord, 25, 53, 61, 63, 64, 66, 68 Squamous, 10, 55, 57, 68 Squamous cell carcinoma, 10, 55, 57, 68 Squamous cells, 57, 68 Staging, 66, 68 Steroid, 5, 66, 68 Stimulus, 54, 56, 59, 68 Stomach, 9, 49, 54, 56, 57, 59, 67, 68 Stool, 58, 68 Strangulation, 7, 68 Suction, 24, 25, 26, 27, 28, 68 Suppositories, 57, 68 Suspensory, 17, 24, 68 Symphysis, 24, 53, 65, 68 Synapse, 49, 61, 64, 68 Synaptic, 62, 67, 68 Systolic, 24, 27, 69 Systolic blood pressure, 24, 27, 69 T Testicle, 14, 57, 69 Testis, 56, 69 Testosterone, 6, 56, 65, 69 Thigh, 6, 69 Thorax, 49, 60, 69 Tibial Nerve, 9, 66, 69 Tissue, 5, 24, 25, 27, 51, 52, 53, 54, 55, 56, 58, 59, 60, 61, 62, 64, 65, 67, 68, 69 Tomography, 53, 66, 69 Tone, 5, 69

Index 77

Tonus, 69 Tourniquet, 7, 9, 12, 69 Trachea, 59, 68, 69 Transdermal, 6, 69 Transduction, 5, 67, 69 Transplantation, 5, 69 Tryptophan, 53, 69 Tumour, 14, 69 Tunica, 24, 69 U Ultrasonography, 11, 20, 70 Unconscious, 58, 70 Ureters, 70 Urethra, 8, 17, 18, 25, 55, 58, 63, 65, 70 Urinary, 3, 25, 27, 28, 51, 57, 58, 70 Urinary tract, 3, 70 Urinate, 5, 70 Urine, 51, 58, 70 Urogenital, 3, 5, 17, 57, 70 Urogenital Abnormalities, 4, 70 Urogenital System, 5, 70 Uterus, 54, 58, 60, 62, 64, 70

V Vagina, 3, 5, 26, 60, 70 Vaginal, 5, 17, 18, 28, 60, 70 Vascular, 4, 24, 50, 54, 55, 58, 62, 63, 70 Vasoactive, 4, 70 Vasodilators, 62, 70 Vector, 69, 70 Vein, 5, 70 Venter, 70 Ventral, 25, 70 Ventricle, 69, 70 Vertebrae, 68, 70 Viral, 69, 70 Virus, 51, 55, 69, 70 Vitro, 71 Vivo, 5, 71 Vocal cord, 6, 71 X Xenograft, 50, 71 X-ray, 53, 66, 71 Y Yeasts, 63, 71

78

Clitoris

Index 79

80

Clitoris

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