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

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

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

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

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Gangrene: 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: 0-597-84432-1 1. Gangrene-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 gangrene. 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 GANGRENE ............................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Gangrene....................................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 12 The National Library of Medicine: PubMed ................................................................................ 13 CHAPTER 2. NUTRITION AND GANGRENE ..................................................................................... 55 Overview...................................................................................................................................... 55 Finding Nutrition Studies on Gangrene...................................................................................... 55 Federal Resources on Nutrition ................................................................................................... 57 Additional Web Resources ........................................................................................................... 58 CHAPTER 3. BOOKS ON GANGRENE................................................................................................ 59 Overview...................................................................................................................................... 59 Book Summaries: Federal Agencies.............................................................................................. 59 Book Summaries: Online Booksellers........................................................................................... 60 Chapters on Gangrene.................................................................................................................. 60 CHAPTER 4. MULTIMEDIA ON GANGRENE ..................................................................................... 63 Overview...................................................................................................................................... 63 Video Recordings ......................................................................................................................... 63 CHAPTER 5. PERIODICALS AND NEWS ON GANGRENE .................................................................. 65 Overview...................................................................................................................................... 65 News Services and Press Releases................................................................................................ 65 Academic Periodicals covering Gangrene .................................................................................... 66 CHAPTER 6. RESEARCHING MEDICATIONS .................................................................................... 69 Overview...................................................................................................................................... 69 U.S. Pharmacopeia....................................................................................................................... 69 Commercial Databases ................................................................................................................. 70 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 75 Overview...................................................................................................................................... 75 NIH Guidelines............................................................................................................................ 75 NIH Databases............................................................................................................................. 77 Other Commercial Databases....................................................................................................... 79 APPENDIX B. PATIENT RESOURCES ................................................................................................. 81 Overview...................................................................................................................................... 81 Patient Guideline Sources............................................................................................................ 81 Finding Associations.................................................................................................................... 83 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 85 Overview...................................................................................................................................... 85 Preparation................................................................................................................................... 85 Finding a Local Medical Library.................................................................................................. 85 Medical Libraries in the U.S. and Canada ................................................................................... 85 ONLINE GLOSSARIES.................................................................................................................. 91 Online Dictionary Directories ..................................................................................................... 91 GANGRENE DICTIONARY ......................................................................................................... 93 INDEX .............................................................................................................................................. 141

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

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

Fournier's Gangrene: A Urologic Emergency Source: American Family Physician. 52(6): 1821-1825. November 1, 1995. Summary: Fournier's gangrene, a form of necrotizing fascitis, is an uncommon, fulminant, rapidly progressing subcutaneous infection of the scrotum and penis, and may occur in all age groups. This article describes Fournier's gangrene, presents an illustrative case, and discusses diagnostic and treatment issues. The author notes that most cases involve a mixed synergistic infection of aerobic and anaerobic bacteria, and occur as a result of one or three mechanisms: local trauma, extension from a urinary tract infection, or extension from a perianal, periurethral, or ischiorectal infection. Fournier's gangrene is a urologic emergency that requires prompt recognition and aggressive hemodynamic stabilization, treatment with parenteral broad-spectrum antibiotics, and surgical debridement. This disease is associated with a high mortality

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rate; a high index of suspicion is essential for early recognition whenever a patient presents with scrotal discomfort and swelling. 4 figures. 1 table. 6 references. (AA-M).

Federally Funded Research on Gangrene The U.S. Government supports a variety of research studies relating to gangrene. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to gangrene. 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 gangrene. The following is typical of the type of information found when searching the CRISP database for gangrene: •

Project Title: BLOOD FACTORS AND PERIPHERAL ARTERIAL DISEASE OUTCOMES Principal Investigator & Institution: Mcdermott, Mary M.; Medicine; Northwestern University Office of Sponsored Research Chicago, Il 60611 Timing: Fiscal Year 2002; Project Start 01-JAN-2001; Project End 31-DEC-2004 Summary: This study will prospectively assess associations between hemostatic and inflammatory blood factors and progression of lower extremity arterial ischemia and cardiovascular events in 499 men and women with lower extremity peripheral arterial disease (PAD) and 241 men and women without PAD. The proposed study is ancillary to an NHLBI funded prospective study of functional and cardiovascular outcomes in men and women with PAD, the Walking and Leg Circulation Study (WALCS). The blood factors we will study, fibrinogen, PAI-1, TPA antigen, d-dimer, prothrombin 1.2, and C-reactive protein (CRP), are associated with progression of coronary atherosclerosis in proposed models of the pathogenesis of coronary atherosclerosis, but are not well studied in PAD. Our primary specific aims are as follows. First, we will determine whether higher baseline blood factor levels are associated with a) progression of lower extremity arterial ischemia (decline in ankle brachial index >= 0.15, lower extremity gangrene, ulcer, revascularization, or amputation);, b) functional decline over 48 month follow-up. Second, we will determine whether higher baseline blood factor levels are associated with new cardiovascular events over 48 month follow-up. We hypothesize that higher blood factor levels at baseline will be associated with PAD progression, functional decline, and higher rates of cardiovascular morbidity and mortality Pilot data from the Cardiovascular Health Study (CHS) show that relative risks of fibrinogen, D-dimer and CRP levels for cardiovascular events are highest for events occurring more proximate to baseline blood factor measurements. Therefore, we

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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will also determine whether blood factor levels measured at the most recent examination prior to cardiovascular events or PAD progression are higher than the levels that do not immediately precede cardiovascular events or PAD progression. We hypothesize that blood factor levels at the most recent examination prior to cardiovascular events or PAD progression will be higher than blood factor levels that do not immediately precede cardiovascular events or PAD progression. The specific aims of this study cannot be answered by the CHS, the Women's Health Study or the Atherosclerosis Risk in Community study. Unique comparisons of the proposed study include the wide spectrum of PAD severity in the WALCS cohort, the large number of PAD participants, the breadth of functional assessments, and the inherent generalizability of our findings to patients routinely encountered by practicing physicians. Much of the data collection is currently funded as part of the WALCS, reducing the marginal cost of our application. Results are expected to lead to subsequent studies identifying mechanisms of any associations demonstrated and lead to interventions that prevent progression of lower extremity arterial ischemia, functional decline, and cardiovascular events in men and women with PAD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COLLAGEN-IV REVASCULARIZATION

REMODELING

IN

ISCHEMIC

LEG

Principal Investigator & Institution: Gagne, Paul J.; Surgery; New York University School of Medicine 550 1St Ave New York, Ny 10016 Timing: Fiscal Year 2004; Project Start 09-DEC-2003; Project End 30-NOV-2008 Summary: (provided by applicant): This proposal describes a five-year development program for an academic career in vascular surgery. The principal investigator is board certified in general and vascular surgery and is pursuing further training as a scientist. Through an intense basic science research experience he will acquire 1) advanced skills in molecular and cell biology; and 2) an expertise in extracellular matrix (ECM) remodeling, matrix metalloproteinases (MMP) and ischemic limb angiogenesis. Limb ischemia can result in gangrene and amputation. Current therapies are often invasive and of limited success. The scientific aim of this proposal is to test the hypothesis that type-IV collagenase-mediated remodeling of type-IV collagen exposes cryptic epitopes that regulate angiogenesis and revascularizationin ischemic limbs. This proposal is based on two sets of observations. First, preliminary data suggest there is a significant increase in type-IV collagenase (i.e., MMP-2, -9) activity in the muscle of ischemic limbs. Second, proteolysis of collagen-IV exposes cryptic epitopes that are inaccessible in mature, native collagen-IV. These epitopes may play a role in the biochemical regulation of angiogenesis in ischemic limbs via cell-matrix interactions in the collagen-IV rich basement membrane of blood vessels. Specifically, essential information for the biochemical regulation of angiogenesis in ischemic limbs may be hidden within the three-dimensional structure of ECM molecules. There is currently little direct evidence available concerning the mechanisms by which molecular remodeling in the ECM is regulated and contributes to angiogenesis. This project will try to identify and characterize this novel regulatory process, which may be significant for the revascularization and salvage of ischemic limbs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COMPARATIVE PERFRINGENS

GENOMIC

ANALYSIS

OF

CLOSTRIDIUM

Principal Investigator & Institution: Paulsen, Ian T.; Assistant Investigator; Institute for Genomic Research Rockville, Md 20850 Timing: Fiscal Year 2001; Project Start 02-JUL-2001; Project End 30-JUN-2004 Summary: (Applicant?s Abstract): Clostridium perfringens has a long history of being associated with a high level of morbidity and mortality in battlefield and clinical settings, due to its ability to produce a wide range of deadly toxins and cause diseases such as gas gangrene and enteric infections. C. perfringens has also been tested as a potential biological warfare (BW) agent in World War II and the Iraqi government is suspected of attempting to develop C. perfringens as a BW agent before the Gulf War. Because most of the genes encoding the toxins have been cloned and sequenced, it is feared that these may be used to produce these toxins on a large scale and inflict casualties on military and civilian populations. In addition, C. perfringens is genetically tractable and is capable of producing a heat resistant spore; these qualities make it an inviting target for developing BW methods for producing and delivering deadly toxins. The information obtained from genomic sequencing of C. perfringens will permit the development of vaccines and diagnostic reagents that can be used to combat and diagnose the disease caused by this bacterium. The genetic sequence will also allow production of DNA microarrays, to determine which genes are turned on in infections and identify host specificity factors that differentiate human and veterinary pathogenic strains. The genome sequence will also provide important information on fundamental biological processes such as spore production and basic metabolism in the Clostridia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IRON IN KIDNEY DISEASE Principal Investigator & Institution: Guadiz, Ramon; Charles R. Drew University of Med & Sci 1621 E 120Th St Los Angeles, Ca 90059 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2008 Summary: Patients with chronic kidney disease (CKD) develop anemia due primarily to deficient production of erythropoeitin (EPO). Administration of EPO to patients with end-stage renal disease (ESRD), stimulates erythropoiesis and often leads to functional iron deficiency. Furthermore, iron losses are high, particularly in the hemodialysis patient. Patients are frequently non-compliant with oral iron supplements due to associated gastrointestinal side-effects. Oral iron supplements frequently fail to maintain adequate iron stores in EPO-treated hemodialysis patients. The use of i.v. iron has been shown to increase hemoglobin, and may therefore improve quality of life, and reduce morbidity and mortality in uremic patients. However, life-threatening/serious acute reactions to i.v. iron have been reported. Recent evidence suggests that i.v. iron leads to oxidative stress in ESRD. Oxidative stress, universally present in ESRD, has been implicated as one of the causes of atherosclerosis and resulting high morbidity and mortality from coronary artery disease, strokes and gangrene in these patients. To explore delivery of iron via the dialysate, ferric pyrophosphate (FePPi), the most stable and nontoxic of all monomeric iron salts has been selected. The present study will test the safety and efficacy of FePPi delivery via the dialysate in preventing iron deficiency, in chronic hemodialysis patients. The specific aims of this study are as follows: 1 ) To determine the efficacy of hemodialysis solutions containing ferric pyrophosphate in preventing the development of iron deficiency, compared with the conventional hemodialysis solutions. 2) To determine the safety of hemodialysis solutions containing

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ferric pyrophosphate, compared with the conventional hemodialysis solutions, by monitoring adverse reactions manifesting clinically or on laboratory testing. 3) To study catalytically active iron on markers of inflammation and oxidative stress 4) To study the effect of dialysate iron on dialyzer reuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MEETING ON THE PATHOGENESIS OF CLOSTRIDIA Principal Investigator & Institution: Sonenshein, Abraham L.; Professor; Molecular Biol & Microbiology; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2003; Project Start 15-APR-2003; Project End 14-APR-2004 Summary: (provided by applicant): The Fourth International Conference on the Molecular Biology and Pathogenesis of the Clostridia will be held April 26-30, 2003 at the Marine Biological laboratories in Woods Hole, MA. This meeting will attract about 150 leading international clostridial researchers from universities, government laboratories, and commercial organizations. The conference will focus on new developments regarding the virulence and basic biology of the pathogenic clostridia, which remain major causes of natural enteric, histotoxic, and neurotoxic disease in humans and economically-important domestic animals. In addition, toxins produced by the pathogenic Clostridia have become major biodefense concerns, with botulinum toxins and C. perfringens epsilon toxin listed as Class A and B select agents, respectively. The conference's goal is two-fold: i) providing a common forum to discuss recent research findings in order to stimulate future progress, and it) training the next generation of clostridial researchers. To accomplish these purposes, the meeting consists of 10 sessions combining talks and posters. The first session will address the clostridial enterotoxins, which cause symptoms of several extremely important noscomial and foodborne diseases. The following session will concern the epidemiology, diagnosis and treatment of clostridial infections. Promising new practical medical and biotechnology applications of the pathogenic clostridia (and their toxins) will then be discussed in the third conference session. Session Four will then specifically focus on membrane-active clostridial toxins, which are so important for histotoxic infections such as gas gangrene. In the fifth session, the economically important clostridial veterinary diseases will be discussed. Exciting new insights provided by several clostridial genome projects will be presented in the 6th session, along with new information about clostridial mobile genetic elements, which are important for virulence. The seventh session will have considerable biodefense relevance since it includes the clostridial neurotoxins, including botulinum toxins. How clostridia regulate virulence gene expression will be the topic of the 8th session, to be followed in session 9 by a discussion of the linkage between clostridial physiology and virulence. The conference will conclude with an in-depth analysis of interactions between the pathogenic clostridia and their hosts in Session 10. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOLECULAR & CELLULAR BASIS OF HOST-PATHOGEN INTERACTIONS Principal Investigator & Institution: Bohach, Gregory A.; Professor; Microbiol/Molec Biol & Biotech; University of Idaho Moscow, Id 838443020 Timing: Fiscal Year 2002; Project Start 15-SEP-2000; Project End 31-AUG-2005 Summary: Although the number of faculty engaged in biomedical research at the University of Idaho (U of I) is not large, our institution is strongly committed to research related to microbial pathogenesis and food-borne illness. The overall objective of this

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project is to build upon our current core of strength in the "study of the molecular and cellular basis of host- pathogen interactions". We will establish the U of I as a premier institutional having a nationally recognized biomedical program with this thematic focus. COBRE funding will allow us to integrate the programs of several established biomedical scientists with those of tow new tenure- track faculty (a virologist and cell biologist) on the main campus in Moscow, ID. In doing so, we will emphasize career development, mentoring, and grantsmanship of all faculty in the Center. We will strengthen our graduate training and research collaboration with the Infectious Diseases Unit of Boise Veterans Affairs Medical Center. Finally, we will integrate the five-state (Wyoming, Washing, Alaska, Montana, and Idaho) WWAMI Medical Program into the COBRE Center to provide a unique opportunity for medical students to become immersed in biomedical research. COBRE center research projects will initially be led by four Co-Investigators , each of whom has proposed an area of multi-disciplinary research relevant to human health and to the overall theme of the Center. This team and their collaborators will work under the administrative and collaborative guidance of Dr. Gregory A. Bohach an investigator established in several areas of microbial pathogenesis. The four independent but complementary projects include: 1) An investigation of the anti-viral activity of Escherichia coli Shiga toxin; 2) Mx expression and uterine mucosal immunity; 3) The mechanism and significance of the internalization of Staphylococcus aureus by epithelial cells; and 4) Phospholipase-C induced plateletleukocyte interactions and defective diapedesis in gas gangrene. In addition to these four projects, our new virologist and cell biologist will submit research proposal to the COBRE Center and our Advisory Board for approval. A plan to develop funding independence following termination of COBRE support has been developed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MRI CORRELATES OF LIMB ISCHEMIA IN PVD Principal Investigator & Institution: Floyd, Thomas F.; Anesthesia; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 22-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Peripheral vascular disease (PVD) caused by smoking, diabetes mellitus, and hypertension, results in limb ischemia in approximately 10% of the population over age 65 years. PVD results in claudication, tissue ischemia, gangrene, and amputation when not treated aggressively. Ninety thousand amputations are performed each year as a result of PVD. Diagnostic methods available at present include invasive techniques such as radiographic angiography, which, because of contrast dye toxicity, can result in serious complications such as renal failure. The diagnostic armamentarium is burgeoning however. Noninvasive techniques such as duplex Doppler and MRI angiography are today allowing surgery to be completed without radiographic angiography and with a high degree of success in selected populations. Patients with Chronic Critical Limb Ischemia (CCLI) are at the highest levels of risk for limb loss and perioperative morbidity and mortality when revascularization or amputation is performed. Evidence indicates that current diagnostic methods, again directed primarily at identifying macro-vascular flow impediments, do not adequately assist the surgeon in assessing potential for revascularization in patients with CCLI. As a result, grafting success is much poorer in this population, leading to repeated procedures, often delayed amputation, prolonged rehabilitation, and excessive morbidity and mortality. Astoundingly, when surgeons predicted that amputation stump wounds would not heal, they were wrong 50% of the time, leading one to wonder if their estimation of appropriate level for amputation doesn't tend to be a bit

Studies

9

too aggressive. We propose the application of a noninvasive MRI method, Arterial Spin Labeling Perfusion MRI to this problem. Arterial spin-labeling sequences have been developed to study micro-vascular blood flow in the calf and foot. We intend to further the development and application of this technique at high field MRI where improved signal and resolution are likely. We also propose to develop flow indices for the foot, calf, and forearm and compare them with recognized diagnostic standards. Finally, we will apply them prospectively to predict graft patency and wound healing after amputation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NON-TRADITIONAL CARDIOVASCULAR RISK FACTORS IN DM TYPE 2 Principal Investigator & Institution: Reaven, Peter D.; U.S. Carl T. Hayden Vet Affairs Med Ctr Affairs Medical Center Phoenix, Az 85012 Timing: Fiscal Year 2003; Project Start 01-APR-2001; Project End 30-NOV-2004 Summary: (Applicant's Abstract) A predominant consequence of diabetes mellitus type 2 (DM 2) is accelerated development of atherosclerosis related conditions. Conventional cardiovascular risk factors (CVRF) only explain a portion of the excess risk for atherosclerosis in this population. The overall goals of this project are to test whether novel CVRF are related to the presence and development of atherosclerosis and macrovascular events in DM 2 and to determine whether intensive glucose lowering therapy will reduce the levels of these CVRF. Specific short-term primary aims include determining the cross- sectional relationship between baseline levels and the presence of atherosclerosis as measured by electron beam computed tomography assessment of coronary artery (CAC) and abdominal aortic calcium (AAC) and the prevalence of clinical macrovascular disease. The investigator proposes to take advantage of the study population and framework of the V A Cooperative study of "Glycemic Control and Complications in DM 2" to address these questions in an efficient and cost-effective manner. The Cooperative study is a prospective, two-arm, randomized, controlled, multicenter trial to assess the effects of tight glycemic control, achieved through intensification of treatment, on clinical macrovascular and microvascular complications in patients with DM 2 who are in poor glycemic control despite pharmacologic therapy. Cooperative study subjects from multiple sites (340 subjects) will be asked to participate in this additional trial. At their baseline visit, subjects will have additional blood and urine collected for a) VLDL, IDL and LDL subfractions b) measures of in vivo oxidative stress (oxidized-phospholipids on plasma LDL, autoantibodies to epitopes of oxidized LDL, F2-isoprostane levels) c) AGE-LDL levels, and d) markers of endothelial activation/injury (PAI-1, VCAM-1 and ICAM-1) and inflammation (C-reactive protein and fibrinogen). Subjects will also have CAC and AAC determined. After enrollment in the study, participants will have measurements of CVRF repeated at six months. Primary and secondary macrovascular endpoints will be identical to those defined in the VA Cooperative study (Primary: myocardial infarction, cardiovascular death, stroke, congestive heart failure, invasive vascular therapy (coronary or peripheral), and amputation due to ischemic gangrene; Secondary: angina pectoris, transient ischemic attacks, and peripheral artery disease). Statistical methods, depending on the specific aim will include categorical age and sex adjusted analyses, t-tests, and multiple regression models. Long- term (future) aims will include evaluating the prospective relationship of these novel cardiovascular risk factors to the progression of atherosclerosis and the development of macrovascular disease in this same population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PLATELET-LEUKOCYTE INTERACTIONS & DIAPEDESIS IN GAS Principal Investigator & Institution: Bryant, Amy E.; University of Idaho Moscow, Id 838443020 Timing: Fiscal Year 2002 Summary: Clostridium perfringens gas gangrene is the most fulminant necrotizing infection affecting humans. In victims of traumatic injury, the infection can become well established in as little as 6-8 hours and the destruction of adjacent healthy muscle can progress several inches per hour despite appropriate antibiotic coverage. Despite modern medical advances and intensive care regimens, radical amputation is often required and mortality remains between 40-70%. The rapid tissue destruction characteristic of clostridial myonecrosis has been attributed, in part, to the absence of a tissue inflammatory response with concomitant vascular leukostasis. We have previously shown that, in vivo, the clostridial phospholipase C (PLC) stimulates the formation of large intra intravascular aggregates of platelets and granulocytes and that formation of these heterotypic complexes is the result of PLC-induced activation of the platelet fibrinogen receptor, gpIIbIIIa. We hypothesize that formation of these complexes prevents normal granulocyte diapedesis and enhances respiratory burst activity of hyperadherent leukocytes, resulting in vascular leukostasis and injury with concomitant ischemic tissue necrosis. Specifically, this proposal will investigate the effects of PLC-stimulated platelets on neutrophil chemotaxis, transendothelial cell migration (adherence and diapedesis), and respiratory burst activity in vitro, and will determine the role of PLC-induced gpIIbIIIa activation in these events. Given the increasing antibiotic resistance among human pathogens, results of this work will provide important new information for the development of a host response-based immunologic strategy to restore the tissue inflammatory response, prevent vascular occlusion and injury, maintain tissue viability, and therefore provide a more modern treatment alternative to radical amputation for patients with this devastating infection. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SAFETY AND EFFICACY OF RH-LACTOFERRIN IN DIABETIC ULCERS Principal Investigator & Institution: Engelmayer, Jose; Agennix, Inc. 8 Greenway Plz, Ste 910 Houston, Tx 77046 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JAN-2004 Summary: (provided by applicant): Research Objectives: Determine the safety, pharmacokinetics, pharmacodynamics, and efficacy of topical recombinant human lactoferrin (rhLF) in promoting healing in diabetic ulcers. There are 7.5 million US patients with chronic skin wounds with annual health care costs of $5-9 billion; diabetic ulcers alone cost $4 billion. Current therapies are inadequate with diabetic patients often developing gangrene and needing amputation. Topical rhLF significantly enhanced wound healing in a mouse model, outperforming placebo as well as Regranex, the only biologic approved for chronic wounds. RhLF appears safe and well tolerated in humans, having been administered to 229 patients (topically and orally) without a drug-related serious adverse event. With a good safety profile and promising pre-clinical efficacy, rhLF may prove to be an effective and safe new drug for wound healing. The aims of this study are to evaluate the clinical safety, pharmacokinetics and pharmacodynamics of topical rhLF in patients with diabetic ulcers. Up to 36 patients will be treated for fourteen days with escalating doses of rhLF. Safety will be evaluated clinically and by laboratory results. Incidence of partial and complete wound closure will also be

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observed. Safety results and any efficacy trends will be used to select rhLF doses for the proposed Phase II trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STUDIES ON CLOSTRIDIUM SEPTICUM LETHAL TOXIN Principal Investigator & Institution: Tweten, Rodney K.; Professor; Microbiology and Immunology; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2002; Project Start 01-JAN-1993; Project End 30-JUN-2004 Summary: (Adapted from the Applicant's Abstract): Clostridium septicum causes several life-threatening infections that, without treatment, are fatal. The most devastating of these diseases is non-traumatic gas gangrene. The only lethal factor secreted by C. septicum is alpha toxin. It is a cytolytic, pore-forming toxin that is produced as an inactive protoxin which requires proteolytic activation by normal cellular proteases such as furin. The investigators propose to continue the detailed study of the cytolytic mechanism of alpha toxin in order to gain insight into its biology and to explore ways that may be used to ameliorate its effect in vivo. They propose to: 1) identify the crucial residues of the propeptide of alpha toxin which facilitate its noncovalent interactions with the main body of the toxin and generate derivatives with a greater inhibitory activity towards alpha toxin, 2) identify the transmembrane domains(s) of alpha toxin, 3) identify the residues of the toxin involved in receptor binding, and 4) crystallize a more soluble derivative of alpha toxin and the complex of this derivative with one of the GPI-anchored receptors for alpha toxin. To achieve the first aim, the residues of the propeptide will be sequentially substituted with glycine, isolated and the affinity of the propeptide for the toxin determined. In aim 2 they will utilize two approaches to map out the membrane-penetrating domains(s) of alpha toxin. The first approach will be to substitute suspected membrane-spanning residues of alpha toxin with cysteine purify these derivatives and then form channels with each toxin in a planar bilayer. Charged derivatives of the sulfhydryl-specific reagent methanethiosulfonate (MTS) are then introduced into aqueous phase on either side of the bilayer. The charged MTS reagent will cause a change in the channel conductance only if the cysteine has been substituted for a channel-lining residue. The same cysteinesubstituted residues (in a cysteine-less derivative of alpha toxin) will also be modified with the environmentally sensitive fluorescent probe NBD and the fluorescence examined before and after the toxin have been allowed to insert into membranes. If alpha toxin interacts with the membrane via either an amphipathic beta sheet or an alpha helix they will observe a difference in the periodicity of the response from both assays. The receptor-binding domain has tentatively been localized to a region near C55 of alpha toxin. Thus, in aim 3, residues near C55 in the structural model of alpha toxin will be changed by in vitro mutagenesis to determine which residues participate in receptor binding. In aim 4 they propose to crystallize alpha toxin and the alpha toxinreceptor complex. This is made possible by the availability of large quantities of a more soluble form of alpha toxin and one of its GPI-anchored receptors, the human folate receptor (hFR). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Gangrene

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “gangrene” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for gangrene in the PubMed Central database: •

Comparison of single and combination antimicrobial agents for prevention of experimental gas gangrene caused by Clostridium perfringens. by Stevens DL, Laine BM, Mitten JE.; 1987 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=174712

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Effects of Chelates in Chemotherapy of Experimental Gas-Gangrene Toxemia. by Lynch KL, Moskowitz M.; 1968 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=252529

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Isolation of Clostridium perfringens Type D from a Case of Gas Gangrene. by Morinaga G, Nakamura T, Yoshizawa J, Nishida S.; 1965 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=315734

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Isolation of Clostridium pseudotetanicum from a patient with gas gangrene. by Katoh N, Watanabe K, Miki Y, Muro T, Ueno K.; 1983 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=270840

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Localised necrosis of scrotum (Fournier's gangrene) in a spinal cord injury patient -- a case report. by Vaidyanathan S, Soni BM, Hughes PL, Mansour P, Singh G, Darroch J, Oo T.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=138815

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Risk of stroke, gangrene from ergot drug interactions. by Wooltorton E.; 2003 Apr 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=152687

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Symmetrical peripheral gangrene: a rare but dreadful complication of sepsis. by Parmar MS.; 2002 Oct 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=134186

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Synergistic Effects of Alpha-Toxin and Perfringolysin O in Clostridium perfringensMediated Gas Gangrene. by Awad MM, Ellemor DM, Boyd RL, Emmins JJ, Rood JI.; 2001 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=98889

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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Use of Genetically Manipulated Strains of Clostridium perfringens Reveals that Both Alpha-Toxin and Theta-Toxin Are Required for Vascular Leukostasis To Occur in Experimental Gas Gangrene. by Ellemor DM, Baird RN, Awad MM, Boyd RL, Rood JI, Emmins JJ.; 1999 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=96825

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

A case of Fournier gangrene complicating idiopathic nephrotic syndrome of childhood. Author(s): Wright AJ, Lall A, Gransden WR, Joyce MR, Rowsell A, Clark G. Source: Pediatric Nephrology (Berlin, Germany). 1999 November; 13(9): 838-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10603132

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A case of Fournier's gangrene contraindicating spinal anesthesia. Author(s): Koitabashi T, Umemura N, Takino Y. Source: Anesthesiology. 2000 January; 92(1): 289-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10638938

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A case of plague successfully treated with ciprofloxacin and sympathetic blockade for treatment of gangrene. Author(s): Kuberski T, Robinson L, Schurgin A. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 February 15; 36(4): 521-3. Epub 2003 January 29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12567312

6 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 dialysis patient with systemic calciphylaxis exhibiting rapidly progressive visceral ischemia and acral gangrene. Author(s): Tamura M, Hiroshige K, Osajima A, Soejima M, Takasugi M, Kuroiwa A. Source: Intern Med. 1995 September; 34(9): 908-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8580568

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A life-threatening infection: Fournier's gangrene. Author(s): Atakan IH, Kaplan M, Kaya E, Aktoz T, Inci O. Source: International Urology and Nephrology. 2002; 34(3): 387-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12899235

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A mode of presentation of tropical idiopathic lower limb gangrene in a neonate. Author(s): Musa AA. Source: Trop Doct. 2001 October; 31(4): 226. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11676065

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A patient with falciparum malaria and bilateral gangrene of the feet who developed arrhythmia/ventricular fibrillation after quinine therapy. Author(s): Kochar Shubhakaran DK, Kumawat B, Kochar SK. Source: Qjm : Monthly Journal of the Association of Physicians. 1998 March; 91(3): 246. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9604078

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A rare case of orbital mucormycosis with gas gangrene panophthalmitis. Author(s): Gupta VK, al-Tuwarqui W. Source: The British Journal of Ophthalmology. 1993 December; 77(12): 824-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8110685

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Abdominal angina and intestinal gangrene--a catastrophic presentation of arterial fibromuscular dysplasia: case report and review of the literature. Author(s): Hamed RM, Ghandour K. Source: Journal of Pediatric Surgery. 1997 September; 32(9): 1379-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9314269

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Acute digital gangrene in a long-term dialysis patient -- a diagnostic challenge. Author(s): Piccoli GB, Quaglia M, Quaglino P, Burdese M, Bermond F, Mezza E, Jeantet A, Segoloni GP. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2002 November; 8(11): Cs83-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12444385

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Acute necrotizing pancreatitis. Hypoperfusion may not be synonymous with gangrene. Author(s): Howard JM. Source: International Journal of Pancreatology : Official Journal of the International Association of Pancreatology. 1997 December; 22(3): 233-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9444556

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Adult T-cell leukemia/lymphoma presenting with digital gangrene. Author(s): Setoyama M, Yamamoto S, Kanzaki T. Source: Dermatology (Basel, Switzerland). 1997; 195(2): 150-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9310723

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Advances in TCM treatment of diabetic acromelic gangrene. Author(s): Li Y, Cheng Y. Source: J Tradit Chin Med. 1998 March; 18(1): 66-70. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10437267

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Aeromonas hydrophila necrotizing fasciitis and gas gangrene in a diabetic patient on haemodialysis. Author(s): Furusu A, Yoshizuka N, Abe K, Sasaki O, Miyazaki K, Miyazaki M, Hirakata Y, Ozono Y, Harada T, Kohno S. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1997 August; 12(8): 1730-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9269663

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An unusual cutaneous manifestation of ulcerative colitis: thrombotic skin gangrene. Author(s): Singh S, Noshirwani K. Source: Postgraduate Medical Journal. 1996 October; 72(852): 623-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8977949

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An unusual presentation of gas gangrene complicated by penicillin allergy. Author(s): Woo PL, Eastaway A, Soutar DS. Source: Br J Clin Pract. 1994 November-December; 48(6): 337-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7848804

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Atypical Kawasaki disease with peripheral gangrene and myocardial infarction: therapeutic implications. Author(s): von Planta M, Fasnacht M, Holm C, Fanconi S, Seger RA. Source: European Journal of Pediatrics. 1995 October; 154(10): 830-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8529683

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Axillofemoral bypass graft in a spinal cord injured patient with impending gangrene. Author(s): Lee BY, Guerra J. Source: J Am Paraplegia Soc. 1994 October; 17(4): 171-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7869060

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Bacterial discitis caused by limb gangrene requiring below-knee amputation. Author(s): Nicholas JJ, Smith WF, Andersson GB. Source: Archives of Physical Medicine and Rehabilitation. 1996 March; 77(3): 301-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8600876

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Bilateral forefoot gangrene secondary to Lemierre's disease. Author(s): Soave RL, Kuchar DJ. Source: Journal of the American Podiatric Medical Association. 2001 March; 91(3): 147-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11266497

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Bilateral forefoot gangrene secondary to Lemierre's disease. Author(s): Kaufman JL. Source: Journal of the American Podiatric Medical Association. 2001 July-August; 91(7): 381. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11466467

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Bilateral gas gangrene of the hand - a unique case. Author(s): Goyal RW, Ng AB, Bale RS. Source: Annals of the Royal College of Surgeons of England. 2003 November; 85(6): 4089. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14629884

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Bilateral lower limb gangrene and stroke as initial manifestations of systemic giant cell arteritis in an African-American. Author(s): Lie JT, Tokugawa DA. Source: The Journal of Rheumatology. 1995 February; 22(2): 363-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7738967

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Bleomycin-induced digital gangrene. Author(s): Surville-Barland J, Caumes E, Ankri A, Frances C, Katlama C, Chosidow O. Source: European Journal of Dermatology : Ejd. 1998 April-May; 8(3): 221. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9935322

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Bone setter's gangrene. Author(s): Bickler SW, Sanno-Duanda B. Source: Journal of Pediatric Surgery. 2000 October; 35(10): 1431-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11051143

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Breast gangrene as a complication of puerperal sepsis. Author(s): Rege SA, Nunes Q, Rajput A, Dalvi AN. Source: Archives of Surgery (Chicago, Ill. : 1960). 2002 December; 137(12): 1441-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12470116

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Calciphylaxis in a patient with end-stage renal disease secondary to systemic lupus erythematosus associated with acral gangrene and mesenteric ischemia. Author(s): Igaki N, Moriguchi R, Hirota Y, Sakai M, Akiyama H, Tamada F, Oimomi M, Goto T. Source: Intern Med. 2001 December; 40(12): 1232-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11813850

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Calciphylaxis of the penis: a unique cause of Fournier's gangrene. Author(s): So A, Bell D, Metcalfe P, Gupta R. Source: Can J Urol. 2001 October; 8(5): 1377-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11718634

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Calciphylaxis: a syndrome of skin necrosis and acral gangrene in chronic renal failure. Author(s): Hafner J, Keusch G, Wahl C, Burg G. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1998 August; 27(3): 137-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9747147

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Cardiac tuberculosis presenting as small intestinal gangrene. Author(s): Vaideeswar P, Jadhav NN, Divate SA. Source: International Journal of Cardiology. 2002 June; 83(3): 277-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12036536

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Case 54: Fournier gangrene. Author(s): Uppot RN, Levy HM, Patel PH. Source: Radiology. 2003 January; 226(1): 115-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12511678

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Case of the season. Fournier's gangrene. Author(s): Maizlin ZV, Vasserman M, Corat-Simon J, Gottlieb P, Strauss S. Source: Semin Roentgenol. 2002 July; 37(3): 182-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12226896

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Case report: Fournier's gangrene--roentgenographic and sonographic findings. Author(s): Biyani CS, Mayor PE, Powell CS. Source: Clinical Radiology. 1995 October; 50(10): 728-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7586970

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Clinical case study: pediatric gas gangrene. Author(s): Ladebauche P. Source: Pediatric Nursing. 1994 May-June; 20(3): 255-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8008473

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Clinical trial of low density lipoprotein-apheresis for treatment of diabetic gangrene. Author(s): Iizuka T, Takeda H, Inoue H, Miyamoto T, Ito H, Omura M, Tsuji H, Chiba S, Nishikawa T. Source: Intern Med. 1997 December; 36(12): 898-902. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9475247

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Clostridial gas gangrene associated with congenital generalized lipodystrophy: report of a case. Author(s): Nakae H, Endo S, Yamada Y, Takakuwa T, Taniguchi S, Kikuchi M. Source: Surgery Today. 1994; 24(12): 1097-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7780235

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Clostridial gas gangrene complicating leukemia. Author(s): Sawhney R, Rees JH, Markowitz SK. Source: Abdominal Imaging. 1994 September-October; 19(5): 451-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7950826

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Clostridial gas gangrene of the abdominal wall after laparoscopic cholecystectomy. Author(s): Samel S, Post S, Martell J, Becker H. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 1997 August; 7(4): 245-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9448120

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Clostridial gas gangrene. I. Cellular and molecular mechanisms of microvascular dysfunction induced by exotoxins of Clostridium perfringens. Author(s): Bryant AE, Chen RY, Nagata Y, Wang Y, Lee CH, Finegold S, Guth PH, Stevens DL. Source: The Journal of Infectious Diseases. 2000 September; 182(3): 799-807. Epub 2000 August 17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10950774

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Clostridium perfringens within intracardiac thrombus: a case of intracardiac gas gangrene. Author(s): Chowdhury PS, Timmis SB, Marcovitz PA. Source: Circulation. 1999 November 16; 100(20): 2119. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10562270

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Clostridium septicum gas gangrene of the gluteus maximus and an ascending colon malignant tumor. A case report. Author(s): Fernandez RJ, Gluck JL. Source: Clinical Orthopaedics and Related Research. 1994 November; (308): 178-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7955680

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Clostridium tertium in necrotizing fasciitis and gangrene. Author(s): Ray P, Das A, Singh K, Bhansali A, Yadav TD. Source: Emerging Infectious Diseases. 2003 October; 9(10): 1347-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14626222

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Clustering of Fournier (male genital) gangrene cases in a pediatric cancer ward. Author(s): Bakshi C, Banavali S, Lokeshwar N, Prasad R, Advani S. Source: Medical and Pediatric Oncology. 2003 November; 41(5): 472-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14515393

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Cocaine-associated intestinal gangrene in a pregnant woman. Author(s): Jawahar D, Leo PJ, Anandarao N, Pachter BR. Source: The American Journal of Emergency Medicine. 1997 September; 15(5): 510-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9270393

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Colorectal cancer presenting as Fournier's gangrene. Author(s): Eke N. Source: The American Journal of Gastroenterology. 1999 March; 94(3): 858-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10086688

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Complication after artery catheterization: digital gangrene in a patient with myeloproliferative disease with thrombocytosis. Author(s): Ulrich B, Kreienbuhl G. Source: Anesthesia and Analgesia. 2000 September; 91(3): 767-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10960425

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Composite gastric seromuscular and omental pedicle flap for urethral and scrotal reconstruction after Fournier's gangrene. Author(s): Kamei Y, Aoyama H, Yokoo K, Fujii K, Kondo C, Sato T, Onishi S. Source: Annals of Plastic Surgery. 1994 November; 33(5): 565-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7857055

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Conservative management of penile gangrene. Author(s): Lewis DC, Mathialahan T, Ray D. Source: British Journal of Urology. 1995 March; 75(3): 412-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7735813

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Co-occurrence of Fournier's gangrene and pancytopenia may be the first sign of acute myelomonocytic leukemia. Author(s): Islamoglu K, Serdaroglu I, Ozgentas E. Source: Annals of Plastic Surgery. 2001 September; 47(3): 352-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11562053

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Crohn's disease presenting with Fournier's gangrene and enterovesical fistula. Author(s): Brings HA, Matthews R, Brinkman J, Rotolo J. Source: The American Surgeon. 1997 May; 63(5): 401-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9128226

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CT of pancreatic gas gangrene. Author(s): McCloskey M, Low VH. Source: Australasian Radiology. 1996 February; 40(1): 75-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8838895

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Cutaneous gangrene due to hyperparathyroidism secondary to chronic renal failure (uraemic gangrene syndrome) Author(s): Torok L, Kozepessy L. Source: Clinical and Experimental Dermatology. 1996 January; 21(1): 75-7. Review. Erratum In: Clin Exp Dermatol 1996 May; 21(3): 252. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8689779

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Cutaneous gangrene in a renal dialysis patient. Author(s): Pantanowitz L, Harton A, Beckwith B. Source: Postgraduate Medical Journal. 2001 November; 77(913): 735, 741-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11677290

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Cutaneous gangrene secondary to metastatic calcification in end stage renal failure--a case report. Author(s): Tan HH, Cheong WK. Source: Singapore Med J. 1996 August; 37(4): 438-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8993151

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Developing venous gangrene in deep vein thrombosis: intraarterial low-dose burst therapy with urokinase--case reports. Author(s): Garg SK, Yadav KS. Source: Angiology. 1999 February; 50(2): 157-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10063948

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Diagnosis and management of clostridium perfringens sepsis and uterine gas gangrene. Author(s): Halpin TF, Molinari JA. Source: Obstetrical & Gynecological Survey. 2002 January; 57(1): 53-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11773832

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Digital gangrene after radial artery catheterization in a patient with thrombocytosis. Author(s): Rehfeldt KH, Sanders MS. Source: Anesthesia and Analgesia. 2000 January; 90(1): 45-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10624974

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Digital gangrene and a mass in the heart. Author(s): Au WY, Jim MH, Lam KY, Kwong YL. Source: Archives of Internal Medicine. 2001 January 22; 161(2): 292-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11176747

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Digital gangrene and anticentromere antibodies without scleroderma. Author(s): Picillo U, Marcialis MR, Matarazzo A, Italiano G, Petti A. Source: British Journal of Rheumatology. 1998 December; 37(12): 1352-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9973164

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Digital gangrene following chemotherapy. Author(s): Goffin E, Angangco R, Shapiro LM, Lockwood CM. Source: The American Journal of Medicine. 1994 June; 96(6): 571. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8017459

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Digital gangrene: a rare skin symptom in systemic lupus erythematosus. Author(s): Vocks E, Welcker M, Ring J. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2000 September; 14(5): 419-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11305390

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Digital gangrene: an unusual late complication of non-union of a proximal humeral fracture. Author(s): Calder FR, Gwyther SJ, Loosemore TM. Source: Injury. 1997 November-December; 28(9-10): 695-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9624358

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Digital ischemia and gangrene due to red blood cell aggregation induced by acquired dysfibrinogenemia. Author(s): Kwaan HC, Levin M, Sakurai S, Kucuk O, Rooney MW, Lis LJ, Kauffman JW. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1997 December; 26(6): 1061-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9423724

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Dihydroergotamine in the treatment of head injury--risk of gangrene and renal failure. Author(s): Grande PO, Nordstrom CH. Source: Acta Anaesthesiologica Scandinavica. 1996 November; 40(10): 1255-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8986192

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Distal gangrene in a polycythemic recipient fetus in twin-twin transfusion. Author(s): Scott F, Evans N. Source: Obstetrics and Gynecology. 1995 October; 86(4 Pt 2): 677-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7675411

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Distal penile gangrene in a patient with chronic renal failure. Author(s): Atalay AC, Karaman MI. Source: International Journal of Urology : Official Journal of the Japanese Urological Association. 1997 July; 4(4): 431-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9256339

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Distinguishing fulminant perineal necrosis as a result of Wegener's granulomatosis from Fournier's gangrene. Author(s): Sarmiento JM, Bannon MP, Bjornsson J, Matteson EL. Source: The American Journal of Medicine. 2000 June 1; 108(8): 680-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10896626

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Dopamine-associated symmetric peripheral gangrene. Author(s): Park JY, Kanzler M, Swetter SM. Source: Archives of Dermatology. 1997 February; 133(2): 247-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9041849

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Early CT findings of Fournier's gangrene in a healthy male. Author(s): Sherman J, Solliday M, Paraiso E, Becker J, Mydlo JH. Source: Clinical Imaging. 1998 November-December; 22(6): 425-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9876913

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Eosinophilic fasciitis with occlusive vasculitis and gangrene of the finger. Author(s): Song YW, Kim HA, Song KY. Source: The Journal of Rheumatology. 1995 February; 22(2): 356-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7738965

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Epidemiological aspects of Fournier's gangrene at Kenyatta National Hospital, Nairobi. Author(s): Ayumba BR, Magoha GA. Source: East Afr Med J. 1998 October; 75(10): 586-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10065193

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Ergotamine induced gangrene. Author(s): Mansoor T, Agarwal R. Source: J Indian Med Assoc. 1996 April; 94(4): 163. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8854642

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Essential thrombocythemia: an uncommon cause of digital gangrene. Author(s): Fernando EA, Senanayake B, Sivakumaran S. Source: Ceylon Med J. 1998 March; 43(1): 34-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9624842

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Exogenously acquired Clostridium septicum gas gangrene--a case report. Author(s): Winter E, Dommke A, Bongers-Binder S, Eiring P, Weise K. Source: Swiss Surg. 1998; (6): 316-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9887679

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Experience in management of Fournier's gangrene. Author(s): Villanueva-Saenz E, Martinez Hernandez-Magro P, Valdes Ovalle M, Montes Vega J, Alvarez-Tostado F JF. Source: Techniques in Coloproctology. 2002 April; 6(1): 5-10; Discussion 11-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12077634

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Extremity gangrene in utero. Author(s): Carr MM, al-Qattan M, Clarke HM. Source: Journal of Hand Surgery (Edinburgh, Lothian). 1996 October; 21(5): 652-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9230955

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Fibrin sealant for the reconstruction of fournier's gangrene sequelae. Author(s): DeCastro BJ, Morey AF. Source: The Journal of Urology. 2002 April; 167(4): 1774-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11912407

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Fournier gangrene associated with Crohn disease. Author(s): Jiang T, Covington JA, Haile CA, Murphy JB, Rotolo FS, Lake AM. Source: Mayo Clinic Proceedings. 2000 June; 75(6): 647-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10852429

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Fournier's gangrene after hemorrhoidectomy: association with drug-induced agranulocytosis. Report of a case. Author(s): Cihan A, Mentes BB, Sucak G, Karamercan A, Naznedar R, Ferahkose Z. Source: Diseases of the Colon and Rectum. 1999 December; 42(12): 1644-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10613488

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Fournier's gangrene after unrelated cord blood stem cell transplantation. Author(s): Yoshida C, Kojima K, Shinagawa K, Hashimoto D, Asakura S, Takata S, Tanimoto M. Source: Annals of Hematology. 2002 September; 81(9): 538-9. Epub 2002 September 07. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12373358

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Fournier's gangrene as a complication of varicella in a 15-month-old boy. Author(s): Guneren E, Keskin M, Uysal OA, Ariturk E, Kalayci AG. Source: Journal of Pediatric Surgery. 2002 November; 37(11): 1632-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12407555

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Fournier's gangrene as first presentation of promyelocytic leukemia. Author(s): Faber HJ, Girbes AR, Daenen S. Source: Leukemia Research. 1998 May; 22(5): 473-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9652735

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Fournier's gangrene caused by Candida species as the primary organism. Author(s): Johnin K, Nakatoh M, Kadowaki T, Kushima M, Koizumi S, Okada Y. Source: Urology. 2000 July 1; 56(1): 153. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10869649

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Fournier's gangrene complicating vasectomy. Author(s): Lema VM. Source: East Afr Med J. 2003 September; 80(9): 492-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14640173

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Fournier's gangrene following penile self-injection with cocaine. Author(s): Mouraviev VB, Pautler SE, Hayman WP. Source: Scandinavian Journal of Urology and Nephrology. 2002; 36(4): 317-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12201928

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Fournier's gangrene in a modern surgical setting: improved survival with aggressive management. Author(s): Corman JM, Moody JA, Aronson WJ. Source: Bju International. 1999 July; 84(1): 85-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10444130

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Fournier's gangrene in HIV-infected patients. Author(s): Merino E, Boix V, Portilla J, Reus S, Priego M. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2001 December; 20(12): 910-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11837650

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Fournier's gangrene in Ibadan. Author(s): Okeke LI. Source: Afr J Med Med Sci. 2000 September-December; 29(3-4): 323-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11714016

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Fournier's gangrene in neonates-differences from that in adults. Author(s): Ratan SK, Rattan KN. Source: Clinical Pediatrics. 2002 May; 41(4): 281-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12041726

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Fournier's gangrene in Nigeria: a review of 21 consecutive patients. Author(s): Eke N, Echem RC, Elenwo SN. Source: Int Surg. 2000 January-March; 85(1): 77-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10817438

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Fournier's gangrene with an unusual urologic etiology. Author(s): Fialkov JM, Watkins K, Fallon B, Kealey GP. Source: Urology. 1998 August; 52(2): 324-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9697806

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Fournier's gangrene. Author(s): Giagounidis AA, Heinsch M, Kasperk R, Aul C. Source: Annals of Hematology. 2003 August; 82(8): 531-2. Epub 2003 June 14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12811517

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Fournier's gangrene. Author(s): Morpurgo E, Galandiuk S. Source: The Surgical Clinics of North America. 2002 December; 82(6): 1213-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12516849

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Fournier's gangrene: a case report. Author(s): Folgaresi M, Simonetti V, Motolese A, Giannetti A. Source: Acta Dermato-Venereologica. 1999 May; 79(3): 252-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10384943

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Fournier's gangrene: a clinical presentation of necrotizing fasciitis after bone marrow transplantation. Author(s): Martinelli G, Alessandrino EP, Bernasconi P, Caldera D, Colombo A, Malcovati L, Gaviglio MR, Vignoli GP, Borroni G, Bernasconi C. Source: Bone Marrow Transplantation. 1998 November; 22(10): 1023-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9849702

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Fournier's gangrene: a review of 1726 cases. Author(s): Kiran RP. Source: The British Journal of Surgery. 2000 November; 87(11): 1596. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11091260

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Fournier's gangrene: a review of 1726 cases. Author(s): Eke N. Source: The British Journal of Surgery. 2000 June; 87(6): 718-28. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10848848

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Fournier's gangrene: an analysis of repeated surgical debridement. Author(s): Chawla SN, Gallop C, Mydlo JH. Source: European Urology. 2003 May; 43(5): 572-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12706005

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Fournier's gangrene: an unusual presentation of sepsis. Author(s): Rotondo N. Source: The Journal of Emergency Medicine. 2002 November; 23(4): 413-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12480026

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Fournier's gangrene: can aggressive treatment save life? Author(s): Fillo J, Cervenakov I, Labas P, Mardiak J, Szoldova K, Kopecny M, Szeiff S, Mal'a M, Chovan D. Source: International Urology and Nephrology. 2001; 33(3): 533-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12230290

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Fournier's gangrene: changing face of the disease. Author(s): Yaghan RJ, Al-Jaberi TM, Bani-Hani I. Source: Diseases of the Colon and Rectum. 2000 September; 43(9): 1300-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11005502

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Fournier's gangrene: diagnostic approach and therapeutic challenge. Author(s): Xeropotamos NS, Nousias VE, Kappas AM. Source: The European Journal of Surgery = Acta Chirurgica. 2002; 168(2): 91-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12113277

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Fournier's gangrene: etiology, treatment, and complications. Author(s): Kilic A, Aksoy Y, Kilic L. Source: Annals of Plastic Surgery. 2001 November; 47(5): 523-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11716264

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Fournier's gangrene: report of six cases. Author(s): Ochiai T, Ohta K, Takahashi M, Yamazaki S, Iwai T. Source: Surgery Today. 2001; 31(6): 553-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11428614

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Fournier's gangrene: risk assessment and enzymatic debridement with lyophilized collagenase application. Author(s): Asci R, Sarikaya S, Buyukalpelli R, Yilmaz AF, Yildiz S. Source: European Urology. 1998; 34(5): 411-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9803004

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Fournier's gangrene--Taiwan experience. Author(s): Yang SC, Wu TJ. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2001 April; 64(4): 239-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11458762

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Gallbladder volvulus with gangrene. Case report and review of the literature. Author(s): Christoudias GC. Source: Jsls. 1997 April-June; 1(2): 167-70. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9876667

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Gangrene bug “killed 35 heroin users”. Author(s): Christie B. Source: Bmj (Clinical Research Ed.). 2000 June 24; 320(7251): 1690. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10864534

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Gangrene bug killed 35 heroin users. Author(s): Christie B. Source: The Western Journal of Medicine. 2000 August; 173(2): 82-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10924416

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Gangrene complicating dopamine therapy. Author(s): Kaul S, Sarela AI, Supe AN, Karnard DR. Source: Journal of the Royal Society of Medicine. 1997 February; 90(2): 80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9068436

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Gangrene of digits associated with radial artery cannulation. Author(s): Wong AY, O'Regan AM. Source: Anaesthesia. 2003 October; 58(10): 1034-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12969061

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Gangrene of Meckel's diverticulum secondary to axial torsion: a rare complication. Author(s): Malhotra S, Roth DA, Gouge TH, Hofstetter SR, Sidhu G, Newman E. Source: The American Journal of Gastroenterology. 1998 August; 93(8): 1373-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9707071

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Gangrene of the back, buttocks, fingers, and toes caused by transient cold agglutinemia induced by a cooling blanket in a patient with sepsis. Author(s): Talisman R, Lin JT, Soroff HS, Galanakis D. Source: Surgery. 1998 May; 123(5): 592-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9591016

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Gangrene of the feet in Churg-Strauss syndrome. Author(s): Naschitz JE, Loberman Z, Wolffson V, Babich JP, Yeshurun D. Source: Vascular Medicine (London, England). 2003 May; 8(2): 129-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14518616

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Gangrene of the fingertips after bleomycin and methotrexate. Author(s): Correia O, Ribas F, Azevedo R, Rodrigues H, Delgado L. Source: Cutis; Cutaneous Medicine for the Practitioner. 2000 October; 66(4): 271-2, 274. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11109149

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Gangrene of the lung: treatment in two stages. Author(s): Refaely Y, Weissberg D. Source: The Annals of Thoracic Surgery. 1997 October; 64(4): 970-3; Discussion 973-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9354511

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Gangrene of the perineum. Author(s): Benizri E, Fabiani P, Migliori G, Chevallier D, Peyrottes A, Raucoules M, Amiel J, Mouiel J, Toubol J. Source: Urology. 1996 June; 47(6): 935-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8677598

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Gangrene of the toes in a patient with chronic myelogenous leukemia after long-term hydroxyurea therapy. Author(s): Leo E, Kramer A, Hochhaus A, Krasniqi F, Hehlmann R, Ho AD. Source: Annals of Hematology. 2002 August; 81(8): 467-9. Epub 2002 August 15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12224005

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Gangrene secondary to axial torsion in a patient with Meckel's diverticulum. Author(s): Eser M, Oncel M, Kurt N. Source: Int Surg. 2002 April-June; 87(2): 104-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12222911

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Gas gangrene after colonoscopy. Author(s): Jamieson NF, Willoughby CP. Source: Postgraduate Medical Journal. 2001 January; 77(903): 47-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11123397

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Gas gangrene following intramuscular injection of vitamin B-complex. Author(s): Chaudhry R, Dhawan B. Source: Indian J Pathol Microbiol. 1998 July; 41(3): 357-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9805861

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Gas gangrene following intramuscular injection. Author(s): Chowdhary GN, Misra MC. Source: J Assoc Physicians India. 1999 November; 47(11): 1125. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10862335

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Gas gangrene in a patient with severe haemophilia A. Author(s): Ghosh K, Jijina F, Pathare AV, Mohanty D. Source: Haemophilia : the Official Journal of the World Federation of Hemophilia. 1999 November; 5(6): 450-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10583535

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Gas gangrene in an immunocompromised girl due to a Clostridium ramosum infection. Author(s): van der Vorm ER, von Rosenstiel IA, Spanjaard L, Dankert J. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1999 April; 28(4): 923-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10825071

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Gas gangrene in patient with atherosclerosis obliterans. Author(s): Niimi M, Ikeda Y, Kan S, Takami H. Source: Asian Cardiovascular & Thoracic Annals. 2002 June; 10(2): 178-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12079950

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Gas gangrene of the arm due to Enterobacter cloacae in a neutropenic patient. Author(s): Fata F, Chittivelu S, Tessler S, Kupfer Y. Source: Southern Medical Journal. 1996 November; 89(11): 1095-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8903295

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Gas gangrene pyaemia with myocardial abscess formation--fatal outcome from a rare infection nowadays. Author(s): Keese M, Nichterlein T, Hahn M, Magdeburg R, Karaorman M, Back W, Sturm J, Kerger H. Source: Resuscitation. 2003 August; 58(2): 219-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12909385

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Gas gangrene. Author(s): Bouachour G, Gouello JP, Harry P, Alquier P. Source: Lancet. 1996 April 20; 347(9008): 1116-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8602086

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Genital Fournier's gangrene: experience with 38 patients. Author(s): Hejase MJ, Simonin JE, Bihrle R, Coogan CL. Source: Urology. 1996 May; 47(5): 734-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8650874

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Genitoperineal gangrene: experience in Singapore. Author(s): Ong HS, Ho YH. Source: The Australian and New Zealand Journal of Surgery. 1996 May; 66(5): 291-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8634045

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Group A streptococcal necrotizing fasciitis Fournier's gangrene--Quebec. Author(s): Goyette M. Source: Can Commun Dis Rep. 1997 July 1; 23(13): 101-3. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9509640

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HBO and gas gangrene. A case report. Author(s): Ferrau S, Sallusti R, Lozano Valdes A, Gonzales C, Jonsson M, Gunnlaugsson G, Gullo A. Source: Minerva Anestesiol. 2001 October; 67(10): 745-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11740423

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Healing of Fournier's gangrene of the scrotum in a haemodialysis patient after conservative therapy alone. Author(s): Horita Y, Miyazaki M, Noguchi M, Tadokoro M, Taura K, Ozono Y, Kohno S. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2000 March; 15(3): 419-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10692532

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Henoch-Schonlein purpura, cryofibrinogenaemia, and peripheral gangrene. Author(s): Gerke P, Kruger S, Steinhoff J. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1999 July; 14(7): 1746-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10435887

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Heparin-induced thrombocytopenia: IgG-mediated platelet activation, platelet microparticle generation, and altered procoagulant/anticoagulant balance in the pathogenesis of thrombosis and venous limb gangrene complicating heparin-induced thrombocytopenia. Author(s): Warkentin TE. Source: Transfusion Medicine Reviews. 1996 October; 10(4): 249-58. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8899954

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Hepatic portal venous gas and small bowel obstruction with no signs of intestinal gangrene after appendicectomy. Author(s): Tsai JA, Calissendorff B, Hanczewski R, Permert J. Source: The European Journal of Surgery = Acta Chirurgica. 2000 October; 166(10): 8267. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11071173

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High-dose adrenaline with low systemic vascular resistance and symmetrical peripheral gangrene. Author(s): Joynt G, Doedens L, Lipman J, Bothma P. Source: S Afr J Surg. 1996 May; 34(2): 99-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8764956

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HIV infection presenting with Fournier's gangrene. Author(s): Roca B, Cunat E, Simon E. Source: The Netherlands Journal of Medicine. 1998 October; 53(4): 168-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9825642

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Hospital gangrene: the scourge of surgeons in the past. Author(s): Cohen J. Source: Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America. 1999 September; 20(9): 638-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10501267

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Hydroxyurea-induced gangrene of the toes in a patient with chronic myelogenous leukemia. Author(s): Yasuda N, Ohmori S, Usui T. Source: American Journal of Hematology. 2000 February; 63(2): 103-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10629580

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Hyperbaric oxygen and gas gangrene. Author(s): Lindsey D. Source: Br J Hosp Med. 1996 February 7-20; 55(3): 147. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8907883

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Hyperbaric oxygen in the treatment of Fournier's gangrene. Author(s): Korhonen K, Hirn M, Niinikoski J. Source: The European Journal of Surgery = Acta Chirurgica. 1998 April; 164(4): 251-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9641365

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Hyperbaric oxygen therapy in the treatment of orbital gas gangrene. Author(s): Fielden MP, Martinovic E, Ells AL. Source: J Aapos. 2002 August; 6(4): 252-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12185353

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Hypereosinophilic syndrome presenting as cutaneous necrotizing eosinophilic vasculitis and Raynaud's phenomenon complicated by digital gangrene. Author(s): Jang KA, Lim YS, Choi JH, Sung KJ, Moon KC, Koh JK. Source: The British Journal of Dermatology. 2000 September; 143(3): 641-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10971345

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Iatrogenic penile gangrene: 10-year follow-up. Author(s): Kurul S. Source: Plastic and Reconstructive Surgery. 1995 January; 95(1): 210-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7809256

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Identification of residues critical for toxicity in Clostridium perfringens phospholipase C, the key toxin in gas gangrene. Author(s): Alape-Giron A, Flores-Diaz M, Guillouard I, Naylor CE, Titball RW, Rucavado A, Lomonte B, Basak AK, Gutierrez JM, Cole ST, Thelestam M. Source: European Journal of Biochemistry / Febs. 2000 August; 267(16): 5191-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10931204

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Idiopathic partial gangrene of the breast. Author(s): Sahoo SP, Khatri A, Khanna A. Source: Trop Doct. 1998 July; 28(3): 178-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9700289

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Iloprost treatment of finger gangrene in a patient with Raynaud's syndrome. Author(s): Levy Y, Sherer Y, Shoenfeld Y. Source: Isr Med Assoc J. 2000 December; 2(12): 960-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11344792

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Images in cardiovascular medicine. Polyarteritis nodosa inducing symmetric peripheral gangrene. Author(s): Fred HL, Serna JH, McDonald GA, Ahmed SS. Source: Circulation. 2003 June 10; 107(22): 2870. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12796415

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Images in cardiovascular medicine. Untreated gangrene in patients with peripheral artery disease. Author(s): Isner JM, Pieczek A, Rosenfield K. Source: Circulation. 1994 January; 89(1): 482-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8281683

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Images in clinical medicine. Gangrene and type I cryoglobulinemia in multiple myeloma. Author(s): Cirasino L, Barbano PR. Source: The New England Journal of Medicine. 1999 November 18; 341(21): 1582. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10564688

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Images in clinical medicine. Gas gangrene associated with occult cancer. Author(s): Schneider DJ, Reid JS. Source: The New England Journal of Medicine. 2000 November 30; 343(22): 1615. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11096169

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Images in clinical medicine. Symmetric peripheral gangrene. Author(s): Berrey MM, van Burik JA. Source: The New England Journal of Medicine. 2001 May 24; 344(21): 1593. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11372011

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Images in medicne. Fournier's gangrene. Author(s): Murphy BL, Pezzullo JA. Source: Medicine and Health, Rhode Island. 2003 April; 86(4): 121. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12751368

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Images in vascular medicine. Phlegmasia coerulea dolens--venous gangrene. Author(s): Szuba A, Cooke JP, Rockson SG. Source: Vascular Medicine (London, England). 1998; 3(1): 29-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9666529

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Impact of diabetes mellitus on the presentation and outcomes of Fournier's gangrene. Author(s): Nisbet AA, Thompson IM. Source: Urology. 2002 November; 60(5): 775-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12429294

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Impact of immunodeficiency virus (HIV) on Fournier's gangrene: observations in Zambia. Author(s): Elem B, Ranjan P. Source: Annals of the Royal College of Surgeons of England. 1995 July; 77(4): 283-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7574321

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Intestinal ischemia and peripheral gangrene in a patient with chronic renal failure. Author(s): Rivera-Nieves J, Bamias G, Alfert J, Bickston SJ, Moskaluk CA, Cominelli F. Source: Gastroenterology. 2002 February; 122(2): 495-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11832463

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Intraoperative superficial femoral artery balloon angioplasty and popliteal to distal bypass graft: an option for combined open and endovascular treatment of diabetic gangrene. Author(s): Schneider PA, Caps MT, Ogawa DY, Hayman ES. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 May; 33(5): 955-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11331834

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Intussusception complicated by gangrene, demarcation and separation of the appendix. Author(s): Varty K, Rance CH. Source: The Australian and New Zealand Journal of Surgery. 1993 November; 63(11): 913-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8216076

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Ischemia and gangrene of the penis. Author(s): Harris CF, Mydlo JH. Source: The Journal of Urology. 2003 May; 169(5): 1795. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12686840

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Isolated gangrene of the round and falciform liver ligaments: a rare cause of peritonitis: case report and review of the world literature. Author(s): Losanoff JE, Kjossev KT. Source: The American Surgeon. 2002 September; 68(9): 751-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12356142

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Kawasaki disease complicated by peripheral gangrene. Author(s): Chang JS, Lin JS, Peng CT, Tsai CH. Source: Pediatric Cardiology. 1999 March-April; 20(2): 139-42. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9986892

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Late presenting gangrene of the extremity in an infant of a diabetic mother. Author(s): Gahukamble DB. Source: Indian J Pediatr. 1995 March-April; 62(2): 241-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10829875

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Life-threatening perineal gangrene from rectal perforation following colonic hydrotherapy: a case report. Author(s): Tan MP, Cheong DM. Source: Ann Acad Med Singapore. 1999 July; 28(4): 583-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10561777

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Limb gangrene and two types of vasculitis. Author(s): Thodiyil PA, Lennox MS, Twaij Z, Keir PM. Source: Journal of the Royal Society of Medicine. 1997 May; 90(5): 276-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9204027

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Limb salvage for streptococcal gangrene of the extremity. Author(s): Schurr M, Engelhardt S, Helgerson R. Source: American Journal of Surgery. 1998 March; 175(3): 213-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9560122

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Livedo reticularis, ulcers, and peripheral gangrene: cutaneous manifestations of primary hyperoxaluria. Author(s): Shih HA, Kao DM, Elenitsas R, Leyden JJ. Source: Archives of Dermatology. 2000 October; 136(10): 1272-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11030785

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Liver cirrhosis with synchronous gas gangrene and spontaneous bacterial peritonitis due to E. coli. Author(s): Murata K, Shimizu A, Takase K, Nakano T, Tameda Y. Source: Journal of Gastroenterology. 1997 April; 32(2): 264-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9085180

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Local treatment of dry gangrene. Author(s): Dreiplatz G, Biro B, Kroger K. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 2002 November; 31(4): 280. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12510556

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Localised necrosis of scrotum (Fournier's gangrene) in a spinal cord injury patient - a case report. Author(s): Vaidyanathan S, Soni BM, Hughes PL, Mansour P, Singh G, Darroch J, Oo T. Source: Bmc Family Practice [electronic Resource]. 2002 December 05; 3(1): 20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12466026

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Lower-extremity gangrene secondary to disseminated intravascular coagulation. Author(s): Cafengiu AM, Hommel BL, Demarco M, Slim J. Source: Journal of the American Podiatric Medical Association. 1999 June; 89(6): 323-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10384761

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Magnetic resonance imaging in the diagnosis of Fournier's gangrene. Author(s): Kickuth R, Adams S, Kirchner J, Pastor J, Simon S, Liermann D. Source: European Radiology. 2001; 11(5): 787-90. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11372608

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Malignancy and pedal gangrene. Author(s): Pacheco NM, Harkless LB, Wynn MH. Source: Journal of the American Podiatric Medical Association. 1996 November; 86(11): 564-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8961662

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Mammary gangrene associated with warfarin ingestion. Author(s): Isenberg JS, Tu Q, Rainey W. Source: Annals of Plastic Surgery. 1996 November; 37(5): 553-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8937612

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Management of clostridial gas gangrene and the role of hyperbaric oxygen. Author(s): Korhonen K, Klossner J, Hirn M, Niinikoski J. Source: Ann Chir Gynaecol. 1999; 88(2): 139-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10392252

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Management of Fournier's gangrene at the Kenyatta National Hospital, Nairobi. Author(s): Ayumba BR, Magoha GA. Source: East Afr Med J. 1998 June; 75(6): 370-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9803623

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Management of Fournier's gangrene: an eleven year retrospective analysis of early recognition, diagnosis, and treatment. Author(s): Norton KS, Johnson LW, Perry T, Perry KH, Sehon JK, Zibari GB. Source: The American Surgeon. 2002 August; 68(8): 709-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12206606

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Management of ischemic heel ulceration and gangrene: An evaluation of factors associated with successful healing. Author(s): Treiman GS, Oderich GS, Ashrafi A, Schneider PA. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2000 June; 31(6): 1110-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10842147

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Managing ergot-induced gangrene: the anesthesiologist as a key player. Author(s): Dam AK, Mishra JC. Source: Anesthesia and Analgesia. 2002 August; 95(2): 409-10, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12145062

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Meleney's synergistic gangrene: a case study. Author(s): Howse EA. Source: Critical Care Nurse. 1995 December; 15(6): 59-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8697764

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Metastatic gas gangrene of the leg due to acute emphysematous cholecystitis. Author(s): Ito T, Shiraki K, Sekoguchi K, Hamada M, Yamanaka T, Takase K, Nakano T. Source: Digestive Diseases and Sciences. 2001 November; 46(11): 2480-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11713957

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Metronidazole extravasation causing digital gangrene. Author(s): Bharani A, Chattopadhyay BP, Dani P, Bhargava KD. Source: Indian J Physiol Pharmacol. 1995 July; 39(3): 307-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8550135

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Minimal debridement in the treatment of Fournier's gangrene. Author(s): Frezza EE, Atlas I. Source: The American Surgeon. 1999 November; 65(11): 1031-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10551751

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Minor amputations on the feet after revascularization for gangrene. A consecutive series of 95 limbs. Author(s): Albrektsen SB, Henriksen BM, Holstein PE. Source: Acta Orthopaedica Scandinavica. 1997 June; 68(3): 291-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9246996

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Monoclonal cryoglobulinemia with extensive gangrene of all four extremities--a case report. Author(s): Sanmugarajah J, Hussain S, Schwartz JM, Friedman S. Source: Angiology. 2000 May; 51(5): 431-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10826861

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Multiple arterial thrombi and in utero leg gangrene in an infant of a diabetic mother. Author(s): Long DK, Lorant DE. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2002 July-August; 22(5): 424-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12082483

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Multiple intestinal stenoses and peripheral gangrene: a combination of two rare surgical complications in a child with Kawasaki disease. Author(s): Krohn C, Till H, Haraida S, Kurnik K, Boehm R, Grantzow R, Joppich I. Source: Journal of Pediatric Surgery. 2001 April; 36(4): 651-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11283900

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Necrotising fasciitis, hospital gangrene, and phagedena. Author(s): Loudon I. Source: Lancet. 1994 November 19; 344(8934): 1416-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7968080

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Necrotizing fasciitis and gangrene of the upper extremity. Author(s): Gonzalez MH. Source: Hand Clin. 1998 November; 14(4): 635-45, Ix. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9884900

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Necrotizing gangrene of the genitalia and perineum. Author(s): Cabrera H, Skoczdopole L, Marini M, Della Giovanna P, Saponaro A, Echeverria C. Source: International Journal of Dermatology. 2002 December; 41(12): 847-51. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12492967

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Neonatal gangrene in an extremity of an infant of a diabetic mother. Author(s): Moazzam A, Riaz M, Brennen MD. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 January; 110(1): 74-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12504941

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Neonatal gangrene of the extremities. Author(s): Letts M, Blastorah B, al-Azzam S. Source: Journal of Pediatric Orthopedics. 1997 May-June; 17(3): 397-401. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9150032

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Non-clostridial gas gangrene caused by Klebsiella pneumoniae: a case report. Author(s): Li CM, Chen PL, Ho YR. Source: Scandinavian Journal of Infectious Diseases. 2001; 33(8): 629-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11525362

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Nonclostridial gas gangrene due to Streptococcus anginosus in a diabetic patient. Author(s): Shimizu T, Harada M, Zempo N, Sadamitsu D, Furumoto H, Uchida H, Yasui H, Ofuji R, Muto M. Source: Journal of the American Academy of Dermatology. 1999 February; 40(2 Pt 2): 347-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10025866

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Non-traumatic gas gangrene in the abdomen: report of six autopsy cases. Author(s): Sasaki T, Nanjo H, Takahashi M, Sugiyama T, Ono I, Masuda H. Source: Journal of Gastroenterology. 2000; 35(5): 382-90. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10832675

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Nontraumatic gas gangrene. Author(s): Valentine EG. Source: Annals of Emergency Medicine. 1997 July; 30(1): 109-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9209235

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Oro-facial gangrene (noma/cancrum oris): pathogenetic mechanisms. Author(s): Enwonwu CO, Falkler WA, Idigbe EO. Source: Critical Reviews in Oral Biology and Medicine : an Official Publication of the American Association of Oral Biologists. 2000; 11(2): 159-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12002813

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Outcome analysis in patients with Fournier's gangrene: report of 45 cases. Author(s): Korkut M, Icoz G, Dayangac M, Akgun E, Yeniay L, Erdogan O, Cal C. Source: Diseases of the Colon and Rectum. 2003 May; 46(5): 649-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12792442

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Outcome prediction in patients with Fournier's gangrene. Author(s): Laor E, Palmer LS, Tolia BM, Reid RE, Winter HI. Source: The Journal of Urology. 1995 July; 154(1): 89-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7776464

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Ovarian cancer and gangrene of the digits: case report and review of the literature. Author(s): Chow SF, McKenna CH. Source: Mayo Clinic Proceedings. 1996 March; 71(3): 253-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8594283

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Paradoxical venous limb gangrene complicating oral anticoagulation in a patient with cancer-associated deep venous thrombosis. Author(s): Georgin S, Pouchot J, Raschilas F, Barete S, Lerolle DL, Vinceneux P. Source: Archives of Dermatology. 2003 September; 139(9): 1126-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12975152

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Pedal gangrene secondary to disseminated intravascular coagulation with gastric carcinoma. Author(s): Gragasin-Saviano L, Isaacson E, Stuck RM. Source: Journal of the American Podiatric Medical Association. 2002 March; 92(3): 14952. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11904327

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Perioperative and rehabilitative outcomes after amputation for ischaemic leg gangrene. Author(s): Peng CW, Tan SG. Source: Ann Acad Med Singapore. 2000 March; 29(2): 168-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10895333

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Peripheral gangrene complicating hemolytic uremic syndrome in a child. Author(s): Ozel A, Caliskan U, Gucer S. Source: Pediatric Nephrology (Berlin, Germany). 2003 May; 18(5): 465-7. Epub 2003 March 28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12736810

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Peripheral gangrene complicating idiopathic and recessive hemolytic uremic syndromes. Author(s): Kaplan BS, Garcia CD, Chesney RW, Segar WE, Giugno K, Chem R. Source: Pediatric Nephrology (Berlin, Germany). 2000 September; 14(10-11): 985-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10975312

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Peripheral gangrene complicating Salmonella typhi septicaemia in a Gambian infant. Author(s): Okoko BJ, Ota MO, Arowolo JO, Whittle HC. Source: Journal of Tropical Pediatrics. 2001 August; 47(4): 250-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11523769

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Peripheral gangrene during infancy: a rare presentation of systemic lupus erythematosus. Author(s): Shetty VB, Rao S, Krishnamurthy PN, Shenoy VU. Source: Archives of Disease in Childhood. 2001 October; 85(4): 335-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11567946

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Plasmodium falciparum cerebral malaria complicated by disseminated intravascular coagulation and symmetrical peripheral gangrene: case report and review. Author(s): Liechti ME, Zumsteg V, Hatz CF, Herren T. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2003 September; 22(9): 551-4. Epub 2003 August 21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12938006

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Platelet apheresis for digital gangrene due to thrombocytosis in chronic myeloid leukaemia. Author(s): Win N, Mitchell DC. Source: Clinical and Laboratory Haematology. 2001 February; 23(1): 65-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11422234

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Pleural gas gangrene secondary to esophageal injury by an ingested fish bone. Author(s): Endo S, Kobayashi A, Hasegawa T, Yamaguchi T, Murayama F, Sohara Y. Source: Jpn J Thorac Cardiovasc Surg. 2002 April; 50(4): 178-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11993201

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Polyvisceral gangrene due to radiation enteritis. Author(s): Wagholikar GD, Gupta RK, Kapoor VK. Source: Trop Gastroenterol. 2002 October-December; 23(4): 209-10. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12833716

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Polyvisceral gangrene due to radiation enteritis. Author(s): Wagholikar GD, Gupta RK, Kapoor VK. Source: Trop Gastroenterol. 2002 April-June; 23(2): 104-5. No Abstract Available. Corrected and Republished In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12632983

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Postoperative synergistic gangrene after spinal fusion. Author(s): Kauffman CP, Bono CM, Vessa PP, Swan KG. Source: Spine. 2000 July 1; 25(13): 1729-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10870152

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Predisposing factors and treatment outcome in Fournier's gangrene. Analysis of 28 cases. Author(s): Gurdal M, Yucebas E, Tekin A, Beysel M, Aslan R, Sengor F. Source: Urologia Internationalis. 2003; 70(4): 286-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12740493

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Prepucial skin flap for reconstruction of the scrotum in Fournier's gangrene. Author(s): al-Shaham AA. Source: Annales De Chirurgie Plastique Et Esthetique. 2001 December; 46(6): 637-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11826715

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Prognostic factors and strategy of treatment in Fournier's gangrene: a 12-year retrospective study. Author(s): Chen CS, Liu KL, Chen HW, Chou CC, Chuang CK, Chu SH. Source: Changgeng Yi Xue Za Zhi. 1999 March; 22(1): 31-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10418207

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Progression to wet gangrene in penile necrosis and calciphylaxis. Author(s): Barthelmes L, Chezhian C, Thomas KJ. Source: International Urology and Nephrology. 2002; 34(2): 231-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12775102

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Progressive gangrene of the hand following extravasation of antibiotics associated with hereditary resistance to activated protein C. Author(s): Borman H, Tuncali D, Apak A, Kostakoglu N. Source: Annals of Plastic Surgery. 1998 August; 41(2): 194-6; Discussion 197-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9718155

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Pulmonary gangrene complicating bacterial pneumonia. Author(s): Kothari PR, Jiwane A, Kulkarni B. Source: Indian Pediatrics. 2003 August; 40(8): 784-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12951383

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Pulmonary gangrene: radiological and pathologic correlation. Author(s): Curry CA, Fishman EK, Buckley JA. Source: Southern Medical Journal. 1998 October; 91(10): 957-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9786293

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Radiologic-Pathologic Conferences of the Massachusetts General Hospital. Necrotizing fasciitis of the scrotum (Fournier's gangrene) Author(s): Fan CM, Whitman GJ, Chew FS. Source: Ajr. American Journal of Roentgenology. 1996 May; 166(5): 1164. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8615262

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Radiology of Fournier's gangrene. Author(s): Rajan DK, Scharer KA. Source: Ajr. American Journal of Roentgenology. 1998 January; 170(1): 163-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9423625

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Rapidly progressive necrotizing fasciitis and gangrene due to Clostridium difficile: case report. Author(s): Bhargava A, Sen P, Swaminathan A, Ogbolu C, Chechko S, Stone F. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 June; 30(6): 954-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10880313

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Raynaud's phenomenon and digital gangrene as a consequence of treatment for Kaposi's sarcoma. Author(s): Hladunewich M, Sawka C, Fam A, Franssen E. Source: The Journal of Rheumatology. 1997 December; 24(12): 2371-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9415644

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Re: Fournier's gangrene as the presenting sign of an undiagnosed human immunodeficiency virus infection. Author(s): Hotter JT. Source: The Journal of Urology. 1996 January; 155(1): 291-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7490862

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Re: Fournier's gangrene in a patient with erectile dysfunction following use of a mechanical erection aid device. Author(s): Trapp JD, Mode DG. Source: The Journal of Urology. 1996 February; 155(2): 656. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8558695

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Re: Gamagami et al. Fournier's gangrene with obstructing cancer. Author(s): Langdon DE. Source: The American Journal of Gastroenterology. 1998 October; 93(10): 1999-2000. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9772081

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Re: Penile gangrene associated with chronic renal failure: report of 7 cases and review of the literature. Author(s): Glass JM, Edwards RJ, Bates CA, Snell ME. Source: The Journal of Urology. 1995 September; 154(3): 1144. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7669114

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Re: Penile gangrene associated with chronic renal failure: report of 7 cases and review of the literature. Author(s): Charles RS, Samaha AM Jr, Greenberg RE, Rosenthal RS, Cutler LA, Shibutani YF. Source: The Journal of Urology. 1995 September; 154(3): 1144. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7637070

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Reduction of gangrene and amputations in diabetic renal transplant patients: the role of a special foot clinic. Author(s): Foster AV, Snowden S, Grenfell A, Watkins PJ, Edmonds ME. Source: Diabetic Medicine : a Journal of the British Diabetic Association. 1995 July; 12(7): 632-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7554788

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Relationship of hemodialysis access to finger gangrene in patients with end-stage renal disease. Author(s): Yeager RA, Moneta GL, Edwards JM, Landry GJ, Taylor LM Jr, McConnell DB, Porter JM. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 August; 36(2): 245-9; Discussion 249. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12170204

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Retroperitoneal gas gangrene complicating elective inguinal hernia repair. Author(s): Privitera A, Edwards DP, Cunningham C. Source: J R Army Med Corps. 2001 October; 147(3): 309-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11766214

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Reversible gangrene. Author(s): Lenzer J, Dolamore M. Source: The Journal of Family Practice. 1994 August; 39(2): 116, 118. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8057060

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Risk factors, ethnic differences and mortality associated with lower-extremity gangrene and amputation in diabetes. The WHO Multinational Study of Vascular Disease in Diabetes. Author(s): Chaturvedi N, Stevens LK, Fuller JH, Lee ET, Lu M. Source: Diabetologia. 2001 September; 44 Suppl 2: S65-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11587052

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Risk of stroke, gangrene from ergot drug interactions. Author(s): Wooltorton E. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 April 15; 168(8): 1015. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12695387

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Severe alcoholic hepatitis accompanied by Fournier's gangrene. Author(s): Zenda T, Kobayashi T, Miyamoto S, Okada T. Source: European Journal of Gastroenterology & Hepatology. 2003 April; 15(4): 419-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12655264

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Small bowel herniation and gangrene from peritoneal dialysis catheter exit site. Author(s): Wong KK, Lan LC, Lin SC, Tam PK. Source: Pediatric Nephrology (Berlin, Germany). 2003 March; 18(3): 301-2. Epub 2003 February 07. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12644930

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Small intestine perforation because of capacitive coupling as a cause of abdominal wall gas gangrene and clostridial sepsis after laparoscopic cholecystectomy. Author(s): Zadrozny D, Sledzinski Z. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2000 December; 10(6): 412-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11147921

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Spontaneous auto-amputation of the foot in a case of diabetes, atherosclerosis and gangrene. Author(s): Kaushik R, Sree B S, Attri AK. Source: J Indian Med Assoc. 2002 September; 100(9): 573-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12455391

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Spontaneous bifocal Clostridium septicum gas gangrene. Author(s): Rai RK, Londhe S, Sinha S, Campbell AC, Aburiziq IS. Source: The Journal of Bone and Joint Surgery. British Volume. 2001 January; 83(1): 1156. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11245518

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Spontaneous bifocal Clostridium septicum gas gangrene. Author(s): Pritchett JW. Source: The Journal of Bone and Joint Surgery. British Volume. 2001 May; 83(4): 621. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11380147

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Spontaneous gas gangrene due to Clostridium perfringens. Author(s): Minutti CZ, Immergluck LC, Schmidt ML. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1999 January; 28(1): 159-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10028101

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Spontaneous gas gangrene in malignant lymphoma: an underreported complication? Author(s): Garcia-Suarez J, de Miguel D, Krsnik I, Barr-Ali M, Hernanz N, Burgaleta C. Source: American Journal of Hematology. 2002 June; 70(2): 145-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12111788

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Structure of the key toxin in gas gangrene. Author(s): Naylor CE, Eaton JT, Howells A, Justin N, Moss DS, Titball RW, Basak AK. Source: Nature Structural Biology. 1998 August; 5(8): 738-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9699639

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Successful treatment of mediastinal gas gangrene due to esophageal perforation. Author(s): Salo JA, Savola JK, Toikkanen VJ, Perhoniemi VJ, Pettila VY, Klossner JA, Toivonen HJ. Source: The Annals of Thoracic Surgery. 2000 December; 70(6): 2143-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11156138

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Sucking injury or gas gangrene? Author(s): Williams AB, Aston NO. Source: Annals of the Royal College of Surgeons of England. 1999 March; 81(2): 115-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10364969

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Surgical management of lung gangrene. Author(s): Krishnadasan B, Sherbin VL, Vallieres E, Karmy-Jones R. Source: Can Respir J. 2000 September-October; 7(5): 401-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11058208

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Symmetric peripheral gangrene and falciparum malaria--an interesting association. Author(s): Anuradha S, Prabhash K, Shome DK, Gaiha M, Singh NP, Agarwal SK, Mandal AK, Jain S, Chaturvedi KU, Sawlani KK. Source: J Assoc Physicians India. 1999 July; 47(7): 733-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10778599

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Symmetrical peripheral gangrene after extracorporeal shockwave lithotripsy. Author(s): Mellor SJ, Cheshire NJ. Source: Bju International. 1999 July; 84(1): 167-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10444142

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Symmetrical peripheral gangrene after suprapubic prostatectomy. Author(s): Trop Gastroenterol. 2002 Oct-Dec;23(4):209-10 Source: Scandinavian Journal of Urology and Nephrology. 2002; 36(6): 478-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12833716

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Symmetrical peripheral gangrene and dopamine. Author(s): Colak T, Erdogan O, Yerebakan O, Arici C, Gurkan A. Source: Ulus Travma Derg. 2003 July; 9(3): 222-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12923702

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Symmetrical peripheral gangrene due to disseminated intravascular coagulation. Author(s): Davis MP, Byrd J, Lior T, Rooke TW. Source: Archives of Dermatology. 2001 February; 137(2): 139-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11176684

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Symmetrical peripheral gangrene following perineal wound infection. Author(s): Morris-Stiff GJ, Haray PN, Foster ME. Source: The Journal of Infection. 1998 May; 36(3): 350-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9661959

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Symmetrical peripheral gangrene: a new presentation of an old disease. Author(s): Knight TT Jr, Gordon SV, Canady J, Rush DS, Browder W. Source: The American Surgeon. 2000 February; 66(2): 196-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10695752

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Symmetrical peripheral gangrene: a rare but dreadful complication of sepsis. Author(s): Parmar MS. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2002 October 29; 167(9): 1037-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12403749

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TCM stage differentiation treatment of diabetic gangrene--an observation on microcirculatory changes. Author(s): Fan G, Lu R. Source: J Tradit Chin Med. 2000 September; 20(3): 163-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11038974

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The continuing challenge of Fournier's gangrene in the 1990s. Author(s): Olsofka JN, Carrillo EH, Spain DA, Polk HC Jr. Source: The American Surgeon. 1999 December; 65(12): 1156-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10597065

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The Journal 150 years ago. Hospital gangrene. Author(s): Colon GA. Source: J La State Med Soc. 1999 April; 151(4): 168-70. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10234889

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The need for action against oro-facial gangrene (noma) Author(s): Barmes DE, Enwonwu CO, Leclercq MH, Bourgeois D, Falkler WA. Source: Tropical Medicine & International Health : Tm & Ih. 1997 December; 2(12): 11114. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9438464

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The obscure object of knowledge: German military medicine confronts gas gangrene during World War I. Author(s): Linton DS. Source: Bulletin of the History of Medicine. 2000 Summer; 74(2): 291-316. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10863830

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The pathogenesis of venous limb gangrene associated with heparin-induced thrombocytopenia. Author(s): Warkentin TE, Elavathil LJ, Hayward CP, Johnston MA, Russett JI, Kelton JG. Source: Annals of Internal Medicine. 1997 November 1; 127(9): 804-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9382401

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The role of clostridial toxins in the pathogenesis of gas gangrene. Author(s): Stevens DL, Bryant AE. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 September 1; 35(Suppl 1): S93-S100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12173116

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The sore, swollen scrotum. Fourier's gangrene. Author(s): Mishriki YY. Source: Postgraduate Medicine. 1999 February; 105(2): 39-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10026700

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The uremic gangrene syndrome: improved healing in spontaneously forming wounds following subtotal parathyroidectomy. Author(s): Kane WJ, Petty PM, Sterioff S, McCarthy JT, Crotty TB. Source: Plastic and Reconstructive Surgery. 1996 September; 98(4): 671-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8773689

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The value of toe pulse waves in determination of risks for limb amputation and death in patients with peripheral arterial disease and skin ulcers or gangrene. Author(s): Carter SA, Tate RB. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 April; 33(4): 708-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11296321

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Threatened premature delivery with prolased amniotic sac leading to neonatal limb gangrene. Author(s): Strobelt N, Mariani E, Locatelli A, Fedeli T, D'Alessio A. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2000 September; 79(9): 805-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10993111

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Thrombosis and gangrene in a patient with sickle cell disease and dactylitis. Author(s): Michaels LA, Maraventano MF, Drachtman RA. Source: The Journal of Pediatrics. 2003 April; 142(4): 449. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12712067

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Toilet seat syndrome: renal failure, perineal gangrene, and sciatic neuropathy. Author(s): Jassal R, Jassal DS, Embil JM. Source: The American Journal of Medicine. 2001 April 1; 110(5): 414-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11294180

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Total scrotal reconstruction after Fournier's gangrene--a case report using rectus abdominis myocutaneous flap. Author(s): Tan BK, Tan KC, Khoo AK. Source: Ann Acad Med Singapore. 1996 November; 25(6): 890-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9055024

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Traditional bone setter's gangrene. Author(s): Walker G. Source: International Orthopaedics. 1999; 23(3): 192. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10486039

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Traditional bone setter's gangrene. Author(s): Onuminya JE, Onabowale BO, Obekpa PO, Ihezue CH. Source: International Orthopaedics. 1999; 23(2): 111-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10422028

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Treatment of ischaemic digital ulcers and prevention of gangrene with intravenous iloprost in systemic sclerosis. Author(s): Zachariae H, Halkier-Sorensen L, Bjerring P, Heickendorff L. Source: Acta Dermato-Venereologica. 1996 May; 76(3): 236-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8800308

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Treatment outcome of nonclostridial gas gangrene at a Level 1 trauma center. Author(s): Takahira N, Shindo M, Tanaka K, Soma K, Ohwada T, Itoman M. Source: Journal of Orthopaedic Trauma. 2002 January; 16(1): 12-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11782626

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Tropical idiopathic lower limb gangrene: case report. Author(s): Musa AA. Source: East Afr Med J. 2001 August; 78(8): 447-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11921572

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Twenty-eight cases of diabetic foot ulcer and gangrene treated with the Chinese herbal medicine combined with injection of ahylsantinfarctase. Author(s): Wang F. Source: J Tradit Chin Med. 2002 March; 22(1): 3-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11977516

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Ultrasonographic appearance of necrotizing gangrene: aid in early diagnosis. Author(s): Kane CJ, Nash P, McAninch JW. Source: Urology. 1996 July; 48(1): 142-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8693639

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Umbilical artery steal syndrome and distal gangrene in a case of twin-twin transfusion syndrome. Author(s): Hecher K, Ville Y, Nicolaides K. Source: Obstetrics and Gynecology. 1994 May; 83(5 Pt 2): 862-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8159379

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Unusual combination of Tc-99m MDP and In-111 WBC scans in gangrene of the foot. Author(s): Makler PT Jr. Source: Clinical Nuclear Medicine. 1998 January; 23(1): 35-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9442965

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Upper extremity venous gangrene following coronary artery bypass. A case report and review of the literature. Author(s): Sullivan VV, Wolk SW, Lampman RM, Prager RL, Hankin FM, Whitehouse WM Jr. Source: The Journal of Cardiovascular Surgery. 2001 August; 42(4): 551-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11455295

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Uraemic gangrene syndrome: is parathyroidectomy always necessary? Author(s): Scharrer K, Mako J, Vajda A, Balo-Bangat JM. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2001 May; 15(3): 252-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11683292

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US case of the day. Fournier gangrene. Author(s): Cumming MJ, Levi CS, Ackerman TE. Source: Radiographics : a Review Publication of the Radiological Society of North America, Inc. 1994 November; 14(6): 1423-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7855351

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Use of electrotherapy to reverse expanding cutaneous gangrene in end-stage renal disease. Author(s): Goldman RJ, Brewley BI, Cohen R, Rudnick M. Source: Advances in Skin & Wound Care. 2003 December; 16(7): 363-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14688644

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Uterine leiomyoma as a rare cause of acute abdomen and intestinal gangrene. Author(s): Sheikh HH. Source: American Journal of Obstetrics and Gynecology. 1998 September; 179(3 Pt 1): 830-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9758003

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Vasculitis with digital gangrene in a patient with HIV infection. Author(s): Kakrani AL, Basavraj A, Madraki R. Source: J Assoc Physicians India. 2003 March; 51: 299-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12839357

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Veno-atrial bypass for the operative treatment of septic gas gangrene secondary to delayed hepatic artery thrombosis. Author(s): Chan G, Tchervenkov J, Cantarovich M, Alpert E, Deschenes M, Ergina P, Metrakos P, Barkun J. Source: American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2003 June; 3(6): 760-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12780569

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Venous gangrene in a patient with adenocarcinoma of the lung. Author(s): Yang MH, Fan FS, Chen PM, Liu JH, Chiou TJ, Wang WS, Yen CC. Source: Japanese Journal of Clinical Oncology. 2000 June; 30(6): 276-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10939433

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Venous gangrene of lower extremities and Staphylococcus aureus sepsis. Author(s): Ibrahim H, Krouskop R, Jeroudi M, McCulloch C, Parupia H, Dhanireddy R. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 March; 21(2): 136-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11324361

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Venous gangrene of the extremities. Author(s): Lorimer JW, Semelhago LC, Barber GG. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1994 October; 37(5): 379-84. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7922898

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Venous gangrene of the limbs. Author(s): Provan JL. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1995 April; 38(2): 190. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7728676

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Venous gangrene of the lower limbs following aortic valve replacement for native valve endocarditis. Author(s): Awad WI, Coumbe A, Walesby RK. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 1998 October; 14(4): 440-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9845154

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Venous gangrene of the upper extremity. Author(s): Kaufman BR, Zoldos J, Bentz M, Nystrom NA. Source: Annals of Plastic Surgery. 1998 April; 40(4): 370-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9555991

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Venous gangrene--further understanding. Author(s): Harris KA. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1994 October; 37(5): 368-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7922893

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Venous limb gangrene during overlapping therapy with warfarin and a direct thrombin inhibitor for immune heparin-induced thrombocytopenia. Author(s): Smythe MA, Warkentin TE, Stephens JL, Zakalik D, Mattson JC. Source: American Journal of Hematology. 2002 September; 71(1): 50-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12221676

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Venous limb gangrene during warfarin treatment of cancer-associated deep venous thrombosis. Author(s): Warkentin TE. Source: Annals of Internal Medicine. 2001 October 16; 135(8 Pt 1): 589-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11601930

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Volvulus and gangrene in intra-abdominal colon after colonoplasty for esophageal stricture. Author(s): Sinha KN. Source: Indian J Gastroenterol. 2000 October-December; 19(4): 190. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11059190

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Wegener's granulomatosis of the elderly: a case report of uncommon severe gangrene of the feet. Author(s): La Civita L, Jeracitano G, Ferri C, Pedrinelli R, Dell'Omo G, Catapano G. Source: Annals of the Rheumatic Diseases. 1995 April; 54(4): 328. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7763116

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Wegener's granulomatosis with gangrene of toes. Author(s): Handa R, Wali JP. Source: Scandinavian Journal of Rheumatology. 1996; 25(2): 103-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8614763

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Wet gangrene in hemodialysis patients with calciphylaxisis is associated with a poor prognosis. Author(s): Davis CA, Valentine RJ. Source: Cardiovascular Surgery (London, England). 2001 December; 9(6): 565-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11604339

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What happened down there? Fournier's gangrene. Author(s): Wang LP, Wong HY, Griffith DP, Ercole C. Source: Urologic Nursing : Official Journal of the American Urological Association Allied. 1997 March; 17(1): 29-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9110903

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

Finding Nutrition Studies on Gangrene 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.7 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 “gangrene” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 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 “gangrene” (or a synonym): •

Arachidonic acid-induced hind limb gangrene: a new experimental rat model of peripheral vascular disease. Author(s): Central Research Laboratories, Zeria Pharmaceutical Co., Ltd., Saitama, Japan. Source: Tanaka, T Takei, M Fukuta, Y Higashino, R Fukuda, Y Nomura, Y Ito, S Tamaki, H Kurimoto, T Suzuki, Y Biol-Pharm-Bull. 1999 March; 22(3): 257-60 0918-6158

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Current surgery/drug combination treatment of diabetic gangrene of the foot. Author(s): Surgery Unit, Bethesda Hospital, Freudenberg, Germany. Source: Lange, E Infection. 1991; 19 Suppl 6S351-4 0300-8126

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Fournier's gangrene during induction treatment of acute promyelocytic leukemia, a case report. Author(s): Service d'Hematologie, Hotel-Dieu de Paris, France. Source: Levy, V Jaffarbey, J Aouad, K Zittoun, R Ann-Hematol. 1998 February; 76(2): 912 0939-5555

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Gangrene and renal failure caused by dihydroergotamine used to treat raised intracranial pressure following head trauma. Author(s): Department of Anesthesiology and Intensive Care, Umed University Hospital, Sweden. Source: Gupta, V L Mjorndal, T O Acta-Anaesthesiol-Scand. 1996 March; 40(3): 389-91 0001-5172

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Gas gangrene from subcutaneous insulin administration. Author(s): Stanford/Kaiser Emergency Medicine Residency Program, Stanford University Hospital, Palo Alto, CA. Source: Chin, R L Martinez, R Garmel, G Am-J-Emerg-Med. 1993 November; 11(6): 622-5 0735-6757

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Influence of prostaglandin E1 on muscular tissue-PO2 in patients with diabetic gangrene. Author(s): Dep. of Medical-Geriatrics, Ruhr-Universitat-Bochum, Marienhospital, Herne, W-Germany. Source: Heinrich, R Krawzak, H W Strosche, H Adv-Exp-Med-Biol. 1989; 248699-704 0065-2598

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Intramuscular imipenem as adjuvant therapy for acute cholecystitis and perforated or gangrenous appendicitis. Author(s): Department of Surgery, Los Angeles County-University of Southern California Medical Center. Source: Yellin, A E Heseltine, P N Berne, T V Appleman, M D Gill, M A Chenella, F C Chemotherapy. 1991; 37 Suppl 237-43 0009-3157

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Nonocclusive mesenteric ischemia in renal patients: recognition and prevention of intestinal gangrene. Author(s): Division of Vascular Surgery, Bethesda Naval Hospital, MD. Source: Valentine, R J Whelan, T V Meyers, H F Am-J-Kidney-Dis. 1990 June; 15(6): 598600 0272-6386

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Peripheral gangrene in African children: a clinical report of twelve cases. Author(s): Department of Orthopedic Surgery, University of Zimbabwe, Harare, Zimbabwe.

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Source: Noyez, J F Sinzobahamvya, N Kalangu, K Acta-Orthop-Belg. 1996 December; 62(4): 207-11 0001-6462 •

Peripheral limb gangrene following rectal biopsy. Treatment with prostacyclin and exchange transfusion. Author(s): Queen Elizabeth Hospital for Children, London, England. Source: Jani, B R Brereton, R J Dillon, M J Clin-Pediatr-(Phila). 1989 December; 28(12): 585-8 0009-9228

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Successful treatment of gangrene in systemic necrotizing vasculitis with iloprost. Author(s): Department of Paediatrics, University of Padua, Italy. Source: Zulian, F Costantini, C Montesco, M C Schiavon, F Zacchello, F Br-J-Rheumatol. 1998 February; 37(2): 228-30 0263-7103

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Summaries for patients. Gangrene of the leg during warfarin treatment in a patient with cancer. Source: Anonymous Ann-Intern-Med. 2001 October 16; 135(8 Pt 1): S-49 0003-4819

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Surgical management of multiple limb gangrene following dehydration in children. Author(s): Department of General Surgery, University of Natal, Durban. Source: Mokoena, T Hadley, G P S-Afr-Med-J. 1991 August 17; 80(4): 185-8 0038-2469

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Symmetrical peripheral gangrene: association with noradrenaline administration. Author(s): Department of Anaesthesia, St. Bartholomew's Hospital, London, UK. Source: Hayes, M A Yau, E H Hinds, C J Watson, J D Intensive-Care-Med. 1992; 18(7): 433-6 0342-4642

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Ticarcillin/clavulanate versus imipenem/cilistatin for the treatment of infections associated with gangrenous and perforated appendicitis. Author(s): Department of Surgery, Santa Clara Valley Medical Center, San Jose, California 95128, USA. Source: Allo, M D Bennion, R S Kathir, K Thompson, J E Lentz, M Meute, M Finegold, S M Am-Surg. 1999 February; 65(2): 99-104 0003-1348

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Treatment of peripheral gangrene due to systemic sclerosis with intravenous pentoxifylline. Source: Goodfield, M J Rowell, N R Clin-Exp-Dermatol. 1989 March; 14(2): 161-2 03076938

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Vasculitis with eosinophilia and digital gangrene in a patient with acquired immunodeficiency syndrome. Author(s): Georgetown Department of Medicine, District of Columbia General Hospital, Washington 20003. Source: Enelow, R S Hussein, M Grant, K Cupps, T R Druckman, D Mortazavi, A Villaflor, S T Glass Royal, M J-Rheumatol. 1992 November; 19(11): 1813-6 0315-162X

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

The following is a specific Web list relating to gangrene; 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: •

Food and Diet Garlic Alternative names: Allium sativum Source: Integrative Medicine Communications; www.drkoop.com

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CHAPTER 3. BOOKS ON GANGRENE Overview This chapter provides bibliographic book references relating to gangrene. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on gangrene 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 “gangrene” (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 gangrene: •

101 Foot Care Tips for People with Diabetes Source: Alexandria, VA: American Diabetes Association. 2000. 120 p. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $14.95 plus shipping and handling. ISBN: 158040040X. Summary: This book answers 101 of the most commonly asked questions about diabetes and foot care. Questions in chapter one provide general information about foot care, including the importance of foot care; the foot problems people with diabetes experience; the people at greatest risk for developing foot problems; the prevention of diabetic foot problems; the role of weight, blood glucose control, and meal planning in diabetic foot problems; and health care checkups. Chapter two offers tips on washing and soaking the feet; caring for dry skin; and dealing with athlete's foot fungus, foot

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odor, and foot swelling. The third chapter provides tips for nail care, including trimming toenails and caring for ingrown toenails. Questions in chapter four provide information on shoe and sock selection. Topics include selecting shoes that fit properly, using insoles and orthotic devices, and seeing a pedorthist. This is followed by a chapter that explains how to treat minor foot problems, including blisters, corns, calluses, warts, bunions, minor injuries, and deformities. Chapter six provides tips for exercising. Questions in the next chapter deal with the identification of major problems, including foot ulcers and infections. This is followed by chapters that answer questions about complications such as peripheral neuropathy and poor circulation. Topics include the symptoms, diagnosis, and treatment of these complications. The final chapter answers questions about other foot problems, including arthritis, gout, Charcot's joint, osteomyelitis, gangrene, and toe amputation. The book also includes a list of resources and an index.

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 “gangrene” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “gangrene” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “gangrene” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Gangrene and Glory: Medical Care During the American Civil War by Frank R. Freemon; ISBN: 0252070100; http://www.amazon.com/exec/obidos/ASIN/0252070100/icongroupinterna

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Gangrene and severe ischemia of the lower extremities; ISBN: 0808911589; http://www.amazon.com/exec/obidos/ASIN/0808911589/icongroupinterna

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Gangrene by Jef. Geeraerts; ISBN: 0670334006; http://www.amazon.com/exec/obidos/ASIN/0670334006/icongroupinterna

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

Chapter 197: Soft Tissue Infections: Erysipelas, Cellulitis, and Gangrenous Cellulitis Source: in Freedberg, I.M., et al., eds. Fitzpatrick's Dermatology in General Medicine. 5th ed., Vol. 2. New York, NY: McGraw-Hill. 1999. p. 2213-2231.

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Contact: Available from McGraw-Hill Customer Services. P.O. Box 548, Blacklick, OH 43004-0548. (800) 262-4729 or (877) 833-5524. Fax (614) 759-3749 or (614) 759-3641. E-mail: [email protected]. PRICE: $395.00 plus shipping and handling. ISBN: 0070219435. Summary: This chapter provides health professionals with information on the etiology, pathogenesis, clinical features, differential diagnosis, laboratory findings, course, prognosis, treatment, and prevention of soft tissue infections (STIs). Normal skin has a critical role in the defense against many pathogens. The details of the host-pathogen interaction are not well understood, but they appear to involve barrier function, bacterial factors, and host factors. STIs are characterized by an acute, diffuse, spreading, edematous, suppurative inflammation of the dermis and subcutaneous tissues. Erysipelas is a distinct type of painful, bright-red, superficial cutaneous cellulitis with marked dermal lymphatic vessel involvement resulting from group A beta-hemolytic streptococcus. Cellulitis involves more of the soft tissues. The tissue feels hard upon palpation and is extremely painful. Staphylococcus aureus and group A streptococci are the most common etiologic agents. Surgical wound infections are classified as incisional or deep. The complications of wound infection arise locally or are systemic. Gangrenous cellulitis is characterized by necrosis of the dermis, hypodermis, fascia, or muscle. Types of necrotizing fasciitis include streptococcal gangrene, necrotizing fasciitis other than streptococcal gangrene, Fournier's gangrene, and synergistic necrotizing cellulitis. Clostridial soft tissue infections are classified as anaerobic cellulitis, anaerobic myonecrosis, and spontaneous, nontraumatic anaerobic myonecrosis. Other forms of gangrenous cellulitis include progressive bacterial synergistic gangrene and gangrenous cellulitis in the immunosuppressed individual. Other infections include infections of intravascular catheters, cellulitis complicating a pressure ulcer, and cellulitis arising at sites of animal bites. Helpful laboratory investigations include smears of pus, exudate, and aspirates; hematology; cultures; skin biopsy; and imaging. The differential diagnosis of STIs includes noninfectious inflammatory disorders and other infections. Bacterial species associated with cellulitis include staphylococcus aureus, beta-hemolytic streptococcus, streptococcus pneumoniae, neisseria meningitidis, haemophilus influenzae, escherichia coli, and other gram-negative bacilli. Specific pathogens are also associated with aqueous environments, soil exposure, and animal exposure. Treatment of STIs involve use of antibiotics, immobilization and elevation of the area affected by a local lesion, and surgery. 12 figures, 7 tables, and 104 references.

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CHAPTER 4. MULTIMEDIA ON GANGRENE Overview In this chapter, we show you how to keep current on multimedia sources of information on gangrene. 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 gangrene is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “gangrene” 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 “gangrene” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on gangrene: •

Evaluation and Management of Lower-Extremity Diabetic Ulcers Source: Kansas City, MO: American Academy of Family Physicians. 2000. (videocassette). Contact: Available from American Academy of Family Physicians. 8880 Ward Parkway, Kansas City, MO 64114-2797. (800) 274-2237. PRICE: $17.95 for members; $25.00 for nonmembers, plus shipping and handling. Summary: Lower extremity ulcers are a major source of disability in people with diabetes, significantly affecting their quality of life and creating a substantial economic burden for society. The majority of patients with diabetes, including those at risk of developing foot ulcers, are treated by family physicians. Educating patients at risk for ulcer development is essential to prevent ulcers. When ulcers develop, early detection and treatment can prevent complications such as infection, gangrene, and the need for amputation. This continuing education program features a videocassette and study guide that review the etiology of diabetic foot ulcers, discuss the physiology of wound

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healing, offer strategies to identify patients at high risk of ulcers, and suggest an approach to treat and prevent diabetic foot ulcers. Specific topics covered include polyneuropathy, altered biomechanics and increased pressure, peripheral vascular insufficiency, the role of prior ulceration, the physical examination of the feet, vascular and neurologic examinations, the assessment of foot biomechanics, inflammation, tissue reformation, tissue remodeling, wound healing in people with diabetes, ulcer classification, recognizing infection, ischemic (blood flow) management, debridement, wound dressing, topical growth factors, control of infection, pressure relief, and custom footwear. A sample patient education hand out is included in the study guide. Through this program, users can qualify for one credit hour of Continuing Medical Education (CME) in category 1; the appropriate posttest is provided. 10 figures. 5 tables. 38 references. •

Ozone and the Politics of Medicine Contact: Threshold Film Incorporated, Suite 301, 356 East 6th Avenue, Vancover, (604) 873-4626. Summary: This videorecording is an investigative documentary of the status of ozone treatment for AIDS in the United States and other countries worldwide. It informs the viewer that ozone therapy has been used successfully in Europe to treat a variety of medical conditions, from excema and gangrene, to cancer, strokes, hepatitis, and AIDS; but is illegal in both the United States and Canada. It argues that the fact that this treatment is illegal is a product of politics and economics that control the health care system. It concludes that opponents of ozone therapy, in combination with scientific and regulatory agencies, have successfully blocked the approval of this therapy; and suggests that public protest may be necessary to overcome this prejudice.

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CHAPTER 5. PERIODICALS AND NEWS ON GANGRENE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover gangrene.

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

Structure of C. perfringens alpha-toxin gives clues to gas gangrene pathophysiology Source: Reuters Medical News Date: July 28, 1998

•

Structure of gas gangrene toxin discovered Source: Reuters Health eLine Date: July 27, 1998

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

Academic Periodicals covering Gangrene Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to gangrene. In addition to

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67

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

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CHAPTER 6. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

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

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to gangrene: Ergotamine, Belladonna Alkaloids, and Phenobarbital •

Systemic - U.S. Brands: Bellergal-S http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202217.html

Methysergide •

Systemic - U.S. Brands: Sansert http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202363.html

Penicillins •

Systemic - U.S. Brands: Amoxil; Bactocill; Beepen-VK; Betapen-VK; Bicillin L-A; Cloxapen; Crysticillin 300 A.S.; Dycill; Dynapen; Geocillin; Geopen; Ledercillin VK; Mezlin; Nafcil; Nallpen; Omnipen; Omnipen-N; Pathocil; Pen Vee K; Pentids; Permapen; Pfizerpen; Pfizerpen-AS http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202446.html

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

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

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

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APPENDICES

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute8: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

8

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 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:10 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

9

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). 10 See http://www.nlm.nih.gov/databases/databases.html.

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•

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

•

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

The NLM Gateway11 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.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “gangrene” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 10000 170 35 9 82 10296

HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 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.15 Simply search by “gangrene” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

11

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

12

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). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists16 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.17 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.18 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

16 Adapted 17

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 18 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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

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

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•

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Other guides Bacterial Infections http://www.nlm.nih.gov/medlineplus/bacterialinfections.html Bone Marrow Transplantation http://www.nlm.nih.gov/medlineplus/bonemarrowtransplantation.html Circulatory Disorders http://www.nlm.nih.gov/medlineplus/circulatorydisorders.html Raynaud's Disease http://www.nlm.nih.gov/medlineplus/raynaudsdisease.html Vasculitis http://www.nlm.nih.gov/medlineplus/vasculitis.html

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

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

•

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

•

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

•

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

•

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

•

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

Patient Resources

•

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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 gangrene. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with gangrene. 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 gangrene. 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 “gangrene” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “gangrene”. 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 “gangrene” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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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 “gangrene” (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.19

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

19

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)20: •

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/

20

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

Finding Medical Libraries 87 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries 89 •

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

91

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

•

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

•

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

•

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

93

GANGRENE 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] Abscess: A localized, circumscribed collection of pus. [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] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acute myeloid leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myelogenous leukemia or acute nonlymphocytic leukemia. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adjuvant Therapy: Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, or hormone therapy. [NIH]

Adrenaline: A hormone. Also called epinephrine. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the

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tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agranulocytosis: A decrease in the number of granulocytes (basophils, eosinophils, and neutrophils). [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 acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH]

Dictionary 95

Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] 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] Angina: Chest pain that originates in the heart. [NIH] 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] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angiography: Radiography of blood vessels after injection of a contrast medium. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Anoxia: Clinical manifestation of respiratory distress consisting of a relatively complete absence of oxygen. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH]

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Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] 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] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. [NIH] Apheresis: Components plateletpheresis. [NIH]

being

separated

out,

as

leukapheresis,

plasmapheresis,

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] 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] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the

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walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Ascending Colon: The part of the colon on the right side of the abdomen. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autopsy: Postmortem examination of the body. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]

Babesiosis: A group of tick-borne diseases of mammals including zoonoses in humans. They are caused by protozoans of the genus babesia, which parasitize erythrocytes, producing hemolysis. In the U.S., the organism's natural host is mice and transmission is by the deer tick ixodes scapularis. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [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] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its

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subdivisions is the basal (basement) lamina. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. EC 3.5.2.6. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biological Warfare: Warfare involving the use of living organisms or their products as disease etiologic agents against people, animals, or plants. [NIH] Biomechanics: The study of the application of mechanical laws and the action of forces to living structures. [NIH] 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] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Biotypes: Causes septicemic and pneumonic pasteurellosis in cattle and sheep, usually in conjunction with a virus infection such as parainfluenza 3. Also recorded as a cause of acute mastitis in cattle. [NIH] Bladder: The organ that stores urine. [NIH] Bleomycin: A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. [NIH]

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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 Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [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 Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Botulinum Toxins: Toxins produced by Clostridium botulinum. There are at least seven different substances, most being proteins. They have neuro-, entero-, and hemotoxic properties, are immunogenic, and include the most potent poisons known. The most commonly used apparently blocks release of acetylcholine at cholinergic synapses. [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] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Artery: The continuation of the axillary artery; it branches into the radial and ulnar arteries. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]

Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [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

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be a sign of cancer. [NIH] Calciphylaxis: Condition of induced systemic hypersensitivity in which tissues respond to appropriate challenging agents with a sudden local calcification. [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] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [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] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Causal: Pertaining to a cause; directed against a cause. [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] 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 Aggregation: The phenomenon by which dissociated cells intermixed in vitro tend to group themselves with cells of their own type. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain

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functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholecystitis: Inflammation of the gallbladder. [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] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic granulocytic leukemia: A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myelogenous leukemia or chronic myeloid leukemia. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or

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chronic granulocytic leukemia. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Chymopapain: A cysteine endopeptidase isolated from papaya latex. Preferential cleavage at glutamic and aspartic acid residues. EC 3.4.22.6. [NIH] Cilastatin: A renal dehydropeptidase-I and leukotriene D4 dipeptidase inhibitor. Since the antibiotic, imipenem, is hydrolyzed by dehydropeptidase-I, which resides in the brush border of the renal tubule, cilastatin is administered with imipenem to increase its effectiveness. The drug also inhibits the metabolism of leukotriene D4 to leukeotriene E4. [NIH]

Cinchona: A genus of rubiaceous South American trees that yields the toxic cinchona alkaloids from their bark; quinine, quinidine, chinconine, cinchonidine and others are used to treat malaria and cardiac arrhythmias. [NIH] Ciprofloxacin: A carboxyfluoroquinoline antimicrobial agent that is effective against a wide range of microorganisms. It has been successfully and safely used in the treatment of resistant respiratory, skin, bone, joint, gastrointestinal, urinary, and genital infections. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] Claudication: Limping or lameness. [EU] 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] Clostridium: A genus of motile or nonmotile gram-positive bacteria of the family Bacillaceae. Many species have been identified with some being pathogenic. They occur in water, soil, and in the intestinal tract of humans and lower animals. [NIH] Clostridium perfringens: The most common etiologic agent of gas gangrene. It is differentiable into several distinct types based on the distribution of twelve different toxins. [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] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH]

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Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [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 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] Concomitant: Accompanying; accessory; joined with another. [EU] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [NIH] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU]

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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] Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]

Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cryoglobulinemia: A condition characterized by the presence of abnormal or abnormal quantities of cryoglobulins in the blood. They are precipitated into the microvasculature on exposure to cold and cause restricted blood flow in exposed areas. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytochrome b: Cytochromes (electron-transporting proteins) with protoheme or a related heme as the prosthetic group. The prosthetic group is not covalently bound to the protein moiety. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources,

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including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Foot: Ulcers of the foot as a complication of diabetes. Diabetic foot, often with infection, is a common serious complication of diabetes and may require hospitalization and disfiguring surgery. The foot ulcers are probably secondary to neuropathies and vascular problems. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diapedesis: The emigration of leucocytes across the endothelium. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diathesis: A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the person more than usually susceptible to certain diseases. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydroergotamine: A derivative of ergotamine prepared by the catalytic hydrogenation of ergotamine. It is used as a vasoconstrictor, specifically for the therapy of migraine. [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] Discitis: Inflammation of an intervertebral disk or disk space which may lead to disk erosion. Until recently, discitis has been defined as a nonbacterial inflammation and has

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been attributed to aseptic processes (e.g., chemical reaction to an injected substance). However, recent studies provide evidence that infection may be the initial cause, but perhaps not the promoter, of most cases of discitis. Discitis has been diagnosed in patients following discography, myelography, lumbar puncture, paravertebral injection, and obstetrical epidural anesthesia. Discitis following chemonucleolysis (especially with chymopapain) is attributed to chemical reaction by some and to introduction of microorganisms by others. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] 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] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH]

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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] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endophthalmitis: Suppurative inflammation of the tissues of the internal structures of the eye; not all layers of the uvea are affected. Fungi, necrosis of intraocular tumors, and retained intraocular foreign bodies often cause a purulent endophthalmitis. [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] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Enterotoxins: Substances that are toxic to the intestinal tract causing vomiting, diarrhea, etc.; most common enterotoxins are produced by bacteria. [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] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU]

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Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] 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] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Epoprostenol: A prostaglandin that is biosynthesized enzymatically from prostaglandin endoperoxides in human vascular tissue. It is a potent inhibitor of platelet aggregation. The sodium salt has been also used to treat primary pulmonary hypertension. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Ergotamine: A vasoconstrictor found in ergot of Central Europe. It is an alpha-1 selective adrenergic agonist and is commonly used in the treatment of migraine headaches. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythropoiesis: The production of erythrocytes. [EU] Escherichia: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria whose organisms occur in the lower part of the intestine of warm-blooded animals. The species are either nonpathogenic or opportunistic pathogens. [NIH] Escherichia coli: A species of gram-negative, facultatively anaerobic, rod-shaped bacteria commonly found in the lower part of the intestine of warm-blooded animals. It is usually nonpathogenic, but some strains are known to produce diarrhea and pyogenic infections. [NIH]

Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Perforation: A dilated vessel in the lower end of the esophagus that result from portal hypertension. [NIH] Esophageal Stricture: A narrowing of the esophagus often caused by acid flowing back from the stomach. This condition may require surgery. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Exhaustion: The feeling of weariness of mind and body. [NIH]

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Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotoxins: Toxins produced, especially by bacterial or fungal cells, and released into the culture medium or environment. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extracorporeal: Situated or occurring outside the body. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciitis: Inflammation of the fascia. There are three major types: 1) Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orangepeel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2) Necrotizing fasciitis, a serious fulminating infection (usually by a beta hemolytic Streptococcus) causing extensive necrosis of superficial fascia; 3) Nodular/Pseudosarcomatous/Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatal Outcome: Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from death, the physiological cessation of life and from mortality, an epidemiological or statistical concept. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU]

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Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [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] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibroid: A benign smooth muscle tumor, usually in the uterus or gastrointestinal tract. Also called leiomyoma. [NIH] Fibromuscular Dysplasia: An idiopathic, segmental, nonatheromatous disease of the musculature of arterial walls, leading to stenosis of small and medium-sized arteries. Most commonly affected are the renal arteries; involvement of the axillary, iliac, basilar, carotid, hepatic and intracranial arteries have been reported. [NIH] Fibrosarcoma: A type of soft tissue sarcoma that begins in fibrous tissue, which holds bones, muscles, and other organs in place. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flatus: Gas passed through the rectum. [NIH] 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] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Foot Care: Taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses. Good care includes daily examination of the feet, toes, and toenails and choosing shoes and socks or stockings that fit well. People with diabetes have to take special care of their feet because nerve damage and reduced blood flow sometimes mean they will have

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less feeling in their feet than normal. They may not notice cuts and other problems as soon as they should. [NIH] Foot Ulcer: Lesion on the surface of the skin of the foot, usually accompanied by inflammation. The lesion may become infected or necrotic and is frequently associated with diabetes or leprosy. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gangrene: Death and putrefaction of tissue usually due to a loss of blood supply. [NIH] Gangrenous: A circumscribed, deep-seated, suppurative inflammation of the subcutaneous tissue of the eyelid discharging pus from several points. [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] Gas Gangrene: A severe condition resulting from bacteria invading healthy muscle from adjacent traumatized muscle or soft tissue. The infection originates in a wound contaminated with bacteria of the genus Clostridium. C. perfringens accounts for the majority of cases (over eighty percent), while C. noyvi, C. septicum, and C. histolyticum cause most of the other cases. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

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

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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] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Gram-Positive Bacteria: Bacteria which retain the crystal violet stain when treated by Gram's method. [NIH] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Granulomatous Disease, Chronic: A recessive X-linked defect of leukocyte function in which phagocytic cells ingest but fail to digest bacteria, resulting in recurring bacterial infections with granuloma formation. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological

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therapy. [NIH] Haematuria: Blood in the urine. [EU] Haemodialysis: The removal of certain elements from the blood by virtue of the difference in the rates of their diffusion through a semipermeable membrane, e.g., by means of a haemodialyzer. [EU] Haemophilia: A haemorrhagic diathesis occurring in two main forms: 1. Haemophilia A (classic haemophilia, factor VIII deficiency), an X-linked disorder due to deficiency of coagulation factor VIII; 2. Haemophilia B (factor IX deficiency, Christmas disease), also Xlinked, due to deficiency of coagulation factor IX. Both forms are determined by a mutant gene near the telomere of the long arm of the X chromosome (Xq), but a different loci, and are characterized by subcutaneous and intramuscular haemorrhages; bleeding from the mouth, gums, lips, and tongue; haematuria; and haemarthroses. [EU] Haemophilus: A genus of Pasteurellaceae that consists of several species occurring in animals and humans. Its organisms are described as gram-negative, facultatively anaerobic, coccobacillus or rod-shaped, and nonmotile. [NIH] Haemophilus influenzae: A species of Haemophilus found on the mucous membranes of humans and a variety of animals. The species is further divided into biotypes I through VIII. [NIH]

Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [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] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodialysis Solutions: Solutions prepared for hemodialysis. The composition of the predialysis solution may be varied in order to determine the effect of solvated metabolites on anoxia, malnutrition, acid-base balance, etc. Of principal interest are the effect of the choice of buffers (e.g., acetate or carbonate), the addition of cations (Na+, K+, Ca2+), and addition of carbohydrates (glucose). [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to

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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] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoidectomy: An operation to remove hemorrhoids. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [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] 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] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [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] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humeral: 1. Of, relating to, or situated in the region of the humerus: brachial. 2. Of or

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belonging to the shoulder. 3. Of, relating to, or being any of several body parts that are analogous in structure, function, or location to the humerus or shoulder. [EU] Hydrogenation: Specific method of reduction in which hydrogen is added to a substance by the direct use of gaseous hydrogen. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hydroxyurea: An antineoplastic agent that inhibits DNA synthesis through the inhibition of ribonucleoside diphosphate reductase. [NIH] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hyperoxaluria: Excretion of an excessive amount of oxalate in the urine. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Iliac Artery: Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs. [NIH] Iloprost: An eicosanoid, derived from the cyclooxygenase pathway of arachidonic acid metabolism. It is a stable and synthetic analog of epoprostenol, but with a longer half-life than the parent compound. Its actions are similar to prostacyclin. Iloprost produces vasodilation and inhibits platelet aggregation. [NIH] Imipenem: Semisynthetic thienamycin that has a wide spectrum of antibacterial activity against gram-negative and gram-positive aerobic and anaerobic bacteria, including many multiresistant strains. It is stable to beta-lactamases. Clinical studies have demonstrated high efficacy in the treatment of infections of various body systems. Its effectiveness is enhanced when it is administered in combination with cilastatin, a renal dipeptidase inhibitor. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH]

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Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incisional: The removal of a sample of tissue for examination under a microscope. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] 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] Inguinal: Pertaining to the inguen, or groin. [EU] Inguinal Hernia: A small part of the large or small intestine or bladder that pushes into the groin. May cause pain and feelings of pressure or burning in the groin. Often requires surgery. [NIH]

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Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]

Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intramuscular injection: IM. Injection into a muscle. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] 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]

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Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kinetic: Pertaining to or producing motion. [EU] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [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] Leiomyoma: A benign tumor derived from smooth muscle tissue, also known as a fibroid tumor. They rarely occur outside of the uterus and the gastrointestinal tract but can occur in the skin and subcutaneous tissues, probably arising from the smooth muscle of small blood vessels in these tissues. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Lethal: Deadly, fatal. [EU] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukaemia: An acute or chronic disease of unknown cause in man and other warm-blooded animals that involves the blood-forming organs, is characterized by an abnormal increase in the number of leucocytes in the tissues of the body with or without a corresponding increase of those in the circulating blood, and is classified according of the type leucocyte most prominently involved. [EU] Leukapheresis: The preparation of leukocyte concentrates with the return of red cells and leukocyte-poor plasma to the donor. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukemic Infiltration: A pathologic change in leukemia in which leukemic cells permeate various organs at any stage of the disease. All types of leukemia show various degrees of infiltration, depending upon the type of leukemia. The degree of infiltration may vary from site to site. The liver and spleen are common sites of infiltration, the greatest appearing in myelocytic leukemia, but infiltration is seen also in the granulocytic and lymphocytic types. The kidney is also a common site and of the gastrointestinal system, the stomach and ileum are commonly involved. In lymphocytic leukemia the skin is often infiltrated. The central nervous system too is a common site. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukostasis: Abnormal intravascular leukocyte aggregation and clumping often seen in leukemia patients. The brain and lungs are the two most commonly affected organs. This

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acute syndrome requires aggressive cytoreductive modalities including chemotherapy and/or leukophoresis. It is differentiated from leukemic infiltration which is a neoplastic process where leukemic cells invade organs. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] 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] Lipodystrophy: A collection of rare conditions resulting from defective fat metabolism and characterized by atrophy of the subcutaneous fat. They include total, congenital or acquired, partial, abdominal infantile, and localized lipodystrophy. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [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 scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Localized: Cancer which has not metastasized yet. [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] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of

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connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mammogram: An x-ray of the breast. [NIH] Mannans: Polysaccharides consisting of mannose units. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medical Records: Recording of pertinent information concerning patient's illness or

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illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Lipids: Lipids, predominantly phospholipids, cholesterol and small amounts of glycolipids found in membranes including cellular and intracellular membranes. These lipids may be arranged in bilayers in the membranes with integral proteins between the layers and peripheral proteins attached to the outside. Membrane lipids are required for active transport, several enzymatic activities and membrane formation. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [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] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [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] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Military Medicine: The practice of medicine as applied to special circumstances associated with military operations. [NIH]

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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] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Myelogenous: Produced by, or originating in, the bone marrow. [NIH] Myelography: X-ray visualization of the spinal cord following injection of contrast medium into the spinal arachnoid space. [NIH] 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] 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 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] Myotonia: Prolonged failure of muscle relaxation after contraction. This may occur after voluntary contractions, muscle percussion, or electrical stimulation of the muscle. Myotonia is a characteristic feature of myotonic disorders. [NIH] Nasopharynx: The nasal part of the pharynx, lying above the level of the soft palate. [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] Neisseria: A genus of gram-negative, aerobic, coccoid bacteria whose organisms are part of the normal flora of the oropharynx, nasopharynx, and genitourinary tract. Some species are primary pathogens for humans. [NIH] Neisseria meningitidis: A species of gram-negative, aerobic bacteria found in cerebrospinal fluid as the causative agent of cerebrospinal meningitis (meningitis, meningococcal) as well as in venereal discharges and blood. [NIH]

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Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotoxic: Poisonous or destructive to nerve tissue. [EU] Neurotoxins: Toxic substances from microorganisms, plants or animals that interfere with the functions of the nervous system. Most venoms contain neurotoxic substances. Myotoxins are included in this concept. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] 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] Neutrophil: A type of white blood cell. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio

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of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Omentum: A fold of the peritoneum (the thin tissue that lines the abdomen) that surrounds the stomach and other organs in the abdomen. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic cup: The white, cup-like area in the center of the optic disc. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Oropharynx: Oral part of the pharynx. [NIH] Orthotic Devices: Apparatus used to support, align, prevent, or correct deformities or to improve the function of movable parts of the body. [NIH] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Oxalate: A chemical that combines with calcium in urine to form the most common type of kidney stone (calcium oxalate stone). [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] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH]

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Pancreatic: Having to do with the pancreas. [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] Pancytopenia: Deficiency of all three cell elements of the blood, erythrocytes, leukocytes and platelets. [NIH] Panophthalmitis: Acute suppurative inflammation of the inner eye with necrosis of the sclera (and sometimes the cornea) and extension of the inflammation into the orbit. Pain may be severe and the globe may rupture. In endophthalmitis the globe does not rupture. [NIH]

Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroidectomy: Excision of one or both of the parathyroid glands. [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] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogen: Any disease-producing microorganism. [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] 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]

Pedicle: Embryonic link between the optic vesicle or optic cup and the forebrain or diencephalon, which becomes the optic nerve. [NIH] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pentoxifylline: A methylxanthine derivative that inhibits phosphodiesterase and affects blood rheology. It improves blood flow by increasing erythrocyte and leukocyte flexibility. It also inhibits platelet aggregation. Pentoxifylline modulates immunologic activity by stimulating cytokine production. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of

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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] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perianal: Located around the anus. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH] Periodicity: The tendency of a phenomenon to recur at regular intervals; in biological systems, the recurrence of certain activities (including hormonal, cellular, neural) may be annual, seasonal, monthly, daily, or more frequently (ultradian). [NIH] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [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] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [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] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the

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cyclic GMP. [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] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Plague: An acute infectious disease caused by Yersinia pestis that affects humans, wild rodents, and their ectoparasites. This condition persists due to its firm entrenchment in sylvatic rodent-flea ecosystems throughout the world. Bubonic plague is the most common form. [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] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] 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] Plasmapheresis: Procedure whereby plasma is separated and extracted from anticoagulated whole blood and the red cells retransfused to the donor. Plasmapheresis is also employed for therapeutic use. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together

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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] Plateletpheresis: The preparation of platelet concentrates with the return of red cells and platelet-poor plasma to the donor. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Popliteal: Compression of the nerve at the neck of the fibula. [NIH] Portal Hypertension: High blood pressure in the portal vein. This vein carries blood into the liver. Portal hypertension is caused by a blood clot. This is a common complication of cirrhosis. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [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] Prejudice: A preconceived judgment made without adequate evidence and not easily alterable by presentation of contrary evidence. [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] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Promyelocytic leukemia: A type of acute myeloid leukemia, a quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. [NIH]

Prophylaxis: An attempt to prevent disease. [NIH]

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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] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with

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formation of smaller polypeptides). [EU] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Protozoan: 1. Any individual of the protozoa; protozoon. 2. Of or pertaining to the protozoa; protozoal. [EU] 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] Pulmonary Embolism: Embolism in the pulmonary artery or one of its branches. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] 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] Quinine: An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radial Artery: The direct continuation of the brachial trunk, originating at the bifurcation of the brachial artery opposite the neck of the radius. Its branches may be divided into three groups corresponding to the three regions in which the vessel is situated, the forearm, wrist, and hand. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons,

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alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] 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] Radius: The lateral bone of the forearm. [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] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [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] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Rehabilitative: Instruction of incapacitated individuals or of those affected with some mental disorder, so that some or all of their lost ability may be regained. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH]

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Renal Dialysis: Removal of certain elements from the blood based on the difference in their rates of diffusion through a semipermeable membrane. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Respiratory Burst: A large increase in oxygen uptake by neutrophils and most types of tissue macrophages through activation of an NADPH-cytochrome b-dependent oxidase that reduces oxygen to a superoxide. Individuals with an inherited defect in which the oxidase that reduces oxygen to superoxide is decreased or absent (granulomatous disease, chronic) often die as a result of recurrent bacterial infections. [NIH] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheology: The study of the deformation and flow of matter, usually liquids or fluids, and of the plastic flow of solids. The concept covers consistency, dilatancy, liquefaction, resistance to flow, shearing, thixotrophy, and viscosity. [NIH] Ribonucleoside Diphosphate Reductase: An enzyme of the oxidoreductase class that catalyzes the formation of 2'-deoxyribonucleotides from the corresponding ribonucleotides using NADPH as the ultimate electron donor. The deoxyribonucleoside diphosphates are used in DNA synthesis. (From Dorland, 27th ed) EC 1.17.4.1. [NIH] Rickettsiae: One of a group of obligate intracellular parasitic microorganisms, once regarded as intermediate in their properties between bacteria and viruses but now classified as bacteria in the order Rickettsiales, which includes 17 genera and 3 families: Rickettsiace. [NIH]

Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rye: A hardy grain crop, Secale cereale, grown in northern climates. It is the most frequent host to ergot (claviceps), the toxic fungus. Its hybrid with wheat is triticale, another grain. [NIH]

Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU]

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Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Septicaemia: A term originally used to denote a putrefactive process in the body, but now usually referring to infection with pyogenic micro-organisms; a genus of Diptera; the severe type of infection in which the blood stream is invaded by large numbers of the causal. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

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

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Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Staphylococcus: A genus of gram-positive, facultatively anaerobic, coccoid bacteria. Its organisms occur singly, in pairs, and in tetrads and characteristically divide in more than one plane to form irregular clusters. Natural populations of Staphylococcus are membranes of warm-blooded animals. Some species are opportunistic pathogens of humans and animals. [NIH] Staphylococcus aureus: Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications. [NIH] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH]

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Stool: The waste matter discharged in a bowel movement; feces. [NIH] Streptococcal: Caused by infection due to any species of streptococcus. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Streptococcus pneumoniae: A gram-positive organism found in the upper respiratory tract, inflammatory exudates, and various body fluids of normal and/or diseased humans and, rarely, domestic animals. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] 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] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire 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

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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] Telomere: A terminal section of a chromosome which has a specialized structure and which is involved in chromosomal replication and stability. Its length is believed to be a few hundred base pairs. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] 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] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [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] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of

Dictionary 137

toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Transient Ischemic Attacks: Focal neurologic abnormalities of sudden onset and brief duration that reflect dysfunction in the distribution of the internal carotid-middle cerebral or the vertebrobasilar arterial system. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [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] Transurethral: Performed through the urethra. [EU] Transurethral resection: Surgery performed with a special instrument inserted through the urethra. Also called TUR. [NIH] Transurethral Resection of Prostate: Resection of the prostate using a cystoscope passed through the urethra. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] 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] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] 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] 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

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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]

Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urokinase: A drug that dissolves blood clots or prevents them from forming. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Varicella: Chicken pox. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasculitis: Inflammation of a blood vessel. [NIH] Vasectomy: An operation to cut or tie off the two tubes that carry sperm out of the testicles. [NIH]

Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venoms: Poisonous animal secretions forming fluid mixtures of many different enzymes, toxins, and other substances. These substances are produced in specialized glands and secreted through specialized delivery systems (nematocysts, spines, fangs, etc.) for disabling prey or predator. [NIH]

Dictionary 139

Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular fibrillation: Rapid, irregular quivering of the heart's ventricles, with no effective heartbeat. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virologist: A specialist of the study of viruses and viral disease. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Volvulus: A twisting of the stomach or large intestine. May be caused by the stomach being in the wrong position, a foreign substance, or abnormal joining of one part of the stomach or intestine to another. Volvulus can lead to blockage, perforation, peritonitis, and poor blood flow. [NIH] Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Wound Healing: Restoration of integrity to traumatized tissue. [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] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers'

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and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

141

INDEX A Abdomen, 40, 52, 93, 97, 99, 112, 117, 119, 124, 125, 126, 134, 136 Abdominal, 9, 14, 18, 46, 54, 93, 100, 115, 119, 121, 124, 125, 126, 137 Abdominal Pain, 93, 126, 137 Abscess, 30, 93 Acetylcholine, 93, 99, 101, 123 Acquired Immunodeficiency Syndrome, 57, 93 Activities of Daily Living, 93 Acute myeloid leukemia, 93, 128 Acute renal, 93, 114 Adenocarcinoma, 52, 93 Adjuvant, 56, 93, 111 Adjuvant Therapy, 56, 93 Adrenaline, 32, 93 Adrenergic, 93, 106, 108, 135 Adverse Effect, 93, 133 Aerobic, 3, 93, 115, 122 Affinity, 11, 93, 94, 133 Age Groups, 3, 94 Aged, 80 and Over, 94 Agonist, 94, 106, 108 Agranulocytosis, 24, 94 Algorithms, 94, 98 Alimentary, 94, 125 Alkaline, 94, 100 Alkaloid, 94, 103, 130 Alpha Particles, 94, 131 Alternative medicine, 66, 94 Amino acid, 94, 95, 112, 115, 125, 128, 129, 137, 138 Amino Acid Sequence, 94, 95 Amphetamines, 94, 103 Amputation, 4, 5, 8, 9, 10, 16, 41, 45, 46, 49, 60, 63, 94 Anaerobic, 3, 61, 95, 108, 113, 115, 134 Anaesthesia, 28, 57, 95, 116 Analgesic, 95, 130 Analog, 95, 115 Analogous, 95, 115, 137 Anatomical, 95, 97, 133 Anemia, 6, 95, 110, 120, 122 Anesthesia, 8, 13, 19, 21, 38, 95, 106, 107 Angina, 9, 14, 95 Angina Pectoris, 9, 95 Angiogenesis, 5, 95, 120

Angiography, 8, 95 Angioplasty, 35, 95 Ankle, 4, 95 Anoxia, 95, 113 Antibacterial, 95, 115, 134 Antibiotic, 10, 95, 99, 102, 125, 134 Antibodies, 21, 95, 97, 108, 113, 120, 127 Antibody, 94, 95, 96, 113, 116, 131, 134 Anticoagulant, 31, 95, 129, 139 Antigen, 4, 94, 95, 96, 108, 115, 116 Antimetabolite, 96, 121 Antimicrobial, 12, 96, 102 Antineoplastic, 96, 98, 115, 121 Antioxidant, 96, 124 Antipyretic, 96, 130 Anus, 96, 103, 126, 131 Aorta, 96, 100, 104, 115, 139 Aortic Valve, 53, 96 Apheresis, 18, 42, 96 Apolipoproteins, 96, 119 Appendicitis, 56, 57, 96 Aqueous, 11, 61, 96, 97 Arachidonic Acid, 96, 115, 129 Arrhythmia, 14, 96 Arterial, 4, 9, 14, 38, 49, 96, 100, 101, 110, 115, 129, 136, 137 Arteries, 96, 99, 100, 104, 110, 115, 119, 121, 122 Arterioles, 96, 97, 99, 122, 138 Arteriolosclerosis, 96, 97 Arteriosclerosis, 96, 122 Arteritis, 16, 97 Artery, 6, 9, 19, 33, 51, 95, 96, 97, 99, 104, 106, 107, 110, 130, 139 Articular, 97, 119 Ascending Colon, 19, 97 Aseptic, 97, 106 Asymptomatic, 97, 125 Atmospheric Pressure, 97, 115 Atrial, 52, 97, 139 Atrial Fibrillation, 97, 139 Atrium, 97, 139 Atrophy, 97, 119 Autoantibodies, 9, 97 Autoantigens, 97 Autodigestion, 97, 125 Autopsy, 40, 97 Axillary, 97, 99, 110

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B Babesiosis, 97, 130 Bacteria, 3, 95, 96, 97, 98, 106, 107, 108, 111, 112, 115, 121, 122, 132, 133, 134, 135, 137, 138 Bacterial Infections, 82, 97, 112, 132 Bacterium, 6, 97, 114, 137 Base, 97, 105, 113, 117, 136, 138 Basement Membrane, 5, 97, 109, 118 Basophils, 94, 98, 112, 118 Benign, 96, 98, 110, 118, 123, 139 Beta-Lactamases, 98, 115 Bilateral, 14, 16, 98 Bile, 98, 111, 119 Biliary, 98, 100, 125 Biliary Tract, 98, 100, 125 Biochemical, 5, 96, 98, 126 Biological therapy, 98, 113 Biological Warfare, 6, 98 Biomechanics, 64, 98 Biopsy, 57, 61, 98, 126 Biotechnology, 7, 12, 13, 66, 77, 98 Biotransformation, 98 Biotypes, 98, 113 Bladder, 98, 116, 119, 129, 132, 138 Bleomycin, 16, 28, 98 Blood Coagulation, 99, 100 Blood Glucose, 59, 99, 114, 117 Blood Platelets, 99, 136 Blood pressure, 99, 115, 126, 128, 133 Body Fluids, 99, 106, 133, 135 Bone Marrow, 26, 82, 93, 99, 101, 120, 122, 128, 134 Bone Marrow Transplantation, 26, 82, 99 Bone scan, 99, 132 Botulinum Toxins, 7, 99 Bowel, 31, 46, 99, 107, 117, 126, 135, 137 Brachial, 4, 99, 114, 130 Brachial Artery, 99, 130 Branch, 89, 99, 114, 125, 134, 136 Breakdown, 99, 105, 111 Broad-spectrum, 3, 99 Buffers, 99, 113 Bypass, 16, 35, 52, 99 C Calcification, 21, 96, 99, 100 Calciphylaxis, 14, 17, 43, 100 Calcium, 9, 99, 100, 120, 121, 124, 125, 130 Calculi, 100, 112 Carbohydrates, 100, 113 Carcinoma, 41, 100 Cardiac, 17, 97, 100, 102, 107, 108, 122

Cardiovascular, 4, 9, 22, 30, 33, 35, 37, 45, 49, 51, 54, 100 Case report, 12, 14, 18, 19, 21, 23, 26, 27, 31, 35, 36, 38, 39, 40, 42, 44, 50, 51, 54, 56, 100, 109 Catecholamine, 100, 106 Catheter, 46, 100, 107, 117, 119 Catheterization, 19, 21, 95, 100, 117 Cations, 100, 113, 117 Causal, 100, 133 Celiac Artery, 100, 114 Cell Aggregation, 22, 100 Cell Division, 97, 100, 112, 127 Cell membrane, 100, 127 Cell proliferation, 97, 100 Cell Survival, 100, 112 Cell Transplantation, 101 Cellulitis, 60, 61, 101 Cellulose, 100, 101, 111, 127 Central Nervous System, 93, 94, 101, 103, 118, 124 Cerebral, 42, 101, 108, 120, 137 Cerebrospinal, 101, 119, 122 Cerebrospinal fluid, 101, 119, 122 Cerebrum, 101 Character, 95, 101, 105 Chemotaxis, 10, 101 Chemotherapy, 12, 21, 56, 93, 101, 119 Chlorophyll, 101, 111 Cholecystectomy, 18, 46, 101 Cholecystitis, 38, 56, 101 Cholesterol, 98, 101, 102, 119, 121 Cholesterol Esters, 101, 119 Cholinergic, 99, 101 Chromosome, 101, 113, 119, 136 Chronic, 6, 8, 10, 17, 20, 22, 29, 32, 34, 42, 44, 101, 102, 107, 116, 118, 125, 133, 135, 137, 138 Chronic Disease, 101, 118 Chronic granulocytic leukemia, 101, 102 Chronic myelogenous leukemia, 29, 32, 101 Chronic renal, 17, 20, 22, 34, 44, 102, 138 Chylomicrons, 102, 119 Chymopapain, 102, 106 Cilastatin, 102, 115 Cinchona, 102, 130 Ciprofloxacin, 13, 102 Circulatory system, 102, 117 Cirrhosis, 36, 102, 128 Claudication, 8, 102 Clinical Medicine, 34, 102, 128

Index 143

Clinical trial, 4, 18, 77, 102, 131 Cloning, 98, 102 Clostridium, 6, 10, 11, 12, 13, 18, 19, 21, 23, 30, 33, 44, 46, 99, 102, 111 Clostridium perfringens, 6, 10, 12, 13, 18, 19, 21, 33, 46, 102 Coagulation, 36, 41, 42, 48, 99, 102, 113, 127, 136, 139 Coca, 102, 103 Cocaine, 19, 25, 102, 103 Colitis, 103 Collagen, 5, 94, 97, 103, 109, 110, 111, 120, 128 Colon, 24, 27, 40, 48, 54, 97, 103, 118, 137 Colonoscopy, 29, 103 Computational Biology, 77, 103 Computed tomography, 9, 103, 132 Computerized tomography, 103 Conception, 103, 110 Concomitant, 10, 103 Congenita, 103, 130 Congestive heart failure, 9, 103 Connective Tissue, 99, 101, 103, 105, 110, 111, 120, 132, 135 Constipation, 103, 126 Constriction, 103, 117 Contamination, 103, 114 Contraindications, ii, 104 Contrast medium, 95, 104, 122 Cornea, 104, 125, 132 Coronary, 4, 6, 9, 51, 95, 104, 121, 122 Coronary Artery Bypass, 51, 104 Coronary Circulation, 95, 104 Coronary Thrombosis, 104, 121, 122 Corpus, 104, 125 Cortex, 104, 124 Cranial, 104, 117, 124 Cryoglobulinemia, 34, 38, 104 Curative, 104, 136 Cutaneous, 15, 20, 21, 28, 33, 36, 52, 61, 104, 119 Cyclic, 104, 127, 129 Cytochrome, 104, 132 Cytochrome b, 104, 132 Cytokine, 104, 125 D Data Collection, 5, 104 Degenerative, 105, 114 Dehydration, 57, 105 Delivery of Health Care, 105, 113 Dementia, 93, 105 Density, 18, 105, 119, 124

Dermal, 61, 105 Dermis, 61, 105, 135 Diabetes Mellitus, 8, 9, 34, 105, 112, 114 Diabetic Foot, 51, 59, 63, 105 Diagnostic procedure, 66, 105 Dialysate, 6, 105 Dialyzer, 7, 105, 113 Diapedesis, 8, 10, 105 Diarrhea, 105, 107, 108 Diastolic, 105, 115 Diathesis, 105, 113 Diencephalon, 105, 125 Digestion, 94, 98, 99, 105, 117, 119, 134 Dihydroergotamine, 22, 56, 105 Dilatation, 95, 105, 128, 138 Direct, iii, 5, 53, 69, 102, 105, 106, 115, 130, 131, 135 Discitis, 16, 105 Dissociation, 94, 106 Distal, 22, 35, 51, 104, 106, 126, 130 Diverticulum, 28, 29, 106 Dopamine, 22, 28, 48, 103, 106, 123 Drug Interactions, 12, 45, 70, 106 Duct, 100, 106, 134, 135 Duodenum, 98, 106, 114, 134 E Edema, 106, 118, 123, 138 Efficacy, 6, 10, 106, 115, 137 Elasticity, 96, 106 Elastin, 103, 106, 109 Elective, 45, 106 Electrocoagulation, 102, 106 Emaciation, 93, 106 Emboli, 106, 107, 139 Embolism, 107, 130, 139 Embolization, 107, 139 Embryo, 107, 116 Endarterectomy, 95, 107 Endemic, 107, 120 Endocarditis, 53, 107 Endocardium, 107 Endogenous, 97, 106, 107 Endophthalmitis, 107, 125 Endothelium, 105, 107 End-stage renal, 6, 17, 45, 52, 102, 107 Enteritis, 42, 107 Enterocolitis, 107 Enterotoxins, 7, 107 Environmental Health, 76, 78, 107 Enzymatic, 27, 94, 100, 107, 121 Enzyme, 107, 121, 126, 127, 129, 131, 132, 136, 139

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Eosinophilia, 57, 107, 109 Eosinophilic, 23, 33, 107, 109 Eosinophils, 94, 107, 112, 118 Epidemiological, 23, 107, 109 Epidermal, 107, 139 Epidermis, 105, 107, 108, 130 Epidural, 106, 108 Epinephrine, 93, 106, 108, 123, 137 Epithelial, 8, 93, 108, 114, 118 Epithelial Cells, 8, 108, 114, 118 Epithelium, 97, 107, 108 Epitopes, 5, 9, 108 Epoprostenol, 108, 115 Erectile, 44, 108, 125 Erection, 44, 108 Ergot, 12, 38, 45, 108, 132 Ergotamine, 23, 70, 105, 108 Erythrocytes, 95, 97, 99, 108, 125, 131 Erythropoiesis, 6, 108 Escherichia, 8, 61, 108, 114 Escherichia coli, 8, 61, 108, 114 Esophageal, 42, 47, 54, 108 Esophageal Perforation, 47, 108 Esophageal Stricture, 54, 108 Esophagus, 108, 134 Exhaustion, 108, 120 Exogenous, 98, 107, 109 Exotoxins, 18, 109 Extracellular, 5, 103, 109, 110, 120, 133 Extracellular Matrix, 5, 103, 109, 110, 120 Extracellular Matrix Proteins, 109, 120 Extracellular Space, 109 Extracorporeal, 47, 109 Extrapyramidal, 106, 109 Extravasation, 38, 43, 109 Extremity, 4, 23, 35, 36, 39, 45, 51, 53, 63, 109 Exudate, 61, 109 F Facial, 40, 49, 109 Family Planning, 77, 109 Fasciitis, 15, 19, 23, 26, 31, 39, 43, 44, 61, 109 Fat, 96, 99, 106, 109, 119, 134 Fatal Outcome, 30, 109 Fatty acids, 109, 112, 129 Femoral, 35, 109, 110 Femoral Artery, 35, 110 Femur, 109, 110 Fetus, 22, 110, 138 Fibrillation, 110 Fibrin, 24, 99, 110, 126, 136

Fibrinogen, 4, 9, 10, 110, 127, 136 Fibroblasts, 109, 110 Fibroid, 110, 118 Fibromuscular Dysplasia, 14, 110 Fibrosarcoma, 109, 110 Fibrosis, 110, 133 Fibula, 110, 128 Fistula, 20, 110 Flatus, 110, 111 Fluorescence, 11, 110 Folate, 11, 110 Fold, 7, 110, 121, 124 Folic Acid, 110 Foot Care, 59, 110 Foot Ulcer, 60, 63, 105, 111 Forearm, 9, 99, 109, 111, 130, 131 Fungi, 107, 111, 121, 139 Fungus, 59, 108, 111, 132 G Gallbladder, 27, 93, 98, 101, 111, 114, 119 Gangrenous, 56, 57, 60, 61, 111 Gastric, 20, 41, 97, 100, 111 Gastrointestinal, 6, 102, 108, 110, 111, 118, 120 Gastrointestinal tract, 110, 111, 118 Gelatin, 111, 112 Gene, 7, 98, 111, 113 Gene Expression, 7, 111 Genital, 19, 30, 102, 111 Genitourinary, 111, 122 Glomerular, 111, 132 Glucose, 9, 99, 101, 105, 111, 112, 113, 117 Glucose Intolerance, 105, 112 Glucuronic Acid, 112, 114 Glycerol, 112, 127 Glycerophospholipids, 112, 127 Glycine, 11, 94, 112, 123 Glycoprotein, 110, 112, 118 Gout, 60, 112 Governing Board, 112, 128 Graft, 9, 16, 35, 112, 114 Grafting, 8, 104, 112 Gram-negative, 61, 108, 112, 113, 115, 122 Gram-positive, 102, 112, 115, 134, 135 Gram-Positive Bacteria, 102, 112 Granulocyte, 10, 112 Granulomatous Disease, Chronic, 112, 132 Groin, 112, 116 Growth, 64, 95, 96, 100, 101, 109, 112, 120, 123, 127, 137 Growth factors, 64, 112

Index 145

H Haematuria, 113 Haemodialysis, 15, 31, 113 Haemophilia, 29, 113 Haemophilus, 61, 113 Haemophilus influenzae, 61, 113 Hair follicles, 105, 113, 134 Half-Life, 113, 115 Haptens, 94, 113 Health Care Costs, 10, 113 Health Expenditures, 113 Heart failure, 113 Heartbeat, 113, 139 Hematology, 24, 25, 29, 32, 47, 53, 61, 113 Hemodialysis, 6, 45, 54, 105, 113, 118 Hemodialysis Solutions, 6, 113 Hemoglobin, 6, 95, 108, 113 Hemolytic, 41, 61, 109, 114 Hemorrhage, 106, 114, 130, 135 Hemorrhoidectomy, 24, 114 Hemorrhoids, 114 Heparin, 31, 49, 53, 114 Hepatic, 31, 52, 100, 110, 114 Hepatic Artery, 52, 114 Hepatitis, 46, 64, 114 Hepatitis A, 46, 114 Hepatocytes, 114 Hepatovirus, 114 Hereditary, 43, 112, 114 Heredity, 111, 114 Heterogeneity, 94, 114 Hormonal, 97, 114, 126 Hormone, 93, 108, 114, 117, 125 Hormone therapy, 93, 114 Host, 6, 8, 10, 61, 97, 114, 132, 139 Humeral, 22, 114 Hydrogenation, 105, 115 Hydrolysis, 98, 115, 129 Hydrophobic, 112, 115, 119 Hydroxylysine, 103, 115 Hydroxyproline, 94, 103, 115 Hydroxyurea, 29, 32, 115 Hyperbaric, 32, 37, 115 Hyperbaric oxygen, 32, 37, 115 Hyperoxaluria, 36, 115 Hypersensitivity, 100, 115 Hypertension, 8, 96, 108, 115, 128, 138 Hyperuricemia, 112, 115 I Id, 7, 10, 58, 82, 88, 90, 115 Idiopathic, 13, 14, 33, 41, 51, 110, 115 Iliac Artery, 110, 115

Iloprost, 33, 50, 57, 115 Imipenem, 56, 57, 102, 115 Immune response, 93, 96, 97, 113, 115, 116, 139 Immune system, 98, 115, 116, 120, 138, 139 Immunity, 8, 93, 116 Immunocompromised, 30, 116 Immunodeficiency, 34, 44, 93, 116 Immunogenic, 99, 116 Immunologic, 10, 116, 125 Immunology, 11, 93, 94, 116 Immunosuppressant, 116, 121 Impotence, 108, 116 In vitro, 10, 11, 100, 116 In vivo, 9, 10, 11, 114, 116 Incision, 116, 117, 129 Incisional, 61, 116 Indicative, 60, 116, 125, 138 Induction, 56, 116 Infancy, 41, 116 Infant, Newborn, 94, 116 Infarction, 116 Infusion, 116, 137 Ingestion, 37, 116, 128 Inguinal, 45, 116 Inguinal Hernia, 45, 116 Inotropic, 106, 117 Insight, 11, 117 Insulin, 56, 117 Insulin-dependent diabetes mellitus, 117 Intensive Care, 10, 56, 117 Intermittent, 117, 126 Internal Medicine, 21, 49, 53, 113, 117 Interstitial, 109, 117, 132 Intervertebral, 105, 117 Intestinal, 14, 17, 19, 31, 34, 39, 52, 56, 102, 107, 117 Intestine, 99, 107, 108, 117, 118, 135, 139 Intracellular, 116, 117, 121, 129, 132 Intracranial Pressure, 56, 117 Intramuscular, 29, 56, 113, 117, 125 Intramuscular injection, 29, 117 Intravascular, 10, 36, 41, 42, 48, 61, 117, 118 Intravenous, 50, 57, 116, 117, 125 Intrinsic, 94, 97, 117 Intubation, 100, 117 Invasive, 5, 8, 9, 116, 117, 120 Ions, 97, 99, 106, 117, 130 Ischemia, 4, 5, 8, 14, 17, 22, 34, 35, 56, 60, 97, 117

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Gangrene

J Joint, 46, 60, 97, 102, 117, 135 K Kb, 76, 117 Kidney Disease, 6, 76, 118 Kidney Failure, 107, 118 Kinetic, 118 L Laminin, 97, 109, 118 Large Intestine, 117, 118, 131, 133, 139 Leiomyoma, 52, 110, 118 Leprosy, 111, 118 Lethal, 11, 118 Leucocyte, 118 Leukaemia, 42, 118 Leukapheresis, 96, 118 Leukemia, 15, 18, 20, 24, 93, 101, 118 Leukemic Infiltration, 118, 119 Leukocytes, 10, 98, 99, 107, 118, 122, 125 Leukostasis, 10, 13, 118 Library Services, 88, 119 Ligaments, 35, 104, 119 Linkage, 7, 119 Lipid, 96, 112, 117, 119, 124 Lipid Peroxidation, 119, 124 Lipodystrophy, 18, 119 Lipopolysaccharide, 112, 119 Lipoprotein, 18, 112, 119 Lithotripsy, 47, 119 Liver, 35, 36, 93, 96, 98, 102, 110, 111, 112, 114, 118, 119, 128, 132 Liver scan, 119, 132 Localized, 11, 93, 116, 118, 119, 124, 127, 133, 137 Low-density lipoprotein, 119 Lumbar, 106, 119 Lumbar puncture, 106, 119 Lupus, 119, 136 Lymph, 97, 102, 107, 119, 120 Lymph node, 97, 119, 120 Lymphatic, 61, 107, 116, 119, 120, 134, 136 Lymphocyte, 93, 96, 120 Lymphocyte Count, 93, 120 Lymphoid, 95, 118, 120 Lymphoma, 15, 47, 120 M Magnetic Resonance Imaging, 120, 132 Malaria, 14, 42, 47, 102, 120 Malaria, Falciparum, 120 Malaria, Vivax, 120 Malignant, 19, 47, 93, 96, 109, 120, 122, 123, 132

Malignant tumor, 19, 120, 122 Malnutrition, 97, 113, 120 Mammary, 37, 104, 120 Mammogram, 99, 120, 121 Mannans, 111, 120 Matrix metalloproteinase, 5, 120 Medial, 96, 120 Mediate, 12, 106, 120 Medical Records, 120, 132 MEDLINE, 77, 121 Membrane, 7, 11, 100, 105, 112, 113, 118, 121, 127, 130, 132, 135 Membrane Lipids, 121, 127 Meningitis, 121, 122 Mental, iv, 4, 76, 78, 105, 106, 121, 131, 138 Mesenteric, 17, 56, 121 Mesentery, 121, 126 Metabolic disorder, 112, 121 Metastasis, 120, 121 Metastatic, 21, 38, 121 Methotrexate, 28, 121 MI, 22, 91, 121 Microbe, 121, 136 Microcalcifications, 99, 121 Microorganism, 121, 125, 139 Micro-organism, 121, 133 Microscopy, 97, 121 Migration, 10, 121 Military Medicine, 49, 121 Modification, 94, 122, 130 Molecular, 5, 7, 8, 18, 77, 79, 95, 98, 103, 110, 114, 122, 135, 137 Molecule, 96, 97, 106, 115, 122, 124, 131 Monocytes, 118, 122 Mononuclear, 109, 122 Morphological, 107, 111, 122 Morphology, 113, 122 Mucus, 122, 137 Multiple Myeloma, 34, 122 Musculature, 110, 122 Myelogenous, 93, 122 Myelography, 106, 122 Myocardial infarction, 9, 15, 104, 121, 122, 139 Myocardial Ischemia, 95, 122 Myocardium, 95, 121, 122 Myotonia, 122, 130 N Nasopharynx, 122 Need, 3, 49, 59, 60, 63, 83, 93, 102, 120, 122 Neisseria, 61, 122 Neisseria meningitidis, 61, 122

Index 147

Neonatal, 39, 50, 123 Neoplasm, 123, 132 Neoplastic, 119, 120, 123 Nephropathy, 118, 123 Nephrosis, 123 Nephrotic, 13, 123 Nephrotic Syndrome, 13, 123 Nerve, 93, 95, 110, 123, 124, 126, 128, 132, 133, 137 Nervous System, 101, 123, 135 Neural, 123, 126 Neurologic, 64, 123, 137 Neurons, 103, 123, 135 Neuropathy, 50, 123, 126 Neurotoxic, 7, 123 Neurotoxins, 7, 123 Neurotransmitter, 93, 94, 106, 112, 123 Neutrons, 94, 123, 130, 131 Neutrophil, 10, 123 Norepinephrine, 93, 106, 123 O Occult, 34, 123 Odds Ratio, 123, 131 Omentum, 114, 124 Opacity, 105, 124 Opportunistic Infections, 93, 124 Optic cup, 124, 125 Optic Nerve, 124, 125, 132 Orbit, 124, 125 Orbital, 14, 32, 124 Oropharynx, 122, 124 Orthotic Devices, 60, 124 Osteomyelitis, 60, 124 Oxalate, 115, 124 Oxidation, 96, 98, 104, 119, 124 Oxidative Stress, 6, 9, 124 P Palliative, 124, 136 Palpation, 61, 124 Pancreas, 93, 114, 117, 124, 125 Pancreatic, 20, 125 Pancreatitis, 15, 125 Pancytopenia, 20, 125 Panophthalmitis, 14, 125 Parathyroid, 125 Parathyroid Glands, 125 Parathyroidectomy, 49, 51, 125 Parenteral, 3, 125 Paroxysmal, 95, 125 Pathogen, 8, 61, 125 Pathogenesis, 4, 7, 31, 49, 61, 125 Pathologic, 43, 98, 104, 115, 118, 125, 138

Pathophysiology, 65, 125 Patient Education, 64, 86, 88, 91, 125 Pedicle, 20, 125 Pelvis, 93, 115, 119, 125, 138 Penicillin, 15, 125 Penis, 3, 17, 35, 125 Pentoxifylline, 57, 125 Peptide, 94, 125, 129 Percutaneous, 46, 119, 126 Perforation, 35, 46, 126, 139 Perianal, 3, 126 Pericardium, 126, 136 Perineal, 22, 35, 48, 50, 126 Perineum, 29, 39, 126, 134 Periodicity, 11, 126 Perioperative, 8, 41, 126 Peripheral Neuropathy, 60, 126 Peripheral Vascular Disease, 56, 126 Peritoneal, 46, 105, 126 Peritoneal Cavity, 126 Peritoneal Dialysis, 46, 105, 126 Peritoneum, 121, 124, 126 Peritonitis, 35, 36, 126, 139 Pharmacodynamics, 10, 126 Pharmacokinetic, 126 Pharmacologic, 9, 95, 113, 126, 136 Phosphodiesterase, 125, 126 Phospholipids, 9, 109, 119, 121, 127 Phosphorus, 100, 125, 127 Photocoagulation, 102, 127 Physical Examination, 64, 127 Physiologic, 94, 113, 127, 129, 131 Physiology, 7, 63, 113, 127 Plague, 13, 127 Plants, 94, 98, 103, 111, 122, 123, 127, 137 Plaque, 95, 127 Plasma, 9, 95, 100, 101, 110, 111, 112, 114, 118, 122, 127, 128, 130 Plasma cells, 95, 122, 127 Plasma protein, 127, 130 Plasmapheresis, 96, 127 Platelet Activation, 31, 127 Platelet Aggregation, 108, 115, 125, 127 Plateletpheresis, 96, 128 Platelets, 10, 125, 127, 128, 136 Pneumonia, 43, 104, 128 Poisoning, 108, 128 Polysaccharide, 96, 101, 128, 129 Popliteal, 35, 128 Portal Hypertension, 108, 128 Practicability, 128, 137 Practice Guidelines, 78, 128

148

Gangrene

Precursor, 96, 106, 107, 123, 128, 130, 137 Prejudice, 64, 128 Prevalence, 9, 124, 128 Probe, 11, 128 Progression, 4, 9, 43, 128 Progressive, 14, 43, 44, 61, 96, 102, 105, 112, 127, 128, 132 Proline, 103, 115, 128 Promoter, 106, 128 Promyelocytic leukemia, 24, 56, 128 Prophylaxis, 128, 139 Prospective study, 4, 129 Prostaglandin, 56, 108, 129 Prostaglandins A, 129 Prostate, 129, 137 Prostatectomy, 47, 129 Protein C, 94, 96, 119, 129 Protein S, 98, 129 Proteins, 94, 96, 99, 100, 103, 104, 109, 120, 121, 122, 126, 127, 129, 133 Proteinuria, 122, 123, 129 Proteoglycans, 97, 109, 129 Proteolytic, 11, 110, 129 Prothrombin, 4, 130, 136 Protons, 94, 130 Protozoa, 121, 130 Protozoan, 120, 130 Proximal, 22, 106, 130 Public Policy, 77, 130 Pulmonary, 43, 99, 107, 108, 118, 130, 139 Pulmonary Embolism, 130, 139 Pulse, 49, 130 Purpura, 31, 130 Putrefaction, 111, 130 Pyogenic, 108, 124, 130, 133 Q Quality of Life, 6, 63, 130 Quinine, 14, 102, 130 R Race, 121, 130 Radial Artery, 21, 28, 130 Radiation, 42, 93, 95, 110, 115, 130, 131, 132, 139 Radiation therapy, 93, 115, 131 Radioactive, 99, 113, 119, 131, 132 Radiological, 43, 52, 126, 131 Radiology, 17, 18, 20, 37, 43, 131 Radius, 130, 131 Randomized, 9, 106, 131 Reagent, 11, 131 Receptor, 10, 11, 96, 106, 131 Recombinant, 10, 131

Rectal, 35, 57, 131 Rectum, 24, 27, 40, 96, 103, 110, 111, 118, 129, 131 Recur, 126, 131 Recurrence, 126, 131 Red blood cells, 108, 114, 131 Reductase, 121, 131 Refer, 1, 111, 123, 131, 137 Refraction, 131, 134 Regimen, 106, 131 Rehabilitative, 41, 131 Relative risk, 4, 131 Renal Dialysis, 20, 132 Renal failure, 8, 21, 22, 50, 56, 132 Respiratory Burst, 10, 132 Retropubic, 129, 132 Retrospective, 37, 43, 132 Retrospective study, 43, 132 Rheology, 125, 132 Ribonucleoside Diphosphate Reductase, 115, 132 Rickettsiae, 132 Rigidity, 117, 127, 132 Risk factor, 9, 45, 129, 131, 132 Rod, 97, 108, 113, 132 Rye, 108, 132 S Saphenous, 104, 132 Saphenous Vein, 104, 132 Sarcoma, 44, 110, 132 Scans, 51, 132 Sclera, 125, 132 Scleroderma, 21, 96, 109, 133 Sclerosis, 9, 50, 57, 96, 133 Screening, 102, 133 Scrotum, 3, 12, 31, 36, 43, 49, 133, 136 Sebaceous, 105, 133 Sebaceous gland, 105, 133 Segmental, 110, 133 Self Care, 93, 133 Sepsis, 12, 17, 21, 26, 28, 46, 48, 52, 133 Septic, 52, 97, 133 Septicaemia, 41, 133 Sequencing, 6, 133 Serum, 119, 126, 133 Shock, 119, 133, 137 Side effect, 69, 93, 98, 115, 133, 136 Skeletal, 122, 133 Skeleton, 110, 117, 129, 133 Skull, 117, 124, 133 Small intestine, 46, 102, 106, 107, 114, 116, 117, 133

Index 149

Smooth muscle, 94, 110, 118, 133 Social Environment, 130, 133 Sodium, 108, 112, 130, 133, 135 Soft tissue, 61, 99, 109, 110, 111, 133, 134 Solid tumor, 95, 98, 134 Somatic, 126, 134 Specialist, 83, 134, 139 Species, 24, 61, 101, 102, 108, 113, 120, 121, 122, 130, 134, 135, 137, 139 Specificity, 6, 94, 134 Spectrum, 5, 115, 134 Sperm, 101, 134, 136, 138 Spinal cord, 12, 16, 36, 99, 101, 108, 122, 123, 134 Spleen, 118, 120, 134 Stabilization, 3, 134 Staging, 132, 134 Staphylococcus, 8, 52, 61, 134 Staphylococcus aureus, 8, 52, 61, 134 Stem cell transplantation, 24, 134 Stem Cells, 134 Stenosis, 110, 134 Stomach, 93, 97, 108, 111, 114, 118, 124, 126, 133, 134, 139 Stool, 103, 118, 135 Streptococcal, 31, 36, 61, 135 Streptococci, 61, 135 Streptococcus, 40, 61, 109, 135 Streptococcus pneumoniae, 61, 135 Stress, 6, 100, 124, 135 Stroke, 9, 12, 16, 45, 76, 135 Subacute, 116, 135 Subclinical, 116, 135 Subcutaneous, 3, 56, 61, 101, 106, 111, 113, 118, 119, 125, 135 Subspecies, 134, 135 Superoxide, 132, 135 Sweat, 105, 135 Sweat Glands, 105, 135 Sympathomimetic, 106, 108, 123, 135 Symptomatic, 125, 135 Synapses, 99, 135 Synergistic, 3, 12, 38, 42, 61, 135 Systemic, 14, 16, 17, 21, 32, 41, 50, 57, 61, 70, 96, 99, 100, 108, 116, 131, 133, 135, 138, 139 Systemic lupus erythematosus, 17, 21, 41, 135 Systolic, 115, 136 T Telomere, 113, 136 Testicles, 133, 136, 138

Therapeutics, 70, 136 Thigh, 109, 110, 112, 136 Thorax, 93, 119, 136 Threshold, 64, 115, 136 Thrombin, 53, 110, 128, 129, 130, 136 Thrombocytes, 128, 136 Thrombocytopenia, 31, 49, 53, 136 Thrombosis, 21, 31, 50, 52, 129, 135, 136 Thrombus, 19, 104, 116, 122, 128, 136, 139 Thymus, 120, 136 Tin, 126, 136 Tomography, 103, 132, 136 Topical, 10, 64, 136 Torsion, 28, 29, 116, 136 Toxic, iv, 102, 107, 116, 123, 132, 136, 137 Toxicity, 8, 33, 106, 136 Toxicokinetics, 136 Toxicology, 78, 136 Toxin, 7, 8, 11, 12, 13, 33, 47, 65, 137 Transfection, 98, 137 Transfusion, 22, 31, 51, 57, 137 Transient Ischemic Attacks, 9, 137 Transmitter, 93, 106, 123, 135, 137 Transplantation, 15, 31, 52, 102, 137 Transurethral, 129, 137 Transurethral resection, 129, 137 Transurethral Resection of Prostate, 129, 137 Trauma, 3, 50, 56, 125, 137, 139 Treatment Outcome, 42, 137 Tryptophan, 103, 137 TYPHI, 41, 137 Typhoid fever, 137 Tyrosine, 106, 137 U Ulcer, 4, 51, 61, 63, 101, 137 Ulceration, 37, 64, 137 Ulcerative colitis, 15, 137 Unconscious, 115, 137 Uraemia, 125, 137 Uremia, 118, 132, 138 Ureter, 119, 138 Urethra, 125, 129, 137, 138 Uric, 112, 115, 138 Urinary, 3, 100, 102, 111, 129, 132, 138 Urinary tract, 3, 138 Urinary tract infection, 3, 138 Urine, 9, 98, 113, 115, 124, 129, 138 Urokinase, 21, 138 Uterus, 104, 110, 118, 138 V Vaccine, 93, 138

150

Gangrene

Varicella, 24, 138 Vascular, 5, 8, 9, 10, 13, 17, 22, 28, 32, 34, 35, 36, 37, 45, 49, 56, 64, 105, 107, 108, 116, 136, 138 Vascular Resistance, 32, 138 Vasculitis, 23, 33, 36, 52, 57, 82, 125, 138 Vasectomy, 24, 138 Vasodilation, 115, 138 Vasodilator, 106, 138 Vein, 21, 117, 128, 132, 138, 139 Venereal, 122, 138 Venoms, 123, 138 Venous, 21, 31, 34, 41, 49, 51, 52, 53, 114, 129, 139 Venous Thrombosis, 41, 53, 139 Ventricle, 96, 130, 136, 139 Ventricular, 14, 139 Ventricular fibrillation, 14, 139 Venules, 99, 139 Vertebrae, 117, 134, 139

Veterinary Medicine, 77, 139 Viral, 8, 139 Virologist, 8, 139 Virulence, 7, 136, 139 Virus, 34, 44, 93, 98, 127, 139 Visceral, 14, 126, 139 Vitro, 114, 139 Vivo, 139 Volvulus, 27, 54, 139 W Warfarin, 37, 53, 57, 139 Warts, 60, 139 White blood cell, 95, 101, 112, 118, 120, 122, 123, 127, 139 Wound Healing, 9, 10, 64, 120, 139 Wound Infection, 48, 61, 139 X X-ray, 103, 104, 110, 120, 122, 131, 132, 139 Y Yeasts, 111, 139

Index 151

152

Gangrene

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