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

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

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GALLBLADDER DISEASE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

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

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2003 by ICON Group International, Inc. Copyright ©2003 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., 1960Gallbladder Disease: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83919-0 1. Gallbladder Disease-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on gallbladder disease. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON GALLBLADDER DISEASE ........................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Gallbladder Disease....................................................................... 6 The National Library of Medicine: PubMed ................................................................................ 12 CHAPTER 2. NUTRITION AND GALLBLADDER DISEASE ................................................................. 49 Overview...................................................................................................................................... 49 Finding Nutrition Studies on Gallbladder Disease...................................................................... 49 Federal Resources on Nutrition ................................................................................................... 51 Additional Web Resources ........................................................................................................... 51 CHAPTER 3. ALTERNATIVE MEDICINE AND GALLBLADDER DISEASE ........................................... 53 Overview...................................................................................................................................... 53 National Center for Complementary and Alternative Medicine.................................................. 53 Additional Web Resources ........................................................................................................... 54 General References ....................................................................................................................... 56 CHAPTER 4. DISSERTATIONS ON GALLBLADDER DISEASE ............................................................. 57 Overview...................................................................................................................................... 57 Dissertations on Gallbladder Disease .......................................................................................... 57 Keeping Current .......................................................................................................................... 57 CHAPTER 5. CLINICAL TRIALS AND GALLBLADDER DISEASE ........................................................ 59 Overview...................................................................................................................................... 59 Recent Trials on Gallbladder Disease........................................................................................... 59 Keeping Current on Clinical Trials ............................................................................................. 60 CHAPTER 6. BOOKS ON GALLBLADDER DISEASE ........................................................................... 63 Overview...................................................................................................................................... 63 Book Summaries: Federal Agencies.............................................................................................. 63 Book Summaries: Online Booksellers........................................................................................... 67 The National Library of Medicine Book Index ............................................................................. 68 Chapters on Gallbladder Disease.................................................................................................. 69 CHAPTER 7. MULTIMEDIA ON GALLBLADDER DISEASE ................................................................. 71 Overview...................................................................................................................................... 71 Video Recordings ......................................................................................................................... 71 Bibliography: Multimedia on Gallbladder Disease ...................................................................... 72 CHAPTER 8. PERIODICALS AND NEWS ON GALLBLADDER DISEASE .............................................. 73 Overview...................................................................................................................................... 73 News Services and Press Releases................................................................................................ 73 Newsletter Articles ...................................................................................................................... 75 Academic Periodicals covering Gallbladder Disease .................................................................... 76 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 79 Overview...................................................................................................................................... 79 NIH Guidelines............................................................................................................................ 79 NIH Databases............................................................................................................................. 81 Other Commercial Databases....................................................................................................... 84 APPENDIX B. PATIENT RESOURCES ................................................................................................. 85 Overview...................................................................................................................................... 85 Patient Guideline Sources............................................................................................................ 85 Finding Associations.................................................................................................................... 88 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 91 Overview...................................................................................................................................... 91 Preparation................................................................................................................................... 91

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Finding a Local Medical Library.................................................................................................. 91 Medical Libraries in the U.S. and Canada ................................................................................... 91 ONLINE GLOSSARIES.................................................................................................................. 97 Online Dictionary Directories ..................................................................................................... 99 GALLBLADDER DISEASE DICTIONARY ............................................................................. 101 INDEX .............................................................................................................................................. 137

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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 gallbladder disease is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about gallbladder disease, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to gallbladder disease, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on gallbladder disease. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to gallbladder disease, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on gallbladder disease. The Editors

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

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

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

Gallbladder Disease and Coronary Artery Disease: Is There a Link? Source: Journal of the American Osteopathic Association. 91(4): 359-361. April 1991. Summary: Both gallstones and coronary artery disease are associated with cholesterol. This article reports on a literature search that attempted to find evidence that gallbladder disease can be considered a risk factor for coronary artery disease. Studies designed to discover whether lipid profiles associated with gallbladder disease are similar to those associated with coronary artery disease have shown contradictory results. Autopsy studies have indicated that atherosclerosis appeared to be more extensive in patients with gallstones, but it was unclear whether the relationship was causal or merely reflected coincidental factors of some other origin. A study attempting to find a relationship between gallstone formation and a low-cholesterol diet actually

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showed a higher rate of gallstone formation among the patients on the low-cholesterol diet. The author offers possible explanations for the results of these various studies. 10 references. (AA-M). •

Endoscopic Ultrasound for Chronic Abdominal Pain and Gallbladder Disease Source: Gastroenterology Nursing. 22(5): 209-212. September-October 1999. Contact: Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (410) 528-8555. Summary: Endoscopic ultrasound (EUS) is a major advance in gastrointestinal endoscopy. This article describes the use of EUS for chronic abdominal pain and for gallbladder disease. EUS combined with stimulated biliary drainage (EUS or SBD) aids in the diagnosis of choledocholithiasis (biliary tract stones), cholecystitis (gallbladder infection), microlithiasis (stones), and various conditions of the upper gastrointestinal tract. The authors describe the EUS SBD procedure and the associated nursing care. A significant number of patients with chronic abdominal pain are diagnosed with gallbladder disease with this endoscopic procedure and, after undergoing cholecystectomy, are relieved of their pain. The authors also present two brief case histories that illustrate the potential benefits of this technique to patients. 2 figures. 10 references.

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Gallbladder Disease and Use of Noncontraceptive Estrogens Source: Geriatric Medicine Today. 9(3): 56, 59-60, 62-63. March 1990. Summary: Epidemiologic data on the physiological effects of estrogen support the contention that use of postmenopausal estrogen increases the risk of gallbladder disease during periods of current use. This article reviews three studies in which ultrasound was used for the diagnosis of gallbladder disease. Results showed no association between estrogen use and an increased risk of gallstones, however, suggesting that estrogens may precipitate symptoms in women with gallstones or may lead to referral of such women for surgery. Topics include implications for prescribing estrogens universally; costs, including those of morbidity and mortality as well as financial costs of gallstone surgery; and the effect of the present standard of estrogen combined with progestin on the risk of surgery for gallbladder disease in postmenopausal women. 1 table. 23 references. (AA-M).

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Liver and Gallbladder Disease Before and After Very-Low-Calorie Diets Source: American Journal of Clinical Nutrition. 56(1): 235S-239S. July 1992. Summary: In this article, hepatobiliary characteristics of untreated obese patients and those of patients reducing weight through very-low-calorie diets (VLCDs) are reviewed. Topics include liver morphology, liver function tests changes in hepatic metabolism, and bile and gallbladder disease in untreated obesity. The author then considers changes in liver morphology after VLCD, metabolic changes after VLCD, and the effect of VLCD on bile and gallstone formation. The author stresses that the positive as well as the deleterious effects of VLCD on liver and bile make it relevant for supervising physicians to consider this organ system. 57 references.

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Right Upper Quadrant Calcification: Porcelain Gallbladder Disease Source: American Family Physician. 45(5): 2171-2174. May 1992.

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Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. Summary: Large solitary calcification in the right upper quadrant is rarely seen in the United States. It may indicate disease in the gallbladder, adrenal glands, kidneys, pancreas, lungs, or chest wall. Disease processes associated with calcification in these organs include echinococcal cysts, calcified renal cysts, chest wall masses, and degenerative cystic lesions of the pancreas and adrenal glands. However, if calcification is associated with porcelain gallbladder, the incidence of carcinoma is high. This article notes that porcelain gallbladder disease is rare and that patients are usually asymptomatic. Treatment consists of cholecystectomy with a careful search for malignancy. The authors present the case of a 61 year old woman with hypertension and diabetes who presented with an eight month history of pain in the right upper quadrant. After a battery of diagnostic tests, surgery was performed, at which the gallbladder was found to be enlarged, white, and rock hard. Cholecystectomy was performed, and a cholangiogram was normal. No stones were seen, and no evidence of malignancy was found on light microscopy. The postoperative course was uneventful, and the patient remained asymptomatic 15 months later. 2 figures. 11 references. (AA-M). •

Recognizing and Treating Hepatobiliary Disease in the Critically Ill Source: Journal of Critical Illness. 14(9): 501-511. September 1999. Contact: Available from Cliggott Publishing Company. 55 Holly Hill Lane, Greenwich, CT 06831-0010. (203) 661-0600. Summary: This article discusses the recognition and treatment of hepatobiliary (liver and bile tract) disease in the critically ill patient. The authors first describe the common causes of abnormal biochemical liver test results in ICU patients. The authors then outline a clinical approach that includes the differentiation of biliary and nonbiliary causes of liver test abnormalities. The authors also review both typical and atypical presentations of cholecystitis (gallbladder infection or inflammation), cholangitis (inflammation of the bile duct), and gallstone pancreatitis. The authors stress that, since the clinical manifestations of biliary disease in these patients are often atypical, effective diagnosis requires alertness and the judicious use of radiologic tests. Liver test abnormalities with systemic causes (such as sepsis, drugs, and hypotension) resolve with improvement of the underlying condition. In patients with acute calculous biliary disease, septic shock can ensue rapidly; early diagnosis and appropriate intervention may be lifesaving. Critically ill patients have much comorbidity and an increased surgical risk, so conventional, definitive therapy (such as open or laparoscopic surgery) may not be appropriate. Often, the best therapeutic approach comprises temporizing measures, such as simple biliary drainage for cholangitis, and minimally invasive techniques, such as percutaneous (through the skin) drainage for acute cholecystitis. 6 figures. 2 tables. 37 references.

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Don't Accept Gallbladder Disease as a Fact of Life Source: Digestive Health and Nutrition. p. 8-11. November-December 2002. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: This article explores the causes of gallstones (cholelithiasis) and offers strategies for preventing their recurrence. Topics include the symptoms of a typical

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gallstone attack, dietary risk factors, how gallstones form, the epidemiology of gallstones, the role of genetics, strategies for preventing gallstones through diet, the importance of weight loss, diagnostic tests used to confirm gallstones, and treatment strategies, including surgical removal, and laparoscopic removal of the gallbladder (cholecystectomy). The author stresses that healthy, slow weight loss along with a balanced diet and moderate exercise is the key. The article concludes with two web site addresses through which readers can obtain more information. •

The Role of Laparoscopy in Hepatobiliary Disease Source: Practical Gastroenterology. 20(4): 23-24, 26-28, 30, 35-36, 38. April 1996. Contact: Available from Shugar Publishing, Inc. 99B Main Street, Westhampton Beach, NY 11978. (631) 288-4404. Fax (631) 288-4435. E-Mail: [email protected]. Summary: This article, the fourth in a series on surgery of the gastrointestinal (GI) tract, describes the role of laparoscopy in hepatobiliary disease. The authors bring readers up to date concerning the status of laparoscopic cholecystectomy and define the role of laparoscopy for the management of common bile duct pathology, obstructive jaundice secondary to periampullary tumors, and portal hypertension. After a brief discussion of the contraindications for laparoscopic cholecystectomy, the authors outline the procedure itself, including positioning, the initial exposure, operative cholangiography, gallbladder dissection, gallbladder removal, and final inspection. Complications include common bile duct injury, cystic duct leakage, lost gallstones, bowel injury, urinary tract injury, ventral hernia, gas embolism, insufflation agent complications, wound infection, and the risks of anesthesia. 7 figures. 14 references. (AA-M).

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Trends in Gallbladder Disease and Treatment Source: Practical Gastroenterology. 16(3): 19-20, 23-24, 26, 29-30, 35. March 1992. Summary: This review article summarizes recent trends in gallbladder disease and treatment. Topics include populations at risk for gallbladder disease, risk factors for gallstones, associated disease states, the natural history of gallbladder stones, therapeutic intervention, acute cholecystitis, noncalculous cholecystitis, chronic acalculous cholecystitis, porcelain gallbladder (calcified gallbladder), gallbladder cancer, surgical treatment options, laparoscopic treatment, nonsurgical treatment options, gallstone dissolution therapy, extracorporeal shock-wave lithotripsy (ESWL), percutaneous cholecystectomy, the risks of gallbladder-preserving therapies, and gallbladder ablation. 2 tables. 63 references.

Federally Funded Research on Gallbladder Disease The U.S. Government supports a variety of research studies relating to gallbladder disease. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions.

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

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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 gallbladder disease. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore gallbladder disease. The following is typical of the type of information found when searching the CRISP database for gallbladder disease: •

Project Title: A DEVICE FOR PHYSICAL ACTIVITY AND ENERGY EXPENDITURE Principal Investigator & Institution: Sun, Ming; Minisun, Inc. 935 E Millcreek Dr Fresno, Ca 93720 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-JUL-2003 Summary: (provided by applicant): Physical activity (PA) is fundamental to human life. With comfort and easiness as the goal, automation and modernization in the past 50 years has dramatically reduced our PA, and completely changed our life style and work environment. Sudden decrease in physical activity can lead to body energy imbalance and diseases such as obesity and cardiovascular dysfunction, as evidenced by NHLBI recently announcement: "About 97 million adults in the United States are overweight or obese. Obesity and overweight substantially increase the risk of morbidity from hypertension; dyslipidemia; type 2 diabetes; coronary heart disease; stroke; gallbladder disease; osteoarthritis; sleep apnea and respiratory problems; and endometrial, breast, prostate, and colon cancers." The government health website (http:/Iwww.health.govlhealthypeop(e/LHI/) lists PA as the leading health indicator for the Nation over the next 10 years. Considering that 10% of positive energy imbalance can lead to 15 lbs of weight increase per year, an accurate device for quantifying PA and energy expenditure (EE) in free-living conditions becomes critical. This proposal plans to improve and validate Intelligent Device for Energy Expenditure and Activity (IDEEA), developed by MiniSun LLC. for measuring PA and EE in free-living humans. The prototype demonstrated dramatic improvement and technical breakthroughs in functions and accuracy over previously available devices. The device records body posture and movement for 24-hrs or longer with time accuracy to sub-second, identifies 21 types of postures, 17 types of limb movement and posture transitions, and 6 types of major PA, including sleeping, reclining, sitting, standing, walking, ascending stairs, descending stairs, running, and jumping with 98.5% accuracy. IDEEA also computes the distance and speed of locomotion, the mechanical work and power of PA, and estimated EE of these activities using the state-of-art methods and techniques. We plan to improve the hardware/software design for ease of use by researchers and to reduce the production cost. We also plan clinical studies to further validate the device. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CFTR AND DUODENAL ANION TRANSPORT Principal Investigator & Institution: Clarke, Lane L.; Associate Professor; Dalton Research Center; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2001; Project Start 01-AUG-1995; Project End 30-NOV-2004 Summary: (Adapted from the Applicant's Abstract): The central role that the cystic fibrosis transmembrane conductance regulator (CFTR) plays in gastrointestinal anion transport physiology is evident from the intestinal and pancreatic manifestations of the genetic disease cystic fibrosis (CF). CFFR is essential to normal Cl- and HCO3- secretion

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across epithelial surfaces. Loss of this function in CF has been closely associated with disease processes such as distal obstructive syndrome, meconium ileus, pancreatic insufficiency, gallbladder disease and duodenal ulceration. Furthermore, the inability of the senescent epithelial cells to unload base may interfere with apoptosis, leading to necrotic cell death and accompanying inflammatory reactions that underlie CF pathogenesis. The present proposal focuses on the role that CFTR plays in mechanisms of Cl- and HCO3- secretion in the duodenum. Although anion secretion across this intestinal segment maintains a critical barrier to gastric effluent, little is known of the electrochemical gradients for anion secretion, the identity of anion exchange proteins that coordinate activity with CFTR, or the distribution of these processes along the crypt-villus axis. Studies will be performed on intact duodenum from geneticallyaltered CF mouse models because they accurately reproduce human CF intestinal disease. Knockout mouse models of other anion transport proteins will be used to dissect the mechanism of Cl- and HCO3- secretion in a physiological setting. We will test several hypotheses predicted from our proposed model of duodenal anion secretion. Microelectrodes and fluorescent dye markers will be used to investigate the hypothesis that CFTR functions as both a Cl- and HCO3- conductance. RT-PCR and immunoblots of normal and CF duodenal epithelia will be used to identify the effect of CFTR activity on anion transport protein expression along the crypt-villus axis. In addition, membrane vesicle and transepithelial flux studies will be used to test the hypothesis that the anion exchanger AE2 provides an alternative Cl- uptake mechanism for transepithelial Cl- secretion whereas the anion exchanger DRA, possibly driven by carbonic anhydrase, operates in parallel with CFTR for transepithelial HCO3- secretion. The successful completion of our proposed studies will firmly establish the mechanisms involved in Cl- and HCO3- secretion across the duodenum. The results will further define the role of CFTR in these processes and therefore have important implications for our understanding of intestinal pathophysiology in CF disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CHANGING CAFETERIA PORTION SIZES TO PREVENT WEIGHT GAIN Principal Investigator & Institution: Volpe, Stella L.; Nutrition; University of Massachusetts Amherst 408 Goodell Building Amherst, Ma 01003 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2005 Summary: (provided by applicant): Broad, Long-Term Objectives: The main objective of this study is to determine the effectiveness of altering the environment to prevent or reduce the incidence of obesity. Obesity has been related to many chronic diseases, such as diabetes mellitus, gallbladder disease, and some cancers. It has been well documented that prevention of obesity would decrease chronic disease, improve quality of life, and decrease health care costs in the U.S. However, many education programs have not resulted in behavioral changes that lead to long-term weight loss and/or prevention of weight gain. Although past research has been conducted in changing cafeteria environments to improve food choices, none of these studies assessed body weight or body composition. A site that would be an ideal setting to assess an environmental change on weight loss would be a university cafeteria. A university cafeteria would provide a captive audience, unlike worksite or community cafeterias, where the same individuals do not consume their meals on a daily basis. University students not only consume the majority of their meals at the dining commons, but they can be tracked over time to assess changes in body weight and body composition. If the proposed intervention were successful, it would greatly impact the number of

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individuals in the U.S. who are obese, because there are more than 12 million students enrolled in the 3600 U.S. colleges and universities (NCES, 1996). In focusing on a university cafeteria, we would most certainly target one of Healthy People 2010's goals to "Reduce the proportion of adults who are obese". Thus, the specific aims for this proposed study are: 1) To assess the effectiveness of decreased portion sizes, and hence, decreased energy intake, within a university dining commons on body weight, body mass index, body fat, and waist girth, and 2) To assess the effectiveness of the environmental change on actual food consumption to determine the impact this change has on body weight, body mass index, body fat, and waist girth. That is, to assess if the changes made were effective. If changing cafeteria portion sizes is successful in a university setting, this same model can be used in other university cafeterias settings. Thus, our next step would be to work with larger communities to focus on altering portion sizes in cafeterias, and even restaurants that do not offer "all you can eat" options. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EPIDEMIOLOGY OF GALLBLADDER SLUDGE & STONES IN PREGNANCY Principal Investigator & Institution: Lee, Sum P.; Professor and Chief; Medicine; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2003; Project Start 01-APR-1996; Project End 28-FEB-2007 Summary: (provided by applicant): The female gender and multiparity are the two most important positive correlates of cholesterol gallstone disease. Pregnancy represents the period of time when the 'lithogenic' pressure on a woman is the highest. Biliary sludge is a precursor stage of gallstones. We studied the etiological factors associated with the development of sludge and stones during pregnancy, and our early results suggest that it is inversely related to physical activity. We also found that being overweight, a known risk factor for gallstone disease, is associated with high blood leptin levels. In addition, the risk associated with high leptin levels is partially mitigated by physical activity. In order to disentangle the effects of physical activity, leptin and gestational diabetes on gallbladder disease risk, and to understand the mechanisms behind the observed associations, we propose to conduct a randomized controlled trial. This interventional study is a logical extension of our previous observational investigation. Our Specific Aims are: 1. To evaluate whether an endurance exercise program is associated with lower risk of gallbladder disease in overweight pregnant women.2. To evaluate whether an endurance exercise intervention program changes leptin levels in pregnancy among overweight women.3. To examine the associations between gallbladder disease incidence and potential causal variables in this prospective trial. These variables include leptin levels, HDL, insulin levels, BMI (as it varies within women classified as overweight), as well as changes in these variables. Gallstone disease affects 15-20% of adult Americans. Cholecystectomy is one of the most commonly performed operations. The morbidity, and the burden of cost, incurred by gallstones are staggering. Yet there is a dearth of understanding in the epidemiology and the cause of this disease. The results of this investigation should generate new, important and useful insights into the pathogenesis, and provide a rational strategy for the prevention, of this common and costly disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Gallbladder Disease

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Project Title: GENETIC LOCI INFLUENCING HUMAN GALLBLADDER DISEASE Principal Investigator & Institution: Nakeeb, Attila; Surgery; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Attila Nakeeb, M.D. completed his residency training in General Surgery at the Johns Hopkins Hospital (1991-1999) and spent two years as a research fellow (1993-1995) in the laboratory of Dr. Henry A. Pitt investigating biliary malignancies and gallstone pathogenesis. He is currently an Assistant Professor of Surgery at the Medical College of Wisconsin (MCW) and continues to have a strong interest in biliary diseases. Dr. Nakeeb is seeking this Mentored Patient-Oriented Research Career Development Award (K-23) to study the genetic loci influencing human gallbladder disease. The long-term goal of this research focus is to understand the role of genetic pathogenic mechanisms underlying gallbladder dysfunction, which in turn can lead to new strategies to prevent gallstone formation. A career development plan consisting of didactic coursework, participation in national seminars and institutional research meetings, close and frequent interaction with mentors, and completion of the research plan is proposed to allow the mastering of competencies and research skills necessary to become a successful clinical investigator. The environment at MCW is ideally suited to study the genetics of human gallbladder disease. A cohort of 2209 individuals from 509 nuclear families has undergone basic phenotyping for obesity as well as DNA genotyping. A subset of these families are participating in refined obesity phenotyping at MCW, and are available for the determination of gallbladder disease specific phenotypes. The specific aims of this proposal are as follows: 1) To characterize potential endophenotypes related to the risk of developing gallbladder disease including presence of gallstones, size and number of stones, gallbladder wall thickness, and gallbladder response to a fat meal 2) To conduct univariate and multivariate quantitative genetic analyses on the phenotypes of gallbladder disease, and 3) To analyze a genome wide scan to identify quantitative trait loci with measurable effects on the expression of gallbladder disease risk factors. The completion of this research plan and the training and knowledge acquired from the mentors should allow Dr. Nakeeb to develop into an independent clinical scientist. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: AMERICANS

GENETICS

OF

GALLBLADDER

DISEASE

IN

MEXICAN

Principal Investigator & Institution: Duggirala, Ravindranath; Medicine; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 15-MAR-2002 Summary: (Adapted from investigator's abstract) Gallbladder disease (GBD) is one of the major causes of morbidity and mortality in the United States. In populations such as the Mexican Americans, the prevalence of GBD is high, and it often clusters with diseases such as non-insulin dependent diabetes mellitus (NIDDM) and obesity. The etiology of GBD is unclear, but it is believed to be multifactorial in origin involving abnormalities of the hepatobiliary system such as supersaturation of bile with cholesterol, changes in cholesterol nucleation, and hypomotility of the gallbladder. Despite the epidemiological evidence for its association with risk factors such as age, sex (higher in women), obesity, native American ancestry, NIDDM, and cardiovascular disease risk factors, evidence for genetic determination of GBD is very limited. The purpose of this project is to conduct a genetic epidemiologic investigation involving

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molecular genetic data, GBD phenotypes, and statistical genetic techniques to examine the genetic basis for variation in GBD phenotypes in a set of 32 low-income Mexican American families that is currently under investigation in relation to the genetic determination of NIDDM (San Antonio Family Diabetes Study: SAFADS). The overall objectives of this study are to measure genetic effects on GBD phenotypes, and to identify and localized GBD susceptibility genes. The specific aims are 1) to define GBD phenotypes such as gallstone disease (presence of gallstones), gallstone number (solitary versus multiple), gallstone diameter, and gallbladder wall thickness using ultrasonography; 2) to perform genetic analysis in order to estimate heritabilities for GBD phenotypes, to detect initial evidence of linkage to GBD susceptibility loci, to refine the initial screening using multipoint linkage analysis, and to detect linkage or association using non-parametric methods. Ultrasound GBD phenotypic data will be collected from 720 individuals distributes across 32 families. The initial genome screening will be based on a subset of SAFADS families involving 444 subjects for whom the 10-15 centiMorgan (cM) genome map based on more than 360 markers is already available. After detecting potential signals for linkage, a high resolution 5 cM gene map to be obtained from a full set of SAFADS families(720 individuals) will be used to precisely localize susceptibility loci influencing GBD phenotypes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AMERICANS

GENETICS

OF

GALLBLADDER

DISEASE

IN

MEXICAN

Principal Investigator & Institution: Stern, Michael P.; Professor; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2001; Project Start 01-DEC-2000; Project End 30-NOV-2001 Summary: The purpose of this epidemiological study is to determine whether gall bladder disease has a familial basis. The study will recruit from the Family Heart Study cohort and will utilize stored blood specimens; participants will undergo ultrasonography for screening and will have cytokines assayed after consumption of a mixed meal. Genomes will be screened for genetic determinants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISTIC ROLE OF PEROXYNITRITE IN GALLBLADDER DISEASE Principal Investigator & Institution: Cullen, Joseph J.; Surgery; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): Cholecystitis affects over 20 million Americans, with an increasing incidence with advancing age, in females, in minorities, and with obesity. Superoxide (O2-) rapidly oxidizes nitric oxide in the gallbladder to form peroxynitrite (ONOO-), which in turn can be protonated to form cytotoxic radicals. Nitrotyrosine, a stable end product of ONOO- oxidation, is increased in human gallbladders during cholecystitis. Our long-range goal is to understand how gallbladder inflammation can be modulated for preventive and therapeutic purposes. The objective of this application is to determine how ONOO-contributes mechanistically to gallbladder injury and dysfunction. The central hypothesis of the application is that ONOO- contributes to gallbladder inflammation by inducing generation of O2- and by direct cytotoxic effects leading to smooth muscle cell injury and cell death. Our hypothesis has been formulated on the basis of strong preliminary data demonstrating increased nitration of proteins

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Gallbladder Disease

containing tyrosine during cholecystitis, ONOO--induced generation of O2-, and ONOO--induced oxidative stress. The rationale for the proposed research is that once it is known how peroxynitrite contributes to gallbladder inflammation, its production and its effects can be manipulated with new and innovative approaches to the prevention and treatment of a variety of diseases. We are particularly well prepared to undertake this proposed research because we have the biochemical techniques to determine free radical production, the molecular techniques to determine cell injury and cell death, and the cell and molecular biology techniques to prevent free radical injury. We plan to test our hypothesis and accomplish the objective of this application by pursuing the following three specific aims: 1) Identify the increased nitrated proteins containing tyrosine present during gallbladder inflammation; 2) Determine if ONOO- induces generation of O2- in gallbladder smooth muscle; 3) Determine if ONOO- induces gallbladder cellular injury and death. The proposed work is innovative because it investigates a specific reactive oxygen species (ONOO-) in conditions that affect the human gallbladder. Additionally, it takes advantage of techniques in free radical biology, which are readily available in our laboratory. It is our expectation that the resultant approach will identify the mechanisms by which ONOO- induces cellular injury and death in gallbladder smooth muscle. These results will be significant because they are expected to provide new targets for preventive and therapeutic interventions for the growing number of persons in this country who have gallbladder disease. In addition, it is expected that the results will fundamentally advance the field of free radical biology and gallbladder physiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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

99mTc-PIPIDA cholescintigraphy in the diagnosis of gallbladder disease. Author(s): Rosen PR, Rusing TW, Nusynowitz ML, Lecklitner ML. Source: The American Journal of the Medical Sciences. 1982 November-December; 284(3): 23-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7148887&dopt=Abstract

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

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A 30-year review of the management of gallbladder disease at a children's hospital. Author(s): Lau GE, Andrassy RJ, Mahour GH. Source: The American Surgeon. 1983 August; 49(8): 411-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6614661&dopt=Abstract

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A Bayesian network model for radiological diagnosis and procedure selection: workup of suspected gallbladder disease. Author(s): Haddawy P, Kahn CE Jr, Butarbutar M. Source: Medical Physics. 1994 July; 21(7): 1185-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7968852&dopt=Abstract

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A case-control study of smoking and gallbladder disease: importance of examining time relations. Author(s): McMichael AJ, Baghurst PA, Scragg RK. Source: Epidemiology (Cambridge, Mass.). 1992 November; 3(6): 519-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1420518&dopt=Abstract

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A case-control study of the relationship between smoking, diet, and gallbladder disease. Author(s): Pastides H, Tzonou A, Trichopoulos D, Katsouyanni K, Trichopoulou A, Kefalogiannis N, Manousos O. Source: Archives of Internal Medicine. 1990 July; 150(7): 1409-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2369240&dopt=Abstract

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A new look at the multifactoral etiology of gallbladder disease in children. Author(s): Shafer AD, Ashley JV, Goodwin CD, Nanagas VN Jr, Elliott D. Source: The American Surgeon. 1983 June; 49(6): 314-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6859671&dopt=Abstract

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A study of a possible association between breast cancer and gallbladder disease. Author(s): Wysowski DK, Goldberg EL, Comstock GW, Diamond EL. Source: American Journal of Epidemiology. 1986 March; 123(3): 532-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3946399&dopt=Abstract

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Acalculous gallbladder disease. Author(s): Parry SW. Source: Southern Medical Journal. 1989 August; 82(8): 1064. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2762892&dopt=Abstract

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Gallbladder Disease

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Acalculous gallbladder disease: a controversial entity and imaging dilemma revisited. Author(s): Ott DJ. Source: The American Journal of Gastroenterology. 1998 July; 93(7): 1181-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9672363&dopt=Abstract

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Acalculous gallbladder disease: a prospective study. Author(s): Keddie NC, Gough AL, Galland RB. Source: The British Journal of Surgery. 1976 October; 63(10): 797-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=990699&dopt=Abstract

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Acalculous gallbladder disease: US evaluation after slow-infusion cholecystokinin stimulation in symptomatic and asymptomatic adults. Author(s): Barr RG, Agnesi JN, Schaub CR. Source: Radiology. 1997 July; 204(1): 105-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9205230&dopt=Abstract

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Acute gallbladder disease in the critical care patient. Author(s): Suntay WJ, Chua GT. Source: Indiana Med. 1989 February; 82(2): 112-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2918215&dopt=Abstract

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Acute gallbladder disease. Author(s): Bevan PG. Source: Annals of the Royal College of Surgeons of England. 1978 November; 60(6): 4715. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=718075&dopt=Abstract

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Advances in the diagnosis and treatment of gallbladder disease in the elderly. Author(s): Redinger R. Source: Geriatrics. 1980 April; 35(4): 105-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7358275&dopt=Abstract

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Age profiles of benign gallbladder disease in 2,000 patients. Author(s): Gutman H, Sternberg A, Deutsch AA, Haddad M, Reiss R. Source: Int Surg. 1987 January-March; 72(1): 30-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3596974&dopt=Abstract

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Alternative treatment of gallbladder disease. Author(s): Moga MM. Source: Medical Hypotheses. 2003 January; 60(1): 143-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12450782&dopt=Abstract

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An audit of biliary scintigraphy in a district general hospital (1993-1998) with special reference to the investigation of acalculous gallbladder disease. Author(s): O'Neill GT, McCreath G. Source: Nuclear Medicine Communications. 2000 September; 21(9): 829-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11065156&dopt=Abstract

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An ultrasound survey of gallbladder disease among Mexican Americans in Starr County, Texas: frequencies and risk factors. Author(s): Hanis CL, Hewett-Emmett D, Kubrusly LF, Maklad MN, Douglas TC, Mueller WH, Barton SA, Yoshimaru H, Kubrusly DB, Gonzalez R, et al. Source: Ethn Dis. 1993 Winter; 3(1): 32-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8508103&dopt=Abstract

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An unusual case of gallbladder disease. Author(s): Purkayastha A, Saran M, Gerfin E. Source: Jama : the Journal of the American Medical Association. 1980 May 23-30; 243(20): 2031. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7373741&dopt=Abstract

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Apolipoprotein E genotype and the risk of gallbladder disease in pregnancy. Author(s): Ko CW, Beresford SA, Alderman B, Jarvik GP, Schulte SJ, Calhoun B, Tsuchida AM, Koepsell TD, Lee SP. Source: Hepatology (Baltimore, Md.). 2000 January; 31(1): 18-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10613722&dopt=Abstract

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Arteriography inthe diagnosis of gallbladder disease. Author(s): Rosch J, Grollman JH Jr, Steckel RJ. Source: Radiology. 1969 June; 92(7): 1485-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5799837&dopt=Abstract

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Ascorbic acid supplement use and the prevalence of gallbladder disease. Heart & Estrogen-Progestin Replacement Study (HERS) Research Group. Author(s): Simon JA, Grady D, Snabes MC, Fong J, Hunninghake DB. Source: Journal of Clinical Epidemiology. 1998 March; 51(3): 257-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9495691&dopt=Abstract

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Association of a history of gallbladder disease with a reduced concentration of highdensity-lipoprotein cholesterol. Author(s): Petitti DB, Friedman GD, Klatsky AL. Source: The New England Journal of Medicine. 1981 June 4; 304(23): 1396-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7231462&dopt=Abstract

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Association of coffee consumption with gallbladder disease. Author(s): Ruhl CE, Everhart JE. Source: American Journal of Epidemiology. 2000 December 1; 152(11): 1034-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11117612&dopt=Abstract

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Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Author(s): Ruhl CE, Everhart JE. Source: Hepatology (Baltimore, Md.). 2000 February; 31(2): 299-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10655249&dopt=Abstract

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Bile acid kinetics in relation to sex, serum lipids, body weights, and gallbladder disease in patients with various types of hyperlipoproteinemia;. Author(s): Einarsson K, Hellstrom K, Kallner M. Source: The Journal of Clinical Investigation. 1974 December; 54(6): 1301-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4373491&dopt=Abstract

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Biliary colic and functional gallbladder disease. Author(s): Rajagopalan AE, Pickleman J. Source: Archives of Surgery (Chicago, Ill. : 1960). 1982 August; 117(8): 1005-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7103715&dopt=Abstract

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Biliary scintigraphy in the investigation of acalculous gallbladder disease. Author(s): Middleton GW, Williams JH. Source: Nuclear Medicine Communications. 2001 May; 22(5): 602-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11388585&dopt=Abstract

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Body mass index, cigarette smoking, and other characteristics as predictors of selfreported, physician-diagnosed gallbladder disease in male college alumni. Author(s): Sahi T, Paffenbarger RS Jr, Hsieh CC, Lee IM. Source: American Journal of Epidemiology. 1998 April 1; 147(7): 644-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9554603&dopt=Abstract

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Central adiposity and gallbladder disease in Mexican Americans. Author(s): Haffner SM, Diehl AK, Stern MP, Hazuda HP. Source: American Journal of Epidemiology. 1989 March; 129(3): 587-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2916552&dopt=Abstract

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Changing trends in surgery for benign gallbladder disease. Author(s): Gutman H, Kott I, Haddad M, Reiss R. Source: The American Journal of Gastroenterology. 1988 May; 83(5): 545-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3364412&dopt=Abstract

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Characteristics of symptomatic gallbladder disease in patients with either solitary or multiple cholesterol gallstones. Author(s): Juvonen T, Niemela O, Makela J, Kairaluoma MI. Source: Hepatogastroenterology. 1994 June; 41(3): 263-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7959550&dopt=Abstract

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Cholecystokinin cholecystography in the diagnosis of gallbladder disease. Author(s): Griffen WO Jr, Bivins BA, Rogers EL, Shearer GR, Liebschutz D, Lieber A. Source: Annals of Surgery. 1980 May; 191(5): 636-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7369823&dopt=Abstract

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Cholecystokinin cholecystography. Controlled evaluation in the diagnosis and management of patients with possible acalculous gallbladder disease. Author(s): Dunn FH, Christensen ED, Reynolds J, Jones V, Fordtran JS. Source: Jama : the Journal of the American Medical Association. 1974 May 20; 228(8): 997-1003. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4406357&dopt=Abstract

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Cholecystokinin cholescintigraphy: detection of abnormal gallbladder motor function in patients with chronic acalculous gallbladder disease. Author(s): Fink-Bennett D, DeRidder P, Kolozsi WZ, Gordon R, Jaros R. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1991 September; 32(9): 1695-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1880571&dopt=Abstract

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Cholecystokinin-enhanced cholescintigraphy in the diagnosis of gallbladder disease. Author(s): Gore RM. Source: Jama : the Journal of the American Medical Association. 1993 September 15; 270(11): 1370. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8360976&dopt=Abstract

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Cholecystosonography: the initial diagnostic test for chronic gallbladder disease. Author(s): Bova JG, Moser R. Source: Military Medicine. 1983 January; 148(1): 60-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6402731&dopt=Abstract

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Cholesterol crystal morphology in acalculous gallbladder disease. Author(s): Landi K, Sinard J, Crawford JM, Topazian M. Source: Journal of Clinical Gastroenterology. 2003 April; 36(4): 364-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12642747&dopt=Abstract

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Chronic acalculous gallbladder disease. Author(s): Lennard TW, Farndon JR, Taylor RM. Source: World Journal of Surgery. 1985 February; 9(1): 181-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3984368&dopt=Abstract

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Chronic acalculous gallbladder disease: a clinical enigma. Author(s): Nora PF, Davis RP, Fernandez MJ. Source: World Journal of Surgery. 1984 February; 8(1): 106-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6702210&dopt=Abstract

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Chronic acalculous gallbladder disease: a clinical variant. Author(s): Frykberg ER, Duong TC, LaRosa JJ, Etienne HB. Source: Southern Medical Journal. 1988 November; 81(11): 1353-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3055320&dopt=Abstract

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Chronic acalculous gallbladder disease: multiimaging evaluation with clinicalpathologic correlation. Author(s): Raptopoulos V, Compton CC, Doherty P, Smith EH, D'Orsi CJ, Patwardhan NA, Goldberg R. Source: Ajr. American Journal of Roentgenology. 1986 October; 147(4): 721-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3529895&dopt=Abstract

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Chronic urticaria and gallbladder disease: clearing after cholecystectomy. Author(s): Bushkell LL. Source: Archives of Dermatology. 1979 May; 115(5): 638. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=443851&dopt=Abstract

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Circulating gastrointestinal hormones in patients with flatulent dyspepsia, with and without gallbladder disease. Author(s): Watson RG, Shaw C, Buchanan KD, Love AH. Source: Digestion. 1986; 35(4): 211-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3545953&dopt=Abstract

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Clinical gallbladder disease in NIDDM subjects. Relationship to duration of diabetes and severity of glycemia. Author(s): Haffner SM, Diehl AK, Valdez R, Mitchell BD, Hazuda HP, Morales P, Stern MP. Source: Diabetes Care. 1993 September; 16(9): 1276-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8404432&dopt=Abstract

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Clinical gallbladder disease in Pima Indians. Its high prevalence in contrast to Framingham, Massachusetts. Author(s): Comess LJ, Bennett PH, Burch TA. Source: The New England Journal of Medicine. 1967 October 26; 277(17): 894-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6061823&dopt=Abstract

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Clofibrate and gallbladder disease. Author(s): Krasno LR, Harrison DC. Source: The New England Journal of Medicine. 1977 September 22; 297(12): 669. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=895770&dopt=Abstract

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Coexistence of gallbladder disease and morbid obesity. Author(s): Calhoun R, Willbanks O. Source: American Journal of Surgery. 1987 December; 154(6): 655-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3425813&dopt=Abstract

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Comments on “Clinical gallbladder disease in NIDDM subjects”. Author(s): Trempe CL. Source: Diabetes Care. 1994 May; 17(5): 462. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8062623&dopt=Abstract

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Comments on management of gallbladder disease. Author(s): Biery DL. Source: J Am Osteopath Assoc. 1981 February; 80(6): 374, 376. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7263325&dopt=Abstract

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Comparison of gallbladder ejection fraction with histopathologic changes in acalculous biliary disease. Author(s): DeCamp JR, Tabatowski K, Schauwecker DS, Siddiqui A, Mullinix FM. Source: Clinical Nuclear Medicine. 1992 October; 17(10): 784-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1424351&dopt=Abstract

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Comparison of preoperative serum CA19-9 levels with results of diagnostic imaging modalities in patients undergoing laparotomy for suspected pancreatic or gallbladder disease. Author(s): Ritts RE Jr, Nagorney DM, Jacobsen DJ, Talbot RW, Zurawski VR Jr. Source: Pancreas. 1994 November; 9(6): 707-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7846013&dopt=Abstract

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Comparison of ultrasonography and oral cholecystography in the diagnosis of gallbladder disease. Author(s): Simpson TE. Source: N C Med J. 1983 July; 44(7): 420. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6577295&dopt=Abstract

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Computed tomographic evaluation of gallbladder disease. Author(s): Itai Y. Source: Critical Reviews in Diagnostic Imaging. 1987; 27(2): 113-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3301215&dopt=Abstract

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Conjugated iopanoic acid (Telepaque) in the small bowel: an aid in the diagnosis of gallbladder disease. Author(s): Nathan MH, Newman A. Source: Radiology. 1973 December; 109(3): 545-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4772161&dopt=Abstract

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Contrast-enhanced power Doppler US: is it useful in the differentiation of gallbladder disease? Author(s): Kim KA, Park CM, Park SW, Cha SH, Seol HY, Cha IH, Lee CH, Lee KY. Source: Clinical Imaging. 2002 September-October; 26(5): 319-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213365&dopt=Abstract

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Coronary risk factors and clinical gallbladder disease: an approach to the prevention of gallstones? Author(s): Diehl AK, Haffner SM, Hazuda HP, Stern MP. Source: American Journal of Public Health. 1987 July; 77(7): 841-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3496013&dopt=Abstract

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Country of birth and prevalence of gallbladder disease in Mexican Americans. Author(s): Tseng M, Millikan R, Maurer KR, Khare M, Everhart JE, Sandler RS. Source: Ethn Dis. 2000 Winter; 10(1): 96-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10764135&dopt=Abstract

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Detection of gallbladder disease in patients with normal oral cholecystograms. Results using a simplified biliary drainage technique. Author(s): Foss DC, Laing RR. Source: Am J Dig Dis. 1977 August; 22(8): 685-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=879136&dopt=Abstract

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Detection of occult gallbladder disease by duodenal drainage collected endoscopically. A clinical and pathologic correlation. Author(s): Susann PW, Sheppard F, Baloga AJ. Source: The American Surgeon. 1985 March; 51(3): 162-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3883867&dopt=Abstract

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Detection of occult gallbladder disease by duodenal drainage. Author(s): Porterfield G, Cheung LY, Berenson M. Source: American Journal of Surgery. 1977 December; 134(6): 702-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=596531&dopt=Abstract

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Development and evaluation of use of cholecystokinin in the diagnosis of acalculous gallbladder disease. Author(s): Cohen WN, Freeman JB. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1975 November; 18(6): 571-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=802894&dopt=Abstract

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Diabetes, gallbladder disease, obesity, and hypertension among Hispanics in New Mexico. Author(s): Samet JM, Coultas DB, Howard CA, Skipper BJ, Hanis CL. Source: American Journal of Epidemiology. 1988 December; 128(6): 1302-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3195569&dopt=Abstract

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Diagnosing gallbladder disease. Author(s): Krishnamurthy GT. Source: Annals of Internal Medicine. 1989 March 15; 110(6): 493-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2645822&dopt=Abstract

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Diagnostic accuracy of 99Tcm-HIDA with cholecystokinin and gallbladder ejection fraction in acalculous gallbladder disease. Author(s): Middleton GW, Williams JH. Source: Nuclear Medicine Communications. 2001 June; 22(6): 657-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11403177&dopt=Abstract

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Dietary intake and gallbladder disease: a review. Author(s): Tseng M, Everhart JE, Sandler RS. Source: Public Health Nutrition. 1999 June; 2(2): 161-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10447244&dopt=Abstract

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Dietary intake and the prevalence of gallbladder disease in Mexican Americans. Author(s): Diehl AK, Haffner SM, Knapp JA, Hazuda HP, Stern MP. Source: Gastroenterology. 1989 December; 97(6): 1527-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2583417&dopt=Abstract

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Does nonopacification of the gallbladder always mean gallbladder disease. Author(s): Brown JW. Source: Gastroenterology. 1977 February; 72(2): 366. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=830588&dopt=Abstract

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Drug-induced gallbladder disease. Incidence, aetiology and management. Author(s): Michielsen PP, Fierens H, Van Maercke YM. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 1992 January-February; 7(1): 32-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1536697&dopt=Abstract

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Effectiveness of cholecystokinin-stimulated cholescintigraphy in the diagnosis and treatment of acalculous gallbladder disease. Author(s): Mishkind MT, Pruitt RF, Bambini DA, Hakenewerth AM, Thomason MH, Zuger JH, Novick T. Source: The American Surgeon. 1997 September; 63(9): 769-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9290518&dopt=Abstract

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Electrocardiographic changes in cardiac patients with acute gallbladder disease. Author(s): Krasna MJ, Flancbaum L. Source: The American Surgeon. 1986 October; 52(10): 541-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3767139&dopt=Abstract

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Endoscopic biliary drainage for detection of gallbladder disease. Author(s): Reisberg IR, Mabee GW. Source: Gastrointestinal Endoscopy. 1979 February; 25(1): 6-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=510893&dopt=Abstract

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Endoscopic duodenal aspiration of bile in diagnosis of gallbladder disease. Author(s): Ragland JJ, Winders RL, Hanna HA. Source: Mo Med. 1985 September; 82(9): 605-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4047018&dopt=Abstract

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Endoscopic stenting of the gallbladder for symptomatic gallbladder disease in patients with end-stage liver disease awaiting orthotopic liver transplantation. Author(s): Shrestha R, Trouillot TE, Everson GT. Source: Liver Transpl Surg. 1999 July; 5(4): 275-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10388500&dopt=Abstract

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Endoscopic ultrasonography for gallbladder disease. Author(s): Dill JE. Source: Gastroenterology. 1999 April; 116(4): 1018. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10206779&dopt=Abstract

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Endoscopic ultrasound for chronic abdominal pain and gallbladder disease. Author(s): Dill B, Dill JE, Berkhouse L, Palmer ST. Source: Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates. 1999 September-October; 22(5): 209-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10776109&dopt=Abstract

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Endosonography/bile drainage combination for difficult-to-diagnose gallbladder disease. Author(s): Dill JE. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 1998 December; 8(6): 361-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9916588&dopt=Abstract

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Enterogastric reflux mimicking gallbladder disease: detection, quantitation and potential significance. Author(s): Arroyo AJ, Burns JB, Huyghe WA, Dollman AE, Patel YP. Source: Journal of Nuclear Medicine Technology. 1999 September; 27(3): 207-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10512476&dopt=Abstract

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Epidemiology of gallbladder disease in an Appalachian community. Author(s): Richardson JD, Scutchfield FD, Proudfoot WH, Benenson AS. Source: Health Serv Rep. 1973 March; 88(3): 241-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4690207&dopt=Abstract

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Estrogen replacement therapy and gallbladder disease in postmenopausal women. Author(s): Uhler ML, Marks JW, Judd HL. Source: Menopause (New York, N.Y.). 2000 May-June; 7(3): 162-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10810961&dopt=Abstract

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Evidence for sphincter dysfunction in patients with gallstone associated pancreatitis: effect of ceruletide in patients undergoing cholecystectomy for gallbladder disease and gallstone associated pancreatitis. Author(s): Cuschieri A, Cumming JG, Wood RA, Baker PR. Source: The British Journal of Surgery. 1984 November; 71(11): 885-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6498460&dopt=Abstract

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Experience with Tc 99m HIDA in the diagnosis of acute gallbladder disease in Columbia county, Florida. Author(s): Bedoya R. Source: J Fla Med Assoc. 1981 May; 68(5): 357-60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7264590&dopt=Abstract

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Factors associated with clinical gallbladder disease in a Canadian Indian population. Author(s): Young TK, Roche BA. Source: Clinical and Investigative Medicine. Medecine Clinique Et Experimentale. 1990 April; 13(2): 55-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2354572&dopt=Abstract

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Familial acalculous gallbladder disease. Author(s): Rizk TA, Deshmukh N. Source: Southern Medical Journal. 1993 February; 86(2): 183-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8434290&dopt=Abstract

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Fatty meal provocation monitored by ultrasonography. A method to diagnose ambiguous gallbladder disease. Author(s): Hederstrom E, Forsberg L, Herlin P, Holmin T. Source: Acta Radiologica (Stockholm, Sweden : 1987). 1988 March-April; 29(2): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2965904&dopt=Abstract

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FM sonography in gallbladder disease: efficacy and comparison with conventional sonography. Author(s): Henley DS, Ralls PW, Johnson MB, Colletti PM, Radin DR, Boswell WD, Halls JM. Source: Journal of Clinical Ultrasound : Jcu. 1988 October; 16(8): 563-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3152400&dopt=Abstract

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Food intake patterns and gallbladder disease in Mexican Americans. Author(s): Tseng M, DeVellis RF, Maurer KR, Khare M, Kohlmeier L, Everhart JE, Sandler RS. Source: Public Health Nutrition. 2000 June; 3(2): 233-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10948391&dopt=Abstract

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Fortnightly review: gallbladder disease. Author(s): Bateson MC. Source: Bmj (Clinical Research Ed.). 1999 June 26; 318(7200): 1745-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10381713&dopt=Abstract

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Gallbladder disease and angina pectoris. Author(s): French AB. Source: Annals of Internal Medicine. 1992 July 15; 117(2): 172. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1520394&dopt=Abstract

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Gallbladder disease and cholecystectomy rate are independently variable. Author(s): Bateson MC. Source: Lancet. 1984 September 15; 2(8403): 621-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6147650&dopt=Abstract

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Gallbladder disease and cholecystectomy: experience with 1500 patients managed in a community hospital. Author(s): Briele HA, Long WB, Parks LC. Source: The American Surgeon. 1969 March; 35(3): 218-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5774450&dopt=Abstract

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Gallbladder disease and coronary artery disease: is there a link? Author(s): Dickerman JL. Source: J Am Osteopath Assoc. 1991 April; 91(4): 359-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1874644&dopt=Abstract

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Gallbladder disease and gallbladder cancer among American Indians in tricultural New Mexico. Author(s): Morris DL, Buechley RW, Key CR, Morgan MV. Source: Cancer. 1978 November; 42(5): 2472-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=719624&dopt=Abstract

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Gallbladder disease and hyperlipoproteinemia. Author(s): Bateson MC. Source: Digestive Diseases and Sciences. 1980 April; 25(4): 315-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7389534&dopt=Abstract

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Gallbladder disease and sex hormones. A statistical study. Author(s): Nilsson S. Source: Acta Chir Scand. 1966 September; 132(3): 275-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5929095&dopt=Abstract

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Gallbladder disease and the cardiac status. Author(s): Palmer ED. Source: Jama : the Journal of the American Medical Association. 1975 October 6; 234(1): 97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1174236&dopt=Abstract

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Gallbladder disease and the gynecologist. Author(s): Smith RP. Source: Clinical Obstetrics and Gynecology. 1995 March; 38(1): 189-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7796547&dopt=Abstract

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Gallbladder disease and the heart. Author(s): Brooks PM, Cutforth R. Source: The Medical Journal of Australia. 1973 February 17; 1(7): 340-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4699028&dopt=Abstract

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Gallbladder disease below the age of 21 years. Author(s): Calabrese C, Pearlman DM. Source: Surgery. 1971 September; 70(3): 413-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5568526&dopt=Abstract

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Gallbladder disease epidemiology in Mexican Americans in Starr County, Texas. Author(s): Hanis CL, Ferrell RE, Tulloch BR, Schull WJ. Source: American Journal of Epidemiology. 1985 November; 122(5): 820-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4050772&dopt=Abstract

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Gallbladder disease in childhood. Author(s): Takiff H, Fonkalsrud EW. Source: Am J Dis Child. 1984 June; 138(6): 565-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6426294&dopt=Abstract

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Gallbladder disease in childhood. Report of four cases including one with “milk of calcium bile”. Author(s): Bass HN. Source: Clinical Pediatrics. 1970 April; 9(4): 229-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5441847&dopt=Abstract

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Gallbladder disease in children and adolescents. Author(s): Fisher M, Rosenstein J, Schussheim A, Shenker IR, Nussbaum M. Source: J Adolesc Health Care. 1981 June; 1(4): 309-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7333934&dopt=Abstract

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Gallbladder disease in children and adolescents. Author(s): Andrassy RJ, Treadwell TA, Ratner IA, Buckley CJ. Source: American Journal of Surgery. 1976 July; 132(1): 19-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=952332&dopt=Abstract

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Gallbladder disease in children. Author(s): Hawkins PE, Graham FB, Holliday P. Source: American Journal of Surgery. 1966 May; 111(5): 741-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5936208&dopt=Abstract

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Gallbladder disease in cystic fibrosis. Author(s): Jebbink MC, Heijerman HG, Masclee AA, Lamers CB. Source: The Netherlands Journal of Medicine. 1992 October; 41(3-4): 123-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1470281&dopt=Abstract

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Gallbladder disease in cystic fibrosis. Author(s): L'heureux PR, Isenberg JN, Sharp HL, Warwick WJ. Source: Ajr. American Journal of Roentgenology. 1977 June; 128(6): 953-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=414561&dopt=Abstract

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Gallbladder disease in hyperlipoproteinaemia. Author(s): Einarsson K, Hellstrom K, Kallner M. Source: Lancet. 1975 March 1; 1(7905): 484-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=46958&dopt=Abstract

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Gallbladder disease in infants and children. Author(s): Graivier L, Dorman DW, Votteler TP. Source: Surgery. 1968 April; 63(4): 690-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4967064&dopt=Abstract

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Gallbladder disease in patients 20 years of age and under. Author(s): Odom FC, Oliver BB, Kline M, Rogers W. Source: Southern Medical Journal. 1976 October; 69(10): 1299-1300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=982105&dopt=Abstract

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Gallbladder disease in patients on long-term parenteral nutrition. Author(s): Roslyn JJ, Pitt HA, Mann LL, Ament ME, DenBesten L. Source: Gastroenterology. 1983 January; 84(1): 148-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6401182&dopt=Abstract

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Gallbladder disease in patients with cystic fibrosis. Author(s): Anagnostopoulos D, Tsagari N, Noussia-Arvanitaki S, Sfougaris D, Valioulis I, Spyridakis I. Source: European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery. [et Al] = Zeitschrift Fur Kinderchirurgie. 1993 December; 3(6): 34851. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8110716&dopt=Abstract

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Gallbladder disease in patients with primary sclerosing cholangitis. Author(s): Brandt DJ, MacCarty RL, Charboneau JW, LaRusso NF, Wiesner RH, Ludwig J. Source: Ajr. American Journal of Roentgenology. 1988 March; 150(3): 571-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3277348&dopt=Abstract

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Gallbladder disease in pima indians. Demonstration of high prevalence and early onset by cholecystography. Author(s): Sampliner RE, Bennett PH, Comess LJ, Rose FA, Burch TA. Source: The New England Journal of Medicine. 1970 December 17; 283(25): 1358-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5481754&dopt=Abstract

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Gallbladder disease in pregnancy. Author(s): Stauffer RA, Adams A, Wygal J, Lavery JP. Source: American Journal of Obstetrics and Gynecology. 1982 November 15; 144(6): 6614. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7137250&dopt=Abstract

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Gallbladder disease in pregnancy. Author(s): Davis A, Katz VL, Cox R. Source: J Reprod Med. 1995 November; 40(11): 759-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8592309&dopt=Abstract

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Gallbladder disease in pregnancy. Author(s): Holman KG, Montgomery PJ, Devabhaktuni D. Source: American Family Physician. 1985 July; 32(1): 147-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4013965&dopt=Abstract

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Gallbladder disease in Southwestern American Indians. Author(s): Nelson BD, Porvaznik J, Benfield JR. Source: Archives of Surgery (Chicago, Ill. : 1960). 1971 July; 103(1): 41-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5088428&dopt=Abstract

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Gallbladder disease in the morbidly obese. Author(s): Amaral JF, Thompson WR. Source: American Journal of Surgery. 1985 April; 149(4): 551-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3985293&dopt=Abstract

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Gallbladder disease in the young male. Author(s): Haff RC, Andrassy RJ, LeGrand DR, Ratner IA. Source: American Journal of Surgery. 1976 February; 131(2): 232-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1251966&dopt=Abstract

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Gallbladder disease in young people. Author(s): Laws HL. Source: The American Surgeon. 1969 July; 35(7): 480-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5785910&dopt=Abstract

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Gallbladder disease in young women. Author(s): Sastic JW, Glassman CI. Source: Surg Gynecol Obstet. 1982 August; 155(2): 209-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7101112&dopt=Abstract

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Gallbladder disease related to human immunodeficiency virus infection: presentation and surgical management. Author(s): Sekar OR, Wynn RF, Brettle RP, Nixon SJ, Thomas JS. Source: The British Journal of Surgery. 1994 November; 81(11): 1649-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7827894&dopt=Abstract

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Gallbladder disease related to use of oral contraceptives and nausea in pregnancy. Author(s): Jarnfelt-Samsioe A, Eriksson B, Leissner KH, Samsioe G. Source: Southern Medical Journal. 1985 September; 78(9): 1040-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4035428&dopt=Abstract

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Gallbladder disease terminology. Author(s): Logan GB, Thistle JL. Source: Pediatrics. 1985 July; 76(1): 140. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4011351&dopt=Abstract

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Gallbladder disease with x-ray films that appear normal. Author(s): Large AM. Source: Archives of Surgery (Chicago, Ill. : 1960). 1968 June; 96(6): 855-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5647557&dopt=Abstract

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Gallbladder disease(-)I. Assessment of validity and reliability of data derived from a questionnaire. A study of 62,739 weight-conscious women. Author(s): Bernstein RA, Gieffer EE, Rimm AA. Source: J Chronic Dis. 1976 January; 29(1): 51-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1254684&dopt=Abstract

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Gallbladder disease, bile composition and bile acid absorption after partial ileal bypass. Author(s): Koivisto P, Miettilnen TA. Source: Hepatogastroenterology. 1990 December; 37 Suppl 2: 49-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2083935&dopt=Abstract

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Gallbladder disease. Author(s): Schellenger DW Jr. Source: Emerg Med Serv. 2002 May; 31(5): 78-81; Quiz 82. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12033056&dopt=Abstract

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Gallbladder disease. Author(s): Cole WH. Source: The Surgical Clinics of North America. 1978 October; 58(5): 917-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=103211&dopt=Abstract

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Gallbladder disease. New trends in diagnosis and management. Author(s): Sali A. Source: Aust Fam Physician. 1984 June; 13(6): 414-5, 417-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6385943&dopt=Abstract

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Gallbladder disease. Prevalence in a South Wales industrial town. Author(s): Bainton D, Davies GT, Evans KT, Gravelle IH. Source: The New England Journal of Medicine. 1976 May 20; 294(21): 1147-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1264115&dopt=Abstract

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Gallbladder disease: acalculus or not? Author(s): Dill JE, Dill B. Source: Gastroenterology. 2001 December; 121(6): 1529-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11758549&dopt=Abstract

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Gallbladder disease: an update on diagnosis and treatment. Author(s): Vogt DP. Source: Cleve Clin J Med. 2002 December; 69(12): 977-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12546270&dopt=Abstract

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Gallbladder disease: appearance of associated transient increased attenuation in the liver at biphasic, contrast-enhanced dynamic CT. Author(s): Ito K, Awaya H, Mitchell DG, Honjo K, Fujita T, Uchisako H, Moritani K, Nomura S, Higuchi M, Kada T, Matsumoto T, Matsunaga N. Source: Radiology. 1997 September; 204(3): 723-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9280250&dopt=Abstract

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Gallbladder disease: current trends and treatments. Author(s): Thorpe CJ, Caprini JA. Source: The American Journal of Nursing. 1980 December; 80(12): 2181-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6906106&dopt=Abstract

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Gallbladder disease: endoscopy and biliary damage in management. Author(s): Coffman RB, Parent JM. Source: J Am Osteopath Assoc. 1980 July; 79(11): 711-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7419445&dopt=Abstract

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Gallbladder disease: risk factor for colorectal carcinoma? Author(s): Allende HD, Ona FV, Davis HT. Source: Journal of Clinical Gastroenterology. 1984 February; 6(1): 51-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6699393&dopt=Abstract

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Gallbladder disease--II. Utilization of the life table method in obtaining clinically useful information. A study of 62,739 weight-conscious women. Author(s): Bernstein RA, Giefer EE, Vieira JJ, Werner LH, Rimm AA. Source: J Chronic Dis. 1977 August; 30(8): 529-41. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=893656&dopt=Abstract

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Gallbladder wall thickening: a new sign of gallbladder disease visualized by gray scale cholecystosonography. Author(s): Crolla MD, Baert AL, Fevery J, Kerremans R. Source: Journal of Clinical Ultrasound : Jcu. 1978 June; 6(3): 177-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=97322&dopt=Abstract

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Gallbladder wall thickening: patients without intrinsic gallbladder disease. Author(s): Ralls PW, Quinn MF, Juttner HU, Halls JM, Boswell WD. Source: Ajr. American Journal of Roentgenology. 1981 July; 137(1): 65-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6787892&dopt=Abstract

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Gallstones, gallbladder disease, and pancreatitis: cross-sectional and 2-year data from the Swedish Obese Subjects (SOS) and SOS reference studies. Author(s): Torgerson JS, Lindroos AK, Naslund I, Peltonen M. Source: The American Journal of Gastroenterology. 2003 May; 98(5): 1032-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12809825&dopt=Abstract

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Gastric emptying in patients with flatulent dyspepsia, with and without gallbladder disease. Author(s): Watson RG, Love AH. Source: Scandinavian Journal of Gastroenterology. 1987 January; 22(1): 47-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3563410&dopt=Abstract

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Genetic admixture and gallbladder disease in Mexican Americans. Author(s): Tseng M, Williams RC, Maurer KR, Schanfield MS, Knowler WC, Everhart JE. Source: American Journal of Physical Anthropology. 1998 July; 106(3): 361-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9696151&dopt=Abstract

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Genetic determinants of variation in gallbladder disease in the Mexican-American population. Author(s): Duggirala R, Mitchell BD, Blangero J, Stern MP. Source: Genetic Epidemiology. 1999; 16(2): 191-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10030401&dopt=Abstract

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Genetics and epidemiology of gallbladder disease in New World native peoples. Author(s): Weiss KM, Ferrell RE, Hanis CL, Styne PN. Source: American Journal of Human Genetics. 1984 November; 36(6): 1259-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6517051&dopt=Abstract

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Geographic differences in the incidence of gallbladder disease. Influence of environment and ethnic background. Author(s): Yamase H, McNamara JJ. Source: American Journal of Surgery. 1972 June; 123(6): 667-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5032021&dopt=Abstract

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Gholecystokinin cholecystography in the differential diagnosis of acalculous gallbladder disease. Author(s): Goldstein F, Grunt R, Margulies M. Source: Am J Dig Dis. 1974 September; 19(9): 835-49. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4852154&dopt=Abstract

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Gray-scale ultrasonography as a screening procedure in the detection of gallbladder disease. Author(s): McIntosh DM, Penney HF. Source: Radiology. 1980 September; 136(3): 725-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7403554&dopt=Abstract

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Hepatobiliary diseases in patients with AIDS: focus on AIDS cholangiopathy and gallbladder disease. Author(s): Wilcox CM, Monkemuller KE. Source: Digestive Diseases (Basel, Switzerland). 1998 July-August; 16(4): 205-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9732180&dopt=Abstract

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Hyperbilirubinemia without common bile duct abnormalities and hyperamylasemia without pancreatitis in patients with gallbladder disease. Author(s): Kurzweil SM, Shapiro MJ, Andrus CH, Wittgen CM, Herrmann VM, Kaminski DL. Source: Archives of Surgery (Chicago, Ill. : 1960). 1994 August; 129(8): 829-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7519418&dopt=Abstract

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Hyperinsulinemia, dyslipidemia, and obesity as risk factors for hospitalized gallbladder disease. A prospective study. Author(s): Boland LL, Folsom AR, Rosamond WD; Atherosclerosis Risk in Communities (ARIC) Study Investigators. Source: Annals of Epidemiology. 2002 February; 12(2): 131-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11880221&dopt=Abstract

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Hypokinetic gallbladder disease: a cause of chronic abdominal pain in children and adolescents. Author(s): Dumont RC, Caniano DA. Source: Journal of Pediatric Surgery. 1999 May; 34(5): 858-61; Discussion 861-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10359196&dopt=Abstract

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Importance of family history in adolescent gallbladder disease. Author(s): Goldenring JM. Source: Am J Dis Child. 1992 January; 146(1): 11-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1736634&dopt=Abstract

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Incidence of gallbladder disease after vagotomy. Author(s): Clave RA, Gaspar MR. Source: American Journal of Surgery. 1969 August; 118(2): 169-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5798388&dopt=Abstract

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Incidence of gallbladder disease in Canada, England, and France. Author(s): Plant JC, Percy I, Bates T, Gastard J, de Nercy YH. Source: Lancet. 1973 August 4; 2(7823): 249-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4124435&dopt=Abstract

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Increased prevalence of clinical gallbladder disease in subjects with non-insulindependent diabetes mellitus. Author(s): Haffner SM, Diehl AK, Mitchell BD, Stern MP, Hazuda HP. Source: American Journal of Epidemiology. 1990 August; 132(2): 327-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2196792&dopt=Abstract

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Individual admixture estimates: disease associations and individual risk of diabetes and gallbladder disease among Mexican-Americans in Starr County, Texas. Author(s): Hanis CL, Chakraborty R, Ferrell RE, Schull WJ. Source: American Journal of Physical Anthropology. 1986 August; 70(4): 433-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3766713&dopt=Abstract

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Infusion cholecystography in the early diagnosis of acute gallbladder disease. Author(s): Dykes EH, Stewart I, Gray H, Simpson C, Davidson S, McArdle CS. Source: The British Journal of Surgery. 1984 November; 71(11): 854-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6388718&dopt=Abstract

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Intervention for gallbladder disease. Author(s): Miller FJ, Rose SC. Source: Cardiovascular and Interventional Radiology. 1990 August-September; 13(4): 264-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2121354&dopt=Abstract

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Intragastric bile acid concentrations are unrelated to symptoms of flatulent dyspepsia in patients with and without gallbladder disease and postcholecystectomy. Author(s): Watson RG, Love AH. Source: Gut. 1987 February; 28(2): 131-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3557185&dopt=Abstract

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Investigation of the Salmonella typhi-paratyphi carrier state in cases of surgical intervention for gallbladder disease. Author(s): Ristori C, Rodriguez H, Vicent P, Lobos H, D'Ottone K, Garcia J, Pinto ME, Nercelles P, Cisneros L. Source: Bull Pan Am Health Organ. 1982; 16(2): 161-71. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6810980&dopt=Abstract

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Kinevac-assisted cholescintigraphy as an accurate predictor of chronic acalculus gallbladder disease and the likelihood of symptom relief with cholecystectomy. Author(s): Reed DN Jr, Fernandez M, Hicks RD. Source: The American Surgeon. 1993 May; 59(5): 273-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8489092&dopt=Abstract

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Laparoscopic cholecystectomy: a treatment option for gallbladder disease in children. Author(s): Sigman HH, Laberge JM, Croitoru D, Hong A, Sigman K, Nguyen LT, Guttman FM. Source: Journal of Pediatric Surgery. 1991 October; 26(10): 1181-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1838116&dopt=Abstract

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Laparoscopic cholecystectomy: the procedure of choice for gallbladder disease. Author(s): Uddo JF Jr, Reine G, Chappuis CW. Source: J La State Med Soc. 1991 November; 143(11): 22-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1836488&dopt=Abstract

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Laparoscopic management of gallbladder disease in children and adolescents. Author(s): Johna S, Shaul D, Taylor EW, Brown CA, Bloch JH. Source: Jsls. 1997 July-September; 1(3): 241-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9876679&dopt=Abstract

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Letter: Haematological effects of gallbladder disease. Author(s): Zacharski LR. Source: Lancet. 1974 July 27; 2(7874): 224. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4136161&dopt=Abstract

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Liver and gallbladder disease before and after very-low-calorie diets. Author(s): Andersen T. Source: The American Journal of Clinical Nutrition. 1992 July; 56(1 Suppl): 235S-239S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1615889&dopt=Abstract

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Long-term parenteral nutrition in children: liver and gallbladder disease. Author(s): Colomb V, Goulet O, Rambaud C, De Potter S, Sadoun E, Ben Hariz M, Jan D, Brousse N, Ricour C. Source: Transplantation Proceedings. 1992 June; 24(3): 1054-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1604512&dopt=Abstract

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Low incidence of hospitalization with gallbladder disease among blacks in the United States. Author(s): Sichieri R, Everhart JE, Roth HP. Source: American Journal of Epidemiology. 1990 May; 131(5): 826-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2321626&dopt=Abstract

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Managing gallbladder disease in a cost-effective manner. Author(s): Orlando R 3rd, Russell JC. Source: The Surgical Clinics of North America. 1996 February; 76(1): 117-28. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8629195&dopt=Abstract

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Managing gallbladder disease with prostaglandin inhibitors. Author(s): Babb RR. Source: Postgraduate Medicine. 1993 July; 94(1): 127-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8321767&dopt=Abstract

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Medical aspects of gallbladder disease. Author(s): Heffernon EW. Source: Gp. 1967 April; 35(4): 99-103. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6022076&dopt=Abstract

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More on gallbladder disease. Author(s): Pollak OJ. Source: Del Med J. 1983 September; 55(9): 533. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6642027&dopt=Abstract

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Non-malignant gallbladder disease in the aged. Author(s): Anderson A, Bergdahl L, Boquist L, Nystrom B. Source: Acta Chir Scand. 1974; 140(3): 242-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4838862&dopt=Abstract

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Nutrient intake of Pima Indian women: relationships to diabetes mellitus and gallbladder disease. Author(s): Reid JM, Fullmer SD, Pettigrew KD, Burch TA, Bennett PH, Miller M, Whedon GD. Source: The American Journal of Clinical Nutrition. 1971 October; 24(10): 1281-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5165014&dopt=Abstract

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Operative therapy of gallbladder disease in patients with cystic fibrosis. Author(s): Snyder CL, Ferrell KL, Saltzman DA, Warwick WJ, Leonard AS. Source: American Journal of Surgery. 1989 June; 157(6): 557-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2729516&dopt=Abstract

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Oral cholecystography or ultrasonography in the diagnosis of calculous gallbladder disease. Author(s): Michielsen P, Pelckmans P, Van Maercke Y. Source: Acta Gastroenterol Belg. 1988 May-June; 51(3): 215-22. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3072815&dopt=Abstract

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Oral contraceptive use and benign gallbladder disease; revisited. Author(s): Vessey M, Painter R. Source: Contraception. 1994 August; 50(2): 167-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7956215&dopt=Abstract

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Oral contraceptives and other risk factors for gallbladder disease. Author(s): Strom BL, Tamragouri RN, Morse ML, Lazar EL, West SL, Stolley PD, Jones JK. Source: Clinical Pharmacology and Therapeutics. 1986 March; 39(3): 335-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3948473&dopt=Abstract

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Oral contraceptives and the risk of gallbladder disease: a meta-analysis. Author(s): Thijs C, Knipschild P. Source: American Journal of Public Health. 1993 August; 83(8): 1113-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8342719&dopt=Abstract

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Parenteral nutrition-induced gallbladder disease: a reason for early cholecystectomy. Author(s): Roslyn JJ, Pitt HA, Mann L, Fonkalsrud EW, DenBesten L. Source: American Journal of Surgery. 1984 July; 148(1): 58-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6430112&dopt=Abstract

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Pathophysiology of tumor progression in human gallbladder: flow cytometry, CEA, and CA 19-9 levels in bile and serum in different stages of gallbladder disease. Author(s): Strom BL, Iliopoulos D, Atkinson B, Herlyn M, West SL, Maislin G, Saul S, Varello MA, Rodriguez-Martinez HA, Rios-Dalenz J, et al. Source: Journal of the National Cancer Institute. 1989 October 18; 81(20): 1575-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2795683&dopt=Abstract

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Peptic ulcers and gallbladder disease. Author(s): Ross RJ, Pudvan WR. Source: Radiology. 1970 July; 96(1): 119-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5420394&dopt=Abstract

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Perforated peptic ulcer masquerading as gallbladder disease: CT findings. Author(s): Gayer G. Source: Isr Med Assoc J. 2002 April; 4(4): 304-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12001712&dopt=Abstract

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Pitfalls in the diagnosis of gallbladder disease in clinically severe obesity. Author(s): Oria HE. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 August; 8(4): 444-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9731681&dopt=Abstract

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Plasma lipids and gallbladder disease. Author(s): Mohr GC, Kritz-Silverstein D, Barrett-Connor E. Source: American Journal of Epidemiology. 1991 July 1; 134(1): 78-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1853863&dopt=Abstract

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Polymorphisms at the apoB, apoA-I, and cholesteryl ester transfer protein gene loci in patients with gallbladder disease. Author(s): Juvonen T, Savolainen MJ, Kairaluoma MI, Lajunen LH, Humphries SE, Kesaniemi YA. Source: Journal of Lipid Research. 1995 April; 36(4): 804-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7616125&dopt=Abstract

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Preoperative diagnosis of gallbladder disease. Author(s): Levy MD. Source: Compr Ther. 1982 December; 8(12): 40-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7160162&dopt=Abstract

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Prevalence and ethnic differences in gallbladder disease in the United States. Author(s): Everhart JE, Khare M, Hill M, Maurer KR. Source: Gastroenterology. 1999 September; 117(3): 632-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10464139&dopt=Abstract

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Prevalence of clinical gallbladder disease in Mexican-American, Anglo, and black women. Author(s): Diehl AK, Stern MP, Ostrower VS, Friedman PC. Source: Southern Medical Journal. 1980 April; 73(4): 438-41, 443. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7367932&dopt=Abstract

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Prevalence of gallbladder disease among Chippewa Indians. Author(s): Thistle JL, Eckhart KL Jr, Nensel RE, Nobrega FT, Poehling GG, Reimer M, Schoenfield LJ. Source: Mayo Clinic Proceedings. 1971 September; 46(9): 603-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5096596&dopt=Abstract

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Prevalence of gallbladder disease and associated clinical variables in a low income population of Mexico City. Author(s): Gonzalez Villalpando C, Stern MP, Arredondo Perez B, Martijnez Diaz S, Gonzalez Villalpando ME, Haffner S, Rivera D, Diehl AK. Source: Archives of Medical Research. 1996 Summer; 27(2): 237-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8696071&dopt=Abstract

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Prevalence of gallbladder disease in American Indian populations: findings from the Strong Heart Study. Author(s): Everhart JE, Yeh F, Lee ET, Hill MC, Fabsitz R, Howard BV, Welty TK. Source: Hepatology (Baltimore, Md.). 2002 June; 35(6): 1507-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12029637&dopt=Abstract

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Prevalence of gallbladder disease in diabetes mellitus. Author(s): Chapman BA, Wilson IR, Frampton CM, Chisholm RJ, Stewart NR, Eagar GM, Allan RB. Source: Digestive Diseases and Sciences. 1996 November; 41(11): 2222-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8943976&dopt=Abstract

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Prevalence of gallbladder disease in hyperlipoproteinemia. Author(s): Ahlberg J, Angelin B, Einarsson K, Hellstrom K, Leijd B. Source: Digestive Diseases and Sciences. 1979 June; 24(6): 459-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=222561&dopt=Abstract

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Prevalence of gallstones and gallbladder disease in Canadian Micmac Indian women. Author(s): Williams CN, Johnston JL, Weldon KL. Source: Can Med Assoc J. 1977 October 8; 117(7): 758-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=907946&dopt=Abstract

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Proceedings: Cholecystokinin cholecystography in acalculous gallbladder disease. Author(s): Nora PF, McCarthy W, Sanez N. Source: Archives of Surgery (Chicago, Ill. : 1960). 1974 April; 108(4): 507-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4815925&dopt=Abstract

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Proceedings: Thermographic patterns in patients with gallbladder disease. Author(s): Herskowitz L, Tilley JP. Source: J Am Osteopath Assoc. 1975 December; 75(4): 428-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1044300&dopt=Abstract

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Progress in understanding acalculous gallbladder disease. Author(s): Mulholland MW. Source: Gastroenterology. 2001 February; 120(2): 570-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11159899&dopt=Abstract

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Prophylactic cholecystectomy with gastric bypass operation: incidence of gallbladder disease. Author(s): Fobi M, Lee H, Igwe D, Felahy B, James E, Stanczyk M, Fobi N. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 June; 12(3): 350-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12082886&dopt=Abstract

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Prospective study of clinical gallbladder disease and its association with obesity, physical activity, and other factors. Author(s): Kato I, Nomura A, Stemmermann GN, Chyou PH. Source: Digestive Diseases and Sciences. 1992 May; 37(5): 784-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1563324&dopt=Abstract

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Real-time ultrasonography. Diagnostic technique of choice in calculous gallbladder disease. Author(s): Cooperberg PL, Burhenne HJ. Source: The New England Journal of Medicine. 1980 June 5; 302(23): 1277-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7366693&dopt=Abstract

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Relationship of gallbladder disease to parity, obesity, and age. Author(s): Bernstein RA, Werner LH, Rimm AA. Source: Health Serv Rep. 1973 December; 88(10): 925-36. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4762102&dopt=Abstract

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Relationship of serum leptin concentration and other measures of adiposity with gallbladder disease. Author(s): Ruhl CE, Everhart JE. Source: Hepatology (Baltimore, Md.). 2001 November; 34(5): 877-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11679957&dopt=Abstract

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Right upper quadrant calcification: porcelain gallbladder disease. Author(s): Hoover EL, Natesha RK, Cooperman M, Hassett J. Source: American Family Physician. 1992 May; 45(5): 2171-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1575112&dopt=Abstract

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Risk factors for postoperative respiratory complications and their predictive value. A study in 40-75 year-old men undergoing elective surgery for peptic ulcer or gallbladder disease. Author(s): Wiren JE, Janzon L. Source: Acta Chir Scand. 1982; 148(6): 479-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7158205&dopt=Abstract

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Role of contrast upper gastrointestinal examination in gallbladder disease. Author(s): Abel ME, Harrier HD, Storz WJ. Source: Military Medicine. 1982 October; 147(10): 863-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6817172&dopt=Abstract

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Serum ascorbic acid and gallbladder disease prevalence among US adults: the Third National Health and Nutrition Examination Survey (NHANES III). Author(s): Simon JA, Hudes ES. Source: Archives of Internal Medicine. 2000 April 10; 160(7): 931-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10761957&dopt=Abstract

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Serum ascorbic acid and other correlates of gallbladder disease among US adults. Author(s): Simon JA, Hudes ES. Source: American Journal of Public Health. 1998 August; 88(8): 1208-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9702150&dopt=Abstract

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Should cholecystography or ultrasound be the primary investigation for gallbladder disease? Author(s): de Lacey G, Gajjar B, Twomey B, Levi J, Cox AG. Source: Lancet. 1984 January 28; 1(8370): 205-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6141345&dopt=Abstract

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Should the presence of other diseases exclude subjects as controls in studies of gallbladder response to cholecystokinin octapeptide (sincalide)? Scintigraphic results in patients with malignancies but no known gallbladder disease. Author(s): Jacobson AF, Teefey SA. Source: Nuclear Medicine Communications. 1996 June; 17(6): 514-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8822750&dopt=Abstract

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Significance of wall thickness in symptomatic gallbladder disease. Author(s): Sariego J, Matsumoto T, Kerstein M. Source: Archives of Surgery (Chicago, Ill. : 1960). 1992 October; 127(10): 1216-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1417489&dopt=Abstract

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Socioeconomic status and the prevalence of clinical gallbladder disease. Author(s): Diehl AK, Rosenthal M, Hazuda HP, Comeaux PJ, Stern MP. Source: J Chronic Dis. 1985; 38(12): 1019-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3877735&dopt=Abstract

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Sonographic pattern of gallbladder disease in children with sickle cell anaemia. Author(s): Nzeh DA, Adedoyin MA. Source: Pediatric Radiology. 1989; 19(5): 290-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2666934&dopt=Abstract

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Special health problems of Mexican-Americans: obesity, gallbladder disease, diabetes mellitus, and cardiovascular disease. Author(s): Diehl AK, Stern MP. Source: Adv Intern Med. 1989; 34: 73-96. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2644769&dopt=Abstract

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Stress and diseases of the upper gut: III. Gallbladder disease. Author(s): Kaplan MH, Wheeler WF, Kelly MJ, Breaux FW. Source: The Mount Sinai Journal of Medicine, New York. 1983 September-October; 50(5): 398-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6606761&dopt=Abstract

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Studies in cholestasis of pregnancy. V. Gallbladder disease, liver function tests, serum lipids and fatty acid composition of serum lecithin in the non-pregnant state. Author(s): Samsioe G, Svendsen P, Johnson P, Gustafson A. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1975; 54(5): 417-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1202902&dopt=Abstract

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Surgery for gallbladder disease in the elderly. Author(s): Gaines RD. Source: Geriatrics. 1977 June; 32(6): 71-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=324871&dopt=Abstract

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The diagnosis of acute gallbladder disease by technetium-99m-labelled HIDA hepatobiliary scanning. Author(s): O'Callaghan JD, Verow PW, Hopton D, Craven JL. Source: The British Journal of Surgery. 1980 November; 67(11): 805-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7427041&dopt=Abstract

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The epidemiology of gallbladder disease: observations in the Framingham Study. Author(s): Friedman GD, Kannel WB, Dawber TR. Source: J Chronic Dis. 1966 March; 19(3): 273-92. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5910970&dopt=Abstract

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The integrity of the cholecystokinin receptor gene in gallbladder disease and obesity. Author(s): Nardone G, Ferber IA, Miller LJ. Source: Hepatology (Baltimore, Md.). 1995 December; 22(6): 1751-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7489984&dopt=Abstract

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The negative cholecystogram in gallbladder disease. Author(s): Reid DR, Rogers IM. Source: The British Journal of Surgery. 1975 July; 62(7): 581-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1174794&dopt=Abstract

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The occurrence and treatment of gallbladder disease in Ontario. Author(s): Milner J, Hewitt D. Source: J Chronic Dis. 1972 February; 25(2): 73-83. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5026536&dopt=Abstract

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The pill, thromboembolism, and gallbladder disease. Author(s): Shapiro S. Source: Lancet. 1973 September 8; 2(7828): 567. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4125331&dopt=Abstract

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The pill, thromboembolism, and gallbladder disease. Author(s): Tuerck DG, Comer TP. Source: Lancet. 1973 August 11; 2(7824): 317-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4124790&dopt=Abstract

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The place of hepatobiliary isotope scanning in the diagnosis of gallbladder disease. Author(s): Hall AW, Wisbey ML, Hutchinson F, Wood RA, Cuschieri A. Source: The British Journal of Surgery. 1981 February; 68(2): 85-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7459628&dopt=Abstract

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The prevalence of gallbladder disease in patients with ileostomy. Author(s): Jones MR, Gregory D, Evans KT, Rhodes J. Source: Clinical Radiology. 1976 October; 27(4): 561-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1000901&dopt=Abstract

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The radiological diagnosis of gallbladder disease. An imaging symposium. Author(s): Berk RN, Ferrucci JT Jr, Fordtran JS, Cooperberg PL, Weissmann HS. Source: Radiology. 1981 October; 141(1): 49-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7291541&dopt=Abstract

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The relationship between gallbladder disease and smoking and drinking habits in middle-aged Japanese. Author(s): Okamoto M, Yamagata Z, Takeda Y, Yoda Y, Kobayashi K, Fujino MA. Source: Journal of Gastroenterology. 2002; 37(6): 455-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12108680&dopt=Abstract

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The role of 99mTc HIDA cholescintigraphy in the diagnosis of acute gallbladder disease: comparison with oral cholecystography and ultrasonography. Author(s): Dykes EH, Wilson N, Gray HW, McArdle CS. Source: Scott Med J. 1986 July; 31(3): 170-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3541202&dopt=Abstract

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The role of eicosanoids in experimental and clinical gallbladder disease. Author(s): Myers SI. Source: Prostaglandins, Leukotrienes, and Essential Fatty Acids. 1992 March; 45(3): 16780. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1589442&dopt=Abstract

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The role of morphine-augmented cholescintigraphy and real-time ultrasound in detecting gallbladder disease. Author(s): Lorberhoym M, Simon J, Horne T. Source: Journal of Nuclear Medicine Technology. 1999 December; 27(4): 294-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10646549&dopt=Abstract

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The role of prostaglandins E and F in acalculous gallbladder disease. Author(s): Kaminski DL, Deshpanda YG, Thomas LA. Source: Hepatogastroenterology. 1987 April; 34(2): 70-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3596460&dopt=Abstract

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The role of sincalide cholescintigraphy in the evaluation of patients with acalculus gallbladder disease. Author(s): Pickleman J, Peiss RL, Henkin R, Salo B, Nagel P. Source: Archives of Surgery (Chicago, Ill. : 1960). 1985 June; 120(6): 693-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4004556&dopt=Abstract

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The use of ultrasonography in the diagnosis of calculous gallbladder disease. Author(s): Wengert PA Jr, Metzger PP, Ecker HA Jr, Patterson LT. Source: The American Surgeon. 1979 July; 45(7): 439-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=464391&dopt=Abstract

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The value of cholecystokinin cholecystography in evaluating gallbladder disease. Author(s): Westbrook RI. Source: Nebr State Med J. 1970 April; 55(4): 245-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4244984&dopt=Abstract

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TPN and gallbladder disease: future directions. Author(s): Roslyn JS. Source: Nutrition (Burbank, Los Angeles County, Calif.). 1990 March-April; 6(2): 189. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2134536&dopt=Abstract

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Transpapillary biopsy in gallbladder disease. Author(s): Watanabe Y, Goto H, Hirooka Y, Itoh A, Taki T, Hayakawa S, Hayakawa T, Naitoh Y, Ohhashi K, Yamao K, Furukawa T. Source: Gastrointestinal Endoscopy. 2000 January; 51(1): 76-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10625804&dopt=Abstract

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Treatment and prognosis of symptomatic gallbladder disease in patients with cystic fibrosis. Author(s): Stern RC, Rothstein FC, Doershuk CF. Source: Journal of Pediatric Gastroenterology and Nutrition. 1986 January; 5(1): 35-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3003321&dopt=Abstract

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Trends in mortality from nonneoplastic gallbladder disease. Author(s): La Vecchia C, Levi F, Lucchini F, Franceschi S. Source: Annals of Epidemiology. 1995 May; 5(3): 215-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7541682&dopt=Abstract

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Two incidental cases of abdominal aortic aneurysm and gallbladder cancer. Further data influencing the management of patients affected by aneurysm and gallbladder disease. Author(s): De Monti M, Ghilardi G, Bianchi E, Kunkl E, Scorza R. Source: Minerva Cardioangiol. 2000 April-May; 48(4-5): 129-35. Review. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10959149&dopt=Abstract

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Ultrasonic cholecystography in gallbladder disease. Author(s): Cano JY, D'Altorio RA, Fink AH, Kim YC. Source: Pa Med. 1979 October; 82(10): 42. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=523150&dopt=Abstract

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Ultrasonographic findings in peptic ulcer disease and pancreatitis that simulate primary gallbladder disease. Author(s): Nyberg DA, Laing FC. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 1983 July; 2(7): 303-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6864875&dopt=Abstract

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Ultrasonography and oral cholecystography: a comparison of their use in the diagnosis of gallbladder disease. Author(s): Detwiler RP, Kim DS, Longerbeam JK. Source: Archives of Surgery (Chicago, Ill. : 1960). 1980 September; 115(9): 1096-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6774698&dopt=Abstract

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Ultrasound in the investigation of gallbladder disease. Author(s): Kappelman NB, Sanders RC. Source: Jama : the Journal of the American Medical Association. 1978 April 3; 239(14): 1426-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=633551&dopt=Abstract

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Umbilical hernia and gallbladder disease. Author(s): Bryant WM, Griffen WO Jr. Source: American Journal of Surgery. 1969 May; 117(5): 653-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5791036&dopt=Abstract

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Urgent and early cholecystectomy for acute gallbladder disease. Author(s): Addison NV, Finan PJ. Source: The British Journal of Surgery. 1988 February; 75(2): 141-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3349301&dopt=Abstract

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Use of duodenal drainage in the diagnosis of acalculous gallbladder disease. Author(s): Smith LA, Jagadish B, Anderson HM, Stephenson SE Jr. Source: The American Surgeon. 1976 December; 42(12): 893-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=999081&dopt=Abstract

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Usefulness of intraductal ultrasonography in gallbladder disease. Author(s): Watanabe Y, Goto H, Naitoh Y, Hirooka Y, Itoh A, Taki T, Hayakawa S, Hayakawa T. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 1998 January; 17(1): 33-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9440106&dopt=Abstract

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CHAPTER 2. NUTRITION AND GALLBLADDER DISEASE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and gallbladder disease.

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

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

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

Ascorbic acid supplement use and the prevalence of gallbladder disease. Heart & Estrogen-Progestin Replacement Study (HERS) Research Group. Author(s): General Internal Medicine Section, Veterans Affairs Medical Center, San Francisco, California 94121, USA. Source: Simon, J A Grady, D Snabes, M C Fong, J Hunninghake, D B J-Clin-Epidemiol. 1998 March; 51(3): 257-65 0895-4356

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Dietary intake and gallbladder disease: a review. Author(s): Department of Epidemiology, University of North Carolina at Chapel Hill, USA. [email protected] Source: Tseng, M Everhart, J E Sandler, R S Public-Health-Nutr. 1999 June; 2(2): 161-72 1368-9800

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Fatty meal provocation monitored by ultrasonography. A method to diagnose ambiguous gallbladder disease. Author(s): Department of Diagnostic Radiology, University Hospital, Lund, Sweden. Source: Hederstrom, E Forsberg, L Herlin, P Holmin, T Acta-Radiol. 1988 Mar-April; 29(2): 207-10 0284-1851

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Food intake patterns and gallbladder disease in Mexican Americans. Author(s): Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599, USA. Source: Tseng, M DeVellis, R F Maurer, K R Khare, M Kohlmeier, L Everhart, J E Sandler, R S Public-Health-Nutr. 2000 June; 3(2): 233-43 1368-9800

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Laparoscopic cholecystectomy: a treatment option for gallbladder disease in children. Author(s): Division of General Surgery, Sir Mortimer B. Davis, Jewish General Hospital, Montreal, Quebec, Canada. Source: Sigman, H H Laberge, J M Croitoru, D Hong, A Sigman, K Nguyen, L T Guttman, F M J-Pediatr-Surg. 1991 October; 26(10): 1181-3 0022-3468

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Prospective study of clinical gallbladder disease and its association with obesity, physical activity, and other factors. Author(s): Japan-Hawaii Cancer Study, Kuakini Medical Center, Honolulu, Hawaii 96817. Source: Kato, I Nomura, A Stemmermann, G N Chyou, P H Dig-Dis-Sci. 1992 May; 37(5): 784-90 0163-2116

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Serum ascorbic acid and gallbladder disease prevalence among US adults: the Third National Health and Nutrition Examination Survey (NHANES III). Author(s): Medical Service, Veterans Affairs Medical Center, San Francisco, Calif, 94121, USA. [email protected] Source: Simon, J A Hudes, E S Arch-Intern-Med. 2000 April 10; 160(7): 931-6 0003-9926

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Sonographic pattern of gallbladder disease in children with sickle cell anaemia. Author(s): Department of Radiology, University of Ilorin, Nigeria. Source: Nzeh, D A Adedoyin, M A Pediatr-Radiol. 1989; 19(5): 290-2 0301-0449

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The role of eicosanoids in experimental and clinical gallbladder disease. Author(s): Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235. Source: Myers, S I Prostaglandins-Leukot-Essent-Fatty-Acids. 1992 March; 45(3): 167-80 0952-3278

Nutrition

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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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The following is a specific Web list relating to gallbladder disease; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Niacin Source: Integrative Medicine Communications; www.drkoop.com Vitamin B3 (Niacin) Source: Integrative Medicine Communications; www.drkoop.com Vitamin C Source: Healthnotes, Inc.; www.healthnotes.com

•

Minerals Lecithin/phosphatidylcholine/choline Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND GALLBLADDER DISEASE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to gallbladder disease. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to gallbladder disease and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “gallbladder disease” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to gallbladder disease: •

Alternative treatment of gallbladder disease. Author(s): Moga MM. Source: Medical Hypotheses. 2003 January; 60(1): 143-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12450782&dopt=Abstract

•

Ascorbic acid supplement use and the prevalence of gallbladder disease. Heart & Estrogen-Progestin Replacement Study (HERS) Research Group. Author(s): Simon JA, Grady D, Snabes MC, Fong J, Hunninghake DB. Source: Journal of Clinical Epidemiology. 1998 March; 51(3): 257-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9495691&dopt=Abstract

•

Dietary intake and the prevalence of gallbladder disease in Mexican Americans. Author(s): Diehl AK, Haffner SM, Knapp JA, Hazuda HP, Stern MP.

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Source: Gastroenterology. 1989 December; 97(6): 1527-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2583417&dopt=Abstract

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

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

•


•

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to gallbladder disease; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Alcohol Withdrawal Source: Healthnotes, Inc.; www.healthnotes.com Bone Loss Source: Integrative Medicine Communications; www.drkoop.com Gallbladder Disease Source: Integrative Medicine Communications; www.drkoop.com Gallstones Source: Healthnotes, Inc.; www.healthnotes.com

Alternative Medicine 55

Menopause Source: Integrative Medicine Communications; www.drkoop.com Osteoporosis Source: Integrative Medicine Communications; www.drkoop.com Rheumatoid Arthritis Source: Prima Communications, Inc.www.personalhealthzone.com •

Chinese Medicine Hezi Alternative names: Medicine Terminalia Fruit; Fructus Chebulae Source: Chinese Materia Medica Maohezi Alternative names: Belleric Terminalia Fruit; Fructus Terminaliae Billericae Source: Chinese Materia Medica

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Herbs and Supplements Blessed Thistle Alternative names: Cnicus benedictus Source: Healthnotes, Inc.; www.healthnotes.com Dandelion Source: Prima Communications, Inc.www.personalhealthzone.com Milk Thistle Alternative names: Silybum marianum, Carduus marianus Source: Healthnotes, Inc.; www.healthnotes.com Prickly Ash Alternative names: Zanthoxylum clava-herculis, Zanthoxylum americanum Source: Healthnotes, Inc.; www.healthnotes.com Taurine Source: Prima Communications, Inc.www.personalhealthzone.com Trace Minerals Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10061,00.html Turmeric Source: Prima Communications, Inc.www.personalhealthzone.com

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

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CHAPTER 4. DISSERTATIONS ON GALLBLADDER DISEASE Overview In this chapter, we will give you a bibliography on recent dissertations relating to gallbladder disease. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “gallbladder disease” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on gallbladder disease, we have not necessarily excluded non-medical dissertations in this bibliography.

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

Gluten Sensitivity As a Possible Potentiator of or Contributor to Gallbladder Disease among Mexican-Americans by Winkler, Barbara Anne, PhD from The University of Texas at Austin, 1990, 179 pages http://wwwlib.umi.com/dissertations/fullcit/9031750

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

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CHAPTER 5. CLINICAL TRIALS AND GALLBLADDER DISEASE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning gallbladder disease.

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

Study of Tauroursodeoxycholic Acid for Hepatobiliary Disease in Cystic Fibrosis Condition(s): Cystic Fibrosis Study Status: This study is currently recruiting patients. Sponsor(s): FDA Office of Orphan Products Development; Children's Hospital Medical Center - Cincinnati Purpose - Excerpt: Objectives: I. Determine the optimum dose of tauroursodeoxycholic acid (TUDCA) required to achieve maximal bioavailability for patients with cystic fibrosis-associated liver disease. II. Compare optimized doses of TUDCA with ursodiol (ursodeoxycholic acid; UDCA) for effects on biliary bile acid composition and metabolism, serum biochemistries, fat absorption, and fat-soluble vitamin status in these patients. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004441

5

These are listed at www.ClinicalTrials.gov.

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•

Safety and efficacy study of IL-10 (Tenovil TM) in the prevention of Post-ERCP Acute Pancreatitis Condition(s): Bile Duct Diseases; Biliary Tract Diseases; Gallbladder Diseases; Pancreatitis; Pancreatic Diseases Study Status: This study is terminated. Sponsor(s): Schering-Plough Purpose - Excerpt: The purpose of this study is to determine if a single dose of IL-10 compared to placebo is safe and effective in reducing the incidence of post-ERCP acute pancreatitis for subjects with increased risk. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00040131

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

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

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

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

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

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

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

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

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•

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

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

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

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

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

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

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

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

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CHAPTER 6. BOOKS ON GALLBLADDER DISEASE Overview This chapter provides bibliographic book references relating to gallbladder disease. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on gallbladder disease include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Diseases of the Liver and Biliary System, Eleventh Edition Source: Malden, MA: Blackwell Science, Inc. 2002. 706 p. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail: [email protected]. Website: www.blackwell-science.com. PRICE: $178.95. ISBN: 0632055820. Summary: Designed to serve practicing physicians, surgeons and pathologists, as well as clinical students, this textbook presents a comprehensive and up-to-date account of diseases of the liver and biliary system. The text offers 38 chapters: anatomy and function; the assessment of liver function; biopsy of the liver; the hematology of liver disease; ultrasound, computed tomography (CT scan) and magnetic resonance imaging (MRI); hepatocellular failure; hepatic encephalopathy; acute liver failure; ascites (fluid

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accumulation); the portal venous system and portal hypertension; the hepatic artery and hepatic vein, and the liver in circulatory failure; jaundice; cholestasis; primary biliary cirrhosis (PBC); sclerosing cholangitis; viral hepatitis, including general features, hepatitis A, hepatitis E, and other viruses; hepatitis B virus and hepatitis Delta virus; hepatitis C virus; chronic hepatitis, its general features and autoimmune chronic disease; drugs and the liver; hepatic cirrhosis (scarring); alcohol and the liver; iron overload states; Wilson's disease; nutritional and metabolic liver diseases; the liver in infancy and childhood; the liver in pregnancy; the liver is systemic disease, granulomas, and hepatic trauma; the liver in infections; nodules and benign liver lesions; malignant liver tumors; the role of interventional radiology and endoscopy in imaging of the biliary tract; cysts and congenital biliary abnormalities; gallstones and inflammatory gallbladder diseases; benign stricture of the bile ducts; diseases of the ampulla of Vater and the pancreas; tumors of the gallbladder and bile ducts; and hepatic transplantation. The text includes full-color and black-and-white illustrations and photographs. A detailed subject index concludes the volume. •

Our Health, Our Lives: A Revolutionary Approach to Total Health Care for Women Source: New York, NY: Pocket Books. 1995. 448 p. Contact: Available from Pocket Books. 1230 Sixth Avenue, New York, NY 10020. (800) 223-2336. PRICE: $24. ISBN: 0671880853. Summary: In this book, the author demonstrates how medicine can function to serve women's needs and shows women how to help start that process in their own lives. Eighteen chapters are presented in four sections: the woman-centered approach; total health in context; women's life cycles; and mind and body together. Topics include becoming one's own health advocation; how the female body works; risk factors for heart disease; women's cancer; diabetes; preventing osteoporosis; bladder conditions; fatigue and the immune system; the patterns in women's lives; pregnancy and beyond; the menopause years; the emotionally healthy woman; healthy sexuality; eating problems; and substance addictions. Specific topics that address digestive diseases include risk factors for colon cancer; nutrition, including fats and fiber; eating disorders; appendicitis; cholesterol; dietary calcium; depression and the immune system; dieting and weight loss; eating habits; gallbladder disease; pregnancy and the gastrointestinal system; systemic lupus erythematosus; obesity; and vitamins. A detailed subject index concludes the book.

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The new ourselves, growing older: Women aging with knowledge and power. (Rev. ed.) Source: New York, NY: Touchstone. 1994. 531 pp. Contact: Available from Touchstone Books, Rockefeller Center, 1230 Avenue of the Americas, New York, NY 10020. $24.00. Summary: This book covers health, family, and social issues for women over the age of forty. The first section discusses aging and well-being, weight, nutrition, and physical fitness. Topics included in the second section are sexuality, birth control, childbearing, menopause, relationships, housing alternatives, work and retirement, the economics of aging, and caregiving. Section three covers women's health and the medical care system, nursing homes, arthritis, osteoporosis and related conditions, dental health, urinary incontinence, hysterectomy and oophorectomy, hypertension, heart disease, and stroke, cancer, diabetes, gallstones and gallbladder disease, sensory and memory loss

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associated with aging, dying and death, and changing society and ourselves. Extensive resources for each topic are included along with an index. •

20 common problems in women's health care Source: New York, NY: McGraw Hill. 2000. 686 pp. Contact: Available from McGraw-Hill Publishing, 11 West 19th Street, Fourth Floor, New York, NY 10011. Telephone: (212) 337-5961. $49.95. Summary: This five-part textbook for health profession students focuses on women's health care issues throughout the life cycle;each chapter includes an overview, summary, and reference list. Part one addresses issues in preventive care/health maintenance such as examinations and screening, delivery of health care services, family planning, prenatal care, and menopause. Topics included in part two are sexuality, obesity, and eating disorders. Part three covers abuse of women, substance abuse, depression and anxiety, and relational problems. Part four discusses gynecological concerns such as vulvar and vaginal disease, urinary incontinence, menstrual disorders, sexually transmitted diseases, pelvic inflammatory disease, miscarriage, and breast disorders. The final part covers other health concerns such as hypertension and ischemic heart disease, gastrointestinal disorders, gallbladder disease, and osteoporosis. The book concludes with an index.

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Gastrointestinal Diseases and Disorders Sourcebook Source: Detroit, MI: Omnigraphics, Inc. 1996. 413 p. Contact: Available from Omnigraphics, Inc. Penobscot Building, Detroit, MI 48226. (800) 234-1340 or (313) 961-1340. Fax (800) 875-1340 or (313) 961-1383. PRICE: $75.00. ISBN: 0780800788. Summary: This health reference book provides nontechnical information about gastrointestinal diseases and disorders. This sourcebook describes the signs and symptoms of many digestive system problems, discusses ongoing research and treatment, provides statistical data, and recommends dietary and lifestyle changes. The book has 46 chapters arranged in five sections: general information, including how the digestive system works, how to maintain healthy digestion, and statistical data; esophageal problems, including hiatal hernia, heartburn, and chronic pulmonary aspiration in children; stomach problems, notably ulcers and their treatment; intestinal and anorectal disorders; and liver, pancreatic, and gallbladder diseases and disorders, including liver function tests, liver transplants, and liver biopsy. The sourcebook includes numerous charts and graphs; a subject index concludes the volume.

•

Pediatric Gastrointestinal Disease. 2nd ed Source: Philadelphia, PA: W.B. Saunders Company. 1999. 823 p. Contact: Available from W.B. Saunders Company. Book Order Fulfillment Department, 11830 Westline Industrial Drive, Saint Louis, MO 63146-9988. (800) 545-2522 or (314) 4537010. Fax (800) 568-5136 or (314) 453-7095. E-mail: [email protected]. Website: customerservice.wbsaunders.com. PRICE: $155.00 plus shipping and handling. ISBN: 0721674615. Summary: This medical textbook covers all facets of clinical pediatric gastrointestinal disease. The text emphasizes a clinical focus and incorporates anatomy and physiology considerations into each chapter rather than a separate section. The book is organized

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into distinct sections, starting with the common clinical problems and followed by organ specific diseases. General chapters on clinical problems cover chronic abdominal pain of childhood and adolescence, vomiting, diarrhea, constipation and encopresis (fecal soiling), failure to thrive, gastrointestinal hemorrhage, eating disorders and obesity, jaundice, ascites, caustic ingestion and foreign bodies, abdominal masses in pediatric patients, and abdominal surgical emergencies. Sections on diseases of the esophagus, stomach, and the small and large bowel (intestine) are followed by chapters reviewing the clinical facets of pediatric liver disease. Specific chapters include gastrointestinal reflux, achalasia and other motor disorders, congenital anomalies, gastric motility disorders, bezoars (a mass of food, hair or other components found in the stomach or intestine), maldigestion and malabsorption, celiac disease, short bowel syndrome, enteric parasites, Crohn's disease, ulcerative colitis, polyps, appendicitis, hernia, Hirschsprung's disease, neoplasms (cancerous and noncancerous), hepatitis, gallbladder diseases, and liver transplantation. The last two sections review diseases of the pancreas and basic nutrition in children, including pancreatitis, cystic fibrosis, nutritional assessment, parenteral (outside the digestive system, for example, intravenous nutrition) and enteral nutrition, and the management of diarrhea. Each chapter offers black and white photographs and figures and concludes with extensive references. A detailed subject index concludes the text. •

Diseases of the Liver and Biliary System. 10th ed Source: Oxford, England: Blackwell Science. 1997. 714 p. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail: [email protected]. PRICE: $150.00. ISBN: 0865429065. Summary: This medical textbook presents a comprehensive account of diseases of the liver and biliary system, designed to be of use to physicians, surgeons and pathologists, and also as a reference text for the clinical student. Chapters cover anatomy and function; assessment of liver function; needle biopsy of the liver; the hematology of liver disease; ultrasound, computed tomography, and magnetic resonance imaging; hepatocellular failure; hepatic encephalopathy; fulminant hepatic failure; ascites; the portal venous system and portal hypertension; the hepatic artery and hepatic veins, i.e., the liver in circulatory failure; jaundice; cholestasis; primary biliary cirrhosis; sclerosing cholangitis; virus hepatitis; chronic hepatitis; drugs and the liver; hepatic cirrhosis; alcohol and the liver; iron overload states; Wilson's disease; nutritional and metabolic liver disease; the liver in infancy and childhood; the liver in pregnancy; the liver in systemic disease and hepatic trauma; the liver in infections; hepatic tumors, including hepato-cellular carcinoma; imaging of the biliary tract, including interventional radiology and endoscopy; cysts and congenital biliary abnormalities; gallstones and inflammatory gallbladder diseases; benign stricture of the bile ducts; diseases of the ampulla of Vater and pancreas; tumors of the gallbladder and bile ducts; and hepatic transplantation. The volume includes full color photographs, extensive reference lists with each chapter, and a detailed subject index.

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20 Common Problems in Gastroenterology Source: New York, NY: McGraw-Hill, Inc. 2002. 317 p. Contact: Available from McGraw-Hill, Inc. 1221 Avenue of the Americas, New York, NY 10020. (612) 832-7869. Website: www.bookstore.mcgraw-hill.com. PRICE: $45.00;plus shipping and handling. ISBN: 0070220557.

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Summary: This text is one from a series that provides concise, practical information for health care professionals. This book focuses on the most common gastroenterological problems encountered in a primary practice setting and represents a selection of 20 clinical issues that every practitioner of primary care and general gastroenterology will encounter on a regular basis. The chapters are organized to support rapid access to the information necessary to evaluate and treat most patients with these problems. The text features three sections: general gastroenterology, gastrointestinal (GI) bleeding, and hepatic (liver) and biliary problems. Twenty chapters cover heartburn, nausea and vomiting, dysphagia (swallowing difficulties), weight loss, dyspepsia, chronic abdominal pain (functional GI disorders), acute abdominal pain, acute upper GI bleeding, acute lower GI bleeding, occult (hidden) bleeding and iron deficiency anemia, flatulence (gasiness), acute diarrhea in adults, constipation, colorectal cancer screening, anal pain, viral hepatitis, right upper quadrant pain (gallbladder disease and its complications), liver masses, abnormal liver function tests, and biliary obstruction. Each chapter includes a chapter outline for quick reference, the text itself, a diagnostic and treatment algorithm, and selected references. The text concludes with a subject index. Color photographs are provided in a special section; black and white photographs, figures, and charts illustrate the volume.

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

Assessment and Management of Hepatobiliary Disease (1987); ISBN: 3540177604; http://www.amazon.com/exec/obidos/ASIN/3540177604/icongroupinterna

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Assessment and Management of Hepatobiliary Disease by L. Okolicsanyi, et al; ISBN: 0387177604; http://www.amazon.com/exec/obidos/ASIN/0387177604/icongroupinterna

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Bile Acids in Hepatobiliary Disease (FALK SYMPOSIUM Volume 110A) by T.C. Northfield (Editor), et al; ISBN: 0792387554; http://www.amazon.com/exec/obidos/ASIN/0792387554/icongroupinterna

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Bile Acids in Hepatobiliary Diseases : Basic Research & Clinical Application by G. Paumgartner (Editor), et al; ISBN: 0792387252; http://www.amazon.com/exec/obidos/ASIN/0792387252/icongroupinterna

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Healthy Digestion the Natural Way: Preventing and Healing Heartburn, Constipation, Gas, Diarrhea, Inflammatory Bowel and Gallbladder Diseases, Ulcers, Irritable Bowel Syndrome, and More by D. Lindsey Berkson (Author); ISBN: 0471349623; http://www.amazon.com/exec/obidos/ASIN/0471349623/icongroupinterna

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Hepatobiliary Diseases by J. Prieto (Editor), et al; ISBN: 0387543260; http://www.amazon.com/exec/obidos/ASIN/0387543260/icongroupinterna

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Hepatobiliary Diseases: Cholestasis and Gallstone (Falk Symposium, Vol 17A) by M. Acalovschi (Editor), G. Paumgartner (Editor) (2001); ISBN: 0792387708; http://www.amazon.com/exec/obidos/ASIN/0792387708/icongroupinterna

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Hepatobiliary Diseases: Pathophysiology and Imaging by Kunio Okuda (Editor), et al; ISBN: 0632055421; http://www.amazon.com/exec/obidos/ASIN/0632055421/icongroupinterna

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Imaging in Hepatobiliary Disease by James Dooley, et al; ISBN: 080161418X; http://www.amazon.com/exec/obidos/ASIN/080161418X/icongroupinterna

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Liver and Biliary Disease (1986); ISBN: 0721696090; http://www.amazon.com/exec/obidos/ASIN/0721696090/icongroupinterna

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Liver and Biliary Disease: Pathophysiology, Diagnosis Management by Ralph Wright (1986); ISBN: 072169991X; http://www.amazon.com/exec/obidos/ASIN/072169991X/icongroupinterna

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Liver and Biliary Diseases by Ralph Wright, et al (1985); ISBN: 0702010650; http://www.amazon.com/exec/obidos/ASIN/0702010650/icongroupinterna

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Liver and Biliary Diseases by Neil Kaplowitz (Editor); ISBN: 0683045288; http://www.amazon.com/exec/obidos/ASIN/0683045288/icongroupinterna

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Nuclear Hepatology: A Textbook of Hepatobiliary Diseases by Gerbail Krishnamurthy, Shakuntala Krishnamurthy; ISBN: 354065917X; http://www.amazon.com/exec/obidos/ASIN/354065917X/icongroupinterna

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Strategies for the Treatment of Hepatobiliary Diseases (Falk Symposium, No 53) by G. Paumgartner, et al (1990); ISBN: 0792389034; http://www.amazon.com/exec/obidos/ASIN/0792389034/icongroupinterna

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Update on Hepatobiliary Diseases 1996 (Falk Symposium, Vol 90) by S.K. Lam (Editor), et al (1997); ISBN: 0792387155; http://www.amazon.com/exec/obidos/ASIN/0792387155/icongroupinterna

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Wright's Liver and Biliary Disease by G.H. Millward-Sadler, et al; ISBN: 0702016551; http://www.amazon.com/exec/obidos/ASIN/0702016551/icongroupinterna

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Wright's Liver and Biliary Disease: Pathophysiology, Diagnosis and Management by R. Wright (Editor), et al (1992); ISBN: 0702013927; http://www.amazon.com/exec/obidos/ASIN/0702013927/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “gallbladder disease” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:6 6 In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic

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Duodenogastric reflux in gallbladder diseases and postcholecystectomy states Author: Ståhlberg, Markku.; Year: 1962; Oulu: University of Oulu, 1982; ISBN: 9514214153

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Gallbladder disease; clinical and pathologico-anatomical features of cholecystitis and cholelithiasis [by] V. Jääskeläinen, M. Siurala and M. Tawast. Author: Jääskeläinen, Visa.; Year: 1958; Helsinki, 1958

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The medical treatment of gallbladder disease, by Martin E. Rehfuss. and Guy M. Nelson. Author: Rehfuss, Martin Emil,; Year: 1935; Philadelphia and London, W. B. Saunders company, 1935

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Treatment of gallbladder disease; guest editor: James B. Carey, Jr. Treatment of menopausal problems: guest editor: Eugene J. Cohen. Author: Carey, James B.,; Year: 1968; [New York] Hoeber [c1968]

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

Investigation of Liver and Biliary Disease Source: in Beckingham, I.J., ed. ABC of Liver, Pancreas and Gallbladder. London, UK: BMJ Publishing Group. 2001. p.1-4. Contact: Available from BMJ Publishing Group. BMA Books, BMA House, Tavistock Square, London WCIH 9JR. Fax 44 (0)20 7383 6402. E-mail: [email protected]. Website: www.bmjbooks.com. PRICE: Contact publisher for price. ISBN: 0727915312. Summary: Diseases of the liver, pancreas, and biliary system affect a substantial proportion of the world's population and involve doctors and health care workers across many disciplines. This introductory chapter on the investigation and diagnosis of liver and biliary disease is from an atlas of the liver, pancreas and gallbladder that covers the symptoms, diagnosis, etiology, natural course, and treatment of these diseases. This chapter covers jaundice (the most common presentation of patients with liver and biliary disease), liver function tests, plasma proteins and coagulation factors, imaging in liver and biliary disease, and the use of liver biopsy. The chapter concludes with summary points of the concepts discussed. 7 figures. 1 table.

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Right Upper Quadrant Pain: Gallbladder Disease and its Complications Source: in Edmundowicz, S.A., ed. 20 Common Problems in Gastroenterology. New York, NY: McGraw-Hill, Inc. 2002. p. 233-253.

database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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Contact: Available from McGraw-Hill, Inc. 1221 Avenue of the Americas, New York, NY 10020. (612) 832-7869. Website: www.bookstore.mcgraw-hill.com. PRICE: $45.00;plus shipping and handling. ISBN: 0070220557. Summary: Right upper quadrant pain is a common problem that accounts for many elective and emergency room visits. Although the list of causes is extensive, one of the most common is cholelithiasis (gallstones) and its associated complications. This chapter on gallbladder disease and its complications is from a book that focuses on the most common gastroenterological problems encountered in a primary practice setting. The chapter is organized to support rapid access to the information necessary to evaluate and treat most patients with this problems. Topics include incidence and background; the principal diagnoses, including types of gallstones and the risk factors for developing gallstones; complications of gallstone disease, including symptomatic cholelithiasis, acute cholecystitis, chronic cholecystitis, choledocholithiasis, cholangitis, gallstone pancreatitis, Mirizzi's syndrome, postcholecystectomy syndrome, malignancy, and motility disorders; the typical presentation and key history; physical examination and ancillary tests, including sonography, cholescintigraphy, oral cholecystography, computed tomography (CT) and magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography (ERCP), and blood tests; treatment options, including cholecystectomy (removal of the gallbladder), percutaneous cholecystostomy, dissolution therapy, and extracorporeal shock wave lithotripsy (ESWL); patient education; common errors in diagnosis and treatment; controversies, including the role of Helicobacter pylori in gallstone disease; and emerging concepts. The chapter includes an outline for quick reference, the text itself, a diagnostic and treatment algorithm, and selected references. 7 figures. 1 table. 34 references. •

Endoscopic and Radiologic Treatment of Biliary Disease Source: in Feldman, M.; Friedman, L.S.; Sleisenger, M.H. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 2002. p. 1167-1192. Contact: Available from Elsevier. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 545-2522. Fax (800) 568-5136. Website: www.us.elsevierhealth.com. PRICE: $229.00 plus shipping and handling. ISBN: 0721689736. Summary: Since the early 1980s, there have been dramatic advances in the treatment of biliary disease. While traditional surgical approaches have been refined, new nonoperative techniques have been developed that have supplanted surgery in many situations. This chapter on endoscopic and radiologic treatment of biliary disease is from a comprehensive and authoritative textbook that covers disorders of the gastrointestinal tract, biliary tree, pancreas, and liver, as well as the related topics of nutrition and peritoneal disorders. Topics include endoscopic versus radiologic approaches; an algorithm for choosing endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography; radiation safety; procedural techniques, including those for radiologic intervention and endoscopic intervention; and treatment of specific diseases, including benign diseases, malignant diseases, other conditions, and the use of laparoscopic cholecystectomy (gallbladder removal). The chapter includes a mini-outline with page citations, full-color illustrations, and extensive references. 36 figures. 1 table. 198 references.

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CHAPTER 7. MULTIMEDIA ON GALLBLADDER DISEASE Overview In this chapter, we show you how to keep current on multimedia sources of information on gallbladder disease. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

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

Gallstones Source: Camp Hill, PA: Chek-Med Systems, Inc. 1993. Contact: Available from Chek-Med Systems, Inc. 200 Grandview Avenue, Camp Hill, PA 17011. (800) 451-5797. Fax (717) 761-0216. PRICE: $89 (as of 1995); bulk prices available. Item Number CV-75. Summary: This patient education videotape describes the causes, symptoms, and diagnosis of gallbladder disease. Focusing on gallstones, lumps of salt and cholesterol that form in the gallbladder, the program describes how gallstones form. In addition, the program explains the surgical procedure used to treat gallstones and the postoperative rehabilitation that may be required. (AA-M).

•

Laparoscopic Cholecystectomy: Gallbladder Removal by Laparoscopy Source: Camp Hill, PA: Chek-Med Systems, Inc. 1994. (videocassette).

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Contact: Available from Chek-Med Systems, Inc. 200 Grandview Avenue, Camp Hill, PA 17011. (800) 451-5797 or (717) 761-1170. Fax (717) 761-0216. PRICE: $120.00 each; $215.00 for two in series of 3; $295.00 for whole series. Summary: This patient education videotape provides a brief overview of the use of laparoscopy for the removal of the gallbladder (laparoscopic cholecystectomy). The videotape features a general introduction to the procedure of laparoscopy, noting that it usually results in less patient discomfort, a quicker recovery time, and lower cost. The program shows a series of patients expressing their concerns and the results they obtained with laparoscopy. The program then defines the role of the gallbladder, the development of gallstones, typical symptoms of gallbladder disease, and diagnostic considerations. After mention of the standard 'open' surgery previously used for gallbladder removal, the program covers the advantages, risk factors and patient selection issues for laparoscopic cholecystectomy. The program then uses graphics to show how the actual laparoscopic procedure is conducted. The program concludes by showing one patient's postoperative recovery period. The program features Dr. Paul Kunkel. •

Laparoscopic Cholecystectomy Source: Timonium, MD: Milner-Fenwick, Inc. 1995. Contact: Available from Milner-Fenwick, Inc. 2125 Greenspring Drive, Timonium, MD 21093. (800) 432-8433. Fax (410) 252-6316. PRICE: $175 (as of 1995). Order Number GS10. Summary: This videotape program on laparoscopic cholecystectomy explains gallbladder disease and notes that surgical removal of the gallbladder is the only permanent cure. The program describes how laparoscopic cholecystectomy has replaced most traditional operations, resulting in shorter and easier recovery. The program also details the patient's hospital experience, home recovery, and risks. (AA-M).

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

Laparoscopic treatment of chronic gallbladder disease and intractable duodenal ulcer [videorecording] Source: produced by Ciné-Med; Year: 1994; Format: Videorecording; Woodbury, Conn.: Ciné-Med, c1994

•

Surgical treatment of gallbladder disease [filmstrip] Source: Trainex Corporation; Year: 1977; Format: Filmstrip; Garden Grove, Calif.: Trainex, c1977

•

Surgical treatment of gallbladder disease [videorecording] Source: Trainex Corporation; Year: 1977; Format: Videorecording; Garden Grove, Calif.: Trainex, c1977

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CHAPTER 8. PERIODICALS AND NEWS ON GALLBLADDER DISEASE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover gallbladder disease.

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

Substantial portion of variations in gallbladder disease due to genetic factors Source: Reuters Medical News Date: June 27, 2002

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Coffee consumption appears not to protect against gallbladder disease Source: Reuters Medical News Date: November 28, 2000

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Low vitamin C levels increase risk of gallbladder disease in women Source: Reuters Medical News Date: April 10, 2000

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Gallbladder disease more prevalent in women, but only at younger age Source: Reuters Medical News Date: September 15, 1999

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Vitamin C Plus Alcohol May Protect Against Gallbladder Disease Source: Reuters Medical News Date: March 10, 1998

•

New Findings From Europe On Gallbladder Disease Presented At Gastro Meeting Source: Reuters Medical News Date: May 16, 1995 The NIH

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

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you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “gallbladder disease” (or synonyms). If you know the name of a company that is relevant to gallbladder disease, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “gallbladder disease” (or synonyms).

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

Gallbladder Disease: What to Do About Troublesome Stones Source: Mayo Clinic Women's Healthsource. 3(9): 6. September 1999. Contact: Available from Mayo Foundation for Medical Education and Research. 200 First Street SW, Rochester, MN 55905. Summary: This health newsletter article offers guidelines to identifying and managing a gallstone attack. The author notes the risk factors for gallstones, including female gender, family history, being moderately overweight, losing weight rapidly, and taking estrogen pills. The author then briefly reviews the placement and function of the gallbladder, notably as the storage facility for liver bile (which helps the small intestine digest fat). Gallstones can be tiny or big and about 80 percent of the time, stones cause no problems. However, gallstones can block the exit from the gallbladder which is when the pain (biliary colic) begins. Gallbladder attacks are infrequent, occurring weeks, months, even years apart, and last from 30 minutes to several hours. Pain is the main symptom of gallstone disease. If the pain is severe and continuous in the upper abdomen and lasts for at least half an hour, the health care provider may recommend an ultrasound to confirm the presence of stones or other signs of gallbladder disease. The treatment for gallstones is usually cholecystectomy (gallbladder removal). Most often, the surgery is performed laparoscopically, which requires only three small incisions. Readers are reassured that gallstone attacks are usually infrequent, but if surgery is required, the cholecystectomy is a safe, common procedure. 2 figures.

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

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APPENDICES

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

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

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

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

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

•

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

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

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

•

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

7

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

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

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

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

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

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

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

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

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

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

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

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

•

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

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

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

•

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

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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

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

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

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

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

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

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

8

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

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•

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

•

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

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “gallbladder disease” using the “Detailed Search” option. Go directly to the following hyperlink: 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 the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “gallbladder disease” (or synonyms) into the “For these words:” box. The following is a sample result: •

Findings from the Survey of American Indians and Alaska Natives: Prevalence of Chronic Diseases Source: Intramural Research Highlights. Number 18: 1-3. November 1992. Summary: This article summarizes information from a study about the prevalence of chronic disease among American Indians and Alaska Natives and the U.S. population. The study used data obtained from the Survey of American Indians and Alaska Natives (SAIAN), a component of the 1987 National Medical Expenditure Survey (NMES) that examined access to health care of American Indians and Alaska Natives living on or near reservations or in the State of Alaska and eligible for health services provided or supported by the Indian Health Service (IHS). Results show that diabetes and gallbladder disease were particularly prevalent in the IHS-eligible population. The article concludes that, while infectious diseases and resulting mortality have decreased substantially for this population over the last decade, their burden of chronic disease, including diabetes, may be rising. 3 figures. 1 reference.

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 “gallbladder disease” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category.

10 11

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).

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Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 32530 160 963 18 0 33671

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 “gallbladder disease” (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 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/.

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

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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/.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on gallbladder disease can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to gallbladder disease. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to gallbladder disease. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “gallbladder disease”:

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•

Other guides Cirrhosis http://www.nlm.nih.gov/medlineplus/cirrhosis.html Digestive Diseases http://www.nlm.nih.gov/medlineplus/digestivediseases.html Gallbladder and Bile Duct Diseases http://www.nlm.nih.gov/medlineplus/gallbladderandbileductdiseases.html Heart Diseases http://www.nlm.nih.gov/medlineplus/heartdiseases.html Hepatitis http://www.nlm.nih.gov/medlineplus/hepatitis.html Hormone Replacement Therapy http://www.nlm.nih.gov/medlineplus/hormonereplacementtherapy.html Liver Diseases http://www.nlm.nih.gov/medlineplus/liverdiseases.html Liver Transplantation http://www.nlm.nih.gov/medlineplus/livertransplantation.html Pancreatic Diseases http://www.nlm.nih.gov/medlineplus/pancreaticdiseases.html

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

Fact Sheet: Hepatitis, Liver and Gallbladder Diseases in the United States Source: New York, NY: American Liver Foundation. 1997. 2 p. Contact: Available from American Liver Foundation. 75 Maiden Lane, Suite 603, New York, NY 10038. (800) 465-4837. Fax: (212) 483-8179. E-mail: [email protected]. Website: www.liverfoundation.org. PRICE: $.50; discounts available for large orders. Summary: This fact sheet offers basic statistics about hepatitis (liver inflammation), liver, and gallbladder diseases in the United States. The fact sheet covers epidemiology,

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mortality (deaths), etiology (causes), transmission, chronic disease (hepatitis), costs, risk factors, ethnic groups, transplantation, and prevention. The fact sheet concludes with the contact information for the American Liver Foundation, a nonprofit, national voluntary health organization dedicated to the prevention, treatment, and cure of hepatitis and other liver diseases. (www.liverfoundation.org). •

Initial Imaging Studies for Suspected Gallbladder Disease Source: Hospital Medicine. 27(2): 86. February 1991. Summary: This one page illustrated fact sheet summarizes the initial imaging studies used for suspected gallbladder disease. In the patient with a history and physical findings characteristic of gallbladder disease, ultrasonography is usually the initial diagnostic study. The fact sheet reviews the usefulness of ultrasound and then suggests that if the sonogram fails to confirm the existence of strongly suspected chronic cholecystitis or cholelithiasis, then an oral cholecystogram may be employed. 3 figures. The National Guideline Clearinghouse™

The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “gallbladder disease” (or synonyms). The following was recently posted: •

American Gastroenterological Association medical position statement: guidelines for the management of malnutrition and cachexia, chronic diarrhea, and hepatobiliary disease in patients with human immunodeficiency virus infection Source: American Gastroenterological Association - Medical Specialty Society; 1996 December (reviewed 2001); 31 pages http://www.guideline.gov/summary/summary.aspx?doc_id=837&nbr=41& string=biliary+AND+disease

•

Treatment of gallstone and gallbladder disease Source: Society for Surgery of the Alimentary Tract, Inc - Medical Specialty Society; 1996 (revised 2000); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1704&nbr=930&am p;string=gallbladder+AND+disease 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 gallbladder disease. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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


•

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 gallbladder disease. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with gallbladder disease. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about gallbladder disease. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “gallbladder disease” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given

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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 “gallbladder disease”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “gallbladder disease” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “gallbladder disease” (or a synonym) into the search box, and click “Submit Query.”

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

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

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

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

18

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

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

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

19

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

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•

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

•

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

•

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

•

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

•

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Gallbladder Disease Gallbladder disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001138.htm

•

Signs & Symptoms for Gallbladder Disease Abdominal fullness, gaseous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003124.htm Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Chest pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm

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Heartburn Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003114.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm •

Diagnostics and Tests for Gallbladder Disease Abdominal CT scan Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003789.htm Abdominal ultrasound Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003777.htm Abdominal X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003815.htm ALT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003473.htm Amylase, urine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003607.htm CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Chem-20 Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003468.htm Chemistry panel Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003468.htm CT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003330.htm Gall bladder radionuclide scan Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003826.htm Ultrasound Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003336.htm White blood cell count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003643.htm X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm

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•

Nutrition for Gallbladder Disease Fat Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002468.htm Fats Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002468.htm

•

Background Topics for Gallbladder Disease Bile Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002237.htm Duodenum Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002347.htm Palpation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002284.htm Weight reduction Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001940.htm

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

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

•

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

•

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

101

GALLBLADDER DISEASE 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] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Ablation: The removal of an organ by surgery. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [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] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aetiology: Study of the causes of disease. [EU] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when

102 Gallbladder Disease

their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaemia: A reduction below normal in the number of erythrocytes per cu. mm., in the quantity of haemoglobin, or in the volume of packed red cells per 100 ml. of blood which occurs when the equilibrium between blood loss (through bleeding or destruction) and blood production is disturbed. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH]

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Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Aneurysm: Aneurysm of the aorta. [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] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Aqueous: Having to do with water. [NIH] 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]


Articular: Of or pertaining to a joint. [EU] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aspiration: The act of inhaling. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bezoars: Concretions of swallowed hair, fruit or vegetable fibers, or similar substances found in the alimentary canal. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU]

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Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biphasic: Having two phases; having both a sporophytic and a gametophytic phase in the life cycle. [EU] Bladder: The organ that stores urine. [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 Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] 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]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic


disease. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Carrier State: The condition of harboring an infective organism without manifesting symptoms of infection. The organism must be readily transmissable to another susceptible host. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Caustic: An escharotic or corrosive agent. Called also cauterant. [EU] Celiac Artery: The arterial trunk that arises from the abdominal aorta and after a short course divides into the left gastric, common hepatic and splenic arteries. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH]

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Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Cholangiography: Radiographic examination of the bile ducts. [NIH] Cholangitis: Inflammation of a bile duct. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Cholecystography: Radiography of the gallbladder after ingestion of a contrast medium. [NIH]

Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [NIH] Cholecystostomy: Establishment of an opening into the gallbladder either for drainage or surgical communication with another part of the digestive tract, usually the duodenum or jejunum. [NIH] Choledocholithiasis: Gallstones in the bile ducts. [NIH] Cholelithiasis: Presence or formation of gallstones. [NIH] Choleretic: A choleretic agent. [EU] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [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] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening,


prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [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] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Common Bile Duct: The largest biliary duct. It is formed by the junction of the cystic duct and the hepatic duct. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the

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classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] 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] 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 Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]

Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] 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] Cystic Duct: The tube that carries bile from the gallbladder into the common bile duct and the small intestine. [NIH] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some nonleukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses

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to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [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] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenum: The first part of the small intestine. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Eicosanoids: A class of oxygenated, endogenous, unsaturated fatty acids derived from arachidonic acid. They include prostaglandins, leukotrienes, thromboxanes, and hydroxyeicosatetraenoic acid compounds (HETE). They are hormone-like substances that act near the site of synthesis without altering functions throughout the body. [NIH]


Ejection fraction: A measure of ventricular contractility, equal to normally 65 8 per cent; lower values indicate ventricular dysfunction. [EU] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolytes: Substances that break up into ions (electrically charged particles) when they are dissolved in body fluids or water. Some examples are sodium, potassium, chloride, and calcium. Electrolytes are primarily responsible for the movement of nutrients into cells, and the movement of wastes out of cells. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encopresis: Incontinence of feces not due to organic defect or illness. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopic retrograde cholangiopancreatography: ERCP. A procedure to x-ray the pancreatic duct, hepatic duct, common bile duct, duodenal papilla, and gallbladder. In this procedure, a thin, lighted tube (endoscope) is passed through the mouth and down into the first part of the small intestine (duodenum). A smaller tube (catheter) is then inserted through the endoscope into the bile and pancreatic ducts. A dye is injected through the catheter into the ducts, and an x-ray is taken. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH]

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Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [NIH] Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocyte Indices: Quantification of size and cell hemoglobin content or concentration of the erythrocyte, usually derived from erythrocyte count, blood hemoglobin concentration, and hematocrit. Includes the mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC). Use also for cell diameter and thickness. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracorporeal: Situated or occurring outside the body. [EU]


Failure to Thrive: A condition in which an infant or child's weight gain and growth are far below usual levels for age. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [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] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fine-needle aspiration: The removal of tissue or fluid with a needle for examination under a microscope. Also called needle biopsy. [NIH] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Fulminant Hepatic Failure: Liver failure that occurs suddenly in a previously healthy person. The most common causes of FHF are acute hepatitis, acetaminophen overdose, and liver damage from prescription drugs. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH]

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Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Bypass: Surgical procedure in which the stomach is transected high on the body. The resulting proximal remnant is joined to a loop of the jejunum in an end-to-side anastomosis. This procedure is used frequently in the treatment of morbid obesity. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal Hemorrhage: Bleeding in the gastrointestinal tract. [NIH] Gastrointestinal Hormones: Hormones secreted by the gastrointestinal mucosa that affect the timing or the quality of secretion of digestive enzymes, and regulate the motor activity of the digestive system organs. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genetic Techniques: Chromosomal, biochemical, intracellular, and other methods used in the study of genetics. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] 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] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU]


Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Granulomas: Small lumps in tissues caused by inflammation. [NIH] Gravidity: Pregnancy; the condition of being pregnant, without regard to the outcome. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [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] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [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] Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hepatic Artery: A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum. [NIH] Hepatic Duct, Common: Predominantly extrahepatic bile duct which is formed by the junction of the right and left hepatic ducts, which are predominantly intrahepatic, and, in turn, joins the cystic duct to form the common bile duct. [NIH] Hepatic Encephalopathy: A condition that may cause loss of consciousness and coma. It is usually the result of advanced liver disease. Also called hepatic coma. [NIH]

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Hepatic Veins: Veins which drain the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatobiliary: Pertaining to the liver and the bile or the biliary ducts. [EU] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocyte: A liver cell. [NIH] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [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] Host: Any animal that receives a transplanted graft. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperlipoproteinemia: Metabolic disease characterized by elevated plasma cholesterol and/or triglyceride levels. The inherited form is attributed to a single gene mechanism. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypotension: Abnormally low blood pressure. [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]


Ileal: Related to the ileum, the lowest end of the small intestine. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Ileus: Obstruction of the intestines. [EU] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunoglobulins: Glycoproteins present in the blood (antibodies) and in other tissue. They are classified by structure and activity into five classes (IgA, IgD, IgE, IgG, IgM). [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Insufflation: The act of blowing a powder, vapor, or gas into any body cavity for experimental, diagnostic, or therapeutic purposes. [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]

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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] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iopanoic Acid: Radiopaque medium used as diagnostic aid. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Laparotomy: A surgical incision made in the wall of the abdomen. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense


reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal tract and the immune system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [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] Lithotripsy: The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is laser lithotripsy. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low-calorie diet: Caloric restriction of about 800 to 1,500 calories (approximately 12 to 15 kcal/kg of body weight) per day. [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] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy

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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] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammogram: An x-ray of the breast. [NIH] Meconium: The thick green-to-black mucilaginous material found in the intestines of a fullterm fetus. It consists of secretions of the intestinal glands, bile pigments, fatty acids, amniotic fluid, and intrauterine debris. It constitutes the first stools passed by a newborn. [NIH]

Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [NIH] 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] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions


which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [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] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Mucilaginous: Pertaining to or secreting mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary

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thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle biopsy: The removal of tissue or fluid with a needle for examination under a microscope. Also called fine-needle aspiration. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP.


[NIH]

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] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Omentum: A fold of the peritoneum (the thin tissue that lines the abdomen) that surrounds the stomach and other organs in the abdomen. [NIH] Oophorectomy: Surgery to remove one or both ovaries. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] 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] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU]

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Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Ducts: Ducts that collect pancreatic juice from the pancreas and supply it to the duodenum. [NIH] Pancreatic Insufficiency: Absence of or reduced pancreatic exocrine secretion into the duodenum and resultant poor digestion of lipids, vitamins, nitrogen, and carbohydrates. [NIH]

Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Papilla: A small nipple-shaped elevation. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Parity: The number of offspring a female has borne. It is contrasted with gravidity, which refers to the number of pregnancies, regardless of outcome. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvic inflammatory disease: A bacteriological disease sometimes associated with intrauterine device (IUD) usage. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves


peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Percutaneous transhepatic cholangiography: A procedure to x-ray the hepatic and common bile ducts. A contrasting agent is injected into the liver or bile duct, and the ducts are then xrayed to find the point of obstruction. Also called PTC. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotypes: An organism as observed, i. e. as judged by its visually perceptible characters resulting from the interaction of its genotype with the environment. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [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] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [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.

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[NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [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] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] 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] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Postcholecystectomy Syndrome: A condition that occurs after gallbladder removal. The muscle between the gallbladder and the small intestine does not work properly, causing pain, nausea, and indigestion. Also called biliary dyskinesia. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prenatal Care: Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality. [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] Primary Biliary Cirrhosis: A chronic liver disease. Slowly destroys the bile ducts in the liver. This prevents release of bile. Long-term irritation of the liver may cause scarring and cirrhosis in later stages of the disease. [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] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] 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 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] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH]

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Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] 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] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] 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] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal cysts: Abnormal fluid-filled sacs in the kidney that range in size from microscopic to


much larger. Many simple cysts are harmless, while other types can seriously damage the kidneys. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] 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] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [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] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sincalide: A polypeptide hormone present in the intestine and brain. When secreted from the gastric mucosa, it stimulates the release of both bile from the gallbladder, and the release of digestive enzymes from the pancreas. [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

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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] Sludge: A clump of agglutinated red blood cells. [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] Software Design: Specifications and instructions applied to the software. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sonogram: A computer picture of areas inside the body created by bouncing sound waves off organs and other tissues. Also called ultrasonogram or ultrasound. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] 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] 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] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions


of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Technetium: The first artificially produced element and a radioactive fission product of uranium. The stablest isotope has a mass number 99 and is used diagnostically as a radioactive imaging agent. Technetium has the atomic symbol Tc, atomic number 43, and atomic weight 98.91. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thromboembolism: Obstruction of a vessel by a blood clot that has been transported from a distant site by the blood stream. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] 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] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH]

Dictionary 133

Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [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] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] TYPHI: The bacterium that gives rise to typhoid fever. [NIH] Typhoid fever: The most important member of the enteric group of fevers which also includes the paratyphoids. [NIH] Typhoid fever: The most important member of the enteric group of fevers which also includes the paratyphoids. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] 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] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Uranium: A radioactive element of the actinide series of metals. It has an atomic symbol U, atomic number 92, and atomic weight 238.03. U-235 is used as the fissionable fuel in nuclear weapons and as fuel in nuclear power reactors. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of


urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] 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] Ursodeoxycholic Acid: An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

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] Vagotomy: The interruption or removal of any part of the vagus (10th cranial) nerve. Vagotomy may be performed for research or for therapeutic purposes. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [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] Ventricular: Pertaining to a ventricle. [EU] Ventricular Dysfunction: A condition in which the ventricles of the heart exhibit a decreased functionality. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Villus: Cell found in the lining of the small intestine. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and

Dictionary 135

kill, tumor cells. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Wound Infection: Invasion of the site of trauma by pathogenic microorganisms. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-Ray Film: A film base coated with an emulsion designed for use with X-rays. [NIH]

137

INDEX A Abdomen, 75, 101, 105, 107, 113, 119, 120, 124, 126, 130, 131, 132 Abdominal, 4, 23, 33, 46, 66, 67, 97, 98, 101, 106, 108, 111, 119, 121, 125, 126, 130, 133 Abdominal Pain, 4, 23, 33, 66, 67, 101, 121, 133 Ablation, 6, 101 Acceptor, 101, 120, 124 Acetaminophen, 101, 114 Acetylcholine, 101, 107, 123 Adaptability, 101, 106 Adipocytes, 101, 119 Adolescence, 66, 101 Adrenal Glands, 5, 101 Adverse Effect, 101, 130 Aetiology, 22, 101 Afferent, 101, 119 Age of Onset, 101, 133 Airway, 101, 131 Albumin, 101, 127 Alertness, 5, 102 Algorithms, 102, 105 Alimentary, 87, 102, 104, 113, 125, 126 Alkaline, 102, 106 Alkaloid, 102, 122 Alpha Particles, 102, 129 Alternative medicine, 74, 102 Amino Acids, 102, 126, 127, 128, 133 Amniotic Fluid, 102, 121 Ampulla, 64, 66, 102, 107, 112 Anaemia, 42, 50, 102 Anal, 67, 102 Analgesic, 101, 102, 122, 124 Anaplasia, 102, 123 Anastomosis, 102, 115 Anatomical, 69, 102, 105, 118 Anemia, 67, 102, 116 Anesthesia, 6, 101, 102 Aneurysm, 46, 102, 103 Angina, 25, 102, 103 Angina Pectoris, 25, 103 Anomalies, 66, 103 Anorectal, 65, 103 Antibody, 103, 108, 110, 118, 121 Antigen, 103, 108, 118, 121 Antioxidant, 103, 104, 124

Anus, 102, 103, 105, 114 Anxiety, 65, 103 Aorta, 103, 106 Aortic Aneurysm, 46, 103 Apnea, 103 Apolipoproteins, 103, 120 Apoptosis, 8, 103 Appendicitis, 64, 66, 103 Aqueous, 103, 104, 110, 112 Arachidonic Acid, 103, 111, 119, 128 Arginine, 103, 123 Arterial, 103, 106, 107, 117, 128, 132 Arteries, 103, 105, 106, 110, 120, 122, 132 Articular, 104, 124 Ascites, 63, 66, 104 Ascorbic Acid, 41, 50, 104 Aspiration, 22, 65, 104 Asymptomatic, 5, 14, 104, 125 Attenuation, 31, 104 Atypical, 5, 104 Autodigestion, 104, 125 B Bacteria, 103, 104, 114, 115, 122, 129, 130, 134 Bacterium, 104, 133 Base, 8, 104, 110, 119, 133, 135 Benign, 14, 16, 37, 64, 66, 70, 104, 123 Bezoars, 66, 104 Bile Acids, 67, 104 Bile Acids and Salts, 104 Bile Ducts, 64, 66, 104, 107, 115, 128 Bile Pigments, 104, 119, 121 Biliary Tract, 4, 60, 64, 66, 104, 125 Bilirubin, 101, 104, 115, 117 Bioavailability, 59, 104 Biochemical, 5, 12, 105, 114, 115, 124 Biopsy, 45, 63, 65, 69, 105, 126 Biotechnology, 12, 68, 74, 81, 105 Biphasic, 31, 105 Bladder, 11, 64, 98, 105, 118, 120, 128, 133, 134 Blood Cell Count, 98, 105, 116 Blood Coagulation, 105, 106 Blood Glucose, 105, 116, 119 Blood pressure, 105, 106, 117, 122 Blood vessel, 105, 106, 112, 126, 131, 132, 134 Body Composition, 8, 105


Body Fluids, 105, 111, 112 Body Mass Index, 9, 105, 124 Body Regions, 105, 108 Bowel, 6, 20, 66, 67, 102, 105, 111, 119, 126, 130, 131, 133 Bowel Movement, 105, 111, 131 Bradykinin, 105, 123, 127 Branch, 95, 105, 116, 125, 131, 132 Breakdown, 105, 111, 115 Bypass, 30, 105 C Cachexia, 87, 105 Calcification, 4, 5, 41, 106 Calcium, 26, 64, 106, 108, 112, 122 Carbohydrates, 106, 125 Carcinoma, 5, 31, 66, 106 Cardiac, 22, 26, 106, 113, 115, 122, 123 Cardiovascular, 7, 10, 34, 42, 106, 120 Cardiovascular disease, 10, 42, 106 Carrier Proteins, 106, 127 Carrier State, 34, 106 Causal, 3, 9, 106 Caustic, 66, 106 Celiac Artery, 106, 116 Celiac Disease, 66, 106 Cell Death, 8, 11, 103, 106, 123 Cell Size, 106, 114 Central Nervous System, 101, 106, 107, 120, 122 Cerebrovascular, 106 Character, 103, 106, 110, 115 Chenodeoxycholic Acid, 107, 134 Chest wall, 5, 107 Cholangiography, 6, 107 Cholangitis, 5, 28, 64, 66, 70, 107 Cholecystectomy, 4, 5, 6, 9, 18, 24, 25, 35, 37, 40, 46, 50, 70, 71, 72, 75, 107 Cholecystitis, 4, 5, 6, 11, 69, 70, 87, 107 Cholecystography, 17, 20, 28, 32, 34, 37, 39, 41, 44, 45, 46, 70, 107 Cholecystokinin, 14, 17, 21, 22, 39, 41, 43, 45, 107 Cholecystostomy, 70, 107 Choledocholithiasis, 4, 70, 107 Cholelithiasis, 5, 69, 70, 87, 107 Choleretic, 107, 134 Cholestasis, 42, 64, 66, 68, 107 Cholesterol, 3, 9, 10, 15, 17, 64, 71, 104, 107, 110, 111, 115, 117, 120 Cholesterol Esters, 107, 120 Choline, 52, 107 Chromatin, 103, 107

Chromosome, 107, 120 Chronic Disease, 8, 64, 82, 87, 106, 107 Chylomicrons, 107, 120 Citrus, 104, 107 Clinical Medicine, 107, 127 Clinical trial, 7, 59, 60, 81, 107, 125, 129 Cloning, 105, 108 Coagulation, 69, 105, 108, 127 Coenzyme, 104, 108 Cofactor, 108, 128 Colic, 16, 75, 108 Colitis, 108 Collapse, 105, 108, 131 Colorectal, 31, 67, 108 Colorectal Cancer, 67, 108 Common Bile Duct, 6, 33, 108, 110, 116, 126 Comorbidity, 5, 108 Complement, 108, 109, 127 Complementary and alternative medicine, 53, 56, 109 Complementary medicine, 53, 109 Computational Biology, 81, 109 Computed tomography, 63, 66, 70, 109 Computerized axial tomography, 109 Computerized tomography, 109 Conception, 109, 114 Connective Tissue, 104, 109, 114, 132 Consciousness, 102, 109, 116 Constipation, 66, 67, 109 Consumption, 9, 11, 16, 74, 109 Contamination, 109, 117 Contraceptive, 37, 109 Contractility, 109, 112 Contraindications, ii, 6, 109 Coronary, 3, 7, 20, 25, 103, 106, 110, 122 Coronary Circulation, 103, 110 Coronary heart disease, 7, 106, 110 Coronary Thrombosis, 110, 122, 123 Cranial, 110, 134 Critical Care, 14, 110 Curative, 110, 123, 132 Cyclic, 110, 116, 123, 128 Cystic Duct, 6, 108, 110, 116 Cytokines, 11, 110 Cytoplasm, 103, 110 Cytotoxic, 11, 110 D Databases, Bibliographic, 81, 110 Degenerative, 5, 110, 117, 124 Deletion, 103, 110 Delivery of Health Care, 65, 110, 116

Index 139

Density, 15, 105, 110, 111, 114, 120, 124, 131 Diabetes Mellitus, 8, 10, 36, 39, 42, 110, 115, 116 Diagnostic Imaging, 19, 20, 110 Diagnostic procedure, 74, 111 Diaphragm, 111, 117 Diarrhea, 66, 67, 87, 111, 121 Diastolic, 111, 117 Digestion, 18, 65, 67, 102, 104, 105, 111, 118, 119, 120, 125, 126, 131 Digestive system, 61, 65, 66, 111, 115 Digestive tract, 107, 111, 131 Dilatation, 102, 111, 134 Direct, iii, 11, 107, 111, 129 Dissection, 6, 111 Distal, 8, 111, 129 Drug Interactions, 111 Duct, 5, 6, 60, 86, 102, 107, 108, 111, 112, 113, 116, 126, 130 Duodenal Ulcer, 8, 72, 111 Duodenum, 8, 99, 104, 107, 111, 112, 116, 119, 125, 131 Dyskinesia, 111, 127 Dyslipidemia, 7, 33, 111 Dyspepsia, 18, 32, 34, 67, 111, 118 Dysphagia, 67, 111 E Eating Disorders, 64, 65, 66, 111 Efficacy, 24, 60, 111 Eicosanoids, 44, 50, 111 Ejection fraction, 19, 21, 112 Elective, 41, 70, 112 Electrocoagulation, 108, 112 Electrolytes, 104, 112 Electrons, 103, 104, 112, 119, 124, 129 Embolism, 6, 112 Emulsion, 112, 135 Encopresis, 66, 112 Endocrine Glands, 112 Endometrial, 7, 112 Endometrium, 112 Endoscope, 112 Endoscopic, 4, 22, 23, 70, 112 Endoscopic retrograde cholangiopancreatography, 70, 112 Endoscopy, 4, 22, 31, 45, 64, 66, 112 Endothelium, 112, 123 Endothelium-derived, 112, 123 Energy balance, 113, 119 Energy Intake, 9, 113 Enteral Nutrition, 66, 113

Environmental Health, 80, 82, 113 Enzymatic, 106, 109, 113 Enzyme, 108, 113, 116, 125, 127 Enzyme Inhibitors, 113, 127 Epidemiological, 10, 11, 113 Epigastric, 113, 125 Epinephrine, 113, 133 Epithelial, 8, 113 Epithelial Cells, 8, 113 Erythema, 113, 134 Erythrocyte Indices, 105, 113 Erythrocytes, 102, 105, 113, 129 Esophageal, 65, 113 Esophagus, 66, 111, 113, 115, 116, 129, 131 Estrogen, 4, 15, 23, 50, 53, 75, 113 Ethnic Groups, 87, 113 Evacuation, 109, 113 Excitation, 113, 114 Exocrine, 107, 113, 125 Exogenous, 113, 133 Extracorporeal, 6, 70, 113 F Failure to Thrive, 66, 114 Family Planning, 65, 81, 114 Fat, 9, 10, 59, 75, 99, 101, 103, 104, 105, 110, 114, 119, 120, 124, 133 Fatigue, 64, 114 Fatty acids, 101, 111, 114, 121, 128, 132 Feces, 109, 112, 114, 131 Fetus, 114, 121, 127, 134 Fibrinogen, 114, 127 Fibrosis, 7, 27, 28, 36, 45, 59, 66, 114 Fine-needle aspiration, 114, 123 Flatulence, 67, 114 Flatus, 114, 115 Flow Cytometry, 37, 114 Fluorescence, 114 Fluorescent Dyes, 114 Fulminant Hepatic Failure, 66, 114 G Gallstones, 3, 4, 5, 6, 9, 10, 11, 17, 20, 32, 39, 54, 64, 66, 70, 71, 72, 75, 104, 107, 115, 134 Gas, 6, 67, 114, 115, 117, 118, 121, 123, 124, 134 Gastric, 8, 32, 40, 66, 104, 106, 115, 116, 126, 130 Gastric Bypass, 40, 115 Gastric Juices, 115, 126 Gastric Mucosa, 115, 126, 130


Gastroenterology, 4, 6, 14, 16, 17, 22, 23, 27, 30, 31, 32, 38, 40, 44, 45, 54, 66, 67, 69, 115 Gastrointestinal, 4, 6, 7, 18, 22, 41, 45, 64, 65, 67, 70, 105, 107, 113, 114, 115, 120, 132 Gastrointestinal Hemorrhage, 66, 115 Gastrointestinal Hormones, 18, 115 Gastrointestinal tract, 4, 70, 114, 115, 120 Gastrostomy, 113, 115 Gene, 11, 38, 43, 68, 105, 115, 117 Genetic Techniques, 11, 115 Genetics, 6, 10, 32, 115 Genotype, 15, 115, 126 Gestational, 9, 115 Gland, 115, 125, 128, 130, 132 Glucose, 104, 105, 110, 115, 116, 118 Glucose Intolerance, 110, 115 Gluten, 57, 106, 115 Governing Board, 116, 127 Granulomas, 64, 116 Gravidity, 116, 125 Growth, 101, 103, 106, 114, 116, 121, 123, 127, 132 Guanylate Cyclase, 116, 123 H Health Care Costs, 8, 116 Health Expenditures, 116 Health Services, iv, 6, 82, 83, 110, 116 Heart attack, 106, 116 Heartburn, 65, 67, 98, 116, 117, 118 Hematocrit, 105, 113, 116 Hematology, 63, 66, 116 Hemoglobin, 102, 105, 113, 116 Hemorrhage, 112, 116, 131 Hepatic, 4, 63, 66, 67, 102, 106, 108, 112, 116, 117, 126 Hepatic Artery, 64, 66, 116 Hepatic Duct, Common, 112, 116 Hepatic Encephalopathy, 63, 66, 116 Hepatic Veins, 66, 117 Hepatitis, 64, 66, 86, 114, 117, 134 Hepatitis A, 87, 117 Hepatobiliary, 4, 5, 6, 10, 33, 43, 59, 67, 68, 87, 117 Hepatocellular, 63, 117 Hepatocyte, 107, 117 Hepatovirus, 117 Heredity, 115, 117 Hernia, 6, 46, 66, 117 Hiatal Hernia, 65, 117

Hormone, 86, 111, 113, 117, 118, 119, 130, 132 Host, 106, 117, 119 Hydrogen, 101, 104, 106, 117, 120, 122, 123, 124, 129 Hydrophobic, 117, 120 Hyperbilirubinemia, 33, 117, 119 Hypercholesterolemia, 111, 117 Hyperlipidemia, 111, 117 Hyperlipoproteinemia, 16, 25, 39, 117 Hypertension, 5, 6, 7, 21, 64, 65, 66, 106, 117, 133 Hypertriglyceridemia, 111, 117 Hypotension, 5, 117 Hysterectomy, 64, 117 I Id, 51, 54, 87, 88, 94, 96, 117 Ileal, 30, 118 Ileostomy, 44, 118 Ileum, 118, 119 Ileus, 8, 118 Immune response, 103, 118, 132, 134 Immune system, 64, 118, 120 Immunodeficiency, 29, 87, 118 Immunoglobulins, 118, 127 Impairment, 107, 111, 118, 121 Incision, 118, 119 Incontinence, 64, 65, 112, 118 Indicative, 67, 118, 125, 134 Indigestion, 118, 127 Infancy, 64, 66, 118 Infarction, 110, 118, 122, 123 Infection, 4, 5, 29, 87, 106, 118, 120, 131, 134 Inflammation, 5, 11, 86, 102, 103, 107, 108, 114, 116, 117, 118, 120, 125, 132, 133, 134 Infusion, 14, 34, 118 Ingestion, 66, 107, 118, 127 Insufflation, 6, 118 Insulin, 9, 10, 16, 34, 118, 119, 133 Insulin-dependent diabetes mellitus, 34, 118, 119 Internal Medicine, 13, 21, 25, 41, 50, 115, 116, 119 Intestinal, 7, 65, 106, 107, 119, 121 Intestine, 66, 104, 105, 108, 119, 130 Intracellular, 115, 118, 119, 123, 128 Intramuscular, 119, 125 Intravenous, 66, 118, 119, 125 Intrinsic, 31, 119 Invasive, 5, 119, 120 Ions, 104, 112, 117, 119

Index 141

Iopanoic Acid, 20, 119 J Jaundice, 6, 64, 66, 69, 117, 119 Jejunostomy, 113, 119 Jejunum, 107, 115, 119 Joint, 104, 119, 124, 132 K Kb, 80, 119 Kinetics, 16, 119 L Laparoscopy, 6, 71, 72, 119 Laparotomy, 19, 119 Large Intestine, 108, 111, 119, 129, 131 Leptin, 9, 40, 119 Leukocytes, 105, 110, 119 Leukotrienes, 44, 103, 111, 119 Library Services, 94, 120 Life cycle, 64, 65, 105, 120 Ligament, 120, 128 Linkage, 11, 120 Lipid, 3, 38, 103, 107, 118, 120, 124, 133 Lipid Peroxidation, 120, 124 Lipoprotein, 15, 111, 120 Lithotripsy, 6, 70, 120 Liver Transplantation, 23, 66, 86, 120 Localized, 11, 118, 120, 127, 133, 134 Locomotion, 7, 120, 127 Loop, 115, 117, 118, 120 Low-calorie diet, 4, 35, 120 Low-density lipoprotein, 111, 120 Lupus, 120, 132 Lymphatic, 112, 118, 120 M Magnetic Resonance Imaging, 63, 66, 70, 120 Malabsorption, 66, 106, 121, 130 Malabsorption syndrome, 121, 130 Malignancy, 5, 70, 121 Malignant, 36, 64, 70, 121, 123 Malnutrition, 87, 102, 105, 121 Mammogram, 106, 121, 122 Meconium, 8, 121 Mediator, 107, 121 MEDLINE, 81, 121 Melanin, 121, 126, 133 Membrane, 8, 109, 121, 122, 126, 127 Memory, 64, 121 Menopause, 23, 55, 64, 65, 121, 127 Menstruation, 121 Mental Disorders, 61, 121 Mentors, 10, 121 Mercury, 114, 121

Meta-Analysis, 37, 121 Metastasis, 122, 123 MI, 17, 38, 65, 99, 122 Microbiology, 104, 122 Microcalcifications, 106, 122 Microscopy, 5, 122 Miscarriage, 65, 122 Mitosis, 103, 122 Modification, 122, 129 Molecular, 11, 12, 81, 83, 105, 109, 114, 122 Molecule, 103, 104, 108, 112, 113, 122, 124, 129 Monitor, 122, 124 Morphine, 44, 122, 123, 124 Morphology, 4, 17, 116, 122 Motility, 66, 70, 122 Motion Sickness, 122, 123 Motor Activity, 115, 122 Mucilaginous, 121, 122 Mucosa, 106, 107, 115, 120, 122 Mucus, 122, 133 Myocardial Ischemia, 103, 122 Myocardium, 103, 122, 123 N Narcotic, 122, 123 Nasogastric, 113, 123 Nausea, 29, 67, 98, 118, 123, 127, 133 NCI, 1, 60, 79, 123 Necrosis, 103, 118, 122, 123 Need, 3, 63, 69, 71, 75, 82, 89, 123 Needle biopsy, 66, 114, 123 Neoplasms, 66, 123 Nerve, 102, 121, 123, 134 Nervous System, 101, 106, 121, 123, 131 Neutrons, 102, 123, 129 Niacin, 52, 123 Nitric Oxide, 11, 123 Nitrogen, 102, 124, 125 Nuclear, 10, 15, 16, 17, 19, 21, 23, 41, 44, 68, 112, 123, 124, 133 Nuclei, 102, 112, 121, 122, 123, 124, 129 Nucleus, 103, 107, 110, 123, 124, 129 Nursing Care, 4, 124 O Occult, 21, 67, 124 Omentum, 116, 124 Oophorectomy, 64, 124 Opacity, 110, 124 Opium, 122, 124 Osteoarthritis, 7, 124 Osteoporosis, 55, 64, 65, 124 Ovaries, 124, 130


Overdose, 114, 124 Overweight, 7, 9, 51, 75, 124 Ovum, 120, 124 Oxidation, 11, 101, 103, 120, 124 Oxidative Stress, 12, 124 P Palliative, 124, 132 Pancreas, 5, 19, 64, 66, 69, 70, 101, 111, 115, 116, 118, 125, 130 Pancreatic, 7, 19, 60, 65, 86, 107, 112, 125 Pancreatic Ducts, 112, 125 Pancreatic Insufficiency, 8, 125 Pancreatitis, 5, 24, 32, 33, 46, 60, 66, 70, 125 Papilla, 112, 125 Parenteral, 27, 35, 37, 66, 113, 125 Parenteral Nutrition, 27, 35, 125 Parity, 40, 125 Paroxysmal, 103, 125 Pathogenesis, 8, 9, 10, 125 Pathologic, 18, 21, 103, 105, 110, 117, 125 Pathologic Processes, 103, 125 Pathophysiology, 8, 37, 68, 70, 125 Patient Education, 70, 71, 72, 86, 92, 94, 99, 125 Patient Selection, 72, 125 Pelvic, 65, 125, 128 Pelvic inflammatory disease, 65, 125 Pepsin, 125, 126 Pepsin A, 125, 126 Peptic, 37, 38, 41, 46, 126 Peptic Ulcer, 38, 41, 46, 126 Peptide, 16, 107, 119, 125, 126, 127, 128 Percutaneous, 5, 6, 70, 120, 126 Percutaneous transhepatic cholangiography, 70, 126 Pericardium, 126, 132 Peritoneal, 70, 104, 126 Peritoneal Cavity, 104, 126 Peritoneum, 124, 126, 130 Pharmacologic, 102, 126, 132 Phenotypes, 10, 11, 126 Phenylalanine, 126, 133 Phospholipids, 114, 120, 126 Phosphorus, 106, 126 Photocoagulation, 108, 126 Physical Examination, 70, 126 Physical Fitness, 64, 126 Physiologic, 110, 121, 126, 128, 129 Physiology, 7, 12, 65, 115, 116, 127 Plants, 102, 107, 115, 122, 127, 132 Plasma, 38, 69, 101, 107, 114, 115, 116, 117, 127, 130

Plasma protein, 69, 101, 127 Platelet Aggregation, 123, 127, 132 Platelets, 123, 127 Poisoning, 121, 123, 127 Polypeptide, 114, 125, 127, 130 Polyposis, 108, 127 Postcholecystectomy Syndrome, 70, 127 Posterior, 102, 125, 127 Postmenopausal, 4, 23, 124, 127 Postoperative, 5, 41, 71, 72, 127 Practice Guidelines, 83, 87, 127 Precursor, 9, 103, 107, 113, 126, 127, 133, 134 Prenatal, 65, 127 Prenatal Care, 65, 127 Prevalence, 10, 15, 19, 20, 22, 28, 30, 34, 38, 39, 41, 42, 44, 50, 53, 82, 128 Primary Biliary Cirrhosis, 64, 66, 128 Progression, 37, 128 Progressive, 116, 123, 124, 128 Prospective study, 14, 33, 40, 50, 128 Prostaglandin, 36, 128, 132 Prostaglandins A, 128 Prostate, 7, 128 Protein C, 101, 103, 120, 128 Protein S, 68, 105, 128 Proteins, 8, 11, 102, 103, 106, 107, 108, 110, 122, 124, 125, 126, 127, 128, 129, 130, 132, 134 Protons, 102, 117, 129 Proximal, 111, 115, 129 Public Policy, 81, 129 Pulmonary, 65, 105, 109, 120, 129 Q Quality of Life, 8, 129 R Radiation, 70, 103, 114, 129, 135 Radioactive, 117, 124, 129, 132, 133 Radiological, 13, 44, 126, 129 Radiology, 14, 15, 20, 31, 33, 34, 37, 42, 44, 50, 64, 66, 129 Randomized, 9, 111, 129 Reactive Oxygen Species, 12, 129 Receptor, 43, 103, 129 Rectum, 103, 105, 108, 111, 114, 115, 118, 119, 128, 129 Recurrence, 5, 129 Red blood cells, 113, 129, 131 Refer, 1, 108, 120, 123, 129 Reflux, 23, 66, 69, 129 Regimen, 111, 129 Regurgitation, 116, 129

Index 143

Reliability, 30, 129 Remission, 129 Renal cysts, 5, 129 Resection, 130 Retrograde, 130 Retroperitoneal, 101, 130 Risk factor, 3, 6, 9, 10, 15, 20, 31, 33, 37, 41, 64, 70, 72, 75, 87, 128, 130 S Salivary, 111, 130 Salivary glands, 111, 130 Screening, 11, 33, 65, 67, 107, 130 Secretion, 7, 115, 119, 122, 125, 130 Semen, 128, 130 Senile, 124, 130 Sepsis, 5, 130 Septic, 5, 130 Serum, 16, 19, 37, 40, 41, 42, 50, 59, 101, 108, 120, 130 Sex Characteristics, 101, 130 Sexually Transmitted Diseases, 65, 130 Shock, 5, 6, 70, 120, 130, 133 Short Bowel Syndrome, 66, 130 Side effect, 101, 130, 132 Signs and Symptoms, 65, 129, 130, 133 Sincalide, 41, 45, 130 Skeleton, 119, 128, 130 Sleep apnea, 7, 131 Sludge, 9, 131 Small intestine, 75, 104, 107, 110, 111, 112, 117, 118, 119, 123, 127, 131, 134 Smooth muscle, 11, 122, 131, 132 Social Environment, 129, 131 Software Design, 7, 131 Somatic, 101, 122, 131 Sonogram, 87, 131 Sound wave, 131 Specialist, 88, 131 Species, 113, 122, 129, 131, 133 Sphincter, 24, 131 Spinal cord, 106, 107, 123, 131 Stomach, 65, 66, 101, 104, 111, 113, 115, 116, 117, 123, 124, 125, 126, 129, 131 Stool, 118, 119, 131 Stress, 5, 42, 123, 124, 131, 134 Stricture, 64, 66, 131 Stroke, 7, 61, 64, 80, 106, 131 Subacute, 118, 131 Subclinical, 118, 131 Subcutaneous, 101, 125, 131 Substance P, 130, 131 Symphysis, 128, 132

Symptomatic, 14, 17, 23, 42, 45, 70, 125, 132 Systemic, 5, 64, 66, 103, 105, 113, 118, 132 Systemic disease, 64, 66, 132 Systemic lupus erythematosus, 64, 132 Systolic, 117, 132 T Technetium, 43, 132 Therapeutics, 37, 132 Thorax, 101, 132 Threshold, 117, 132 Thromboembolism, 43, 132 Thrombosis, 128, 131, 132 Thromboxanes, 103, 111, 132 Thyroid, 132, 133 Tomography, 132 Toxic, iv, 132 Toxicity, 111, 121, 132 Toxicology, 22, 82, 132 Toxins, 103, 118, 132 Transfection, 105, 133 Transplantation, 35, 64, 66, 87, 133 Trauma, 64, 66, 123, 125, 133, 135 Triglyceride, 117, 133 Tuberculosis, 109, 120, 133 Type 2 diabetes, 7, 133 TYPHI, 34, 133 Typhoid fever, 133 Tyrosine, 12, 133 U Ulcer, 111, 126, 133 Ulcerative colitis, 66, 133 Ultrasonography, 11, 20, 23, 24, 33, 37, 40, 44, 45, 46, 47, 50, 87, 133 Unconscious, 117, 133 Uraemia, 125, 133 Uranium, 132, 133 Ureter, 120, 133 Urethra, 128, 133, 134 Urinary, 6, 64, 65, 118, 133, 134 Urinary tract, 6, 134 Urine, 98, 105, 118, 133, 134 Ursodeoxycholic Acid, 59, 134 Urticaria, 18, 134 Uterus, 112, 117, 121, 124, 134 V Vaccines, 134 Vagina, 121, 134 Vaginal, 65, 134 Vagotomy, 33, 134 Vascular, 112, 118, 123, 134 Vasculitis, 125, 134


Vasodilators, 123, 134 Vein, 64, 102, 119, 124, 134 Venous, 64, 66, 105, 128, 134 Venous blood, 105, 134 Ventral, 6, 134 Ventricular, 112, 134 Ventricular Dysfunction, 112, 134 Veterinary Medicine, 81, 134 Villous, 106, 134 Villus, 8, 134

Viral, 64, 67, 134 Viral Hepatitis, 64, 67, 134 Virus, 29, 64, 66, 87, 134 W Weight Gain, 8, 114, 135 Wound Infection, 6, 135 X X-ray, 29, 98, 109, 112, 114, 121, 124, 126, 129, 135 X-Ray Film, 29, 135

Index 145


Index 147


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

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

Foot and Mouth Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

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

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Tay-Sachs Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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

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

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

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

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