LYMPHEDEMA 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., 1960Lymphedema: 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: 0-597-84021-0 1. Lymphedema-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.
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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 lymphedema. 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 LYMPHEDEMA........................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Lymphedema ................................................................................. 4 E-Journals: PubMed Central ....................................................................................................... 21 The National Library of Medicine: PubMed ................................................................................ 22 CHAPTER 2. NUTRITION AND LYMPHEDEMA ................................................................................. 67 Overview...................................................................................................................................... 67 Finding Nutrition Studies on Lymphedema ................................................................................ 67 Federal Resources on Nutrition ................................................................................................... 70 Additional Web Resources ........................................................................................................... 71 CHAPTER 3. ALTERNATIVE MEDICINE AND LYMPHEDEMA .......................................................... 73 Overview...................................................................................................................................... 73 National Center for Complementary and Alternative Medicine.................................................. 73 Additional Web Resources ........................................................................................................... 82 General References ....................................................................................................................... 84 CHAPTER 4. DISSERTATIONS ON LYMPHEDEMA ............................................................................ 85 Overview...................................................................................................................................... 85 Dissertations on Lymphedema ..................................................................................................... 85 Keeping Current .......................................................................................................................... 85 CHAPTER 5. CLINICAL TRIALS AND LYMPHEDEMA ....................................................................... 87 Overview...................................................................................................................................... 87 Recent Trials on Lymphedema ..................................................................................................... 87 Keeping Current on Clinical Trials ............................................................................................. 88 CHAPTER 6. PATENTS ON LYMPHEDEMA ....................................................................................... 91 Overview...................................................................................................................................... 91 Patents on Lymphedema .............................................................................................................. 91 Patent Applications on Lymphedema ........................................................................................ 100 Keeping Current ........................................................................................................................ 106 CHAPTER 7. BOOKS ON LYMPHEDEMA ......................................................................................... 109 Overview.................................................................................................................................... 109 Book Summaries: Online Booksellers......................................................................................... 109 The National Library of Medicine Book Index ........................................................................... 110 Chapters on Lymphedema .......................................................................................................... 111 CHAPTER 8. MULTIMEDIA ON LYMPHEDEMA .............................................................................. 113 Overview.................................................................................................................................... 113 Video Recordings ....................................................................................................................... 113 Bibliography: Multimedia on Lymphedema............................................................................... 114 CHAPTER 9. PERIODICALS AND NEWS ON LYMPHEDEMA ........................................................... 115 Overview.................................................................................................................................... 115 News Services and Press Releases.............................................................................................. 115 Newsletter Articles .................................................................................................................... 117 Academic Periodicals covering Lymphedema............................................................................. 118 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 119 Overview.................................................................................................................................... 119 U.S. Pharmacopeia..................................................................................................................... 119 Commercial Databases ............................................................................................................... 120 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 123 Overview.................................................................................................................................... 123 NIH Guidelines.......................................................................................................................... 123
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NIH Databases........................................................................................................................... 125 Other Commercial Databases..................................................................................................... 127 The Genome Project and Lymphedema ...................................................................................... 127 APPENDIX B. PATIENT RESOURCES ............................................................................................... 133 Overview.................................................................................................................................... 133 Patient Guideline Sources.......................................................................................................... 133 Associations and Lymphedema .................................................................................................. 137 Finding Associations.................................................................................................................. 139 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 143 Overview.................................................................................................................................... 143 Preparation................................................................................................................................. 143 Finding a Local Medical Library................................................................................................ 143 Medical Libraries in the U.S. and Canada ................................................................................. 143 ONLINE GLOSSARIES................................................................................................................ 149 Online Dictionary Directories ................................................................................................... 150 LYMPHEDEMA DICTIONARY ................................................................................................. 151 INDEX .............................................................................................................................................. 195
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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 lymphedema 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 lymphedema, 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 lymphedema, 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 lymphedema. 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 lymphedema, 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 lymphedema. 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 LYMPHEDEMA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on lymphedema.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and lymphedema, 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 “lymphedema” (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: •
Gastrointestinal and Granulomatous Diseases Source: Periodontology 2000. Volume 18: 95-101. October 1998. Contact: Available from Munksgaard International Publishers Ltd. Commerce Place, 350 Main Street, Malden, MA 02148-5018. (781) 388-8273. Fax (781) 388-8274. Summary: The oral cavity arises from the primitive stomatodeum and is both ectodermal and endodermal in origin. It is therefore not surprising that, since the mouth is at the entrance to the gastrointestinal (GI) tract, a number of digestive diseases may also manifest in the mouth and that the gingiva and periodontium are sometimes involved. This article reviews how individual disorders specific to the GI tract may manifest as periodontal problems. The GI organs and diseases covered include the esophagus, stomach, liver, small intestine, large intestine, and ulcerative colitis.
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Granulomatous diseases (several of which manifest in the mouth) discussed include chronic granulomatous disease of childhood, Langerhans cell histiocytosis, bacterial infections (tuberculosis), fungal infections (deep mycoses), midline granulomas (Wegener's granulomatosis, peripheral T cell lymphoma), and orofacial lymphedema (local, Crohn's disease, and sarcoidosis). 9 figures. 1 table. 68 references. •
Communication Problems in Turner Syndrome: A Sample Survey Source: Journal of Communication Disorders. 32(6): 435-446. November-December 1999. Contact: Available from Elsevier Science. Customer Support Department, P.O. Box 945, New York, NY 10159-0945. (888) 437-4636 or (212) 633-3730. Fax (212) 633-3680. E-mail:
[email protected]. Summary: Turner syndrome is a genetic condition in females characterized by a short stature, ovarian dysgenesis (lack of ovaries), neck webbing, congenital peripheral lymphedema, coarction of the aorta, dysplastic nails, and pigmented nevi. In addition, psychosocial difficulties, including communication disorders may occur. This article reports on a communications study of a sample survey in 128 girls with Turner syndrome. The girls ranged in age from 2.4 to 58.8 years. The authors present results on the occurrence and nature of speech and language problems (voice disorders, articulation problems, stuttering, and delayed language development), on the presence of learning disabilities, and on educational history. Almost one quarter of the subjects interviewed were receiving or had received treatment for stuttering, articulation problems, or delayed language development; this compares to an incidence of approximately 10 percent in the general population of U.S. children. Another finding of the present study is that the possible voice changes as a result of growth hormone treatment do not seem to be a genuine problem. The article concludes with a self test of continuing education questions. 1 table. 36 references.
Federally Funded Research on Lymphedema The U.S. Government supports a variety of research studies relating to lymphedema. 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 lymphedema. 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 lymphedema. The following is typical of the type of information found when searching the CRISP database for lymphedema:
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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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Project Title: BREAST CANCER PATTERNS OF CARE AND MORBIDITY Principal Investigator & Institution: Norman, Sandra A.; Research Associate Professor; Biostatistics and Epidemiology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 30-SEP-1997; Project End 31-AUG-2003 Summary: Studies of treatment-associated morbidity are becoming increasingly important as clinical trials continue to document equivalent mortality rates for a variety of treatment options for breast cancer. Lymphedema has been identified by women who experience it as one of the most distressing long-term consequences of breast cancer treatment; yet there are insufficient data about its incidence and risk factors to counsel women appropriately. Sparse data suggest that risk may be higher in older women. The Specific Aims of the proposed study are: 1) to measure prospectively the incidence of lymphedema and identify risk factors for its occurrence, using multivariate modelling to estimate the relative risk of lymphedema associated with characteristics of the disease at diagnosis, and with treatment, recurrence and patient-specific factors; and 2) to measure health-related quality of life in breast cancer patients with and without lymphedema, taking into account age, stage of disease, cancer treatment, co-morbid conditions and other patient factors that can influence the quality of life. A combined cross-sectional and prospective cohort design will be used for this population-based study. A random sample of 900 patients newly diagnosed with primary breast cancer from Philadelphia and Delaware Counties of Pennsylvania will be used to estimate the prevalence of different treatment modalities for breast cancer and will be followed prospectively to assess the incidence of lymphedema and risk factors for its occurrence, as well as morbidity accompanying lymphedema, taking into account type and extent of disease at diagnosis and other potentially confounding factors. Data collection will include an in-person, hoe interview, seven months after diagnosis to measure preexisting characteristics of patients that may be associated with late occurrences of lymphedema, and to assess the presence of lymphedema and arm-related morbidity; telephone follow-up interviews at 13, 19 and 25 months after diagnosis to measure the occurrence of lymphedema and arm-related morbidity, and exposures during the interval that may be associated with risk of lymphedema; in-person observation of all patients whose questionnaire results indicate the presence of lymphedema and a random sample of women, who do not report lymphedema, and medical records review to obtain clinical data regarding the characteristics of the disease at diagnosis, treatment modality, and recurrence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BREAST CANCER SURVIVORS, PHYSICAL ACTIVITY, AND QOL Principal Investigator & Institution: Basen-Engquist, Karen M.; Associate Professor; Behavioral Science; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2001; Project Start 11-MAY-2001; Project End 30-APR-2003 Summary: (adapted from Investigator's abstract) Breast cancer survivors represent a significant and growing segment of the long-term cancer survivor population. While more patients are living disease-free, they frequently are not symptom-free as problems may persist that affect both emotional (depression and anxiety) and physical (weight gain, fatigue, lymphedema) functioning. Although research indicates quality of life may be compromised in breast cancer survivors, no studies have attempted to provide a comprehensive intervention that targets multiple quality of life domains in these
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women. Previous studies suggest that psychological interventions may result in improvements in emotional well-being, but they are not effective in alleviating physical symptoms or restoring physical functioning. Physical activity has been demonstrated to have a positive effect on both emotional well-being and physical functioning. A physical activity intervention may serve as a tertiary prevention strategy that increases the quality of life of breast cancer survivors because of its potential effectiveness in targeting both emotional and physical symptoms that persist. Data from the Lifestyle Physical Activity (LPA) intervention from Project Active, on which our LPA intervention will be based, suggests that accumulating short bouts of moderate physical activity throughout the day results in increases in physical activity and fitness, and decreases in cardiovascular risk factors. Other studies indicate physical activity improves overall quality of life, including both emotional and physical well-being. The proposed project will involve collecting data to adapt the LPA intervention for breast cancer survivors and pilot test the intervention. Using interviews and questionnaires, we will conduct a descriptive study of breast cancer survivors to assess their quality of life, the prevalence of specific health and emotional problems, levels of physical activity, and preferences regarding intervention format and logistics. We will also pilot test proposed questionnaires to assess their psychometric properties in the population. Finally, we will pilot test the LPA intervention, conduct process evaluation, and explore its effects on mediating (physical activity, self-efficacy, decisional balance, processes of change, social support) and the outcome variables (emotional well-being and physical functioning). The information obtained in this pilot project will be used to propose a larger group randomized trial of the LPA intervention in the breast cancer survivor population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CANCER AND LEUKEMIA GROUP B Principal Investigator & Institution: Taplin, Mary E.; Assistant Professor; Medicine; Univ of Massachusetts Med Sch Worcester Office of Research Funding Worcester, Ma 01655 Timing: Fiscal Year 2001; Project Start 09-JUL-1998; Project End 31-MAR-2003 Summary: (adapted from the applicant's abstract): Since its inception in 1993, the University of Massachusetts Cancer Center has sought to elucidate new insights into normal and cancer cell biology. Investigators based at U Mass are beginning to translate this knowledge into clinical correlative studies and therapeutic approaches through the CALGB. For example, Dr. Mary-Ellen Taplin has described specific androgen receptor gene mutations that may target more effective treatments for hormone independent prostate cancer. These initial studies constitute one of the funded Correlative Science Studies through the CALGB and comprises one of the CALGB Core Labs. Based on our experience and substantial base in hematopoietic cell biology, a major focus of the U Mass Cancer Center has been in transplantion biology. Efforts have centered on (1) determining factors that enhance engraftment, (2) the development of entirely new transplant models using minimal myeloablation, (3) cord blood transplantation, (4) NOD-SCID preclinical transplant models to detect minimal residual disease, and (5) gene therapy approaches such as MDR1 transfer into normal hematopoietic stem cells. Many principles of hematopoietic stem cell biology "are now being applied to solid organ systems, with investigators at U Mass evaluating growth characteristics of both normal and neoplastic cells by defining the malignant stem cell" in solid tumor systems and defining autocrine and paracrine loop pathways of growth control. Stem cell "studies in breast cancer, prostate cancer, and glioblastoma" are ongoing and may provide important clinical correlative studies as companion studies to CALGB treatment protocols. Our Group Activities and Scientific contributions have increased significantly
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in the past four years. U Mass investigators in CALGB have contributed substantially to activities in Transplant, Breast Cancer, Prostate Cancer, Surgery, and Gastrointestinal Cancer. Administrative contributions through the Audit committee and other ad hoc committees have been substantial. Major efforts have led to improvement in accrual to Group Studies and improvement in the quality of data submitted on CALGB clinical trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COMMUNITY CLINICAL ONCOLOGY PROGRAM Principal Investigator & Institution: Locker, Gershon Y.; Chief; Evanston Northwestern Healthcare Res Ins Evanston, Il 60201 Timing: Fiscal Year 2001; Project Start 01-SEP-1983; Project End 31-MAY-2003 Summary: (Applicant's Description) Evanston Hospital Corporation which has been renamed as Evanston Northwestern Health care (ENH), has been a CCOP since 1093 and has participated in studies of the Eastern Cooperative Oncology Group (ECOG), the National Surgical Adjuvant Breast and Bowel Program (NSABP), and propose to accrue patients to the Gynecology Oncology Group (GOG). It accrued 259 patients with 272 credits to therapeutic trials between June of 1992 to May of 1997. ENH also contributed non-COP patients to NIH-sponsored studies on brain tumors. ENH investigators have chaired ECOG protocols in genitourinary, breast, and hematologic malignancies. They have also chaired steering committees and served in leadership roles in these groups. Currently, Dr. Ann Thor is on the Executive and directs the ECOG Pathology Coordination Office. Dr. David Calls chains the Health Behavior and Practices Committee and the Outcomes Subcommittee. The CCOP has participated in approved cancer control projects in the NSABP-sponsored breast cancer prevention trial with tamoxifen, the Prostate Cancer Prevention Trial, and other cancer control studies. During the 5 years, 279.5 cancer control credits were awarded. ENH investigators have been active in several cancer control projects outside the CCOP pertaining to epidemiology, diagnosis, "diagnostic marker" and dietary manipulation. These include a NCI funded study of low- fat diet in post-menopausal breast cancer, and the Women's Health Initiative, treatment of post-mastectomy arm lymphedema. The CCOP has been reorganized to increase accrual by: recruitment of new investigators, adding Swedish Covenant Hospital as an affiliate, and GOG as a research base. Efforts are underway to encompass minority enrollment. A 24-bed Clinical Pharmacology Unit sponsored by Searle is operation, with the PI on the advisory committee. We have expanded our education activities through Grand Rounds and lecture series. In the last 4 years, ENH investigators published 63 papers and 10 abstracts pertaining to clinical cancer treatment and control. A research effort in cellular and molecular biology has been developed with the establishment of a program in molecular genetics. Thus, a vertical integration, e.g., from laboratory studies to delivery of care in the local community is being sought. Support is asked for ENH's continued participation in the CCOP. Funding is sought for continued accrual of patients to cancer therapy and cancer control studies of the ECG, NSABP, and GOG. Thus, our participation in cancer control and therapeutic trials will promoter medical advances as well as stimulate better patient care. These in turn will impact favorably on the level of knowledge of staff and physicians within the community. Since 1983, we have successfully participated in the CCOP program, and our record and proposed changes promise continued success in the future. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COMMUNITY CLINICAL ONCOLOGY PROGRAM Principal Investigator & Institution: Loprinzi, Charles L.; Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2001; Project Start 15-SEP-1983; Project End 31-MAY-2006 Summary: (Applicant's Description) The Mayo Clinic, through the vehicle of the North Central Cancer Treatment Group (NCCTG), will serve as a primary research base for the following 15 CCOPs: Ann Arbor Regional CCOP, Carle Cancer Center CCOP, Cedar Rapids Oncology Project CCOP, Des Moines CCOP, Duluth CCOP, Merit Care Hospital CCOP, Geisinger CCOP, Metro Minnesota CCOP, Missouri Valley Cancer Consortium CCOP, Ochsner Clinic CCOP, Illinois Oncology Research Association CCOP, Scottsdale CCOP, Siouxland Community Cancer Consortium CCOP, Toledo CCOP, and the Wichita CCOP. We will also serve as a research base for cancer control protocol activity of non-CCOP participants and for the multiple CCOPs outside of our group who contribute to intergroup cancer treatment and cancer control protocols which we lead. We will cooperate with our affiliated CCOPs in planning their program and in conducting appropriate continuing education and workshops. We will provide training and active support for their data managers and oncology nurses. We will coordinate their multidisciplinary involvement in clinical cancer research protocols. This will include evolving and maintaining standard reporting procedures for surgery, pathology, and radiation therapy. We will hold regular meetings of the CCOPs for review of ongoing research, planning future research, and for related professional activities. We will continue the rigid quality control procedures which have proved so successful in the past, and upgrade these procedures as indicated. We will constantly monitor CCOP performance not only by timely review of patients, data sheets, pathology material, operative reports, and radiation therapy port films, but also by periodic randomly scheduled monitoring site visits. We will work with each CCOP participant to aid in their maturation as clinical investigators. We will assist them in developing new protocols for which they will share leadership, and we will work with them in preparing publications as well as presentations for national and regional meetings. We will make every effort to provide them with justifiable pride in their participation in the National Cancer Program. A high priority over this grant period will be the further expansion of our cancer control efforts with incorporation of associated basic laboratory support, leading to scientifically rigorous translational research efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CONTROL OF LYMPHATIC ENDOTHELIAL DIFFERENTIATION PROGRAM Principal Investigator & Institution: Alitalo, Kari K.; University of Helsinki 33 Fabianinkatu Helsinki, Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2007 Summary: (provided by applicant): The lymphatic vasculature is essential for the maintenance of fluid balance in the body, for immune defense and for the uptake of dietary fat. Absent or damage lymphatic vessels lead to lymphedema, a chronic and disfiguring swelling of the extremities. In cancer patients the lymphatic vessels serve as a major route for the spread of tumor cells. Our long-term goal is to understand, at the molecular level, the mechanisms of lymphatic vessel growth, to identify the key molecules in the lymphatic endothelial differentiation program, and to use this knowledge to generate and differentiate lymphatic endothelial cells in vitro with a view to potential clinical applications, such as treatment of lymphedema. To address the
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regulation of the lymphatic endothelial differentiation program, transcription factors specifically expressed in the lymphatic endothelial cells (LECs), such as Prox-1 and eight other novel transcription factors identified in our preliminary studies, LECs or they will be overexpressed in blood vascular endothelial cells (BECs), and changes in the transcriptional programs of the two cell types will be monitored using DNA microarrays. To confirm our results in vivo, transgenic mice expressing inducible Prox-1 in blood vessels will be produced, and the expression of potential Prox-1 target genes will be studied. The transcriptional programs initiated in BECs and LECs upon stimulation with major regulators of angiogenesis and lymphangiogenesis, VEGF and VEGF-C, respectively, as well as with ligands specific for the three known VEGF receptors, will be studied. To understand the differences between lymphatic endothelial from different organs, human intestinal and skin LECs will be isolated, and molecules differentially expressed in the two cell populations will be identified. The tissue-specific expression of cell surface proteins in LECs from the skin and gut will be investigated using the in vivo/in vitro phage peptide and cDNA display approach. These studies will provide fundamental new insights into the mechanisms of lymphatic endothelial growth and differentiation. They should also identify molecular markers distinguishing superficial and visceral lymphatic vessels, which could then be used to develop targeted drug delivery to these vessels. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ESTIMATION AND IMAGING OF TISSUE ELASTICITY Principal Investigator & Institution: Ophir, Jonathan; Professor of Radiology; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2001 Summary: In the present funding period of this project, we have accomplished the following tasks. 1. We have demonstrated that it is possible to produce images (elastograms) of good objective quality from phantoms and tissue sin vivo and in vitro using a slightly modified commercial ultrasound scanner. 2. It has been demonstrated that reliable elastic modulus contrast exists in normal tissue component and in tumors; 3. The scientific foundations of the mechanical, mathematical, statistical, acoustical and signal processing issues involved in the production of quality elastograms have been elucidated and upper performance bounds have been calculated. Numerous new tools have been developed to improve the tradeoffs among the relevant parameters. In this renewal application, our hypothesis is that significant improvements to elastograms may be obtained by using our knowledge about basic elastic tissue properties and about the elastographic image formation process. In order to test this hypothesis, we propose the specific aims shown below. Aims 1 through 3 are designed to further improve on the objective quality of the elastograms and to derive additional relevant information from them; aims 4 and 5 strive to increase our understanding of basic tissue mechanical properties, and to investigate the practical issues involved in imaging them. Aim 1. Investigate the theoretical and practical aspects of elastographic texture in software, phantom models and tissues. Relate elastographic texture (modulus and strain) to actual stiffness texture. Aim 2. Investigate acquisition and signal processing strategies for improving objective elastographic image parameters. Aim 3. Investigate the theoretical and practical issues involved in the imaging of axial and lateral tissue strains, tissue Poisson's ratios, and in applying corrections of elastograms for motions in orthogonal directions. Aim 4. Continue to investigate the basic elastic behavior of tissues (Baylor subcontract). Aim 5. Develop an Incoherent Spectral Strain Estimation technique and its applications to elastography in noisy environments.
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Lymphedema
Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FOXC2 IN HEREDITARY LYMPHEDEMA AND LYMPHATIC DEVELOPMENT Principal Investigator & Institution: Glover, Thomas W.; Professor; Human Genetics; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-APR-2006 Summary: (provided by applicant): The hereditary lymphedemas are developmental disorders of the lymphatic system that lead to disfiguring and often disabling edema (swelling) of the extremities together with various associated abnormalities. Most are autosomal dominant with variable expression and age of onset. The primary target tissue in these conditions is the lymphatic system, a poorly understood component of the vascular system responsible for microcirculation of fluids drained from tissues and the return to the blood vascular system, and for trafficking cells of the immune system. Despite its importance in congenital and acquired disease, including cancer, very little is known about the molecular events involved in development of the lymphatic system. As with many other developmental pathways, genes involved in hereditary lymphedema can provide important insights into the molecular events Involved in lymphangiogenesis. We recently identified the gene responsible for hereditary lymphedema-distichiasis (LD). This disorder is characterized by lymphedema and extra rows of eyelashes arising from the Meibomian glands. Associated abnormalities include tetralogy of Fallot, cleft palate, hydrops fetalis and cystic hygroma. The gene responsible for LD is the FOXC2 forkhead family transcription factor. The overall goals of this project are to determine the role of FOXC2 in hereditary lymphedema and in the development of the mammalian lymphatic system. Preliminary data indicates that Foxc2+/- mice have highly abnormal lymphatic vessels and lymph nodes analogous to those in patient's with LD. Specific aims are: (1) to fully characterize Foxc2 +/- and -/mice, and transgenic mice overexpressing the gene, for lymphatic abnormalities as a model system for lymphedema-distichiasis and abnormal lymphatic development in mammals; (2) to determine the expression patterns of Foxc2 in the lymphatic system during development to begin to assess the mechanism of Foxc2 insufficiency on lymphatic phenotype and development; (3) to begin to establish the role of Foxc2 in the pathways and hierarchy of genes controlling lymphangiogenesis in mammals; (4) to assess the timing of Foxc2 deficiency in lymphatic and other abnormalities by creating mice in which Foxc2 is conditionally expressed during development. From these studies we will learn the precise defects in the developing mouse lymphatic system caused by Foxc2 deficiency, whether Foxc2 expression in lymphatic or other cell types is correlated with these defects, the timing of Foxc2 insufficiency on phenotype, and will begin to determine the role of Foxc2 in the complex biochemical pathways involved in lymphangiogenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GENETIC STUDIES OF LYMPHEDEMA Principal Investigator & Institution: Finegold, David N.; Associate Professor; Human Genetics; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2003 Summary: Lymphedema is a chronic disabling condition which results in swelling of the extremities. Patients with lymphedema suffer from recurrent local infections, physical
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impairment, social stigmatization, and may be at increased risk of developing cancers such as lymphangiosarcoma. This is an incurable disorder requiring lifelong attention. Despite a general understanding of the pathophysiology resulting in the development of lymphedema, prior to our work essentially nothing had been known about the genetic basis of primary lymphedema. Understanding the genetic basis for the subset of inherited lymphedemas would be a major advance in robust classification of lymphatic disorders. Genotypic classification would serve as a basis for the evaluation of careful treatment trials. We have linked chromosomal region 5q34-35 to, the lymphedema phenotype and provided evidence for allelic and locus heterogeneity for hereditary lymphedema. We identified and expressed mutations in VEGFR-3 which demonstrate it as a causative gene for hereditary lymphedema. We propose to further characterize the genetic basis of hereditary lymphedema by 1) mutation analysis of VEGFR-3 and other contributory genes; 2) linkage studies, positional and biochemical candidate gene analysis to identify new contributory loci to the lymphedema phenotype: 3) in vitro functional studies to establish the causal relationship between mutation and phenotype; 4) genetic epidemiologic studies to assess the role of specific lymphedema loci in predisposing individuals to secondary lymphedema. These studies will ultimately lead to a better understanding of the developmental biology of the lymphatic system, and provide a means of identifying high risk individuals in lymphedema families, as well as the normal population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INFLUENCES OF LYMPH FLOW ON THE LYMPHATIC PUMP Principal Investigator & Institution: Zawieja, David C.; Medical Physiology; Texas A&M University Health Science Ctr College Station, Tx 778433578 Timing: Fiscal Year 2003; Project Start 15-MAR-2003; Project End 28-FEB-2007 Summary: (provided by applicant): The lymphatic system plays important roles in body fluid circulation, macromolecular homeostasis, fat absorption, and immunity. A common lymphatic dysfunction, lymphedema is diversely expressed, and results in significant morbidity. Lymphedema can be associated with the long periods of enhanced lymph flow. Until now, very limited information about flow-mediated lymphatic responses and their impact has been available. Thus investigation of the mechanisms regulating lymph flow is extremely important to ongoing attempts to discover the pathogenesis and the effective treatment of lymphedema. The general objectives of proposal are to investigate the effects of lymph flow on lymphatic contractile function and to evaluate the mechanisms involved in these effects. The proposed studies will focus on: 1) Qualitatively and quantitatively evaluate the patterns and magnitudes of lymph flow and velocity in lymphatics under differing conditions in situ. We will measure lymphatic diameter, lymph pressures and velocities in rat mesenteric lymphatics under control conditions as well as during periods of enhanced lymph formation/flow by hypotonic volumeinfusion. Servo-null micropressure, optical velocimetry and video freeze-frame techniques will be used in these studies. 2) Investigate the quantitative and temporal patterns of flow-mediated alterations in lymphatic contractile function in isolated lymphatics. We will determine the pressure profiles needed in the isolated lymphatic to simulate the range of lymph pressures and velocities observed in situ and then evaluate the temporal pattern of flow-mediated effects on various aspects of lymphatic contractile pump function over the course of minutes to hours. Computerized servo controlled pumps and latex microspheres (about 5 mu m diameter) incorporated into perfusion system will be used to control the lymph pressure and velocities. 3) Investigate the cellular and molecular mechanisms that are
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Lymphedema
responsible for the effects of flow on lymphatic contractile function. In isolated lymphatic experiments we will verify if the flow-mediated events are dependent upon an intact endothelium. Studies will then focus on 3 likely endothelial-dependent pathways (nitric oxide, prostanoid, and endothelial-dependent hyperpolarization factor) of the flow-mediated responses of lymphatics. Studies will be conducted using various blockers of these 3 pathways to determine if and to what degree these pathways might be involved in flow-mediated alteration of lymphatic contractile function. Endpoints of these experiments will include measurement of intracellular calcium of lymphatic endothelial and muscle cells in isolated lymphatics as well as lymph pressure, flow, velocity, shear, wall tension and lymphatic diameter. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTEGRATED OPTICAL IMAGING RAT OF MESENTERY Principal Investigator & Institution: Zharov, Vladimir P.; Otolaryngology; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, Ar 72205 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-AUG-2005 Summary: REVISED (by applicant): The goal of this proposal is to develop an integrated optical system that improves the sensitivity and resolution of small-animal imaging devices. This new system will integrate recent advances in high-resolution videotransmission microscopy, laser fluid velocimetry, and laser spectroscopy. Specifically, this system will be used for imaging rat mesentery in vivo at the cellular level. This technology has a broad spectrum of biomedical applications including imaging of microlymphatic functioning in normal and pathological states and under different interventions, such as drug or radiation therapy; modeling of experimental lymphedema; optimization of laser treatment of vascular lesions, and so on. The Specific Aims are to: Specific Aim 1. Develop an integrated optical system combining transmission microscopy and laser velocimetry for highly sensitive imaging of rat mesentery structures at the cellular level. Specific Aim 2. Explore the capability of this integrated optical imaging system for studying rat mesentery microcirculation in response to therapeutic interventions. This new system will provide high contrast of mesenteric microstructures of different small animals in the visible-light range with high resolution. The most innovative features of this project include noninvasive high imaging of cellular structures in vivo, guidance of laser therapy and microsurgery, and quantitative characterization of blood and lymph microcirculation. Long-term goals are to develop 3-D imaging systems and to study laser-cell and drug-cell interactions in vivo. The technical realization of this new imaging system is relatively simple, combining transmission microscopy and laser technique already routinely in use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: LYMPHEDEMA AFTER BREAST CANCER TREATMENT Principal Investigator & Institution: Ridner, Sheila H.; None; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2001; Project Start 02-AUG-2001 Summary: The proposed research training plan in this level 1 application will address the problem of lymphedema following breast cancer treatment. Training plan specific aims are to: 1) describe the physiological and pathophysiological processes relative to lymphedema; 2) critically review and synthesize theory and research related to lymphedema specifically and cancer symptom management more generally; 3) identify valid and reliable lymphedema measurement methods that can be feasibly
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implemented in outpatient oncology settings; 4) evaluate current treatment modalities for lymphedema; 5) examine biopsychosocial outcomes potentially related to lymphedema (e.g. altered touch, fine or gross motor movement, and sexuality); and 6) perform independent research in this area. The research question is: What is the shortterm effectiveness of a multi-modal treatment regimen on reducing lymphedema and improving quality of life (QOL) outcomes when given as a first line treatment for breast cancer survivors? Research specific aims are to: 1) examine the short-term effectiveness of a multi-modal treatment regimen on reducing lymphedema when given as a first line treatment to breast cancer survivors; 2) examine tolerance to the multi-modal treatment regimen when given as a first line treatment to breast cancer survivors; 3) assess QOL outcomes associated with reduction of lymphedema. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MANAGING LYMPHEDEMA IN BREAST CANCER SURVIVORS Principal Investigator & Institution: Fu, Mei; None; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2001; Project Start 20-AUG-2001 Summary: The purpose of this phenomenological study is to describe the experience of managing lymphedema in breast cancer survivors. To date, little research designed to describe how lymphedema is managed in breast cancer survivors has been found in the literature. The specific aims are: (a) to delineate phenomena and component phenomena of the experience of managing lymphedema in breast cancer survivors; (b) to delineate the intentions that reflect each woman's unique experience of managing lymphedema; (c) to identify important factors that promote or impede successful lymphedema management, such as factors related to coping strategies, psychosocial, and cognitive adjustment; (d) to explore the possible impact of age on the experience by comparing the experience of participants under and over the age of 60. A longitudinal design will be used with a three-stage sampling technique. Four semi- structured interviews will be conducted with 12 breast cancer survivors over a 12-month period. Physiological measures of limb fluid volume by circumferential measures, water displacement, and infra-red perometry will be carried out to verify the presence of lymphedema. The Husserlian phenomenological method will be employed to delineate a taxonomy of the phenomena that are the essential structures of the experience of managing lymphedema. Findings will provide an excellent foundation, in later research, for an intervention study focused on lymphedema management in the areas of coping strategies and psychosocial and cognitive adjustment. Thus, the proposed foundational study is a priority for current lymphedema research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MASSAGE LYMPHEDEMA
THERAPY
FOR
BREAST
CANCER-RELATED
Principal Investigator & Institution: Bernas, Michael J.; Surgery; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-MAY-2004 Summary: (provided by applicant): Massage therapy [in the form of Manual Lymph Drainage (MLD)] is an integral component, with compression bandaging (CB), of Combined Physical Therapy (CPT), the international consensus-recommended optimal treatment for peripheral lymphedema (LE). According to the World Health Organization, LE afflicts hundreds of millions worldwide (most from parasitic filarial
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infestation) and probably millions in the United States (most from operative and irradiation treatment of cancer). For more than a century, close links between various forms of massage and salutary effects on lymph circulation have been postulated but the efficacy of MLD alone without CB remains to be convincingly demonstrated. New experimental data derived from our NCCAMR21 funded investigation of a rat subacute LE model mimicking cancer-treatment related unilateral LE (radical groin lymphectomy/lymphadenectomy + irradiation) suggests that MLD alone reduces established LE volume as effectively as CB and CPT while minimizing LE development. As an initial translation of these experimental findings to patients and based on our retrospective clinical observations, we propose to examine prospectively the short-term and long-term efficacy of MLD alone compared to MLD + CB as part of CPT in a randomized trial in patients with mild (5-20% increase in arm volume) breast cancer treatment-related LE using and further developing both objective (serial arm LE volume reduction and lymphatic tracer transport enhancement using minimally invasive lymphangioscintigraphy) and standardized subjective/qualitative outcome measures (improved quality of life/compliance/cost-benefit scores). This initial study should lay the groundwork and evidence-based rationale for the design and implementation of expanded prospective randomized clinical trials of MLD alone in various types and stages of upper and lower extremity LE in children and adults. This combined experimental and clinical translational approach should thereby shed light not only on the physiologic mechanisms underlying massage therapy but also have potentially substantial impact on simpler cost-effective LE treatment alternatives worldwide. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MASSAGE THERAPY FOR EXPERIMENTAL LYMPHEDEMA Principal Investigator & Institution: Witte, Marlys H.; Professor of Surgery; Surgery; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2001; Project Start 05-FEB-2001; Project End 31-DEC-2002 Summary: (Applicant's Abstract): Massage therapy (in the form of Manual Lymph Drainage (MLD) or Manual Lymphedema Treatment (MLT) is an integral component of the international consensus-recommended optimal treatment for lymphedema(LE) of the arms and legs, which according to the World Health Organization affects hundreds of millions worldwide. Indeed, for more than a century, close links between various forms of massage and salutary effects on lymph circulation have been postulated. Nonetheless, experimental work and clinical trials have not yielded clear evidence that MLD alone (without accompanying mechanical compression) is efficacious in preventing or ameliorating LE in its early stages of high-protein fluid accumulation or particularly when lymphostasis has been long-standing with associated soft tissue hardening (elephantiasis). Furthermore, the precise protocol of MLO as part of CPT or for testing as an independent modality as well as the optimal quantitative measures to be followed have not been objectively evaluated. This exploratory proposal will utilize our newly refined standardized LE animal model, closely resembling the clinical condition following radical groin dissection/radiation for cancer. Unilateral hindlimb LE is produced in Wistar-fuzzy rats by unilateral surgery + radiation (consisting of sequential operative inguinal lymphatic ablation and lymphadenectomy followed by localized groin irradiation). Control contralateral limbs and control unmanipulated and sham-manipulated rats will serve for comparisons. Aided by refined lymphatic/soft tissue imaging/analytic modalities, we will examine and compare quantifiable evidence of the efficacy of varying "doses" and regimens of MLD alone and in combination with mechanical compression including "mechanical massage" by sequential multi-chamber
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pneumatic compression pumping in enhancing lymphatic absorptive capacity to meet the lymphatic obligatory load, reducing LE volume or preventing LE, and remolding the LE limb in early largely fluid LE and subsequently, in chronic LE with fibrosis and bulky fat deposits. We will also assess additive and synergistic interactions among the various manipulative approaches miniaturized and standardized for the rodent model. This exploratory study will lay the groundwork and evidence-based rationale for the subsequent design and implementation of randomized cross-over clinical trial of MLD alone and in combination with different forms of mechanical compression in prevention and treatment of various forms and stages of upper and lower limb LE in children and adults. It will also provide a useful practical standardized LE animal model for detailed delineation of physiologic mechanisms/effects in the lymphatic system, and (lymph)edema postulated for a wide array of inadequately tested alternative/complementary approaches (e.g. herbal remedies, manipulative methods, diathermy) in current popular use around the world as "lymphotonics" and/or for LE treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOLECULAR CHARACTERIZATION OF FAMILIAL LYMPHEDEMA Principal Investigator & Institution: Sarfarazi, Mansoor; Professor; Surgery; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 Timing: Fiscal Year 2001; Project Start 20-AUG-2001; Project End 31-JUL-2004 Summary: (Adapted from investigator's abstract): Primary lymphedema is a condition in which there is a deficiency of lymphatic drainage, leading to swelling, frequent recurrent cellulites, and disfigurement of the affected limb or lower torso, in the absence of vascular, cardiac, surgical, renal or hepatic causes for the edema. The PI has mapped three different forms of primary lymphedema inherited as autosomal dominants: primary congenital (PCL), onset with puberty (POL, the most common), and the rare lymphedema-distichiasis syndrome (LDS) in which there is hyperplasia of lymphatics, aplasia or hypoplasia of thoracic duct, and frequent cardiac malformations, in association with double row of eyelashes (distichiasis). The primary congenital lymphedema, mapped to 5q35.3, was recently shown by a group of investigators from Finland to be due in some families to missense mutations in the cytoplasmic tyrosine kinase domain of the vegfr3 gene. The specific aims of this proposal are two fold: 1) to investigate the genetic linkage relationship of 113 families to 3 sites of PCL, LDS and POL as well as other locations that may become available during the course of this study and, to determine the genetic contribution of each lymphedema locus to the overall presentation of this phenotype; and 2) to search for mutation in a number of POL (and/or PCL) candidate genes and eventually to identify, clone, isolate and characterize the putative lymphedema genes. Depending on these results, they may embark on another round of a genome-wide search at 5-cM intervals in order to identify the chromosomal location of as yet unknown other POL loci. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PAIN SIMILARITIES IN BREAST CANCER AND FIBROMYALGIA Principal Investigator & Institution: Burckhardt, Carol S.; Professor; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 15-SEP-2001; Project End 31-AUG-2004 Summary: (from applicant's Abstract) The majority of women with breast cancer are likely to survive for many years after the initial diagnosis and treatment. Unfortunately,
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long-term disease and treatment-related symptoms, such as chronic pain, can have wide-ranging consequences for health, functioning, and life quality. The purpose of this pilot project is to describe the characteristics of the chronic pain experienced by women with breast cancer who are post-breast cancer surgery with particular emphasis on the description of widespread pain, The specific aims are to: (1) describe characteristics of the chronic pain experienced by women who are post-breast cancer surgery; and (2) compare and contrast the pain characteristics, sensory thresholds, upper body muscle strength and impairment, syndrome impact, health status, and quality of life of women with neuropathic pain only with that of women who meet criteria for fibromyalgia, a specific syndrome of widespread pain. The immediate goal of this pilot project is to test an assessment strategy for characterizing the pain, impairment, and impact. The long term goals are to use the information to support the development of better diagnostic assessments of post-breast cancer surgery pain and the development of innovative early intervention strategies to prevent widespread pain and increase the functioning, health and quality of life of women who have post-breast cancer surgery pain. The study will use a descriptive design in which 30 women, with either post-surgery chronic pain that is limited to the operated side or widespread body pain, will be assessed for descriptions of the pain, muscle strength of the upper extremities, lymphedema, tender points, joint tenderness and swelling, sensory integrity, thermal sensation, health status, and quality of life. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROSPECTIVE LYMPHEDEMA
NURSING
STUDY
OF
BREAST
CANCER
Principal Investigator & Institution: Armer, Jane M.; Associate Professor,Co-Director, Office; None; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2001; Project Start 15-JUL-2001; Project End 30-APR-2006 Summary: (provided by applicant): In the Western world, breast cancer and its treatment are the leading causes of lymphedema. More than two million women living with breast cancer in this country, accounting for nearly 25 percent of all cancer survivors, are at risk for development of lymphedema throughout their lifetimes. Lymphedema occurs as both an acute and chronic condition, characterized by significant persistent swelling associated with an abnormal accumulation of protein-rich fluid in the affected area. The impact of unmanaged and unresolved lymphedema on quality of life among women surviving breast cancer is extensive, encompassing interpersonal and family relationships, functional abilities, occupational roles, selfimage, and self-esteem. The goal of the proposed nursing study is the description of measurement, incidence, management, and overall effect of lymphedema among women diagnosed with and treated for breast cancer and followed over 30 months. The primary aims of this study are two-fold: Aim 1: Compare the reliability and clinical validity of two measurement methods for limb fluid volume: (a) traditional circumferential arm measurement versus (b) infrared perometry, at pre-operative, postoperative, and routine follow-up points. Aim 2: Examine across time the type of symptoms experienced and functional health status of breast cancer patients with and without lymphedema. A secondary aim (Aim 3) is: Examine and compare over time the complex relations (main effects, moderators, mediators) between: (a) problem solving and social support, (b) lymphedema and coping effectiveness, and (c) post-treatment psychosocial adjustment and functional health. These aims will be met through a prospective, longitudinal design, which will support the examination of measurement, incidence, psychosocial adjustment, and health status among women treated for breast
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cancer through psychometrically sound face-to-face interviews, and physiological measures. Some 200 women diagnosed and subsequently treated for breast cancer will be recruited and enrolled in years 1 and 2 and followed over 30 months. The study will provide new information about the measurement of lymphedema, which is a critical issue in furthering an accurate understanding of the incidence, management, and effect of lymphedema on the lives of breast cancer patients. Findings from this investigation will also provide important information about lymphedema signs and symptoms, selfcare management, and its impact on psychosocial adjustment and functional health; this information will form the basis of subsequent interventions with lymphedema patients. The results identifying more complex relationships between the physiological and psychosocial variables will guide development and testing of nursing interventions to prevent, detect, and manage post-breast cancer treatment lymphedema. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROX1 IN MAMMALIAN LYMPHANGIOGENESIS Principal Investigator & Institution: Oliver, Guillermo C.; Associate Member; St. Jude Children's Research Hospital Memphis, Tn 381052794 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2007 Summary: (provided by applicant): The lymphatic system is crucial for the maintainance of good health and for the prevention and cure of disease. Congenital hypoplasia and failed regeneration of lymphatic tissue result in lymphedema. Primary lymphedema appears at birth (Milroy disease) or, more commonly, after puberty (Meige disease). Although lymphedema was first described more than a century ago, little progress has been made in understanding the mechanisms that cause it. Furthermore, little progress has been made in identifying the players that participate in the normal development of the lymphatic vasculature. Investigation of the normal development of the lymphatic system has been hindered by the lack of known lymphatic-specific markers. Consequently, hypotheses about the origin of the lymphatic vessels are still controversial. The most widely accepted view, which was proposed by F. Sabin in 1902, is that isolated primitive lymph sacs bud from the endothelium of veins during early development; from these primary lymph sacs, the peripheral lymphatic system spreads by endothelial sprouting into tissues where local capillaries form. This grant proposal is based in our identification of the homeobox gene Proxl as the first specific marker of lymphatic endothelial cells. Functional inactivation of Proxl in mice leads to phenotypic alterations in lymphatic vasculature and, ultimately, to embryo death. Detailed analyses of Proxl-null and Proxl heterozygous mice have indicated that lymphangiogenesis requires activity of Proxl in a subpopulation of endothelial cells in embryonic veins. Proxl-null mice are devoid of lymphatic vasculature. Proxl activity also determines the final lymphatic fate of budding endothelial cells. The elucidation of the molecular mechanisms by which Proxl participates in the formation of the lymphatic vasculature and the identification of other novel molecules that participates in this process will increase our understanding of normal lymphangiogenesis, and therefore, advance the treatment and prevention of disorders of the lymphatic system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PYCNOGENOL FOR TREATMENT OF ARM LYMPHEDEMA Principal Investigator & Institution: Hutson, Paul R.; Associate Professor; None; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 30-APR-2005
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Summary: (provided by applicant): Lymphedema of the arm affects the function and self-image of approximately 600,000 of the 2 million breast cancer survivors in the United States. Chronic lymphedema can lead to recurrent infections and permanent swelling, in some cases impairing function. Although various methods of massage and the use of non-elastic compression "sleeves" have been shown to decrease the severity of lymphedema, these methods of physical therapy are limited in terms of patient acceptance, compliance, and by the availability of trained therapists. There is presently no pharmacologic treatment that has proven effective in treating or preventing the development of lymphedema in women treated for breast cancer. We propose a doubleblind, placebo-controlled trial of an extract of the bark of the French maritime pine tree (Pycnogenol(r)) as a treatment for arm lymphedema in breast cancer survivors. Pycnogenol(r) is widely used in Europe for lymphedema of the leg and varicose veins, and is thought to act by several mechanisms including vascular permeability and vascular constriction. The development of such a therapeutic approach would therefore constitute a major breakthrough in the treatment of this common symptom of breast cancer lymphedema. Bioelectric impedance is a painless, quick, and easily-performed method of estimating the extracellular and total water volume of the body or segment, such as the arm. We will compare the correlation of both a single- and a multiplefrequency bioelectric impedance instrument in measuring change in arm volume to a standard assessment using water displacement. We expect that bioelectric impedance will prove faster and more sensitive to changes in extracellular water (lymphedema) than the water displacement method. We also propose to use a small oral dose of midazolam and single blood sampling to screen for effects of Pycnogenol(r) on the activity of the common drug metabolizing enzyme CYP3A4. For those subjects who are already receiving digoxin, we will use digoxin urine excretion to screen for effects of the botanical upon the activity of P-glycoprotein. Finally, we will continue the evaluation of a new questionnaire of lymphedema symptoms presently being tested as a tool for assessing the severity and improvement of symptoms with treatment. In summary, the successful completion of this research can be expected to provide an alternative therapy and new instruments for treating and measuring lymphedema. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SHEAR STRESS & CELLULAR CONTROL OF CAPILLARY FUNCTION Principal Investigator & Institution: Williams, Donna A.; None; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-JUL-2006 Summary: (provided by the applicant): Over 100 years ago Starling deduced that hydrostatic and protein osmotic pressures on either side of the capillary barrier control filtration and absorption. Until recently, the assumption has been that the barrier itself does not participate in fluid balance. With modem scientific methods it has become eminently clear that capillaries sense humoral and metabolic signals, which originate from distant organs or locally from tissues that surround the microcirculation. Consequently, a very different picture of a dynamic capillary barrier is coming to the forefront. The long-term goal of the N's laboratory focuses on mechanical stimulation of capillaries. The mechanical stimuli of interest are fluid shear stress and fluid acceleration, two forces imparted to the capillary wall by flowing blood. Measurements of hydraulic conductivity (Lp) will be performed on capillaries located in a living preparation of frog mesentery and cannulated individually with glass micropipettes. In this model, capillary pressure, surface area, network location, blood flow rate, and
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direction are known. In SPECIFIC AIM 1 we examine the new and exciting possibility that absolute values of capillary Lp relate directly to very SLOW rates of fluid acceleration through the capillary (30 to 50 ums-2). SPECIFIC AIM 2 focuses on the glycocalyx, a layer of glycoproteins located on the capillary lumenal surface, and its potential role in modulating the response of intact capillaries to fluid acceleration. Prostacyclin is one autocoid known to be released acutely (sec to min) upon stimulating cultured endothelial cells with a change in fluid shear stress. SPECIFIC AIM 3 focuses on cyclooxygenase activity (COX), prostacyclin, and the second messenger, adenosine 3'5'-cyclic monophosphate (cAMP) as essential for protecting the capillary barrier in the face of changes in blood flow. Finally, in SPECIFIC AIM 4, we propose two unique mechanisms for sensing fluid stimuli in vivo. Partial digestion of the glycocalyx will be combined with inhibition of COX. Capillaries will be challenged with SLOW (5 min) or ABRUPT (< 0.1 s) changes in fluid velocity to reveal lumenal versus whole cell mechanisms for sensing flow. Collectively, the results from these studies will be critical to our understanding of capillary barrier function, mechanotransduction in vivo, and whole body fluid balance. Chronic venous insufficiency, congestive heart failure, and lymphedema represent three human diseases where the capillary barrier is not functioning properly and mechanical stimulation of the microcirculation may exacerbate the problem. The work proposed here will impact directly on clinical research efforts focused on these costly and potentially life-threatening diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE GENETIC BASIS OF HEREDITARY LIVER DISEASE Principal Investigator & Institution: Bull, Laura N.; Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-JUL-2005 Summary: (Investigator's abstract): The goals of this project are to identify and characterize the molecular bases for two forms of inherited liver disease, cholestasislymphedema syndrome (CLS) and familial hyperbileacidemia (FHB). We will work toward this goal through the following three specific aims: 1) identify the gene mutated in CLS, and further genetically characterize this disorder; 2) characterize the expression pattern of the CLS gene and protein; and 3) identify the gene mutated in FHB, and further genetically characterize this disorder. These genes will be genetically localized through use of recently developed, highly efficient genetic mapping techniques, and then candidate genes identified through analysis of available sequence databases, and use of laboratory-based gene identification techniques. Mutations causing CLS and FHB will be identified, and clinical data examined to identify any correlations between the type of mutation present in a patient, and the characteristics of that patient's disease. The types of cells in which the CLS gene is expressed will be identified using in situ hybridization approaches, and the cellular and subcellular localization of the CLS protein will be characterized, using immunohistochemical techniques. The identification of genes mutated in hereditary disorders, and the subsequent characterization of their protein products, has become a valuable tool for increasing our understanding of the pathophysiology of diseases, including disorders of the hepatobiliary system, which affect millions of people in the U.S. Identification of the genetic cause of a disease assists in diagnosis, and also aids further study that may lead to better treatment and prevention. Most importantly, the identification of a disease gene provides specific insight into the biological pathways that are deranged in the illness, and tools for further study of these pathways. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE LYMPHATIC CONTINUUM CONFERENCE Principal Investigator & Institution: Rockson, Stanley G.; Professor; Lymphatic Research Foundation, Inc. 39 Pool Dr Roslyn, Ny 11576 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2003 Summary: (provided by applicant): On May 3 and 4, 2002, the Lymphatic Research Foundation (LRF) will sponsor an important conference at the Natcher Center of the National Institutes of Health, entitled The Lymphatic Continuum. The meeting will address the interface between lymphatic research and multiple expressions of human disease, including cancer, infection, metabolism, wound healing and fibrosis, immune disorders, and vascular and developmental biology, among others. The participating scientists and investigators will share their perspectives on the current research efforts in various disciplines that represent the potential research methodologies and approaches to be applied to future investigative efforts in lymphatic biology, pathophysiology, and therapeutics. The conference will serve as a forum for active and interested investigators to share state-of-the-art research perspectives and will elucidate the potential for dynamic cross-fertilization of seemingly disparate research techniques and questions to foster advances in lymphatic biology. In addition, a key goal of the conference will be to introduce young scientists and trainees, drawn from potentially interrelated investigative disciplines, to the exciting research opportunities in the field of lymphatic biology and disease. These opportunities have recently been enhanced through the publication of a Program Announcement (PA-01-035) soliciting research into the Pathogenesis and Treatment of Lymphedema. It is, therefore, a specific goal of this conference to foster awareness of this program announcement, through the direct stimulation of interest in research topics in lymphatic biology. CME credits for attendance at the plenary session will be offered through the Stanford University School of Medicine. The first day's lectures will address various topics that are germane to the lymphatic continuum, including vasculogenesis and angiogenesis, the genetics of lymphatic disorders, muscle cell biology, interstitial signaling mechanisms, and others. The first day of the conference will be open to all interested scientists and clinicians. On the second day of the symposium, attendance will be limited to a working nucleus of 5060 invited participants in order to encourage open discussion and formulation of theoretical research agendas. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TRANSMISSION IN IMMUNITY AND LYMPHATIC PATHOLOGY IN FILARIASIS Principal Investigator & Institution: Kazura, James W.; Professor; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2001 Summary: The goals of this research are to understand the role of host immunity in the pathogenesis of the major disease manifestations of bancroftian filariasis, why they are distributed heterogeneously in at-risk populations, and how control programs will affect this morbidity. Based on observations made in a highly endemic area of Papua New Guinea over the past 17 years, the three specific aims will: 1. Examine the hypothesis that lymphatic dilatation of the vas deferens and hydroceles are due to establishment of adult worms and not related to antigen-specific host immunity. 2. Determine the importance of host T-cell immunity and related allergic responses m the pathogenesis of ADL and chronic lymphedema of the leg. This aim will evaluate filarial Ag-stimulated T-cell and basophil responses in persons with recurrent ADL and chronic lymphedema
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of the leg, and compare them with those of asymptomatic individuals matched for age, infection status, and transmission intensity. 3. Evaluate the reversibility of the various types of clinically overt and asymptomatic lymphatic pathology following introduction of mass chemotherapy, and determine whether they correlate with changes in filarial Ag-specific immunity. These studies will provide novel insights into how transmission, immunity, and lymphatic pathology are interrelated, and advance knowledge of how current strategies to control lymphatic filariasis may affect the major types of morbidity associated with this infectious disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ULTRASOUND CHARACTERIZATION
LOAD-INDENTOR
FOR
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Principal Investigator & Institution: Geyer, Mary J.; Dynamic Contours, Llc 4124 Northampton Dr Allison Park, Pa 15101 Timing: Fiscal Year 2001; Project Start 28-SEP-2001; Project End 27-MAR-2003 Summary: (provided by applicant): Dynamic Contours, LLC, proposes to develop an inexpensive, practical, noninvasive device for in vivo quantitative assessment of soft tissue mechanical properties, i.e. stiffness/compliance and/or stress relaxation. Quantifying the mechanical responses of tissue which has undergone pathological changes associated with various disorders has potential for use in early identification, differential diagnosis, disease staging, predicting incidence and healing rates and evaluating pharmacotherapeutic and support surface/interface interventions. Attempts to quantify such characteristics using palpation, biopsy specimens, load-indentation devices and radiological imaging techniques have failed to produce a valid method of assessing mechanical tissue properties. The Investigators have developed a novel ultrasound load-indentation device for objective assessment of buttock tissue in persons at high risk for pressure or venous ulcers. A portable version of this device appropriate for lower extremity assessment would have broad clinical and commercial application. Our short-term aims (Phase I) are to design, fabricate and evaluate a full-scale prototype of the proposed design. Long-term aims (Phase II) are the development of a preproduction prototype and beta-testing for sensitivity and specificity of the device in human subjects with venous disease and lymphedema. It is our intent to manufacture, market and distribute the device or to license the rights to a third party. PROPOSED COMMERCIAL APPLICATION: This device has the potential to replace high risk, expensive diagnostic techniques and improve diagnosis and treatment in pathologies affecting the soft tissues. It will be used to aid in early detection and differential diagnosis as well as to monitor outcomes of therapeutic interventions. There are currently no practical clinical tools on the market to directly measure soft tissue properties for use in diagnosing various pathological conditions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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
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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
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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 “lymphedema” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for lymphedema in the PubMed Central database: •
A model for gene therapy of human hereditary lymphedema. by Karkkainen MJ, Saaristo A, Jussila L, Karila KA, Lawrence EC, Pajusola K, Bueler H, Eichmann A, Kauppinen R, Kettunen MI, Yla-Herttuala S, Finegold DN, Ferrell RE, Alitalo K.; 2001 Oct 23; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=60113
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Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema. by Harris SR, Hugi MR, Olivotto IA, Levine M.; 2001 Jan 23; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=80678
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VEGF-C gene therapy augments postnatal lymphangiogenesis and ameliorates secondary lymphedema. by Yoon YS, Murayama T, Gravereaux E, Tkebuchava T, Silver M, Curry C, Wecker A, Kirchmair R, Hu CS, Kearney M, Ashare A, Jackson DG, Kubo H, Isner JM, Losordo DW.; 2003 Mar 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=151891
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 lymphedema, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “lymphedema” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for lymphedema (hyperlinks lead to article summaries):
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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. 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 “balanced” Y;16 translocation associated with Turner-like neonatal lymphedema suggests the location of a potential anti-Turner gene on the Y chromosome. Author(s): Erickson RP, Hudgins L, Stone JF, Schmidt S, Wilke C, Glover TW. Source: Cytogenetics and Cell Genetics. 1995; 71(2): 163-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7656589&dopt=Abstract
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A gene for lymphedema-distichiasis maps to 16q24.3. Author(s): Mangion J, Rahman N, Mansour S, Brice G, Rosbotham J, Child AH, Murday VA, Mortimer PS, Barfoot R, Sigurdsson A, Edkins S, Sarfarazi M, Burnand K, Evans AL, Nunan TO, Stratton MR, Jeffery S. Source: American Journal of Human Genetics. 1999 August; 65(2): 427-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10417285&dopt=Abstract
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A model for gene therapy of human hereditary lymphedema. Author(s): Karkkainen MJ, Saaristo A, Jussila L, Karila KA, Lawrence EC, Pajusola K, Bueler H, Eichmann A, Kauppinen R, Kettunen MI, Yla-Herttuala S, Finegold DN, Ferrell RE, Alitalo K. Source: Proceedings of the National Academy of Sciences of the United States of America. 2001 October 23; 98(22): 12677-82. Epub 2001 Oct 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11592985&dopt=Abstract
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A novel therapy for lymphedema complicated by lymphorrhea. Author(s): Szuba A, Cooke JP, Rockson SG. Source: Vascular Medicine (London, England). 1996; 1(4): 247-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9552579&dopt=Abstract
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A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema. Author(s): Johansson K, Lie E, Ekdahl C, Lindfeldt J. Source: Lymphology. 1998 June; 31(2): 56-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9664269&dopt=Abstract
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A randomized, controlled, parallel-group clinical trial comparing multilayer bandaging followed by hosiery versus hosiery alone in the treatment of patients with lymphedema of the limb. Author(s): Badger CM, Peacock JL, Mortimer PS. Source: Cancer. 2000 June 15; 88(12): 2832-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10870068&dopt=Abstract
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A rare case of sarcoidosis with bilateral leg lymphedema as an initial symptom. Author(s): Tomoda F, Oda Y, Takata M, Futamura A, Fujii N, Inoue H, Kitagawa M. Source: The American Journal of the Medical Sciences. 1999 December; 318(6): 413-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10616166&dopt=Abstract
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A retrospective study of the effects of the Lymphapress pump on lymphedema in a pediatric population. Author(s): Hassall A, Graveline C, Hilliard P. Source: Lymphology. 2001 December; 34(4): 156-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11783593&dopt=Abstract
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A review of measures of lymphedema. Author(s): Gerber LH. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2803-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874401&dopt=Abstract
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A study of the advantages of elastic stockings for leg lymphedema. Author(s): Yasuhara H, Shigematsu H, Muto T. Source: International Angiology : a Journal of the International Union of Angiology. 1996 September; 15(3): 272-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8971591&dopt=Abstract
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A surgical approach to penoscrotal lymphedema. Author(s): Steinberg J, Kim ED, McVary KT. Source: The Journal of Urology. 1996 November; 156(5): 1770. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8863600&dopt=Abstract
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A universally applicable clinical classification of lymphedema. Author(s): Miller AJ, Bruna J, Beninson J. Source: Angiology. 1999 March; 50(3): 189-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10088797&dopt=Abstract
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Absence of HHV-8 infection in 37 patients with peripheral lymphedema. Author(s): Martin L, Dupin N, Mareelin AG, Calvez V, Vaillant L. Source: Lymphology. 2002 March; 35(1): 39-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11939571&dopt=Abstract
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Acquired lymphedema of the hand due to herpes simplex virus type 2. Author(s): Butler DF, Malouf PJ, Batz RC, Stetson CL. Source: Archives of Dermatology. 1999 September; 135(9): 1125-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10490127&dopt=Abstract
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Acute lymphedema of the lower extremities revealed by lymphoscintigraphy. Author(s): Habib GS, Saliba WR, Kotler C, Ben-Haim S. Source: Clinical Nuclear Medicine. 2002 October; 27(10): 727-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12352117&dopt=Abstract
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Advances in symptom management: lymphedema. Author(s): O'Rourke ME. Source: Clinical Journal of Oncology Nursing. 1999 July; 3(3): 125-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10690044&dopt=Abstract
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Age of onset in hereditary lymphedema. Author(s): Levinson KL, Feingold E, Ferrell RE, Glover TW, Traboulsi EI, Finegold DN. Source: The Journal of Pediatrics. 2003 June; 142(6): 704-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12838201&dopt=Abstract
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Alterations of untreated lymphedema and it's grades over time. Author(s): Casley-Smith JR. Source: Lymphology. 1995 December; 28(4): 174-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8771010&dopt=Abstract
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American Cancer Society Lymphedema Workshop. Workgroup I: Treatment of the axilla with surgery and radiation--preoperative and postoperative risk assessment. Author(s): Leitch AM, Meek AG, Smith RA, Boris M, Bourgeois P, Higgins S, Pressman PI, Stevens J, Stevens RE. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2877-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874415&dopt=Abstract
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American Cancer Society Lymphedema Workshop. Workgroup II: Patient education-pre-and posttreatment. Author(s): Runowicz CD, Passik SD, Hann D, Berson A, Chang H, Makar K, Moss R, Osuch J, Petrek JD, Vaillant-Newman AM. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2880-1. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874416&dopt=Abstract
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American Cancer Society Lymphedema Workshop. Workgroup III: Diagnosis and management of lymphedema. Author(s): Rockson SG, Miller LT, Senie R, Brennan MJ, Casley-Smith JR, Foldi E, Foldi M, Gamble GL, Kasseroller RG, Leduc A, Lerner R, Mortimer PS, Norman SA, Plotkin CL, Rinehart-Ayres ME, Walder AL. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2882-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874417&dopt=Abstract
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American Cancer Society Lymphedema Workshop. Workgroup IV: Lymphedema treatment resources--professional education and availability of patient services. Author(s): Walley DR, Augustine E, Saslow D, Bailey S, Jeffs E, Lasinski B, Plotkin J, Walker M. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2886-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874418&dopt=Abstract
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American Cancer Society Lymphedema Workshop: Workgroup V: Collaboration and advocacy. Author(s): Candeira M, Schuch W, Greiner L, Buckley L, Gold H, Langer A, McKane B, Melin M, Oakley M, Schellenbach J, Schuch A, Thiadens SR, Thompson G, Upstill C. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2888-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874419&dopt=Abstract
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Angiosarcoma associated with chronic lymphedema (Stewart-Treves syndrome) of the leg: MR imaging. Author(s): Nakazono T, Kudo S, Matsuo Y, Matsubayashi R, Ehara S, Narisawa H, Yonemitsu N. Source: Skeletal Radiology. 2000 July; 29(7): 413-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10963428&dopt=Abstract
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Angiosarcoma in a chronically lymphedematous leg: an unusual presentation of Stewart-Treves syndrome. Author(s): Komorowski AL, Wysocki WM, Mitus J. Source: Southern Medical Journal. 2003 August; 96(8): 807-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14515924&dopt=Abstract
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Antiseptic efficacy of local disinfecting povidone-iodine (Betadine) therapy in chronic wounds of lymphedematous patients. Author(s): Daroczy J. Source: Dermatology (Basel, Switzerland). 2002; 204 Suppl 1: 75-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12011526&dopt=Abstract
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Are hemodynamic factors important in arm lymphedema after treatment of breast cancer? Author(s): Martin KP, Foldi I. Source: Lymphology. 1996 December; 29(4): 155-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9013466&dopt=Abstract
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Are lymphedema precautions required following breast cancer surgery? Author(s): Whitman M, Benedet R, Vann D, Burke CC. Source: Ons News / Oncology Nursing Society. 1995 June; 10(6): 5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7667028&dopt=Abstract
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Assessment and management of the woman with lymphedema after breast cancer. Author(s): Horan D, McMullen M. Source: Journal of the American Academy of Nurse Practitioners. 1998 April; 10(4): 1559. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9801548&dopt=Abstract
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Assessment of abnormal lymph drainage for the diagnosis of lymphedema by isotopic lymphangiography and by indirect lymphography. Author(s): Partsch H. Source: Clinics in Dermatology. 1995 September-October; 13(5): 445-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8665455&dopt=Abstract
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Assessment of limb volume by manual and automated methods in patients with limb edema or lymphedema. Author(s): Mayrovitz HN, Sims N, Macdonald J. Source: Advances in Skin & Wound Care. 2000 November-December; 13(6): 272-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12669673&dopt=Abstract
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Bacteriologic studies of skin, tissue fluid, lymph, and lymph nodes in patients with filarial lymphedema. Author(s): Olszewski WL, Jamal S, Manokaran G, Pani S, Kumaraswami V, Kubicka U, Lukomska B, Dworczynski A, Swoboda E, Meisel-Mikolajczyk F. Source: The American Journal of Tropical Medicine and Hygiene. 1997 July; 57(1): 7-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9242310&dopt=Abstract
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Bacteriological studies of blood, tissue fluid, lymph and lymph nodes in patients with acute dermatolymphangioadenitis (DLA) in course of 'filarial' lymphedema. Author(s): Olszewski WL, Jamal S, Manokaran G, Pani S, Kumaraswami V, Kubicka U, Lukomska B, Tripathi FM, Swoboda E, Meisel-Mikolajczyk F, Stelmach E, Zaleska M. Source: Acta Tropica. 1999 October 15; 73(3): 217-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10546838&dopt=Abstract
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Beneficial effect of etanercept on rheumatoid lymphedema. Author(s): Ostrov BE. Source: Arthritis and Rheumatism. 2001 January; 44(1): 240-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11212167&dopt=Abstract
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Breast cancer lymphedema: pathophysiology and risk reduction guidelines. Author(s): Ridner SH. Source: Oncology Nursing Forum. 2002 October; 29(9): 1285-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12370698&dopt=Abstract
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Breast radiotherapy and lymphedema. Author(s): Meek AG. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2788-97. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874399&dopt=Abstract
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Can a comprehensive lymphedema management program decrease limb size and reduce the incidence of infection in a woman with postmastectomy lymphedema? Author(s): Wing PL. Source: Physical Therapy. 2002 September; 82(9): 923; Author Reply 923-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211239&dopt=Abstract
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Can a practicing surgeon detect early lymphedema reliably? Author(s): Bland KL, Perczyk R, Du W, Rymal C, Koppolu P, McCrary R, Carolin KA, Kosir MA. Source: American Journal of Surgery. 2003 November; 186(5): 509-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14599616&dopt=Abstract
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Can patients at risk for lymphedema use hot tubs? Author(s): Rymal C. Source: Clinical Journal of Oncology Nursing. 2002 November-December; 6(6): 369. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12434473&dopt=Abstract
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Case study: management of lymphedema. Author(s): Keller AM. Source: Oncology Nursing Forum. 1999 April; 26(3): 507. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10375323&dopt=Abstract
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Cause of primary congenital lymphedema. Author(s): Child AH, Beninson J, Sarfarazi M. Source: Angiology. 1999 April; 50(4): 325-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10225468&dopt=Abstract
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Challenging the myth of exercise-induced lymphedema following breast cancer: a series of case reports. Author(s): Harris SR, Niesen-Vertommen SL. Source: Journal of Surgical Oncology. 2000 June; 74(2): 95-8; Discussion 98-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10914817&dopt=Abstract
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Changes in lymphatic function after complex physical therapy for lymphedema. Author(s): Hwang JH, Kwon JY, Lee KW, Choi JY, Kim BT, Lee BB, Kim DI. Source: Lymphology. 1999 March; 32(1): 15-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10197323&dopt=Abstract
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Changes of tissue fluid hyaluronan (hyaluronic acid) in peripheral lymphedema. Author(s): Liu NF, Zhang LR. Source: Lymphology. 1998 December; 31(4): 173-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9949388&dopt=Abstract
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Chronic eyelid lymphedema and acne rosacea. Report of two cases. Author(s): Bernardini FP, Kersten RC, Khouri LM, Moin M, Kulwin DR, Mutasim DF. Source: Ophthalmology. 2000 December; 107(12): 2220-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11097600&dopt=Abstract
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Chronic penile lymphedema: a report of 6 cases. Author(s): Porter W, Dinneen M, Bunker C. Source: Archives of Dermatology. 2001 August; 137(8): 1108-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11493116&dopt=Abstract
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Circumcision as an unusual cause of penile lymphedema. Author(s): Yildirim S, Taylan G, Akoz T. Source: Annals of Plastic Surgery. 2003 June; 50(6): 665-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783029&dopt=Abstract
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Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema. Author(s): Harris SR, Hugi MR, Olivotto IA, Levine M; Steering Committee for Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2001 January 23; 164(2): 191-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11332311&dopt=Abstract
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Coagulation factor V gene mutation associated with activated protein C resistance leading to recurrent thrombosis, leg ulcers, and lymphedema: successful treatment with intermittent compression. Author(s): Peus D, von Schmiedeberg S, Pier A, Scharf RE, Wehmeier A, Ruzicka T, Krutmann J. Source: Journal of the American Academy of Dermatology. 1996 August; 35(2 Pt 2): 3069. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8698912&dopt=Abstract
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Combined opto-electronic perometry and bioimpedance to measure objectively the effectiveness of a new treatment intervention for chronic secondary leg lymphedema. Author(s): Moseley A, Piller N, Carati C. Source: Lymphology. 2002 December; 35(4): 136-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12570322&dopt=Abstract
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Combined physical therapy for lymphedema evaluated by fluorescence microlymphography and lymph capillary pressure measurements. Author(s): Franzeck UK, Spiegel I, Fischer M, Bortzler C, Stahel HU, Bollinger A. Source: Journal of Vascular Research. 1997 July-August; 34(4): 306-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9256091&dopt=Abstract
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Combined surgical correction of bilateral congenital lower limb lymphedema with associated anomalies. Author(s): Avrahami R, Haddad M, Zelikovski A. Source: Lymphology. 1998 June; 31(2): 65-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9664270&dopt=Abstract
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Commentary: the nurse's role in providing health education about lymphedema. Author(s): Keller AM. Source: Oncology Nursing Forum. 1999 April; 26(3): 507-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10214585&dopt=Abstract
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Commentary: the physical therapist's role in treating lymphedema. Author(s): Pillion M. Source: Oncology Nursing Forum. 1999 April; 26(3): 508-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10214586&dopt=Abstract
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Comparative study of the clinical efficacy of two different coumarin dosages in the management of arm lymphedema after treatment for breast cancer. Author(s): Burgos A, Alcaide A, Alcoba C, Azcona JM, Garrido J, Lorente C, Moreno E, Murillo E, Olsina-Pavia J, Olsina-Kissler J, Samaniego E, Serra M. Source: Lymphology. 1999 March; 32(1): 3-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10197321&dopt=Abstract
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Complete decongestive physiotherapy and the Lerner Lymphedema Services Academy of Lymphatic Studies (the Lerner School). Author(s): Lerner R. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2861-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874411&dopt=Abstract
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Congenital elephantiasis-like lymphangiomatosis of a lower limb. Author(s): Imiela A, Salle-Staumont D, Breviere GM, Catteau B, Martinot-Duquennoy V, Piette F. Source: Acta Dermato-Venereologica. 2003; 83(1): 40-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12636021&dopt=Abstract
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Congenital hereditary lymphedema caused by a mutation that inactivates VEGFR3 tyrosine kinase. Author(s): Irrthum A, Karkkainen MJ, Devriendt K, Alitalo K, Vikkula M. Source: American Journal of Human Genetics. 2000 August; 67(2): 295-301. Epub 2000 June 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10856194&dopt=Abstract
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Congenital lymphedema and distichiasis. Author(s): Samlaska CP. Source: Pediatric Dermatology. 2002 March-April; 19(2): 139-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11994178&dopt=Abstract
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Congenital lymphedema presenting with increased nuchal translucency at 13 weeks of gestation. Author(s): Souka AP, Krampl E, Geerts L, Nicolaides KH. Source: Prenatal Diagnosis. 2002 February; 22(2): 91-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11857608&dopt=Abstract
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Congenital lymphedema. Author(s): Kamble M, Prajapati NC. Source: Indian Pediatrics. 2001 March; 38(3): 304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255317&dopt=Abstract
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Congenital penoscrotal lymphedema complicated by sepsis associated with a streptococcal infection. Author(s): Watanabe T. Source: Pediatric Emergency Care. 2000 December; 16(6): 423-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11138888&dopt=Abstract
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Conservative approaches to lymphedema treatment. Author(s): Rinehart-Ayres ME. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2828-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874406&dopt=Abstract
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Controlling lymphedema-related swelling. Author(s): Whitman M. Source: Clinical Journal of Oncology Nursing. 2000 March-April; 4(2): 101-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11107385&dopt=Abstract
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Current status of education and treatment resources for lymphedema. Author(s): Thiadens SR. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2864-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874412&dopt=Abstract
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Cutaneous angiosarcoma in an irradiated breast after breast conservation therapy for cancer: association with chronic breast lymphedema. Author(s): Majeski J, Austin RM, Fitzgerald RH. Source: Journal of Surgical Oncology. 2000 July; 74(3): 208-12; Discussion 212-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10951419&dopt=Abstract
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Cutaneous metastasis presenting as facial lymphedema. Author(s): Jang KA, Choi JH, Sung KJ, Moon KC, Koh JK. Source: Journal of the American Academy of Dermatology. 1998 October; 39(4 Pt 1): 6378. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9777773&dopt=Abstract
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De Quervain's tenosynovitis in patients with lymphedema: a report of 2 cases with management approach. Author(s): Lin JT, Stubblefield MD. Source: Archives of Physical Medicine and Rehabilitation. 2003 October; 84(10): 1554-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14586925&dopt=Abstract
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Debilitating lymphedema of the upper extremity after treatment of breast cancer. Author(s): Bumpers HL, Best IM, Norman D, Weaver WL. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 2002 August; 25(4): 365-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12151966&dopt=Abstract
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Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema. A randomized, prospective study of a role for adjunctive intermittent pneumatic compression. Author(s): Szuba A, Achalu R, Rockson SG. Source: Cancer. 2002 December 1; 95(11): 2260-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436430&dopt=Abstract
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Decongestive lymphatic therapy for patients with cancer-related or primary lymphedema. Author(s): Szuba A, Cooke JP, Yousuf S, Rockson SG. Source: The American Journal of Medicine. 2000 September; 109(4): 296-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10996580&dopt=Abstract
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Development and validation of a telephone questionnaire to characterize lymphedema in women treated for breast cancer. Author(s): Norman SA, Miller LT, Erikson HB, Norman MF, McCorkle R. Source: Physical Therapy. 2001 June; 81(6): 1192-205. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11380275&dopt=Abstract
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Diagnosis and treatment of concomitant venous obstruction in patients with secondary lymphedema. Author(s): Szuba A, Razavi M, Rockson SG. Source: Journal of Vascular and Interventional Radiology : Jvir. 2002 August; 13(8): 799803. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12171983&dopt=Abstract
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Diagnostic difficulties in lymphedema distichiasis. Author(s): Brice G. Source: Pediatric Dermatology. 2003 January-February; 20(1): 89; Author Reply 89-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12558856&dopt=Abstract
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Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Author(s): Tiwari A, Cheng KS, Button M, Myint F, Hamilton G. Source: Archives of Surgery (Chicago, Ill. : 1960). 2003 February; 138(2): 152-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578410&dopt=Abstract
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Distichiasis-lymphedema syndrome: tetralogy of Fallot, chylothorax, and neonatal death. Author(s): Chen E, Larabell SK, Daniels JM, Goldstein S. Source: American Journal of Medical Genetics. 1996 December 18; 66(3): 273-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8985486&dopt=Abstract
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Early diagnosis of lymphedema in postsurgery breast cancer patients. Author(s): Cornish BH, Chapman M, Thomas BJ, Ward LC, Bunce IH, Hirst C. Source: Annals of the New York Academy of Sciences. 2000 May; 904: 571-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10865807&dopt=Abstract
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Early diagnosis of lymphedema using multiple frequency bioimpedance. Author(s): Cornish BH, Chapman M, Hirst C, Mirolo B, Bunce IH, Ward LC, Thomas BJ. Source: Lymphology. 2001 March; 34(1): 2-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11307661&dopt=Abstract
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Edema volume, not timing, is the key to success in lymphedema treatment. Author(s): Ramos SM, O'Donnell LS, Knight G. Source: American Journal of Surgery. 1999 October; 178(4): 311-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10587190&dopt=Abstract
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Effect of complex decongestive physiotherapy on gene expression for the inflammatory response in peripheral lymphedema. Author(s): Foldi E, Sauerwald A, Hennig B. Source: Lymphology. 2000 March; 33(1): 19-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10769812&dopt=Abstract
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Effect of sequential intermittent pneumatic compression on both leg lymphedema volume and on lymph transport as semi-quantitatively evaluated by lymphoscintigraphy. Author(s): Miranda F Jr, Perez MC, Castiglioni ML, Juliano Y, Amorim JE, Nakano LC, de Barros N Jr, Lustre WG, Burihan E. Source: Lymphology. 2001 September; 34(3): 135-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11549125&dopt=Abstract
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Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. Author(s): McKenzie DC, Kalda AL. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 February 1; 21(3): 463-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12560436&dopt=Abstract
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Effective management of marked lymphedema of the leg. Author(s): Araujo JA, Curbelo JG, Mayol AL, Pascal GG, Vignale RA, Fleurquin F. Source: International Journal of Dermatology. 1997 May; 36(5): 389-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9199993&dopt=Abstract
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Effective treatment of lymphedema of the extremities. Author(s): Ko DS, Lerner R, Klose G, Cosimi AB. Source: Archives of Surgery (Chicago, Ill. : 1960). 1998 April; 133(4): 452-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9565129&dopt=Abstract
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Effectiveness of acupuncture and moxibustion treatment for lymphedema following intrapelvic lymph node dissection: a preliminary report. Author(s): Kanakura Y, Niwa K, Kometani K, Nakazawa K, Yamaguchi Y, Ishikawa H, Watanabe A, Tokunaga Y. Source: The American Journal of Chinese Medicine. 2002; 30(1): 37-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12067095&dopt=Abstract
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Effects of compression bandaging with or without manual lymph drainage treatment in patients with postoperative arm lymphedema. Author(s): Johansson K, Albertsson M, Ingvar C, Ekdahl C. Source: Lymphology. 1999 September; 32(3): 103-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10494522&dopt=Abstract
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Effects of microwave heating on systemic and local infiltrating lymphocytes in patients with chronic limb lymphedema. Author(s): Cao W, Chang T, Gan J. Source: Chinese Medical Journal. 1999 September; 112(9): 822-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11717954&dopt=Abstract
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Efficacy of Daflon 500 mg in the treatment of lymphedema (secondary to conventional therapy of breast cancer). Author(s): Pecking AP, Fevrier B, Wargon C, Pillion G. Source: Angiology. 1997 January; 48(1): 93-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8995350&dopt=Abstract
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End-stage renal disease in a patient with congenital lymphangiectasia and lymphedema. Author(s): Sombolos KI, Papachillea AI, Natse TM, Gogos KI, Pavlidis GO, Barboutis KA, Mavromatidis KS. Source: Pediatric Nephrology (Berlin, Germany). 2001 February; 16(2): 151-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11261684&dopt=Abstract
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Epidermoid carcinoma arising in chronic lymphedema. Author(s): Bilen BT, Gurlek A, Alaybeyoglu N, Celik M, Aydin NE. Source: European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2003 October; 29(8): 697-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14511621&dopt=Abstract
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Episodic dermatolymphangioadenitis (DLA) in patients with lymphedema of the lower extremities before and after administration of benzathine penicillin: a preliminary study. Author(s): Olszewski WL. Source: Lymphology. 1996 September; 29(3): 126-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8897357&dopt=Abstract
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Evaluation by lymphoscintigraphy of the effect of a micronized flavonoid fraction (Daflon 500 mg) in the treatment of upper limb lymphedema. Author(s): Pecking AP. Source: International Angiology : a Journal of the International Union of Angiology. 1995 September; 14(3 Suppl 1): 39-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8919264&dopt=Abstract
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Evidence for dermal angiogenesis in breast cancer related lymphedema demonstrated using dual-site fluorescence angiography. Author(s): Mellor RH, Stanton AW, Menadue L, Levick JR, Mortimer PS. Source: Microcirculation (New York, N.Y. : 1994). 2002 July; 9(3): 207-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12080418&dopt=Abstract
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Evidence for genetic heterogeneity in lymphedema-cholestasis syndrome. Author(s): Fruhwirth M, Janecke AR, Muller T, Carlton VE, Kronenberg F, Offner F, Knisely AS, Geleff S, Song EJ, Simma B, Konigsrainer A, Margreiter R, van der Hagen CB, Eiklid K, Aagenaes O, Bull L, Ellemunter H. Source: The Journal of Pediatrics. 2003 April; 142(4): 441-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12712065&dopt=Abstract
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Excision of subcutaneous tissue and deep muscle fascia for advanced lymphedema. Author(s): Kim DI, Huh S, Lee SJ, Hwang JH, Kim YI, Lee BB. Source: Lymphology. 1998 December; 31(4): 190-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9949391&dopt=Abstract
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Experience of a new surgical procedure for the treatment of unilateral obstructive lymphedema of the lower extremity: adipo-lymphatico venous transfer. Author(s): Tanaka Y, Tajima S, Imai K, Tsujiguchi K, Ueda K, Yabu K. Source: Microsurgery. 1996; 17(4): 209-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9140953&dopt=Abstract
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Experimental study on protein transmission through the human muscle fascia: preliminary results and application theory in lymphedema. Author(s): Vettorello GF, Rubbini M, Nastruzzi C, Menegatti E, Esposito E, Mascoli F, Pozza E, Cataldi A, Donini IG. Source: The Journal of Cardiovascular Surgery. 1996 August; 37(4): 345-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8698777&dopt=Abstract
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Factors associated with the development of arm lymphedema following breast cancer treatment: a match pair case-control study. Author(s): Johansson K, Ohlsson K, Ingvar C, Albertsson M, Ekdahl C. Source: Lymphology. 2002 June; 35(2): 59-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12081053&dopt=Abstract
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Familial congenital pulmonary lymphangectasia, non-immune hydrops fetalis, facial and lower limb lymphedema: confirmation of Njolstad's report. Author(s): Jacquemont S, Barbarot S, Boceno M, Stalder JF, David A. Source: American Journal of Medical Genetics. 2000 August 14; 93(4): 264-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10946350&dopt=Abstract
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Flow velocity of cutaneous lymphatic capillaries in patients with primary lymphedema. Author(s): Fischer M, Costanzo U, Hoffmann U, Bollinger A, Franzeck UK. Source: Int J Microcirc Clin Exp. 1997 May-June; 17(3): 143-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9272465&dopt=Abstract
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Focused review: postmastectomy lymphedema. Author(s): Brennan MJ, DePompolo RW, Garden FH. Source: Archives of Physical Medicine and Rehabilitation. 1996 March; 77(3 Suppl): S7480. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8599548&dopt=Abstract
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Follow-up study of upper limb lymphedema patients treated by microsurgical lymphaticovenous implantation (MLVI) combined with compression therapy. Author(s): Yamamoto Y, Horiuchi K, Sasaki S, Sekido M, Furukawa H, Oyama A, Yajima K, Sugihara T. Source: Microsurgery. 2003; 23(1): 21-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616515&dopt=Abstract
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FOXC2 truncating mutation in distichiasis, lymphedema, and cleft palate. Author(s): Bahuau M, Houdayer C, Tredano M, Soupre V, Couderc R, Vazquez MP. Source: Clinical Genetics. 2002 December; 62(6): 470-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12485195&dopt=Abstract
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Ga-67-avid massive cellulitis within a chronic lymphedematous limb in a survivor of Hodgkin's disease. Author(s): Suga K, Ariga M, Motoyama K, Hara A, Kume N, Matsunaga N. Source: Clinical Nuclear Medicine. 2001 September; 26(9): 791-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11507304&dopt=Abstract
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Generalized nevus spilus and nevus anemicus in a patient with a primary lymphedema: a new type of phakomatosis pigmentovascularis? Author(s): Bielsa I, Paradelo C, Ribera M, Ferrandiz C. Source: Pediatric Dermatology. 1998 July-August; 15(4): 293-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9720696&dopt=Abstract
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Hair tourniquet syndrome: an unusual cause of perinatologic secondary lymphedema. Author(s): Papendieck CM. Source: Lymphology. 1999 December; 32(4): 171-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10652701&dopt=Abstract
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Hereditary lymphedema: evidence for linkage and genetic heterogeneity. Author(s): Ferrell RE, Levinson KL, Esman JH, Kimak MA, Lawrence EC, Barmada MM, Finegold DN. Source: Human Molecular Genetics. 1998 December; 7(13): 2073-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9817924&dopt=Abstract
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Hypotrichosis, lymphedema of the legs and acral telangiectasias--new syndrome? Author(s): Glade C, van Steensel MA, Steijlen PM. Source: Eur J Dermatol. 2001 November-December; 11(6): 515-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11701398&dopt=Abstract
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Images in vascular medicine. Lymphoscintigraphy in congenital lymphedema. Author(s): de los Santos M, Szuba A, Rockson SG. Source: Vascular Medicine (London, England). 1998; 3(4): 327-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10102673&dopt=Abstract
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Impaired hemorheology in patients with postmastectomy lymphedema. Author(s): Djavanmard MP, Michl I, Korpan M, Fazeny B, Budinsky AC, Wiesinger E, Weinlander G, Binder M, Puspok M, Zielinski CC, Fialka V, Koppensteiner R, Marosi C. Source: Breast Cancer Research and Treatment. 1996; 38(3): 283-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8739081&dopt=Abstract
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Incidence of breast carcinoma-related lymphedema. Author(s): Petrek JA, Heelan MC. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2776-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874397&dopt=Abstract
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Increased lymphoscintigraphic flow pattern in the lower extremity under evaluation for lymphedema. Author(s): Howarth DM. Source: Mayo Clinic Proceedings. 1997 May; 72(5): 423-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9146684&dopt=Abstract
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Inhibition of lymphangiogenesis with resulting lymphedema in transgenic mice expressing soluble VEGF receptor-3. Author(s): Makinen T, Jussila L, Veikkola T, Karpanen T, Kettunen MI, Pulkkanen KJ, Kauppinen R, Jackson DG, Kubo H, Nishikawa S, Yla-Herttuala S, Alitalo K. Source: Nature Medicine. 2001 February; 7(2): 199-205. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11175851&dopt=Abstract
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Insights into the molecular pathogenesis and targeted treatment of lymphedema. Author(s): Saaristo A, Karkkainen MJ, Alitalo K. Source: Annals of the New York Academy of Sciences. 2002 December; 979: 94-110. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543720&dopt=Abstract
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Investigation of the mechanism of lymphocyte injection therapy in treatment of lymphedema with special emphasis on cell adhesion molecule (L-selectin). Author(s): Ogawa Y, Yoshizumi M, Kitagawa T, Kitaichi T, Katoh I, Hisaeda H, Himeno K. Source: Lymphology. 1999 December; 32(4): 151-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10652698&dopt=Abstract
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Is postirradiation angiosarcoma of the breast so rare and does breast lymphedema contribute to its development? Author(s): Polgar C, Orosz Z, Fodor J. Source: Journal of Surgical Oncology. 2001 March; 76(3): 239-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11276029&dopt=Abstract
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Isoprostane 8-epi-prostaglandin F2 alpha decreases lymph capillary pressure in patients with primary lymphedema. Author(s): Amann-Vesti BR, Gitzelmann G, Koppensteiner R, Franzeck UK. Source: Journal of Vascular Research. 2003 January-February; 40(1): 77-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12644728&dopt=Abstract
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I've heard that lymphedema can develop after cancer treatment. What is lymphedema, and how is it treated? Author(s): Runowicz CD. Source: Health News. 2003 March; 9(3): 12. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12703443&dopt=Abstract
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Kaposiform hemangioendothelioma associated with Milroy's disease (primary hereditary lymphedema). Author(s): Mendez R, Capdevila A, Tellado MG, Somoza I, Liras J, Pais E, Vela D. Source: Journal of Pediatric Surgery. 2003 July; 38(7): E9-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12861592&dopt=Abstract
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Knowledge about preventing and managing lymphedema: a survey of recently diagnosed and treated breast cancer patients. Author(s): Bosompra K, Ashikaga T, O'Brien PJ, Nelson L, Skelly J, Beatty DJ. Source: Patient Education and Counseling. 2002 June; 47(2): 155-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12191539&dopt=Abstract
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Lack of effect of coumarin in women with lymphedema after treatment for breast cancer. Author(s): Loprinzi CL, Kugler JW, Sloan JA, Rooke TW, Quella SK, Novotny P, Mowat RB, Michalak JC, Stella PJ, Levitt R, Tschetter LK, Windschitl H. Source: The New England Journal of Medicine. 1999 February 4; 340(5): 346-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9929524&dopt=Abstract
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Large pericardial and pleural effusions associated with familial lymphedema. Author(s): Feldman L, Kleiner-Baumgarten A, Maislos M. Source: Isr Med Assoc J. 2001 October; 3(10): 769-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11692554&dopt=Abstract
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Levels of selenium in the skin of patients with chronic lymphedema. Author(s): Werner GT. Source: Lymphology. 1999 September; 32(3): 126-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10494526&dopt=Abstract
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Lipedema complicated by lymphedema of the abdominal wall and lower limbs. Author(s): Zelikovski A, Haddad M, Koren A, Avrahami R, Loewinger J. Source: Lymphology. 2000 June; 33(2): 43-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10897469&dopt=Abstract
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Liposuction gives complete reduction of chronic large arm lymphedema after breast cancer. Author(s): Brorson H. Source: Acta Oncologica (Stockholm, Sweden). 2000; 39(3): 407-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10987239&dopt=Abstract
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Liposuction reduces arm lymphedema without significantly altering the already impaired lymph transport. Author(s): Brorson H, Svensson H, Norrgren K, Thorsson O. Source: Lymphology. 1998 December; 31(4): 156-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9949387&dopt=Abstract
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Long-term follow-up after lymphaticovenular anastomosis for lymphedema in the leg. Author(s): Koshima I, Nanba Y, Tsutsui T, Takahashi Y, Itoh S. Source: Journal of Reconstructive Microsurgery. 2003 May; 19(4): 209-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12858242&dopt=Abstract
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Long-term results after lymphatic-venous anastomoses for the treatment of obstructive lymphedema. Author(s): Campisi C, Boccardo F, Zilli A, Maccio A, Napoli F. Source: Microsurgery. 2001; 21(4): 135-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11494379&dopt=Abstract
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Lymphangiosarcoma of the pubic region: a rare complication arising in congenital non-hereditary lymphedema. Author(s): Cerri A, Gianni C, Corbellino M, Pizzuto M, Moneghini L, Crosti C. Source: Eur J Dermatol. 1998 October-November; 8(7): 511-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9854166&dopt=Abstract
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Lymphedema after sentinel lymph node biopsy for cutaneous melanoma: a report of 5 cases. Author(s): Wrone DA, Tanabe KK, Cosimi AB, Gadd MA, Souba WW, Sober AJ. Source: Archives of Dermatology. 2000 April; 136(4): 511-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10768650&dopt=Abstract
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Lymphedema after sentinel lymphadenectomy for breast carcinoma. Author(s): Sener SF, Winchester DJ, Martz CH, Feldman JL, Cavanaugh JA, Winchester DP, Weigel B, Bonnefoi K, Kirby K, Morehead C. Source: Cancer. 2001 August 15; 92(4): 748-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11550143&dopt=Abstract
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Lymphedema and lymphocysts following lymphadenectomy may be prevented by omentoplasty: A pilot study. Author(s): Logmans A, Kruyt RH, de Bruin HG, Cox PH, Pillay M, Trimbos JB. Source: Gynecologic Oncology. 1999 December; 75(3): 323-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10600283&dopt=Abstract
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Lymphedema and microsurgery. Author(s): Campisi C, Boccardo F. Source: Microsurgery. 2002; 22(2): 74-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11921075&dopt=Abstract
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Lymphedema and quality of life in survivors of early-stage breast cancer. Author(s): Beaulac SM, McNair LA, Scott TE, LaMorte WW, Kavanah MT. Source: Archives of Surgery (Chicago, Ill. : 1960). 2002 November; 137(11): 1253-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413312&dopt=Abstract
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Lymphedema and the nurse practitioner. Author(s): Romero R. Source: Nurse Pract Forum. 1999 September; 10(3): 159-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10614361&dopt=Abstract
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Lymphedema awareness. Author(s): Burns N. Source: Dermatology Nursing / Dermatology Nurses' Association. 1999 October; 11(5): 388. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10670345&dopt=Abstract
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Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Author(s): Petrek JA, Senie RT, Peters M, Rosen PP. Source: Cancer. 2001 September 15; 92(6): 1368-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11745212&dopt=Abstract
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Lymphedema in women treated for breast cancer. Author(s): Loudon L, Petrek J. Source: Cancer Practice. 2000 March-April; 8(2): 65-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11898179&dopt=Abstract
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Lymphedema in women treated for breast cancer. Author(s): Hull MM. Source: Semin Oncol Nurs. 2000 August; 16(3): 226-37. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10967795&dopt=Abstract
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Lymphedema management in patients with lymphoma. Author(s): Rymal C. Source: Nurs Clin North Am. 2001 December; 36(4): 709-34, Vi. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11726349&dopt=Abstract
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Lymphedema management training for physical therapy students in the United States. Author(s): Augustine E, Corn M, Danoff J. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2869-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874413&dopt=Abstract
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Lymphedema of the external genitalia. Author(s): McDougal WS. Source: The Journal of Urology. 2003 September; 170(3): 711-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12913680&dopt=Abstract
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Lymphedema of the hand following recurrent erysipelas secondary to fissured irritant contact dermatitis. Author(s): Proske S, Uter W, Schwanitz HJ. Source: Contact Dermatitis. 2000 June; 42(6): 368-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10871118&dopt=Abstract
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Lymphedema of the limb. An overview of treatment options. Author(s): Tunkel RS, Lachmann E. Source: Postgraduate Medicine. 1998 October; 104(4): 131-4, 137-8, 141 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9793560&dopt=Abstract
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Lymphedema of the lower extremity as a complication of local burns. Author(s): Anand S, Lal H, Dhaon BK. Source: Burns : Journal of the International Society for Burn Injuries. 1998 December; 24(8): 767-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9915682&dopt=Abstract
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Lymphedema praecox of the lower extremity. Author(s): Bauer T, Wechselberger G, Schoeller T, Piza-Katzer H. Source: Surgery. 2002 November; 132(5): 899-900. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464878&dopt=Abstract
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Lymphedema prevention and management knowledge in women treated for breast cancer. Author(s): Coward DD. Source: Oncology Nursing Forum. 1999 July; 26(6): 1047-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10420422&dopt=Abstract
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Lymphedema therapy during adjuvant therapy for cancer. Author(s): Rymal C. Source: Clinical Journal of Oncology Nursing. 2003 July-August; 7(4): 449-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12929278&dopt=Abstract
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Lymphedema, lipedema, and the open wound: the role of compression therapy. Author(s): Macdonald JM, Sims N, Mayrovitz HN. Source: The Surgical Clinics of North America. 2003 June; 83(3): 639-58. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12822730&dopt=Abstract
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Lymphedema. Author(s): Rockson SG. Source: The American Journal of Medicine. 2001 March; 110(4): 288-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11239847&dopt=Abstract
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Lymphedema: an immunologically vulnerable site for development of neoplasms. Author(s): Ruocco V, Schwartz RA, Ruocco E. Source: Journal of the American Academy of Dermatology. 2002 July; 47(1): 124-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12077591&dopt=Abstract
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Lymphedema: classification, diagnosis and therapy. Author(s): Szuba A, Rockson SG. Source: Vascular Medicine (London, England). 1998; 3(2): 145-56. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9796078&dopt=Abstract
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Lymphedema: current issues in research and management. Author(s): Petrek JA, Pressman PI, Smith RA. Source: Ca: a Cancer Journal for Clinicians. 2000 September-October; 50(5): 292-307; Quiz 308-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11075239&dopt=Abstract
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Lymphedema: patient and provider education: current status and future trends. Author(s): Runowicz CD. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2874-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874414&dopt=Abstract
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Lymphedema: strategies for management. Author(s): Cohen SR, Payne DK, Tunkel RS. Source: Cancer. 2001 August 15; 92(4 Suppl): 980-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11519024&dopt=Abstract
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Lymphedema-distichiasis and FOXC2 gene mutations. Author(s): Erickson RP. Source: Lymphology. 2001 March; 34(1): 1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11307659&dopt=Abstract
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Lymphedema-distichiasis syndrome and FOXC2 gene mutation. Author(s): Traboulsi EI, Al-Khayer K, Matsumoto M, Kimak MA, Crowe S, Wilson SE, Finegold DN, Ferrell RE, Meisler DM. Source: American Journal of Ophthalmology. 2002 October; 134(4): 592-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12383817&dopt=Abstract
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Lymphedema-distichiasis syndrome: report of a case and review. Author(s): Johnson SM, Kincannon JM, Horn TD. Source: Archives of Dermatology. 1999 March; 135(3): 347-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10086462&dopt=Abstract
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Lymphedema-lymphangiectasia-mental retardation (Hennekam) syndrome: a review. Author(s): Van Balkom ID, Alders M, Allanson J, Bellini C, Frank U, De Jong G, Kolbe I, Lacombe D, Rockson S, Rowe P, Wijburg F, Hennekam RC. Source: American Journal of Medical Genetics. 2002 November 1; 112(4): 412-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12376947&dopt=Abstract
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Lymphoscintigraphic evaluation of congenital lymphedema of the newborn. Author(s): Bellini C, Arioni C, Mazzella M, Campisi C, Taddei G, Boccardo F, Serra G. Source: Clinical Nuclear Medicine. 2002 May; 27(5): 383-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11953585&dopt=Abstract
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Magnetic resonance imaging of peripheral lymphedema. Author(s): Werner GT, Scheck R, Kaiserling E. Source: Lymphology. 1998 March; 31(1): 34-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9561511&dopt=Abstract
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Magnetic resonance imaging of peripheral lymphedema. Author(s): Insua EM, Viano J, Martime N. Source: Lymphology. 1997 March; 30(1): 24-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9106136&dopt=Abstract
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Management of lymphedema. Author(s): Neese PY. Source: Lippincott's Primary Care Practice. 2000 July-August; 4(4): 390-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11261115&dopt=Abstract
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Managing lymphedema. Author(s): Mortimer PS. Source: Clinics in Dermatology. 1995 September-October; 13(5): 499-505. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8665461&dopt=Abstract
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Manual lymphatic drainage for lymphedema limited to the breast. Author(s): Mondry TE, Johnstone PA. Source: Journal of Surgical Oncology. 2002 October; 81(2): 101-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12355412&dopt=Abstract
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Mapping of primary congenital lymphedema to the 5q35.3 region. Author(s): Evans AL, Brice G, Sotirova V, Mortimer P, Beninson J, Burnand K, Rosbotham J, Child A, Sarfarazi M. Source: American Journal of Human Genetics. 1999 February; 64(2): 547-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9973292&dopt=Abstract
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Mapping of the locus for cholestasis-lymphedema syndrome (Aagenaes syndrome) to a 6.6-cM interval on chromosome 15q. Author(s): Bull LN, Roche E, Song EJ, Pedersen J, Knisely AS, van Der Hagen CB, Eiklid K, Aagenaes O, Freimer NB. Source: American Journal of Human Genetics. 2000 October; 67(4): 994-9. Epub 2000 August 30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10968776&dopt=Abstract
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Massive hemangioma or lymphedema? A case with a diagnostic dilemma. Author(s): Bhatnagar P, Batra A, Sharma S, Krishan S, Soni NL, Tripathy RP, Bhatnagar A. Source: Clinical Nuclear Medicine. 2002 April; 27(4): 261-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11914665&dopt=Abstract
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Massive localized lymphedema in the morbidly obese: a histologically distinct reactive lesion simulating liposarcoma. Author(s): Farshid G, Weiss SW. Source: The American Journal of Surgical Pathology. 1998 October; 22(10): 1277-83. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9777990&dopt=Abstract
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Massive localized lymphedema of suprapubic origin. Author(s): Barr J. Source: Plastic and Reconstructive Surgery. 2000 December; 106(7): 1663-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11129210&dopt=Abstract
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Massive localized lymphedema: additional locations and association with hypothyroidism. Author(s): Wu D, Gibbs J, Corral D, Intengan M, Brooks JJ. Source: Human Pathology. 2000 September; 31(9): 1162-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11014586&dopt=Abstract
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Massive periorbital lymphedema after excision of cutaneous malignancy. Author(s): Lober CW, Haas BD. Source: Southern Medical Journal. 1998 April; 91(4): 411-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9563441&dopt=Abstract
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Merkel cell carcinoma after postmastectomy lymphedema. Author(s): Peterson CM, Lane JE, Guill MA. Source: Journal of the American Academy of Dermatology. 2003 June; 48(6): 983. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789202&dopt=Abstract
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Metastatic basal cell carcinoma presenting as unilateral lymphedema. Author(s): Christian MM, Murphy CM, Wagner RF Jr. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1998 October; 24(10): 1151-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9793528&dopt=Abstract
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Microcephaly/lymphedema and terminal deletion of the long arm of chromosome 13. Author(s): Fryns JP. Source: American Journal of Medical Genetics. 1995 July 3; 57(3): 504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7545871&dopt=Abstract
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Microcephaly-lymphedema syndrome: report of a family with short stature as additional manifestation. Author(s): Strenge S, Froster UG. Source: American Journal of Medical Genetics. 1998 December 28; 80(5): 506-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9880217&dopt=Abstract
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Microcephaly-lymphedema-chorioretinal dysplasia: a unique genetic syndrome with variable expression and possible characteristic facial appearance. Author(s): Limwongse C, Wyszynski RE, Dickerman LH, Robin NH. Source: American Journal of Medical Genetics. 1999 September 17; 86(3): 215-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10482868&dopt=Abstract
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Microsurgical lymphaticovenous implantation for the treatment of chronic lymphedema. Author(s): Yamamoto Y, Sugihara T. Source: Plastic and Reconstructive Surgery. 1998 January; 101(1): 157-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9427930&dopt=Abstract
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Microwave heating in the management of postmastectomy upper limb lymphedema. Author(s): Gan JL, Li SL, Cai RX, Chang TS. Source: Annals of Plastic Surgery. 1996 June; 36(6): 576-80; Discussion 580-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8792965&dopt=Abstract
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Minimizing secondary arm lymphedema from axillary dissection. Author(s): Clodius L. Source: Lymphology. 2001 September; 34(3): 106-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11549122&dopt=Abstract
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Morphologic and functional changes of the microlymphatic network in patients with advancing stages of primary lymphedema. Author(s): Bollinger A, Stanton AW, Mortimer PS. Source: Lymphology. 2003 June; 36(2): 92-3; Author Reply 93-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12926834&dopt=Abstract
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Morphologic and functional changes of the microlymphatic network in patients with advancing stages of primary lymphedema. Author(s): Allegra C, Sarcinella R, Bartolo M Jr. Source: Lymphology. 2002 September; 35(3): 114-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12363221&dopt=Abstract
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MR imaging of primary, secondary, and mixed forms of lymphedema. Author(s): Astrom KG, Abdsaleh S, Brenning GC, Ahlstrom KH. Source: Acta Radiologica (Stockholm, Sweden : 1987). 2001 July; 42(4): 409-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11442467&dopt=Abstract
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MRI and ultrasonographic findings in the investigation of lymphedema and lipedema. Author(s): Dimakakos PB, Stefanopoulos T, Antoniades P, Antoniou A, Gouliamos A, Rizos D. Source: Int Surg. 1997 October-December; 82(4): 411-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9412843&dopt=Abstract
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Multiple effusions and lymphedema in the yellow nail syndrome. Author(s): Riedel M. Source: Circulation. 2002 January 22; 105(3): E25-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11805000&dopt=Abstract
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Mutations in FOXC2 (MFH-1), a forkhead family transcription factor, are responsible for the hereditary lymphedema-distichiasis syndrome. Author(s): Fang J, Dagenais SL, Erickson RP, Arlt MF, Glynn MW, Gorski JL, Seaver LH, Glover TW. Source: American Journal of Human Genetics. 2000 December; 67(6): 1382-8. Epub 2000 November 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11078474&dopt=Abstract
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Mutations in the transcription factor gene SOX18 underlie recessive and dominant forms of hypotrichosis-lymphedema-telangiectasia. Author(s): Irrthum A, Devriendt K, Chitayat D, Matthijs G, Glade C, Steijlen PM, Fryns JP, Van Steensel MA, Vikkula M. Source: American Journal of Human Genetics. 2003 June; 72(6): 1470-8. Epub 2003 May 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740761&dopt=Abstract
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New possibilities in the pathogenesis of secondary lymphedema. Author(s): Hall JG. Source: Lymphology. 2002 September; 35(3): 129. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12363223&dopt=Abstract
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Non-invasive assessment of the lymphedematous limb. Author(s): Stanton AW, Badger C, Sitzia J. Source: Lymphology. 2000 September; 33(3): 122-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11019400&dopt=Abstract
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Not so massive localized lymphedema. Author(s): Brooks JS, Cihak RW. Source: Human Pathology. 2001 January; 32(1): 139. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11172310&dopt=Abstract
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Nuclear imaging in a patient with praecox lymphedema. Author(s): Tsai SC, Kao CH, Lin WY, Wang SJ. Source: Clinical Nuclear Medicine. 1996 November; 21(11): 907-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8922869&dopt=Abstract
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Nurses teach complete decongestive physiotherapy for lymphedema management. Author(s): Connell M, Rymal C. Source: Oncology Nursing Forum. 1997 May; 24(4): 640-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9159776&dopt=Abstract
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On the pathophysiology of arm lymphedema after treatment for breast cancer. Author(s): Foldi M. Source: Lymphology. 1995 September; 28(3): 151-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7475264&dopt=Abstract
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Osteopetrosis, lymphedema, anhidrotic ectodermal dysplasia, and immunodeficiency in a boy and incontinentia pigmenti in his mother. Author(s): Dupuis-Girod S, Corradini N, Hadj-Rabia S, Fournet JC, Faivre L, Le Deist F, Durand P, Doffinger R, Smahi A, Israel A, Courtois G, Brousse N, Blanche S, Munnich A, Fischer A, Casanova JL, Bodemer C. Source: Pediatrics. 2002 June; 109(6): E97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12042591&dopt=Abstract
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Overcoming lymphedema. Author(s): Brown JL. Source: Rehab Manag. 2003 July; 16(6): 34-7, 50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12861775&dopt=Abstract
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Overview of treatment options and review of the current role and use of compression garments, intermittent pumps, and exercise in the management of lymphedema. Author(s): Brennan MJ, Miller LT. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2821-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874405&dopt=Abstract
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Pasteurella multocida arthritis of the shoulder associated with postsurgical lymphedema. Author(s): Fellows L, Boivin M, Kapusta M. Source: The Journal of Rheumatology. 1996 October; 23(10): 1824-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8895169&dopt=Abstract
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Persistence of lymphedema reduction after noninvasive complex lymphedema therapy. Author(s): Boris M, Weindorf S, Lasinkski S. Source: Oncology (Huntingt). 1997 January; 11(1): 99-109; Discussion 110, 113-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9115856&dopt=Abstract
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Persistent lower eyelid lymphedema after Le Fort III maxillary fracture. Author(s): Akoz T, Erdogan B, Gorgu M, Ayhan M. Source: Plastic and Reconstructive Surgery. 1998 March; 101(3): 858-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9500411&dopt=Abstract
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Phenotypic and genotypic heterogeneity in familial Milroy lymphedema. Author(s): Witte MH, Erickson R, Bernas M, Andrade M, Reiser F, Conlon W, Hoyme HE, Witte CL. Source: Lymphology. 1998 December; 31(4): 145-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9949386&dopt=Abstract
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Physical therapist management of lymphedema following treatment for breast cancer: a critical review of its effectiveness. Author(s): Megens A, Harris SR. Source: Physical Therapy. 1998 December; 78(12): 1302-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9859949&dopt=Abstract
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Physical therapists play an important role in treating lymphedema. Author(s): Augustine E. Source: Oncology Nursing Forum. 1996 April; 23(3): 421-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8801502&dopt=Abstract
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Physical therapy intervention following surgical treatment of carpal tunnel syndrome in an individual with a history of postmastectomy lymphedema. Author(s): Donachy JE, Christian EL. Source: Physical Therapy. 2002 October; 82(10): 1009-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12350215&dopt=Abstract
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Physiotherapy results in a baby with congenital lymphedema: a follow-up study. Author(s): Akbayrak T, Citak I, Demirturk F, Kerem M, Akarcali I. Source: Turk J Pediatr. 2002 October-December; 44(4): 349-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12458815&dopt=Abstract
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Possibilities and restriction of isotopic lymphography for the assessment of therapeutic effects in lymphedema. Author(s): Pecking AP. Source: Wiener Medizinische Wochenschrift (1946). 1999; 149(2-4): 105-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10378340&dopt=Abstract
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Possible new autosomal recessive syndrome of lymphedema, hydroceles, atrial septal defect, and characteristic facial changes. Author(s): Irons MB, Bianchi DW, Geggel RL, Marx GR, Bhan I. Source: American Journal of Medical Genetics. 1996 December 2; 66(1): 69-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8957515&dopt=Abstract
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Postmastectomy lymphedema management: evolution of the complex decongestive therapy technique. Author(s): Daane S, Poltoratszy P, Rockwell WB. Source: Annals of Plastic Surgery. 1998 February; 40(2): 128-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9495459&dopt=Abstract
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Postsurgical dermal lymphedema clinically mimicking inflammatory breast carcinoma. Author(s): King R, Duncan L, Shupp DL, Googe PB. Source: Archives of Dermatology. 2001 July; 137(7): 969-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11453830&dopt=Abstract
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Post-therapeutic lymphedema: scintigraphy before and after autologous lymph vessel transplantation: 8 years of long-term follow-up. Author(s): Weiss M, Baumeister RG, Hahn K. Source: Clinical Nuclear Medicine. 2002 November; 27(11): 788-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394126&dopt=Abstract
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Precipitating factors in lymphedema: myths and realities. Author(s): Rockson SG. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2814-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874403&dopt=Abstract
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Predominant CD8+ infiltrate in limb biopsies of individuals with filarial lymphedema and elephantiasis. Author(s): Freedman DO, Horn TD, Maia e Silva CM, Braga C, Maciel A. Source: The American Journal of Tropical Medicine and Hygiene. 1995 December; 53(6): 633-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8561266&dopt=Abstract
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Prenatal diagnosis of Milroy's primary congenital lymphedema. Author(s): Makhoul IR, Sujov P, Ghanem N, Bronshtein M. Source: Prenatal Diagnosis. 2002 September; 22(9): 823-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12224079&dopt=Abstract
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Prenatal diagnosis of Nonne-Milroy lymphedema. Author(s): Franceschini P, Licata D, Rapello G, Guala A, Di Cara G, Franceschini D. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2001 August; 18(2): 182-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11547763&dopt=Abstract
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Prenatal ultrasonographic diagnosis of atypical Nonne-Milroy lymphedema. Author(s): Lev-Sagie A, Hamani Y, Raas-Rothschild A, Yagel S, Anteby EY. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2003 January; 21(1): 72-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12528167&dopt=Abstract
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Preservation of muscle fascia to decrease lymphedema after complete axillary and ilioinguinofemoral lymphadenectomy for melanoma. Author(s): Lawton G, Rasque H, Ariyan S. Source: Journal of the American College of Surgeons. 2002 September; 195(3): 339-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12229941&dopt=Abstract
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Prevention and treatment of lymphedema after breast cancer. Author(s): Price J, Purtell JR. Source: The American Journal of Nursing. 1997 September; 97(9): 34-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9311336&dopt=Abstract
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Prevention of secondary lymphedema. Author(s): Pissas A, Rzal K, Math ML, el Nasser M, Dubois JB. Source: Ann Ital Chir. 2002 September-October; 73(5): 489-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12704988&dopt=Abstract
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Primary amyloidosis of the mesentery and the retroperitoneum presenting with lymphedema. Author(s): Halm U, Berr F, Tannapfel A, Kloppel R, Secknus R, Mossner J. Source: The American Journal of Gastroenterology. 1998 November; 93(11): 2299-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9820426&dopt=Abstract
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Primary congenital lymphedema. A case report. Author(s): Gragnani SG, Michelotti F, Rocca R, Sardi R, Bardini N. Source: Minerva Pediatr. 1999 June; 51(6): 217-9. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10544636&dopt=Abstract
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Primary cutaneous B-cell lymphoma of the leg in a chronic lymphedematous extremity. Author(s): Torres-Paoli D, Sanchez JL. Source: The American Journal of Dermatopathology. 2000 June; 22(3): 257-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10871070&dopt=Abstract
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Primary lymphedema of the genitalia in children and adolescents. Author(s): Ross JH, Kay R, Yetman RJ, Angermeier K. Source: The Journal of Urology. 1998 October; 160(4): 1485-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9751400&dopt=Abstract
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Primary lymphedema of the penis: surgical correction by preputial unfurling. Author(s): Shenoy VG, Jawale SA, Oak SN, Kulkarni BK. Source: Pediatric Surgery International. 2001 March; 17(2-3): 169-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11315280&dopt=Abstract
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Prognostic factors for lymphedema after primary treatment of breast carcinoma. Author(s): Herd-Smith A, Russo A, Muraca MG, Del Turco MR, Cardona G. Source: Cancer. 2001 October 1; 92(7): 1783-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11745250&dopt=Abstract
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Prophylaxis of recurrent lymphangitis complicating lymphedema. Author(s): Babb RR, Spittell JA Jr, Martin WJ, Schirger A. Source: Jama : the Journal of the American Medical Association. 1966 March 7; 195(10): 871-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608187&dopt=Abstract
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Psoriasis arthropathy and lymphedema. Author(s): Yamamoto T, Nishioka K. Source: The Journal of Dermatology. 2002 December; 29(12): 812-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12532050&dopt=Abstract
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Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Author(s): Passik SD, McDonald MV. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2817-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874404&dopt=Abstract
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Pumps and lymphedema. Author(s): Witte CL. Source: Lymphology. 2001 December; 34(4): 150-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11783591&dopt=Abstract
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Quality of life and peripheral lymphedema. Author(s): Pereira de Godoy JM, Braile DM, de Fatima Godoy M, Longo O Jr. Source: Lymphology. 2002 June; 35(2): 72-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12081054&dopt=Abstract
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Quality of life of breast cancer patients with lymphedema. Author(s): Velanovich V, Szymanski W. Source: American Journal of Surgery. 1999 March; 177(3): 184-7; Discussion 188. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10219851&dopt=Abstract
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Quantification of lymphatic function for investigation of lymphedema: depot clearance and rate of appearance of soluble macromolecules in blood. Author(s): Pain SJ, Nicholas RS, Barber RW, Ballinger JR, Purushotham AD, Mortimer PS, Peters AM. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 2002 March; 43(3): 318-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11884490&dopt=Abstract
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Quantitative radionuclide lymphoscintigraphy predicts outcome of manual lymphatic therapy in breast cancer-related lymphedema of the upper extremity. Author(s): Szuba A, Strauss W, Sirsikar SP, Rockson SG. Source: Nuclear Medicine Communications. 2002 December; 23(12): 1171-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464781&dopt=Abstract
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Radical excision and delayed reconstruction of a lymphedematous leg with a 15 year follow-up. Author(s): Dumanian GA, Futrell JW. Source: Lymphology. 1996 March; 29(1): 20-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8721975&dopt=Abstract
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Radionuclide lymphangioscintigraphy in the evaluation of peripheral lymphedema. Author(s): Williams WH, Witte CL, Witte MH, McNeill GC. Source: Clinical Nuclear Medicine. 2000 June; 25(6): 451-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10836695&dopt=Abstract
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Reactivity to bacterial, fungal, and parasite antigens in patients with lymphedema and elephantiasis. Author(s): Baird JB, Charles JL, Streit TG, Roberts JM, Addiss DG, Lammie PJ. Source: The American Journal of Tropical Medicine and Hygiene. 2002 February; 66(2): 163-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12135288&dopt=Abstract
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Recurrent cellulitis complicating chronic lymphedema. Author(s): Woodruff A, Olivero JJ. Source: Hosp Pract (Off Ed). 1995 March 15; 30(3): 87, 91. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7883813&dopt=Abstract
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Regarding “Lower extremity lymphedema caused by acquired immune deficiency syndrome-related Kaposi's sarcoma”. Author(s): Dougherty M, Calligaro KD, DeLaurentis DA. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1996 February; 23(2): 378. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8637119&dopt=Abstract
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Rehabilitation protocol in upper limb lymphedema. Author(s): Leduc O, Leduc A. Source: Ann Ital Chir. 2002 September-October; 73(5): 479-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12704986&dopt=Abstract
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Risk factors of arm lymphedema in breast cancer patients. Author(s): Kocak Z, Overgaard J. Source: Acta Oncologica (Stockholm, Sweden). 2000; 39(3): 389-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10987236&dopt=Abstract
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Risk of lymphedema after regional nodal irradiation with breast conservation therapy. Author(s): Coen JJ, Taghian AG, Kachnic LA, Assaad SI, Powell SN. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 April 1; 55(5): 1209-15. Review. Erratum In: Int J Radiat Oncol Biol Phys. 2003 June 1; 56(2): 604. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654429&dopt=Abstract
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Rosaceous lymphedema: a rare variant of a common disorder. Author(s): Harvey DT, Fenske NA, Glass LF. Source: Cutis; Cutaneous Medicine for the Practitioner. 1998 June; 61(6): 321-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9640553&dopt=Abstract
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Segregation analyses and a genome-wide linkage search confirm genetic heterogeneity and suggest oligogenic inheritance in some Milroy congenital primary lymphedema families. Author(s): Holberg CJ, Erickson RP, Bernas MJ, Witte MH, Fultz KE, Andrade M, Witte CL. Source: American Journal of Medical Genetics. 2001 February 1; 98(4): 303-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11170072&dopt=Abstract
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Selenium in the treatment of radiation-associated secondary lymphedema. Author(s): Micke O, Bruns F, Mucke R, Schafer U, Glatzel M, DeVries AF, Schonekaes K, Kisters K, Buntzel J. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 May 1; 56(1): 40-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694822&dopt=Abstract
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Sentinel lymph node biopsy lowers the rate of lymphedema when compared with standard axillary lymph node dissection. Author(s): Golshan M, Martin WJ, Dowlatshahi K. Source: The American Surgeon. 2003 March; 69(3): 209-11; Discussion 212. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12678476&dopt=Abstract
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Serum immunoglobulins, IL-1beta, IL-2, and IFN-gamma gamma level in patients with lymphedema treated with ortho-beta-hydroxy-ethyl rutosides (HR). Author(s): de Schenquer DG, Schenquer N. Source: Archives of Medical Research. 2001 March-April; 32(2): 129-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11343810&dopt=Abstract
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Severe lower limbs lymphedema of late onset revealing polysplenia syndrome--a case report. Author(s): Granel B, Serratrice J, Juhan V, Champsaur P, Weiller-Merli C, Pache X, Swiader L, Disdier P, Weiller PJ. Source: Angiology. 2001 June; 52(6): 421-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11437033&dopt=Abstract
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Severe lymphedema, intestinal lymphangiectasia, seizures and mild mental retardation: further case of Hennekam syndrome with a severe phenotype. Author(s): Forzano F, Faravelli F, Loy A, Di Rocco M. Source: American Journal of Medical Genetics. 2002 July 22; 111(1): 68-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12124738&dopt=Abstract
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Skin blood flow of the lymphedematous arm before and after liposuction. Author(s): Brorson H, Svensson H. Source: Lymphology. 1997 December; 30(4): 165-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9476248&dopt=Abstract
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Skin failure and lymphedema. Author(s): Ryan TJ. Source: Lymphology. 1995 December; 28(4): 171-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8771009&dopt=Abstract
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Skin graft reconstruction of chronic genital lymphedema. Author(s): Morey AF, Meng MV, McAninch JW. Source: Urology. 1997 September; 50(3): 423-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9301709&dopt=Abstract
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Sodium selenite as prophylaxis against erysipelas in secondary lymphedema. Author(s): Kasseroller R. Source: Anticancer Res. 1998 May-June; 18(3C): 2227-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9703790&dopt=Abstract
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Spontaneous chylothorax associated with primary lymphedema and a lymphangioma malformation. Author(s): Dagenais F, Ferraro P, Duranceau A. Source: The Annals of Thoracic Surgery. 1999 May; 67(5): 1480-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10355439&dopt=Abstract
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Squamous cell carcinoma in chronic lymphedema: case report and review of the literature. Author(s): Furukawa H, Yamamoto Y, Minakawa H, Sugihara T. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2002 October; 28(10): 951-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12410682&dopt=Abstract
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Staged skin and subcutaneous excision for lymphedema: a favorable report of longterm results. Author(s): Miller TA, Wyatt LE, Rudkin GH. Source: Plastic and Reconstructive Surgery. 1998 October; 102(5): 1486-98; Discussion 1499-501. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9774002&dopt=Abstract
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Stewart-Treves angiosarcoma of arm and ipsilateral breast in post-traumatic lymphedema. Author(s): Trattner A, Shamai-Lubovitz O, Segal R, Zelikovski A. Source: Lymphology. 1996 June; 29(2): 57-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8823727&dopt=Abstract
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Successful complex decongestive physiotherapy for lymphedema and lymphocutaneous reflux of the female external genitalia after radiation therapy. Author(s): Liao SF, Huang MS, Chou YH, Wei TS. Source: J Formos Med Assoc. 2003 June; 102(6): 404-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12923593&dopt=Abstract
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Supermicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema in the upper extremities. Author(s): Koshima I, Inagawa K, Urushibara K, Moriguchi T. Source: Journal of Reconstructive Microsurgery. 2000 August; 16(6): 437-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10993089&dopt=Abstract
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Surgical outcomes after breast cancer surgery: measuring acute lymphedema. Author(s): Kosir MA, Rymal C, Koppolu P, Hryniuk L, Darga L, Du W, Rice V, Mood D, Shakoor S, Wang W, Bedoyan J, Aref A, Biernat L, Northouse L. Source: The Journal of Surgical Research. 2001 February; 95(2): 147-51. Erratum In: J Surg Res 2001 April; 96(2): 304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11162038&dopt=Abstract
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Surgical treatment and lymphedema. Author(s): Pressman PI. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2782-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874398&dopt=Abstract
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Surgical treatment of penile-scrotal lymphedema. Author(s): Guedes Neto HJ. Source: Lymphology. 1996 September; 29(3): 132-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8897358&dopt=Abstract
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Symptomatic skeletal muscle metastasis and elephantiastic lymphedema in a patient with recurrent ovarian carcinoma. Author(s): Foldi M, Randelzhofer B, Gitsch G. Source: Gynecologic Oncology. 2003 August; 90(2): 471-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893222&dopt=Abstract
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The diagnosis and treatment of peripheral lymphedema. Consensus document of the International Society of Lymphology. Author(s): International Society of Lymphology. Source: Lymphology. 2003 June; 36(2): 84-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12926833&dopt=Abstract
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The diagnosis and treatment of peripheral lymphedema: draft revision of the 1995 Consensus Document of the International Society of Lymphology Executive Committee for discussion at the September 3-7, 2001, XVIII International Congress of Lymphology in Genoa, Italy. Author(s): Bernas MJ, Witte CL, Witte MH; International Society of Lymphology Executive Committee. Source: Lymphology. 2001 June; 34(2): 84-91. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11471576&dopt=Abstract
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The effect of complete decongestive therapy on the quality of life of patients with peripheral lymphedema. Author(s): Weiss JM, Spray BJ. Source: Lymphology. 2002 June; 35(2): 46-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12081052&dopt=Abstract
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The effects of Unguentum Lymphaticum on skin in patients with obstructive lymphedema of the lower extremities. Author(s): Olszewski WL, Kubicka U. Source: Lymphology. 2002 December; 35(4): 171-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12570326&dopt=Abstract
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The experience of lower limb lymphedema for women after treatment for gynecologic cancer. Author(s): Ryan M, Stainton MC, Jaconelli C, Watts S, MacKenzie P, Mansberg T. Source: Oncology Nursing Forum. 2003 May-June; 30(3): 417-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719742&dopt=Abstract
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The incidence of co-morbidities in the treatment of lymphedema. Author(s): Carson CJ, Coverly K, Lasker-Hertz S. Source: J Oncol Manag. 1999 July-August; 8(4): 13-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10539520&dopt=Abstract
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The pathogenesis of filarial lymphedema: is it the worm or is it the host? Author(s): Lammie PJ, Cuenco KT, Punkosdy GA. Source: Annals of the New York Academy of Sciences. 2002 December; 979: 131-42; Discussion 188-96. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543723&dopt=Abstract
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The pathophysiology of lymphedema. Author(s): Mortimer PS. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2798-802. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874400&dopt=Abstract
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The quality of life after breast cancer--solving the problem of lymphedema. Author(s): Ganz PA. Source: The New England Journal of Medicine. 1999 February 4; 340(5): 383-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9929532&dopt=Abstract
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The risk of genital edema after external pump compression for lower limb lymphedema. Author(s): Boris M, Weindorf S, Lasinski BB. Source: Lymphology. 1998 March; 31(1): 15-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9561507&dopt=Abstract
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The role of operative management of varicose veins in patients with lymphedema and/or lipedema of the legs. Author(s): Foldi M, Idiazabal G. Source: Lymphology. 2000 December; 33(4): 167-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191657&dopt=Abstract
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The role of pneumatic compression in the treatment of postmastectomy lymphedema. A randomized phase III study. Author(s): Dini D, Del Mastro L, Gozza A, Lionetto R, Garrone O, Forno G, Vidili G, Bertelli G, Venturini M. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 1998 February; 9(2): 187-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9553664&dopt=Abstract
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The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. Author(s): Szuba A, Shin WS, Strauss HW, Rockson S. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 2003 January; 44(1): 43-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12515876&dopt=Abstract
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The treatment of lymphedema. Author(s): Foldi E. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2833-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874407&dopt=Abstract
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The treatment of lymphedema. Author(s): Laverson S. Source: Plastic and Reconstructive Surgery. 1999 September; 104(4): 1207-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10654776&dopt=Abstract
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The use of vein grafts in the treatment of peripheral lymphedemas: long-term results. Author(s): Campisi C, Boccardo F, Zilli A, Maccio A, Napoli F. Source: Microsurgery. 2001; 21(4): 143-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11494381&dopt=Abstract
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Therapy approaches for lymphedema. Author(s): Mortimer PS. Source: Angiology. 1997 January; 48(1): 87-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8995349&dopt=Abstract
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There are many benzo-pyrones for lymphedema. Author(s): Casley-Smith JR. Source: Lymphology. 1997 March; 30(1): 38-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9106139&dopt=Abstract
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Time- and dose-limiting erysipeloid rash confined to areas of lymphedema following treatment with gemcitabine--a report of three cases. Author(s): Brandes A, Reichmann U, Plasswilm L, Bamberg M. Source: Anti-Cancer Drugs. 2000 January; 11(1): 15-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10757558&dopt=Abstract
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Transaxial computer tomography of lower extremity lymphedema. Author(s): Marotel M, Cluzan R, Ghabboun S, Pascot M, Alliot F, Lasry JL. Source: Lymphology. 1998 December; 31(4): 180-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9949389&dopt=Abstract
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Treatment for lymphedema of the arm--the Casley-Smith method: a noninvasive method produces continued reduction. Author(s): Casley-Smith JR, Boris M, Weindorf S, Lasinski B. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2843-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874410&dopt=Abstract
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Treatment of breast-cancer-related lymphedema with or without manual lymphatic drainage--a randomized study. Author(s): Andersen L, Hojris I, Erlandsen M, Andersen J. Source: Acta Oncologica (Stockholm, Sweden). 2000; 39(3): 399-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10987238&dopt=Abstract
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Treatment of chronic postmastectomy lymphedema with low level laser therapy: a 2.5 year follow-up. Author(s): Piller NB, Thelander A. Source: Lymphology. 1998 June; 31(2): 74-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9664272&dopt=Abstract
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Treatment of lymphedema and patient rehabilitation. Author(s): Foldi E. Source: Anticancer Res. 1998 May-June; 18(3C): 2211-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9703785&dopt=Abstract
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Treatment of peripheral lymphedema by concomitant application of magnetic fields, vibration and hyperthermia: a preliminary report. Author(s): Ohkuma M. Source: Lymphology. 2002 June; 35(2): 87-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12081056&dopt=Abstract
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Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial. Author(s): Carati CJ, Anderson SN, Gannon BJ, Piller NB. Source: Cancer. 2003 September 15; 98(6): 1114-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12973834&dopt=Abstract
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Treatment of secondary lymphedema of the arm with physical decongestive therapy and sodium selenite: a review. Author(s): Kasseroller RG, Schrauzer GN. Source: American Journal of Therapeutics. 2000 August; 7(4): 273-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11486162&dopt=Abstract
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Trends in the evaluation of lymphedema. Author(s): Caban ME. Source: Lymphology. 2002 March; 35(1): 28-38. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11939570&dopt=Abstract
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Truncating mutations in FOXC2 cause multiple lymphedema syndromes. Author(s): Finegold DN, Kimak MA, Lawrence EC, Levinson KL, Cherniske EM, Pober BR, Dunlap JW, Ferrell RE. Source: Human Molecular Genetics. 2001 May 15; 10(11): 1185-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11371511&dopt=Abstract
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Tuberous sclerosis associated with congenital lymphedema. Author(s): Hirsch RJ, Silverberg NB, Laude T, Weinberg JM. Source: Pediatric Dermatology. 1999 September-October; 16(5): 407-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10627220&dopt=Abstract
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Ultrastructural observations of lymphatic vessels in lymphedema in human extremities. Author(s): Koshima I, Kawada S, Moriguchi T, Kajiwara Y. Source: Plastic and Reconstructive Surgery. 1996 February; 97(2): 397-405; Discussion 406-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8559823&dopt=Abstract
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Upper limb lymphedema in inflammatory arthropathy. Author(s): Salvarani C. Source: The Journal of Rheumatology. 1995 February; 22(2): 370. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7738969&dopt=Abstract
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Upper-extremity volume measurements in women with lymphedema: a comparison of measurements obtained via water displacement with geometrically determined volume. Author(s): Sander AP, Hajer NM, Hemenway K, Miller AC. Source: Physical Therapy. 2002 December; 82(12): 1201-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444879&dopt=Abstract
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Use of the C-scan in evaluation of peripheral lymphedema. Author(s): Ketterings C, Zeddeman S. Source: Lymphology. 1997 June; 30(2): 49-62. Erratum In: Lymphology 1997 December; 30(4): 203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9215975&dopt=Abstract
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Using lymphoscintigraphy to evaluate suspected lymphedema of the extremities. Author(s): Moshiri M, Katz DS, Boris M, Yung E. Source: Ajr. American Journal of Roentgenology. 2002 February; 178(2): 405-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11804905&dopt=Abstract
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Venous dynamics in leg lymphedema. Author(s): Kim DI, Huh S, Hwang JH, Kim YI, Lee BB. Source: Lymphology. 1999 March; 32(1): 11-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10197322&dopt=Abstract
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Vulvar hypertrophy with lymphedema. A mimicker of aggressive angiomyxoma. Author(s): Vang R, Connelly JH, Hammill HA, Shannon RL. Source: Archives of Pathology & Laboratory Medicine. 2000 November; 124(11): 1697-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11079029&dopt=Abstract
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Well-differentiated liposarcoma (atypical lipoma) of the lower extremity in a patient with bilateral leg lipodystrophy and lymphedema. Author(s): Wyatt LE, Gresens CJ, Miller TA. Source: Plastic and Reconstructive Surgery. 1996 November; 98(6): 1076-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8911481&dopt=Abstract
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What advice can I give my patients with lymphedema? Author(s): Ramos SM. Source: The Western Journal of Medicine. 1999 May; 170(5): 282-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10379221&dopt=Abstract
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Women's experiences of lymphedema. Author(s): Carter BJ. Source: Oncology Nursing Forum. 1997 June; 24(5): 875-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9201739&dopt=Abstract
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CHAPTER 2. NUTRITION AND LYMPHEDEMA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and lymphedema.
Finding Nutrition Studies on Lymphedema 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 “lymphedema” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
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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 “lymphedema” (or a synonym): •
A multiscintigraphic approach to imaging of lymphedema and other causes of the congenitally enlarged extremity. Author(s): Department of Medical Imaging, Alfred I duPont Institute, Wilmington, DE 19899. Source: Mandell, G A Alexander, M A Harcke, H T Semin-Nucl-Med. 1993 October; 23(4): 334-46 0001-2998
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Advances in symptom management: lymphedema. Source: O'Rourke, M E Clin-J-Oncol-Nurs. 1999 July; 3(3): 125-6 1092-1095
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Atypical neutrophilic dermatosis on the upper extremity affected by postmastectomy lymphedema: report of 2 cases. Author(s): Department of Dermatology, Sanuma General Hospital, Sendai, Japan. Source: Demitsu, T Tadaki, T Dermatologica. 1991; 183(3): 230-3 0011-9075
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Comparative study of the clinical efficacy of two different coumarin dosages in the management of arm lymphedema after treatment for breast cancer. Author(s): Laboratorios Knoll, Madrid, Spain. Source: Burgos, A Alcaide, A Alcoba, C Azcona, J M Garrido, J Lorente, C Moreno, E Murillo, E Olsina Pavia, J Olsina Kissler, J Samaniego, E Serra, M Lymphology. 1999 March; 32(1): 3-10 0024-7766
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Dietary treatment of lymphedema by restriction of long-chain triglycerides. Author(s): Department of Nutrition and Dietetics, Hospital Ramon y Cajal, Madrid, Spain. Source: Soria, P Cuesta, A Romero, H Martinez, F J Sastre, A Angiology. 1994 August; 45(8): 703-7 0003-3197
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Effect of Endotelon (procyanidolic oligomers) on experimental acute lymphedema of the rat hindlimb. Author(s): Department of General Pharmacology Sanofi-Recherche, Montpellier, France. Source: Doutremepuich, J D Barbier, A Lacheretz, F Lymphology. 1991 September; 24(3): 135-9 0024-7766
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Efficacy of Daflon 500 mg in the treatment of lymphedema (secondary to conventional therapy of breast cancer). Author(s): Department of Nuclear Medicine, Centre Rene Hugenin, Saint Cloud, France. Source: Pecking, A P Fevrier, B Wargon, C Pillion, G Angiology. 1997 January; 48(1): 938 0003-3197
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Evaluation by lymphoscintigraphy of the effect of a micronized flavonoid fraction (Daflon 500 mg) in the treatment of upper limb lymphedema. Author(s): Centre Rene Huguenin, Department of Nuclear Medicine, Saint Cloud, France. Source: Pecking, A P Int-Angiol. 1995 September; 14(3 Suppl 1): 39-43 0392-9590
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Lack of effect of coumarin in women with lymphedema after treatment for breast cancer. Author(s): Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
[email protected] Source: Loprinzi, C L Kugler, J W Sloan, J A Rooke, T W Quella, S K Novotny, P Mowat, R B Michalak, J C Stella, P J Levitt, R Tschetter, L K Windschitl, H N-Engl-J-Med. 1999 February 4; 340(5): 346-50 0028-4793
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Lymphedema of the lower extremities: evaluation by microcolloidal imaging. Author(s): Department of Radiation Oncology and Nuclear Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107. Source: Intenzo, C M Desai, A G Kim, S S Park, C H Merli, G J Clin-Nucl-Med. 1989 February; 14(2): 107-10 0363-9762
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Lymphoscintigraphy to confirm the clinical diagnosis of lymphedema. Author(s): Division of Vascular Surgery, Johns Hopkins Medical Institutions, Baltimore, MD. Source: Golueke, P J Montgomery, R A Petronis, J D Minken, S L Perler, B A Williams, G M J-Vasc-Surg. 1989 September; 10(3): 306-12 0741-5214
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Measurement of lymphatic flow variation by noninvasive method cases of lymphedema. Author(s): Service des Urgences, Vandoeuvre-Les-Nancy, France. Source: Thibaut, G Durand, A Follignoni, P Bertrand, A Angiology. 1992 July; 43(7): 56771 0003-3197
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Reduction of filaritic lymphoedema and elephantiasis by 5,6 benzo-alpha-pyrone (coumarin), and the effects of diethylcarbamazine (DEC). Author(s): Henry Thomas Laboratory, University of Adelaide, Australia. Source: Casley Smith, J R Jamal, S Casley Smith, J Ann-Trop-Med-Parasitol. 1993 June; 87(3): 247-58 0003-4983
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Serum immunoglobulins, IL-1beta, IL-2, and IFN-gamma gamma level in patients with lymphedema treated with ortho-beta-hydroxy-ethyl rutosides (HR). Author(s): Seccion de Inmunologia, Facultad de Ciencias Medicas, Universidad Nacional, Rosario, Argentina. Source: de Schenquer, D G Schenquer, N Arch-Med-Res. 2001 Mar-April; 32(2): 129-35 0188-4409
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Sodium selenite as prophylaxis against erysipelas in secondary lymphedema. Author(s): Wittlinger's Therapy Center, Walchsee, Austria. Source: Kasseroller, R Anticancer-Res. 1998 May-June; 18(3C): 2227-30 0250-7005
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Spontaneous cluster formation of dendritic (veiled) cells and lymphocytes from skin lymph obtained from dogs with chronic lymphedema. Author(s): Department of Surgical Research and Transplantation, Polish Academy of Sciences, Warsaw. Source: Galkowska, H Olszewski, W L Lymphology. 1992 September; 25(3): 106-13 00247766
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The effects of 5,6 benzo-[a]-pyrone (coumarin) and DEC on filaritic lymphoedema and elephantiasis in India. Preliminary results. Author(s): Department Plastic Surgery, Madras Medical College, India. Source: Jamal, S Casley Smith, J R Casley Smith, J R Ann-Trop-Med-Parasitol. 1989 June; 83(3): 287-90 0003-4983
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The pathophysiology of lymphedema and the action of benzo-pyrones in reducing it. Author(s): Henry Thomas Laboratory (Microcirculation Research), University of Adelaide, Australia. Source: Casley Smith, J R Casley Smith, J R Lymphology. 1988 September; 21(3): 190-4 0024-7766
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The use of 5,6 benzo-[alpha]-pyrone (coumarin) and heating by microwaves in the treatment of chronic lymphedema of the legs. Author(s): Department of Plastic & Reconstructive Surgery, Ninth People's Hospital of Shanghai, Shanghai Second Medical University, China. Source: Chang, T S Gan, J L Fu, K D Huang, W Y Lymphology. 1996 September; 29(3): 106-11 0024-7766
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Topical treatment of acute hindlimb lymphedema of the rat using a troxerutinphosphatidylcholine complex in liposomal-like microdispersion. Author(s): Henry Thomas Lab, University of Adelaide, Australia. Source: Casley Smith, J R Casley Smith, J R Curri, S Foldi, M Lymphology. 1993 March; 26(1): 25-7 0024-7766
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Treatment of filarial lymphoedema and elephantiasis with 5,6-benzo-alpha-pyrone (coumarin). Author(s): Henry Thomas Laboratory, University of Adelaide, Australia. Source: Casley Smith, J R Wang, C T Casley Smith, J R Zi hai, C BMJ. 1993 October 23; 307(6911): 1037-41 0959-8138
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Treatment of lymphedema by complex physical therapy, with and without oral and topical benzopyrones: what should therapists and patients expect. Author(s): Henry Thomas Laboratory (Microcirculation Research), University of Adelaide, Australia. Source: Casley Smith, J R Casley Smith, J R Lymphology. 1996 June; 29(2): 76-82 00247766
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Treatment of secondary lymphedema of the arm with physical decongestive therapy and sodium selenite: a review. Author(s): Medical Department, Wittlinger's Therapy Center, Walchsee-Alpenbad GmbH, Walchsee, Austria. Source: Kasseroller, R G Schrauzer, G N Am-J-Ther. 2000 August; 7(4): 273-9 1075-2765
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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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER 3. ALTERNATIVE MEDICINE AND LYMPHEDEMA Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to lymphedema. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to lymphedema and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “lymphedema” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to lymphedema: •
A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema. Author(s): Johansson K, Lie E, Ekdahl C, Lindfeldt J. Source: Lymphology. 1998 June; 31(2): 56-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9664269&dopt=Abstract
•
A randomized, controlled, parallel-group clinical trial comparing multilayer bandaging followed by hosiery versus hosiery alone in the treatment of patients with lymphedema of the limb. Author(s): Badger CM, Peacock JL, Mortimer PS. Source: Cancer. 2000 June 15; 88(12): 2832-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10870068&dopt=Abstract
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Acquired lymphedema: a chart review of nine women's responses to intervention. Author(s): Dennis B.
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Source: Am J Occup Ther. 1993 October; 47(10): 891-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8109609&dopt=Abstract •
An analysis of prognostic factors in response to conservative treatment of postmastectomy lymphedema. Author(s): Bertelli G, Venturini M, Forno G, Macchiavello F, Dini D. Source: Surg Gynecol Obstet. 1992 November; 175(5): 455-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1440176&dopt=Abstract
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Anatomical and physiological basis for physical therapy of lymphedema. Author(s): Foldi M. Source: Experientia Suppl. 1978; 33: 15-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=282150&dopt=Abstract
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Can patients at risk for lymphedema use hot tubs? Author(s): Rymal C. Source: Clinical Journal of Oncology Nursing. 2002 November-December; 6(6): 369. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12434473&dopt=Abstract
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Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema. Author(s): Harris SR, Hugi MR, Olivotto IA, Levine M; Steering Committee for Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2001 January 23; 164(2): 191-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11332311&dopt=Abstract
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Combined physical therapy for lymphedema evaluated by fluorescence microlymphography and lymph capillary pressure measurements. Author(s): Franzeck UK, Spiegel I, Fischer M, Bortzler C, Stahel HU, Bollinger A. Source: Journal of Vascular Research. 1997 July-August; 34(4): 306-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9256091&dopt=Abstract
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Conservative approaches to lymphedema treatment. Author(s): Rinehart-Ayres ME. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2828-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874406&dopt=Abstract
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Current status of education and treatment resources for lymphedema. Author(s): Thiadens SR.
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Source: Cancer. 1998 December 15; 83(12 Suppl American): 2864-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874412&dopt=Abstract •
Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Author(s): Tiwari A, Cheng KS, Button M, Myint F, Hamilton G. Source: Archives of Surgery (Chicago, Ill. : 1960). 2003 February; 138(2): 152-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578410&dopt=Abstract
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Does medical treatment of lymphedema act by increasing lymph flow? Author(s): Francois A, Richaud C, Bouchet JY, Franco A, Comet M. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1989; 18(4): 281-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2609733&dopt=Abstract
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Effect of complex decongestive physiotherapy on gene expression for the inflammatory response in peripheral lymphedema. Author(s): Foldi E, Sauerwald A, Hennig B. Source: Lymphology. 2000 March; 33(1): 19-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10769812&dopt=Abstract
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Effect of Endotelon (procyanidolic oligomers) on experimental acute lymphedema of the rat hindlimb. Author(s): Doutremepuich JD, Barbier A, Lacheretz F. Source: Lymphology. 1991 September; 24(3): 135-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1753805&dopt=Abstract
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Effect of manual lymph drainage massage on urinary excretion of neurohormones and minerals in chronic lymphedema. Author(s): Kurz W, Wittlinger G, Litmanovitch YI, Romanoff H, Pfeifer Y, Tal E, Sulman FG. Source: Angiology. 1978 October; 29(10): 764-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=717839&dopt=Abstract
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Effect of manual lymphdrainage massage on blood components and urinary neurohormones in chronic lymphedema. Author(s): Kurz W, Kurz R, Litmanovitch YI, Romanoff H, Pfeifer Y, Sulman FG. Source: Angiology. 1981 February; 32(2): 119-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6163379&dopt=Abstract
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Effective treatment of lymphedema of the extremities. Author(s): Ko DS, Lerner R, Klose G, Cosimi AB.
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Source: Archives of Surgery (Chicago, Ill. : 1960). 1998 April; 133(4): 452-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9565129&dopt=Abstract •
Effectiveness of acupuncture and moxibustion treatment for lymphedema following intrapelvic lymph node dissection: a preliminary report. Author(s): Kanakura Y, Niwa K, Kometani K, Nakazawa K, Yamaguchi Y, Ishikawa H, Watanabe A, Tokunaga Y. Source: The American Journal of Chinese Medicine. 2002; 30(1): 37-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12067095&dopt=Abstract
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Effects of compression bandaging with or without manual lymph drainage treatment in patients with postoperative arm lymphedema. Author(s): Johansson K, Albertsson M, Ingvar C, Ekdahl C. Source: Lymphology. 1999 September; 32(3): 103-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10494522&dopt=Abstract
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Efficacy of Daflon 500 mg in the treatment of lymphedema (secondary to conventional therapy of breast cancer). Author(s): Pecking AP, Fevrier B, Wargon C, Pillion G. Source: Angiology. 1997 January; 48(1): 93-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8995350&dopt=Abstract
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Electron microscopy of the effects of Unguentum lymphaticum on acute experimental lymphedema and various high-protein edemas. Author(s): Casley-Smith JR. Source: Lymphology. 1983 December; 16(4): 233-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6664118&dopt=Abstract
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Evaluation by lymphoscintigraphy of the effect of a micronized flavonoid fraction (Daflon 500 mg) in the treatment of upper limb lymphedema. Author(s): Pecking AP. Source: International Angiology : a Journal of the International Union of Angiology. 1995 September; 14(3 Suppl 1): 39-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8919264&dopt=Abstract
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Evaluation of the results of three different methods of postmastectomy lymphedema treatment. Author(s): Zanolla R, Monzeglio C, Balzarini A, Martino G. Source: Journal of Surgical Oncology. 1984 July; 26(3): 210-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6738072&dopt=Abstract
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Excision of subcutaneous tissue and deep muscle fascia for advanced lymphedema. Author(s): Kim DI, Huh S, Lee SJ, Hwang JH, Kim YI, Lee BB.
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Source: Lymphology. 1998 December; 31(4): 190-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9949391&dopt=Abstract •
Limb volume reduction after physical treatment by compression and/or massage in a rodent model of peripheral lymphedema. Author(s): Kriederman B, Myloyde T, Bernas M, Lee-Donaldson L, Preciado S, Lynch M, Stea B, Summers P, Witte C, Witte M. Source: Lymphology. 2002 March; 35(1): 23-7. Erratum In: Lymphology 2002 June; 35(2): 96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11939569&dopt=Abstract
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Lymphedema 30 years after radical mastectomy. Author(s): Brennan MJ, Weitz J. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 1992 February; 71(1): 12-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1739437&dopt=Abstract
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Lymphedema and vitamins. Author(s): Foldi-Borcsok E, Foldi M. Source: The American Journal of Clinical Nutrition. 1973 February; 26(2): 185-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4703053&dopt=Abstract
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Lymphedema as a cause of unilateral leg swelling: a case report with 6-yr follow-up. Author(s): Mestan MA, Ameen J. Source: Journal of Manipulative and Physiological Therapeutics. 1998 September; 21(7): 479-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9777548&dopt=Abstract
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Lymphedema management. Author(s): Cheville AL, McGarvey CL, Petrek JA, Russo SA, Taylor ME, Thiadens SR. Source: Seminars in Radiation Oncology. 2003 July; 13(3): 290-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12903017&dopt=Abstract
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Lymphedema praecox. Author(s): Lewis JM, Wald ER. Source: The Journal of Pediatrics. 1984 May; 104(5): 641-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6371208&dopt=Abstract
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Lymphedema reduction by noninvasive complex lymphedema therapy. Author(s): Boris M, Weindorf S, Lasinski B, Boris G.
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Source: Oncology (Huntingt). 1994 September; 8(9): 95-106; Discussion 109-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7993730&dopt=Abstract •
Lymphedema. Author(s): Rockson SG. Source: Current Treatment Options in Cardiovascular Medicine. 2000 June; 2(3): 237-242. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11096529&dopt=Abstract
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Lymphedema: strategies for management. Author(s): Cohen SR, Payne DK, Tunkel RS. Source: Cancer. 2001 August 15; 92(4 Suppl): 980-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11519024&dopt=Abstract
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Malignant lymphoma of skin associated with postmastectomy lymphedema. Author(s): Waxman M, Fatteh S, Elias JM, Vuletin JC. Source: Archives of Pathology & Laboratory Medicine. 1984 March; 108(3): 206-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6546506&dopt=Abstract
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Manual lymphatic drainage for lymphedema limited to the breast. Author(s): Mondry TE, Johnstone PA. Source: Journal of Surgical Oncology. 2002 October; 81(2): 101-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12355412&dopt=Abstract
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On nonoperative management of chronic lymphedema. Author(s): Clodius L, Foldi E, Foldi M. Source: Lymphology. 1990 March; 23(1): 2-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2352439&dopt=Abstract
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Overview of treatment options and review of the current role and use of compression garments, intermittent pumps, and exercise in the management of lymphedema. Author(s): Brennan MJ, Miller LT. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2821-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874405&dopt=Abstract
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Persistence of lymphedema reduction after noninvasive complex lymphedema therapy. Author(s): Boris M, Weindorf S, Lasinkski S. Source: Oncology (Huntingt). 1997 January; 11(1): 99-109; Discussion 110, 113-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9115856&dopt=Abstract
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Physical treatment of postmastectomy lymphedema. Author(s): STILLWELL GK, REDFORD JW.
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Source: Mayo Clinic Proceedings. 1958 January 8; 33(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13505880&dopt=Abstract •
Physiotherapy results in a baby with congenital lymphedema: a follow-up study. Author(s): Akbayrak T, Citak I, Demirturk F, Kerem M, Akarcali I. Source: Turk J Pediatr. 2002 October-December; 44(4): 349-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12458815&dopt=Abstract
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Psychosocial benefits of postmastectomy lymphedema therapy. Author(s): Mirolo BR, Bunce IH, Chapman M, Olsen T, Eliadis P, Hennessy JM, Ward LC, Jones LC. Source: Cancer Nursing. 1995 June; 18(3): 197-205. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7600551&dopt=Abstract
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Rehabilitation of the postmastectomy patient with lymphedema. Author(s): Grabois M. Source: Ca: a Cancer Journal for Clinicians. 1976 March-April; 26(2): 75-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=816433&dopt=Abstract
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Rehabilitation protocol in upper limb lymphedema. Author(s): Leduc O, Leduc A. Source: Ann Ital Chir. 2002 September-October; 73(5): 479-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12704986&dopt=Abstract
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Relationship between lymphatic and venous pressure in normal and lymphedematous rabbit ears. Author(s): Huang GK, Hsin YP. Source: Microsurgery. 1984; 5(1): 36-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6708800&dopt=Abstract
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Serum immunoglobulins, IL-1beta, IL-2, and IFN-gamma gamma level in patients with lymphedema treated with ortho-beta-hydroxy-ethyl rutosides (HR). Author(s): de Schenquer DG, Schenquer N. Source: Archives of Medical Research. 2001 March-April; 32(2): 129-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11343810&dopt=Abstract
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Spontaneous cluster formation of dendritic (veiled) cells and lymphocytes from skin lymph obtained from dogs with chronic lymphedema. Author(s): Galkowska H, Olszewski WL. Source: Lymphology. 1992 September; 25(3): 106-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1434785&dopt=Abstract
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Successful complex decongestive physiotherapy for lymphedema and lymphocutaneous reflux of the female external genitalia after radiation therapy. Author(s): Liao SF, Huang MS, Chou YH, Wei TS. Source: J Formos Med Assoc. 2003 June; 102(6): 404-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12923593&dopt=Abstract
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The diagnosis and management of primary lymphedema. Author(s): Browse NL. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1986 January; 3(1): 181-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3510325&dopt=Abstract
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The effect of “Unguentum lymphaticum” on acute experimental lymphedema and other high-protein edemas. Author(s): Casley-Smith JR, Casley-Smith JR. Source: Lymphology. 1983 September; 16(3): 150-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6195489&dopt=Abstract
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The effects of Unguentum Lymphaticum on skin in patients with obstructive lymphedema of the lower extremities. Author(s): Olszewski WL, Kubicka U. Source: Lymphology. 2002 December; 35(4): 171-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12570326&dopt=Abstract
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The influence of local hyperthermia on lymphedema and lymphedematous skin of the human leg. Author(s): Liu NF, Olszewski W. Source: Lymphology. 1993 March; 26(1): 28-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8464223&dopt=Abstract
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The pathophysiology of lymphedema and the action of benzo-pyrones in reducing it. Author(s): Casley-Smith JR, Casley-Smith JR. Source: Lymphology. 1988 September; 21(3): 190-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3059075&dopt=Abstract
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The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. Author(s): Szuba A, Shin WS, Strauss HW, Rockson S. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 2003 January; 44(1): 43-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12515876&dopt=Abstract
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The treatment of experimental lymphedema. Author(s): Foldi-Borcsok E, Casley-Smith JR, Foldi M. Source: Angiologica. 1972; 9(2): 92-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4564850&dopt=Abstract
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The use of 5,6 benzo-[alpha]-pyrone (coumarin) and heating by microwaves in the treatment of chronic lymphedema of the legs. Author(s): Chang TS, Gan JL, Fu KD, Huang WY. Source: Lymphology. 1996 September; 29(3): 106-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8897354&dopt=Abstract
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Therapy approaches for lymphedema. Author(s): Mortimer PS. Source: Angiology. 1997 January; 48(1): 87-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8995349&dopt=Abstract
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Topical treatment of acute hindlimb lymphedema of the rat using a troxerutinphosphatidylcholine complex in liposomal-like microdispersion. Author(s): Casley-Smith JR, Casley-Smith JR, Curri S, Foldi M. Source: Lymphology. 1993 March; 26(1): 25-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8464222&dopt=Abstract
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Treatment for lymphedema of the arm--the Casley-Smith method: a noninvasive method produces continued reduction. Author(s): Casley-Smith JR, Boris M, Weindorf S, Lasinski B. Source: Cancer. 1998 December 15; 83(12 Suppl American): 2843-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874410&dopt=Abstract
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Treatment of breast-cancer-related lymphedema with or without manual lymphatic drainage--a randomized study. Author(s): Andersen L, Hojris I, Erlandsen M, Andersen J. Source: Acta Oncologica (Stockholm, Sweden). 2000; 39(3): 399-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10987238&dopt=Abstract
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Treatment of lymphedema by complex physical therapy, with and without oral and topical benzopyrones: what should therapists and patients expect. Author(s): Casley-Smith JR, Casley-Smith JR. Source: Lymphology. 1996 June; 29(2): 76-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8823730&dopt=Abstract
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Treatment of secondary lymphedema of the arm with physical decongestive therapy and sodium selenite: a review. Author(s): Kasseroller RG, Schrauzer GN.
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Source: American Journal of Therapeutics. 2000 August; 7(4): 273-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11486162&dopt=Abstract •
Treatment of secondary lymphedema of the upper limb with CYCLO 3 FORT. Author(s): Cluzan RV, Alliot F, Ghabboun S, Pascot M. Source: Lymphology. 1996 March; 29(1): 29-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8721977&dopt=Abstract
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What advice can I give my patients with lymphedema? Author(s): Ramos SM. Source: The Western Journal of Medicine. 1999 May; 170(5): 282-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10379221&dopt=Abstract
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Women's experiences of lymphedema. Author(s): Carter BJ. Source: Oncology Nursing Forum. 1997 June; 24(5): 875-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9201739&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
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The following is a specific Web list relating to lymphedema; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Cellulitis Source: Integrative Medicine Communications; www.drkoop.com Edema Source: Healthnotes, Inc.; www.healthnotes.com Skin Infection Source: Integrative Medicine Communications; www.drkoop.com
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Alternative Therapy Massage Source: Integrative Medicine Communications; www.drkoop.com
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Herbs and Supplements Calendula (Pot Marigold) Alternative names: Calendula officinalis Source: Integrative Medicine Communications; www.drkoop.com Calendula Officinalis Source: Integrative Medicine Communications; www.drkoop.com Centella Alternative names: Gotu Kola; Centella asiatica (Linn.) Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Ginkgo Alternative names: Ginkgo biloba Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org OPCS (Oligomeric Proanthocyanidins) Source: Prima Communications, Inc.www.personalhealthzone.com Pot Marigold Alternative names: Calendula officinalis Source: Integrative Medicine Communications; www.drkoop.com Zanthoxylum Alternative names: Prickly Ash; Zanthoxylum sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org
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General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON LYMPHEDEMA Overview In this chapter, we will give you a bibliography on recent dissertations relating to lymphedema. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “lymphedema” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on lymphedema, we have not necessarily excluded nonmedical dissertations in this bibliography.
Dissertations on Lymphedema ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to lymphedema. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
Incidence and Prevalence of Lymphedema in Patients Following Burn Injury: a Fiveyear Retrospective and Three-month Prospective Study by Hettrick, Heather Leigh; PhD from Nova Southeastern University, 2003, 88 pages http://wwwlib.umi.com/dissertations/fullcit/3089865
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND LYMPHEDEMA Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning lymphedema.
Recent Trials on Lymphedema The following is a list of recent trials dedicated to lymphedema.8 Further information on a trial is available at the Web site indicated. •
Axillary Drainage Following Lymph Node Dissection in Women With Stage I or Stage II Breast Cancer Condition(s): stage I breast cancer; stage perioperative/postoperative complications
II
breast
cancer;
Lymphedema;
Study Status: This study is currently recruiting patients. Sponsor(s): Royal Marsden NHS Trust Purpose - Excerpt: RATIONALE: The use of axillary drains may help to prevent complications following axillary lymph node dissection. PURPOSE: Randomized clinical trial to compare the effectiveness of three methods of axillary drainage following lymph node dissection in women who have stage I or stage II breast cancer. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005600 •
Fibrin Sealant in Decreasing Lymphedema Following Surgery to Remove Lymph Nodes in Patients With Cancer of the Vulva Condition(s): Lymphedema; perioperative/postoperative complications; stage I vulvar cancer; stage II vulvar cancer; stage III vulvar cancer; stage IV vulvar cancer Study Status: This study is currently recruiting patients.
8
These are listed at www.ClinicalTrials.gov.
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Sponsor(s): Gynecologic Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Fibrin sealant may decrease lymphedema following surgery to remove lymph nodes in the groin by helping to seal the lymphatic vessels. It is not yet known if fibrin sealant is effective in decreasing lymphedema following surgery to remove lymph nodes. PURPOSE: Randomized phase III trial to determine the effectiveness of fibrin sealant in reducing lymphedema following surgical removal of lymph nodes in patients who have cancer of the vulva. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00028951 •
Massage Therapy for Breast Cancer Treatment-Related Swelling of the Arms Condition(s): Lymphedema Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The purpose of this study is to examine the short-term and long-term efficacy of massage therapy alone compared to massage therapy plus compression bandaging in the treatment of breast cancer treatment-related swelling of the arms and legs. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00058851
•
Pycnogenol for the Treatment of Lymphedema of the Arm in Breast Cancer Survivors Condition(s): Lymphedema; Breast; Cancer Study Status: This study is not yet open for patient recruitment. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The goal of this study is to evaluate the effectiveness of a standardized botanical extract of Pycnogenol as a treatment for stable arm lymphedema in breast cancer survivors. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00064857
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions.
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The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “lymphedema” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON LYMPHEDEMA Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “lymphedema” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on lymphedema, we have not necessarily excluded nonmedical patents in this bibliography.
Patents on Lymphedema By performing a patent search focusing on lymphedema, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on lymphedema: •
Compression sleeve for treating lymphedema Inventor(s): Turtzo; Craig H. (Clearwater, FL) Assignee(s): MEDassist-OP, Inc. (Palm Harbor, FL) Patent Number: 6,254,554 Date filed: September 10, 1999 Abstract: A compression sleeve for treating lymphedema is provided. The compression sleeve is comprised of an outer inelastic fabric layer and an inner flexible sheet padding layer. A plurality of tightening straps are laterally disposed in vertical succession along an exterior side of the sleeve to independently apply circumferential pressure along the length of the sleeve. The sleeve is able to apply a consistent gradient pressure from a distal part of the limb to a proximal end of the limb to help squeeze excess lymph from the limb. The inner padding layer is comprised of a high density foam material provided in a thin, continuous surface, flat sheet and has a high degree of firmness capable of evenly distributing the pressure generated by the tightening straps to prevent pockets of swelling within the sleeve. The compression sleeve can be configured for use with both arms and legs. Excerpt(s): The present invention relates to a sleeve apparatus for applying compressive pressure to a person's arm or leg to facilitate the drainage of lymph fluid. An excessive amount of lymphatic fluid can accumulate in one's limb due to trauma to the lymphatic system, creating a condition called lymphedema. This is often seen, for instance, in the case of post-mastectomy patients who have had the lymph system compromised around the treated area. The result is swelling, discomfort, loss of range of motion and activities of daily living. Additionally, the lymph in the affected limb has a very high protein count and can be a potential breeding area for bacteria if the patient's skin is punctured. There is no viable surgical or pharmacological intervention available to cure lymphedema. The only effective treatment is called Complete Decongestive Physical Therapy ("CDP"). This treatment protocol involves manual lymph massage, bandaging, exercise and education in self-care. The bandaging is intended to create gradient pressure that is highest at the distal area of the limb and which steadily decreases up the limb towards the body. Because it is a goal to drain the limb of all excessive lymph fluid, it is important in the bandaging process to make sure that pockets in the bandages are avoided so that no pools of trapped lymph can be created along the surface of the person's arm. Self bandaging is time consuming and difficult for the patient to accomplish on his own. There have been several attempts to manufacture a product as a substitute for, or as an adjunct to, self bandaging. Some sleeves comprise an elastic outer shell which snuggly fits against the limb. However, the lymph engorged limb will stretch the outer fabric of the sleeve, therefore defeating its purpose as an effective source of compression. There also exist certain compression sleeves which comprise an inelastic outer sleeve which constrains the swelling of the limb, thus forcing the lymph to drain from the limb back towards the body. Many of these types of devices are intended to be used in conjunction with bandaging wraps and themselves do not provide padding. Needless to say, these types of sleeves can be quite uncomfortable for the patient. There further exists a compression sleeve which provides internal padding having several raised projections. This padding is of a low density type foam and is designed to apply pressure mainly along the points of the projections. The low density
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foam used in this sleeve is thick and bulky. When worn, it can inhibit flexion of the limb which can lead to discomfort. Further, with this type of sleeve, pooling of lymph fluid can occur at those points in the interstitial area between the raised projections. Accordingly, while lymph flow may be improved, maximum drainage of lymphatic fluid may be precluded. This type of sleeve is useful for prolonged wear, but is not consistent for use with complete decongestive physical therapy where the goal is maximum lymph drainage. Web site: http://www.delphion.com/details?pn=US06254554__ •
Electronic device for pneumomassage to reduce lymphedema Inventor(s): Villanueva; Raul (4102 Mischire, Houston, TX 77035) Assignee(s): none reported Patent Number: 4,374,518 Date filed: October 9, 1980 Abstract: The invention relates to a device for pneumomassage of a limb of a patient. The device is provided with an outer boot having a series of compartments which conform to the contour of a human foot and leg, the foot part of the boot having a rigid sole, and an inner boot having a single compartment. A compressor is provided for successively inflating and deflating the inner and outer boots in a rythmic, preselected cycle. A timer is provided for maintaining the pressure in the boots for an indefinite period of time and for raising the pressure at any time during the cycle. Excerpt(s): Lymphedema of the extremities is a disease that could be primary, such as congenital lymphedema, or secondary, such as following radical lymphnode disection of the axilla and/or groin as in treatment for cancer. Secondary lymphedema presents itself in many variables and one of the forms of treatment is an outside compression in order to help remove from the limb the extra lymph fluid that may accumulate every day in the subcutaneous tissue. Conservative treatment is utilized in the form of pneumatic massage, Ace bandages wrapping, arm elevation, etc. The apparatus here described is one that will produce a true gradient, from distal to proxymal pressure on the affected limb, that will help in reducing the amount of lymphedema, or edema, present in the subcutaneous tissue. Web site: http://www.delphion.com/details?pn=US04374518__
•
Method and apparatus for treating edema and other swelling disorders Inventor(s): Reid; Tony (P.O. Box 7433, Menlo Park, CA 94025) Assignee(s): none reported Patent Number: 5,916,183 Date filed: September 5, 1997 Abstract: This invention is an apparatus for treating lymphedema having a sleeve with inwardly projecting-elastomeric fingers and externally fitted pressure adjusting circular bands. When the sleeve is fitted to a patient's limb, the fingers impose a grid pattern of pressure points against skin of swollen limb. Space around and between the pressure points provide channels under the skin through which lymphatic fluids are able to migrate up the arm to the shoulder where healthy nodes process it and channel it to the
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large veins. Similar applications are applied to other limbs, hands, and feet with sleeves, and to the shoulder, chest wall, and back with vests. Excerpt(s): The present invention relates generally to medical devices and methods, and in particular to a device and method for removing edema fluids from a body trunk and/or extremity such as an arm or a leg. Breast cancer is a serious disease in women, and a variety of modalities are employed in its treatment. Many of these treatments result in damage to the lymphatic and/or venous system which, in turn, can cause a condition referred to as "lymphedema." Lymphedema is the accumulation of excessive lymph fluid and swelling of subcutaneous tissues due to the obstruction or destruction of lymph vessels. In breast cancer patients, lymphedema occurs in the arm and results in painful swelling. Excessive fluid accumulation, referred to as edema, can also arise in the arms, legs and, trunk from a variety of other causes, including infection, radiation therapy, and other conditions which result in damage to or destruction of portions of the lymphatic and/or venous system. A variety of devices and methods have been proposed for the treatment of lymphedema in the arms and elsewhere. Many such devices utilize a sequential pump which works like a multiplicity of blood pressure cuffs extending from the shoulder to the hand, which contract and expand individually. When pressure is exerted by any one chamber or cuff, it applies a `blanket pressure` (i.e. an annular pressure which completely circumscribes the limb or other body portion) to the skin directly underneath the area of that chamber. When the pressure upon that area is released, a similar blanket pressure is then applied to the portion of the arm covered by the next adjacent chamber, and so on up the arm. Such blanket pressures are applied sequentially from the distal to the proximal ends of the arm, with the intention of forcing the fluids up the arm and into the trunk of the body, where existing lymph nodes can process them. Web site: http://www.delphion.com/details?pn=US05916183__ •
Method and apparatus to medically treat soft tissue damage lymphedema or edema Inventor(s): Kellogg; Donald L. (115 Oakdale Dr., Aptos, CA 95003) Assignee(s): none reported Patent Number: 5,976,099 Date filed: December 18, 1997 Abstract: A method and apparatus for the alleviation of an undesirable fluid accumulation in a body area of a patient is provided. The apparatus, or static reaction system has enclosure containing a multiplicity of particles that are pressed against the body area. The shape of the enclosure and the physical qualities of the particles affect the suitability of specific versions of the invention to particular conditions and body areas. Pockets are included in some versions of the enclosure to capture and isolate subsets of the multiplicity of particles. An optional directional flow pattern feature is established by the orientation, sizes and shapes of the optional pockets and thereby affects the rate at which the fluid accumulation is reduced. Lightweight and flexible materials are used to manufacture various comfortable, transportable and storable models of the invention. The enclosure is optionally constructed with low friction, porous and breathing fabrics and materials to improve patient comfort and patient compliance. The enclosure is pressed, held and/or forced against a selected body area by means of a detachable compression cover, a pneumatic pack, compressive bandaging or wrapping, and made with velcro stretch fabric and/or with velcro strapping or other suitable means. Certain versions of the invention are applied by a capable and
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competently trained patient and with reduced need of constant professional supervision. Excerpt(s): The lymphatic system is organized like the blood system in that it includes a system of numerous tiny vessels connected to a network of larger vessels, and through which system and network a liquid medium containing solutes and particulates is transferred. A healthy lymphatic system continuously drains lymphatic fluid, consisting of a mixture of lymph, water, proteins and other matter, away from various interstitial areas of the body and back into the blood system. Lymph is the clear, liquid medium or solvent of the lymphatic system. The lymph fluid is pumped through the lymphatic system and away from various body areas by both the action of adjacent muscle tissue and the contraction of the larger lymphatic vessels. Foreign matter is filtered out of the lymph fluid as the fluid passes through bundles of lymph nodes during its course through the lymphatic system. The lymph nodes also monitor the contents of the lymph fluid to determine if any appropriate immune reactions should be initiated by the host's immune system. The lymph is then transferred back into the blood system after this filtration. Lymphedema is a deficiency, blocking or dysfunction of the lymphatic system that limits the flow of lymph fluid from a body area. The most frequent causes of lymphedema include primary insufficiency, traumatic accidents, chronic venous diseases, radiation therapy of the lymph nodes, prostate operations, mastectomies, amputations and other surgical operations. Lymphedema most typically occurs in arms and legs, but most other body areas can become lymphedemic, such as the genitals and the trunk of the body. Web site: http://www.delphion.com/details?pn=US05976099__ •
Method and means for treating limb swelling disorders and the like Inventor(s): Reid; Tony R. (2032 E. Grand Ave., Des Moines, IA 50317) Assignee(s): none reported Patent Number: 5,904,145 Date filed: November 12, 1996 Abstract: An apparatus for treating lymphedema in the limb of a patient as an outer sleeve configured to encircle the limb of the patient. A plurality of straps are secured in a lateral configuration on the sleeve to tighten the sleeve about the limb of the patient. Detachable markers are located on each of the straps adjacent a reference point on the straps to permit the straps to be tightened, loosened and then retightened to the same positions. The method for treating edema in the limb of a patient at a multiplicity of spaced apart locations comprises encircling the limb of a patient with an elongated sleeve having an elongated open seam and a plurality of spaced apart laterally extending releasable enclosable tightening straps. Strap are closed to secure the sleeve to the patient's limb. One of the straps is released, and a partially air-inflated pneumatic bladder is inserted through the seam underneath the released strap to position the bladder adjacent the patient's limb and the interior of the sleeve. The released strap is then closed and tightened against the bladder to cause a predetermined increase of pressure to be achieved within the bladder. The tightened strap that extends over the bladder is then released and the bladder is removed from the sleeve. The strap that extended over the bladder is then tightened to the same tightened position that existed prior to the bladder being removed. The foregoing steps are then sequentially repeated in regard to the remaining straps.
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Excerpt(s): Lymphedema is the accumulation of excessive lymph fluid and swelling of subcutaneous tissues due to the obstruction or destruction of lymph vessels. In breast cancer patients, lymphedema occurs in the arm and results in painful swelling. Excessive fluid accumulation, referred to as edema, can also arise in the arms, legs and, trunk from a variety of other causes, including infection, radiation therapy, and other conditions which result in damage to or destruction of portions of the lymphatic and/or venous system. Sleeve devices have been previously used to apply pressure at various locations along the length of an arm, for example, to relieve swelling due to lymphedema and other causes. Such sleeves have a plurality of laterally extending strap elements which can be tightened to exert pressure points or lines against the skin to permit the release and flow back of fluid to the remaining healthy lymph nodes. Such a device and method of use are disclosed in co-pending application U.S. application Ser. No. 08/390,866 now abandoned. While such devices are effective, they incur some difficulty in use because they provide no way to measure the hardness or softness of the arm, and they provide no way of determining how much pressure should be or is applied to the limb being treated. One of the problems in this area of medicine is to measure how soft or hard the arm is. Is there a lot of fluid that is easily displaced, or is the tissue hard and fibrotic? Understanding this helps us guide therapy. Different treatments are used if the tissue is soft or hard. The soft, fluid filled edema is called pitting edema. In pitting edema, application of pressure with a finger, for example, will cause the fluid to move away from the area where the pressure is applied and will leave an impression of the finger, or a pit. After the pressure is removed, the impression of the finger will remain for some time. In other conditions there is no pitting, the tissue is hard and fibrotic and no pit is left in the skin after the application of pressure with a finger. It is therefore a principal object of this invention to provide a method of determining the hardness or softness of the limb being treated. Web site: http://www.delphion.com/details?pn=US05904145__ •
Method for promoting flow of a body fluid within a human limb Inventor(s): Wright; Edward S. (Pittsburgh, PA), Wright; Sonja J. (Sewickley, PA) Assignee(s): Wright Linear Pump, Inc. (Imperial, PA) Patent Number: 4,922,893 Date filed: May 13, 1988 Abstract: An improved method and apparatus for promoting flow of a body fluid within a human limb, which has been subjected to an amputation procedure, wherein a novel distal inflatable cell having a pair of inflatable cell portions, one of which encompasses such a limb adjacent the stump end thereof and the other of which extends transversely across the stump end thereof, is utilized in a novel method of therapy to treat Lymphedema and similar fluid accumulation disorders of the extremities. Excerpt(s): It is well known in the medical arts that the treatment of certain physical conditions benefits markedly by the application of pressure to a body extremity such as an arm or a leg in a manner to promote the flow of a body fluid within the same from a distal portion thereof toward a proximal portion thereof. For example, the afflication known as lymphedema often may cause a limb of the afflicted to swell to a size much greater than normal size as lymphatic fluid accumulates in the limb. One prior mode of treatment for this afflication has been a double-walled sheath or stocking in which air pressure is introduced between the walls to squeeze the limb. It has been found that this and other similar systems which rely on uniform pressure application throughout the
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length of the afflicated limb do not perform very well and in fact may interfere with the desired distal-to-proximal flow of lymphatic fluid. Other approaches to treatment of such disorders have included employment of a sheath that is separated into a number of longitudinally spaced inflatable air cells encircling the limb to be treated. These cells are inflated with uniform air pressure successively from the distal end to the proximal end of the sheath with the intent of promoting fluid flow in the desired direction. However, many of these systems also have been ineffectual as they rely on the air pressure being maintained at the same level or magnitude in all of the pressurized cells. U.S. Pat. Nos. 2,533,504 and 2,781,041 disclose examples of such systems. Prior U.S. Pat. No. 4,370,975 of one of the joint inventors herein discloses an apparatus for treating lymphedema and similar fluid retention afflications through the use of a multi-cell inflatable sheath which encompasses the swollen limb. Pressure is applied in the cells of the sheath in timed sequence from the distal cell to the proximal cell, the sequence of pressure applied also defining a decreasing gradient pressure from a maximum pressure applied in the distal cell to a minimum pressure applied in the proximal cell when all of the cells are pressurized. Generally, for each of the adjacent cells the more distal has applied therein a higher pressure than the more proximal. This application of gradient pressure from distal to proximal cells in time sequence, as described, comprises a cycle, and such cycle may be repeated indefinitely to effectively promote the flow of lymphatic fluid from the afflicted limb in a proximal direction. Web site: http://www.delphion.com/details?pn=US04922893__ •
Method for the treatment of lymphedema using guaifenesin Inventor(s): Yue; Samuel K. (Edina, MN) Assignee(s): Sky BioHealth Solutions, Inc. (Eden Prairie, MN) Patent Number: 6,436,448 Date filed: June 25, 2001 Abstract: A novel method for preventing and treating lymphedema and for inducing weight-loss in a patient having an elevated protein concentration in the patient's by administering a therapeutically effective amount of guaifenesin or its analog to the patient. In one embodiment, the method further includes administering in the patient's diet an enzyme supplement chosen to increase the ability of the patient's gastrointestinal tract to digest food and administering to the patient an effective amount of relaxin hormone. Excerpt(s): The present invention relates to a novel method for the treatment of lymphedema and in reducing weight gain associated with lymphedema. The lymphatic system is a complex structure organized like the blood system in that it includes a system of numerous tiny vessels connected to a network of larger vessels, and through which system and network a liquid medium containing solutes and particulates is transferred. A healthy lymphatic system continuously drains lymphatic fluid, consisting of a mixture of lymph, water, proteins and other matter, away from various interstitial areas of the body and back into the blood system. Lymph is the clear, liquid medium or solvent of the lymphatic system. In contrast to the blood system, which utilizes the heart to pump blood throughout the body, the lymph fluid is pumped through the lymphatic system and away from various body areas by both the action of adjacent muscle tissue and the contraction of the larger lymphatic vessels. Foreign matter is filtered out of the lymph fluid as the fluid passes through bundles of lymph nodes during its course through the lymphatic system. The lymph nodes also monitor the contents of the lymph
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fluid to determine if any appropriate immune reactions should be initiated by the host's immune system. The lymphatic vessels are not interconnected in the same manner as blood vessels, but rather form a set of coordinated structures including the initial lymphatic sinuses which drain into the lymphatic capillaries and subsequently to the collecting lymphatics which drain into the lymphatic trunks and the thoracic duct which ultimately drains into the blood system after the filtration. Web site: http://www.delphion.com/details?pn=US06436448__ •
Multi-channel, interferential wave, micro current device and methods for treatment using micro current Inventor(s): Suzuki; James Y. (5766 S. Oaklawn Pl., Seattle, WA 98118) Assignee(s): none reported Patent Number: 5,817,138 Date filed: November 27, 1996 Abstract: An interferential wave, micro current device is disclosed. The device typically has a power supply, a frequency generator, a pulse generator, a pulse envelope generator, an electrical current controller, and four or more channels for applying micro amperes of electrical current to patient tissue. Each channel has two electrodes for completing a micro current electrical circuit through patient tissue. The controller provides a controlled amount of current in each channel from about 20 micro amperes to about 200 micro amperes at a frequency up to about 300 Hertz. Also disclosed are methods for treating lymphedema, edema, fibrosis and fibromylagea by application of interferential wave form micro current. Excerpt(s): The present invention relates to a multi-channel, interferential wave, micro current device that is useful for treatment of edema and other indications and to methods for treating edema and other indications using micro current. The various tissue of mammalian organs all produce small (less than 1 milliamp) direct ("DC") electrical currents. Electroencephalograms and electrocardiograms (EEGs and EKGs, respectively) are measurements of these DC currents in the brain and heart, respectively, of man. Damage to these and other mammalian tissues produce significant changes in the patterns of these electrical currents which appear to be generated in part by the precise spatial organization of anionic and cationic components of the intra-andextracellular structures within these organs. The external surface of the skin, for example, is electronegative while the internal base of the skin is electropositive. Like the charge separation between the two poles of a battery, a small current of electricity moves through the dermis or middle layer of the skin (30-100 mV). With injury, this structure is altered and the resistance to electric current flow of the injured tissue is reduced. Intrusion of fluids (blood, serum) into the damaged dermis further reduces this electrical resistance. Web site: http://www.delphion.com/details?pn=US05817138__
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•
Protective arm and hand covering for a healthcare patient to prevent lymphedema Inventor(s): Weaver; Lois A. (1190 Parkside Ave., Trenton, NJ 08618) Assignee(s): none reported Patent Number: 6,155,263 Date filed: February 15, 2000 Abstract: A protective arm and hand covering for a healthcare patient in a healthcare with healthcare workers which includes warning notices on the external surface thereof to notify a healthcare worker that no healthcare activities are to be conducted with respect to one specific hand and arm of the patient because this patient has a propensity for lymphedema. The hand and arm covering is adapted to completely cover the upper and lower arm area on both sides of the elbow as well as the entire wrist, hand and finger area of the user. The device can include a plurality of markings or indicia on the external surface thereof warning healthcare workers that various activities such as blood pressure, venipuncture and intravenous are not to be performed with respect to that specific arm. Other warning graphic representations can be included in order to notify a healthcare worker that blood pressure or intravenous lines or blood should not be drawn from that particular arm even in those situations where the patient is asleep and is unable to notify the healthcare worker that all these activities are to be performed with respect to the patient's other arm. Excerpt(s): The present invention deals with the field of devices for providing medical alert information to healthcare workers. The conveying of medical alert information to healthcare workers is a very rapidly growing field which can encompass many different types of devices. For example, bracelets or anklets or necklaces with important medical information imprinted thereon are commonly used today. The present invention provides a specific type of medical alert information carried upon an arm, hand and finger covering of a user to notify a healthcare worker that no healthcare activities should be performed with respect to the user's arm. This device is primarily designed to be worn within a healthcare environment such as a hospital and is particularly useful in those situations where a user is asleep or unconscious or in a coma and, as such, cannot notify the healthcare worker at the time of servicing that such activity should not be performed with respect to that specific arm. As such, the present invention falls into the general field of medical alert devices. Other devices have been utilized for the purposes of providing medical alert for carrying information or other indicia upon clothing material or for protecting hands, arm and fingers of a user or for preventing unwanted contact of a material or fluid with respect to the hand, arm or fingers of a particular user such as U.S. Pat. No. 1,837,148 patented Dec. 15, 1931 to A. G. David and assigned to The Nevins-Church Press on an "Advertising Cuff"; and U.S. Pat. No. 3,416,518 patented Dec. 17, 1968 to B. M. Samuels et al on a "Cast Cover"; and U.S. Pat. No. 3,638,334 patented Feb. 1, 1972 to E. Malikowski on a "Training Garment"; and U.S. Pat. No. 3,648,291 patented Mar. 14, 1972 to A. Pankers and assigned to William A. Braddock on a "Protective Garment For Bedridden People"; and U.S. Pat. No. 4,254,566 patented Mar. 10, 1981 to S. Haskell on a "Jogger And Runner Shoe Identification"; and U.S. Pat. No. 4,330,887 patented May 25, 1982 to Joanne White on "Terry Cloth Gloves (Terry Grippers)"; U.S. Pat. No. 4,710,981 patented Dec. 8, 1987 to David Sanchez on an "Interactive Message Garment"; and U.S. Pat. No. 4,742,578 patented May 10, 1988 to Arnold Seid on a "Penetration-Resistant Surgical Glove"; and U.S. Pat. No. 4,991,233 patented Feb. 12, 1991 to Andrew Hall on a "Garment With Indicia"; and U.S. Pat. No. 4,991,337 patented Feb. 12, 1991 to Laurie Solon on an "Inexpensive Disposable Identification Bracelet"; and U.S. Pat. No. 5,023,953 patented Jun. 18, 1991 to Laurence A.
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Bettcher and assigned to Bettcher Industries, Inc. on a "Garment And Protective Sleeve"; and U.S. Pat. No. 5,084,915 patented Feb. 4, 1992 to J. Shotwelkl et al on a "Method Of Displaying Information"; and U.S. Pat. No. 5,187,813 patented Feb. 23, 1993 to L. Klein and assigned to Levrette Lee Klein on a "Combination Napkin And Sleeve/Forearm Protector (Cuff-Nap); and U.S. Pat. No. 5,335,372 patented Aug. 9, 1994 to G. Wiedner et al and assigned to Rotecno AG on an "Article Of Clothing, In Particular For The Medical Or Chemical Field"; and U.S. Pat. No. 5,357,633 patented Oct. 25, 1994 to G. Rael on an "Arm Protective Garment"; and U.S. Pat. No. 5,379,461 patented Jan. 10, 1995 to R. Wilmers on an "Interactive Clothing with Indicia And Cover Panel"; and U.S. Pat. No. 5,4022,536 patented Apr. 4, 1995 to J. Matthews on a "Forearm Protector For Medical, Dental And Other Health Care Workers"; and U.S. Design Pat. No. Des.357,567 patented Apr. 25, 1995 to L. Fingleson et al on a "Garment Having Printed Instructions For SelfExamination Of The Breasts"; and U.S. Pat. No. 5,444,871 patented Aug. 29, 1995 to F. Lopez and assigned to Johnson & Johnson Medical, Inc. on a "Medical Gown With Seamless Sleeve Protector"; and U.S. Pat. No. 5,511,241 patented Apr. 30, 1996 to G. Ziegler and assigned to Azon Corporation on "Chain Mail Garments Impregnated With An Elastomeric Material"; and U.S. Pat. No. 5,519,952 patented May 28, 1996 to C. Kolton et al and assigned to B&G Plastics, Inc. on a "Belt And Indicator Assembly"; and U.S. Pat. No. 5,542,121 patented Aug. 6, 1996 to P. Lahaussois et al and assigned to Dale Strohl on a "Dispensable, Disposable Reversible Forearm Protector"; and U.S. Pat. No. 5,546,955 patented Aug. 20, 1996 to P. Wilk on a "Medical Stocking For Temperature Detection"; and U.S. Pat. No. 5,601,895 patented Feb. 11, 1997 to F. Cunningham on a "Flexible Puncture Proof Material"; and U.S. Pat. No. 5,628,062 patented May 13, 1997 to L. Tseng on an "Arm And Hand UV Protection Sleeve For Driving"; and U.S. Pat. No. 5,638,546 patented Jun. 17, 1997 to D. Vita on an "Arm Warmer Garment"; and U.S. Pat. No. 5,682,616 patented Nov. 4, 1997 to M. Pisano on a "Hosiery Having A Protective Sleeve For Preventing Debris-Intrusion"; and U.S. Pat. No. 5,734,992 patented Apr. 7, 1998 to M. Ross for a "Protective Hand And Arm Covering Article"; and U.S. Pat. No. 5,802,876 patented Sep. 8, 1998 to A. Miller et al on a "Bracelet"; and U.S. Design Pat. No. Des.398,862 patented Sep. 29, 1998 to D. Craven on a "Medical-Alert Wristwatch"; and U.S. Pat. No. 5,909,801 patented Jun. 8, 1999 to H. Coffman on an "Arm Warming Sleeve"; and U.S. Design Pat. No. Des.415,058 patented Oct. 12, 1999 to R. Haase on a "Medical Condition Bracelet"; and U.S. Pat. No. 5,974,586 patented Nov. 2, 1999 to D. Reinoso on a "Sunlight Blocking Sleeves". The present invention provides a protective arm and hand covering for a patient for preventing a healthcare worker from having access to a particular arm and hand area in order to prevent a patient from experiencing lymphedema. Web site: http://www.delphion.com/details?pn=US06155263__
Patent Applications on Lymphedema As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to lymphedema:
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This has been a common practice outside the United States prior to December 2000.
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Compression garment for selective application for treatment of lymphedema and related illnesses manifested at various locations of the body Inventor(s): Kloecker, Richard J.; (St. Louis, MO) Correspondence: Paul M. Denk; 763 South New Ballas Road; ST. Louis; MO; 63141; US Patent Application Number: 20020042585 Date filed: November 13, 2001 Abstract: A compression garment for selective application for treatment of lymphedema and related illnesses manifested at various locations of the body. The garment includes a pair or series of layers of hermetically sealed material, that can capture pressurized air, when applied therein, and is formed through the patterned sealing of the layers of the garment together, at select locations, to form air pockets that can selectively apply isolated points of pressure to the patient's affected area, without disrupting normal vascular and lymphatic functioning. The garment is design cut, for application to various segments of the body, and apply encompassing pressure over the entire affected area, and includes valves that can allow for the injection of measurable air, to the desired pressure points, or its deflation, after treatment. Excerpt(s): This application is realted to and comprises a continuation in part of the United States patent application of the same inventor, Ser. No. 09/559,682, filed on Apr. 27, 2000; said previous application being related to its provisional application having Ser. No. 60/131,697, filed on Apr. 30, 1999, all of said applications being owned by the same inventor. This invention relates primarily to the treatment of lymphedema, and the use of various instrumentation that can effectively lessen the painful and deleterious aspects of such disease as manifested in the body. As is well known in the art, lymphedema is a collection of fluids within the tissue, usually extremities, such as one or both of the arms, one or both of the legs, and which is caused from various etiological causes. Lymphedema can be a primary illness that is congenital. This can either result from aplasia of the lymphatic system, which may occur as a result of a complete lack of development of the same, or can be caused by hypoplasia of the lymphatics, such as an underdevelopment of the lymphatic system. Furthermore, lymphedema can be caused, and result from inflammatory diseases. These include mostly bacterialogical infections. The non-infectious inflammatory causes are due to a variety of impairments, such as malignancies where the lymphatics can be blocked by tumor cells, or the lymph nodes can be blocked by tumor cells. In addition, it can result from the surgical removal of various lymph nodes, and the surgical interuption of the normal performance of the lymphatics. Furthermore, such can come from radiation that causes sclerosis or scarring of the lymphatics. Furthermore, such can result from chronic venous diseases of long standing origin. In addition, lymphedema can come from severe local injury to a limb. Furthermore, it is usually the infectious element that accompanies such an injury, that may result in the onset of lymphedema. Lymphedema can also originate from the blockage of lymphatics by various parasites. Finally, pathology in lymphatics can come from various systemic diseases including myxedema, renal disease, such as nephritis or nephrosis, with loss of protein materials, and can derive from various collagen diseases and fibrotic diseases. All of these diseases result in obstruction of the lymphatic flow and thus causes an accumulation of fluids in the effected limb or limbs. It is also known that cardiac failure can also cause the onset of this malady. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Enhancing lymph channel development and treatment of lymphatic obstructive disease Inventor(s): Epstein, Stephen E; (Rockville, MD) Correspondence: Vorys Sater Seymour And Pease; Suite 1111; 1828 L Street N W; Washington; DC; 20036-5104; US Patent Application Number: 20030211988 Date filed: February 14, 2003 Abstract: Disclosed and claimed are compositions and methods for therapy and/or prevention of lymphedema. The compositions can include an agent that induces development of lymphatic channels or lymphangiogenesis, such as, VEGF-C and/or that which stimulates VEGF-C expression and/or that which stimulates VEGF-C expression or that which stimulates its interaction or that which stimulates other pathways to so stimulate the development of lymphatic channels or lymphangiogenesis or that which stimulates along any point of or any molecules involved in the signal transduction pathway leading to lymphangiogenesis or lymph channel development (and/or vector(s) expressing one or more of these agent(s)). Embodiments can include kits. Excerpt(s): This application claims the benefit of copending U.S. Provisional Application No. 60/175,393, filed Jan. 11, 2000. This invention relates to the use of a protein or of proteins or a vector or vectors or a combination thereof that can enhance the development of lymphatic channels; for instance, in individuals with obstructed lymph channels (lymphedema). The process by which the enhancement of the development of lymphatic channels occurs is herein termed lymphangiogenesis. The protein(s) can either be injected into the affected site directly as protein(s), or as a vector containing the gene encoding the relevant protein or proteins. The protein(s) can be delivered either directly, or in a vehicle (such as liposomes) that can facilitate delivery of the protein to the targets site. The vector containing the gene can be a naked plasmid DNA vector, or in any other suitable vector that contains the gene. The resulting new or enlarged lymphatic channels enhance lymph conduction around the obstructed channels, thereby alleviating the lymphedema of the tissue drained by the obstructed lymphatics. The present invention relates to compositions and methods for the preventing and/or treatment of lymphedema. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Low level laser therapy method and means Inventor(s): Angel, Patricia Ann; (Henley Beach, AU), Walmsley, Richard; (South Yarra, AU) Correspondence: Klauber & Jackson; 411 Hackensack Avenue; Hackensack; NJ; 07601 Patent Application Number: 20030171795 Date filed: February 14, 2003 Abstract: The invention described provides a treatment for edema, lymphedema and extra-cellular fluid with Low Level Laser Therapy (LLLT). The invention in particular will be effective in the treatment of lymphedema that includes the effects of lymph gland damage, disease or removal (LO) following surgery typically associated with cancer treatment or at least provides an alternative to other treatments. In particular the
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use of LLLT according to the method and apparatus of the invention can effectively treat LO and post surgery LO of a limb associated with the removal of a lymph gland. A method of treatment of the lymphatic system/lymphedema and edema in a mammalian subject includes the step of radiation of the surface of the skin of a mammal in the area of physiological-concern with a low-level infrared laser. The laser is a Class 1 laser arranged to emit a pulsed beam. The laser is applied at discrete points on the surface of the skin for up to 1 minute per point in the area of physiological concern being nodal areas adjacent to an affected limb. The wavelength of the laser emission is between 600 to 1100 nm the laser having pulse widths from 1 nanosecond to 1 second with peak powers from 1 milliwatt to 1000 Watts, average powers from 1 microWatt to 1000 milliWatts at repetition rates from 0.1 to 100 kilohertz. Further, the energy of the laser is delivered at substantially 5 Joules with an energy density of about 1.5 Joules per square centimetre. Excerpt(s): This invention relates to the treatment of edema including lymphatic system induced edema wherein the treatment involves Low Level Laser Therapy (LLLT) in particular for the treatment of lymphedema (LO) both primary and secondary. An example is provided in treating post-mastectomy LO with LLLT. At the molecular level, there are reports that LLLT affects cytochromes of the mitochondrial electron transport chain (Karu 1989), and induces local gradients in energy delivery due to laser speckle resulting in local gradients in cellular heating (Horvth & Donko 1992). At the cellular level, LLLT is reported to stimulate mitogenic activity, adhesion, synthetic activity and viability of fibroblasts (Abergel et al, 1984; Boulton & Marshall 1986; Glassberg et al 1988; Yu et al, 1994; Conlan et al, 1996, Bednarska et al, 1998), although this may only be true for systems that are operating sub-optimally (Abergel et al, 1984). Macrophages were stimulated by LLLT to produce factors that increased or decreased fibroblast proliferation, depending on the wavelength of laser used (Young et al, 1990). LLLT stimulate lymphocytes to proliferate and to become activated, both in vitro and in vivo (Inoue et al 1989; Tadakuma, 1993; Ganju et al, 1999), although again this may only be true in pathological settings, where LLLT `primes` lymphocytes to be more responsive to natural stimulatory products (Smol'yaninova et al, 1991). All of these cell types may have a role to play in resolution of lymphedema. At the cellular level, it has been suggested that there are stimulatory/protective effects of applying LLLT on endothelial cells and vascular endothelium in situ (Lamuraglia et al 1992). This may involve angiogenic factor production by T-lymphocytes (associated with endothelial cell proliferation; Agaiby et al, 2000), or increased vascular endothelial growth factor (VEGF) production by smooth muscle cells or fibroblasts (Kipshidze et al, 2001). Use of LLLT enhanced endothelial regeneration after damage in animal models (De Scheerder et al, 1998; Kipshidze et al, 1998), and in humans after coronary arterial stent implantation (De Scheerder et al, 2000). The inventors have not seen any reports of LLLT on lymphangiogensis, but proposed that lymphatic vessels will respond similarly to blood vessels, since members of the VEGF family, VEGF-C and -D, stimulate lympangiogensis (Plate, 2001). There are reports of stimulation of local fluid circulation (Horvth & Donko, 1992), and stimulatory effects on lymphatic vessels (Lieviens et al, 1985), probably in response to increased fluid mobility in radiated tissues. There does not seem to be a direct consistent effect of low level laser on lymphatic vessel contractility when laser is applied to the vessels alone (Carati et al, 1998). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Lymphedema treatment system Inventor(s): McKee, Eric L.; (East Bethel, MN), Waldridge, Irene A.; (Shakopee, MN) Correspondence: Richard C. Stempkovski, JR.; Nawrocki, Rooney & Sivertson, P.A.; Suite 401, Broadway Place East; 3433 Broadway Street Northeast; Minneapolis; MN; 55413; US Patent Application Number: 20010018563 Date filed: December 5, 2000 Abstract: A method of body manipulation in furtherance of treating lymphedema is provided. A wrap, adapted to fit about a body extremity and having a trunk region, and limb regions, and a plurality of compartments distributed throughout the regions, is provided and applied to the body extremity. Each of the compartments of the plurality of compartments are capable of selective pressurization and depressurization. The body extremity is prepared for receipt of lymph fluid via a first pressurization and depressurization sequence of select compartments within select regions of the regions of the wrap, and lymph fluid is drained from the body extremity via a second pressurization and depressurization sequence of select compartments within select regions of the regions of the wrap, whereby the lymphatic system is stimulated so as to promote readsorption of pooled lymph fluid within surrounding tissue. Excerpt(s): This application is a continuation-in-part of co-pending application Ser. No. 08/843,023 filed on Apr. 11, 1997. This invention relates to apparatus and method for the treatment of lymphedema. More particularly it relates to a wrap having a series of bladders applied to the trunk of the body, wherein the bladders are compressed and decompressed on an individual basis to stimulate the lymphatic system. The lymphatic system consists of lymph vessels, lymph nodes and lymphoid tissues and is a secondary system within the circulatory system that removes waste. Unlike the closed-loop blood circulatory system, the lymphatic system works according to a one-way principal. That is, the lymphatic system is a drainage system to drain away lymph which continually escapes from the blood in small amounts. The lymph is first collected at the lymph capillaries, which in turn drain into larger vessels. The lymph is pumped in and out of these vessels by movements of adjacent muscles and by contractions of the walls of the larger vessels, and moves through the lymphatic system in one direction. Foreign matter and bacteria are filtered at various lymph node groups after which the fluid empties into the venous portion of the blood system, mainly through the thoracic duct. A healthy person will drain one to two liters of lymph fluid through this duct every 24 hours. Without proper drainage into the duct, lymphedema results. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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SCREENING AND THERAPY FOR LYMPHATIC DISORDERS INVOLVING THE FLT4 RECEPTOR TYROSINE KINASE (VEGFR-3) Inventor(s): ALITALO, KARI; (HELSINKI, FI), FERRELL, ROBERT E.; (PITTSBURGH, PA), FINEGOLD, DAVID N.; (PITTSBURGH, PA), KARKKAINEN, MARIKA; (HELSINKI, FI) Correspondence: Marshall O'toole Gerstein; Murray & Borun; 6300 Sears Tower; 233 South Wacker Drive; Chicago; IL; 606066402 Patent Application Number: 20030026759 Date filed: August 16, 1999
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Abstract: The present invention provides materials and methods for screening for and treating hereditary lymphedema in human subjects. Excerpt(s): This application is a Continuation-in-Part of International Patent Application No. PCT/US99/06133, filed Mar. 26, 1999, incorporated herein by reference in its entirety. The present invention relates generally to the fields of molecular biology and medicine; more particularly to the areas of genetic screening and the identification and treatment of hereditary disorders; and more particularly to identification and treatment of hereditary lymphedema. The lymphatic system is a complex structure organized in parallel fashion to the circulatory system. In contrast to the circulatory system, which utilizes the heart to pump blood throughout the body, the lymphatic system pumps lymph fluid using the inherent contractility of the lymphatic vessels. The lymphatic vessels are not interconnected in the same manner as the blood vessels, but rather form a set of coordinated structures including the initial lymphatic sinuses [Jeltsch et al., Science, 276:1423-1425 (1997); and Castenholz, A., in Olszewski, W. L. (ed.), Lymph Stasis: Pathophysiology, Diagnosis, and Treatment. CRC Press: Boca Raton, Fla. (1991), pp.15-42] which drain into the lymphatic capillaries and subsequently to the collecting lymphatics which drain into the lymphatic trunks and the thoracic duct which ultimately drains into the venous circulation. The composition of the channels through which lymph passes is varied [Olszewski, W. L., in Olszewski, W. L. (ed), Lymph Stasis: Pathophysiology, Diagnosis, and Treatment. CRC Press: Boca Raton, Fla. (1991), pp. 235258; and Kinmonth, J. B., in Kinmonth, J. B. (ed), The Lymphatics: Diseases, Lymphography and Surgery. Edward Arnold Publishers: London, England (1972), pp. 82-86], including the single endothelial layers of the initial lymphatics, the multiple layers of the collecting lymphatics including endothelium, muscular and adventitial layers, and the complex organization of the lymph node. The various organs of the body such as skin, lung, and GI tract have components of the lymphatics with various unique features. [See Ohkuma, M., in Olszewski (1991), supra, at pp. 157-190; Uhley, H. and Leeds, S., in Olszewski (1991), supra, at pp. 191-210; and Barrowman, J. A., in Olszewski (1991), at pp. 221-234).] Molecular biology has identified at least a few genes and proteins postulated to have roles mediating the growth and/or embryonic development of the lymphatic system. One such gene/protein is the receptor tyrosine kinase designated Flt4 (fms-like tyrosine kinase 4), cloned from human erythroleukaemia cell and placental cDNA libraries. [See U.S. Pat. No.5,776,755; Aprelikova et al., Cancer Res., 52: 746-748 (1992); Galland et al., Genomics, 13: 475-478 (1992); Galland et al., Oncogene, 8: 1233-1240 (1993); andPajusola et al., Cancer Res., 52:5738-5743 (1992), all incorporated herein by reference.] Studies showed that, in mouse embryos, a targeted disruption of the Flt4 gene leads to a failure of the remodeling of the primary vascular network, and death after embryonic day 9.5 [Dumont et al., Science, 282: 946-949 (1998)]. These studies suggested that Flt4 has an essential role in the development of the embryonic vasculature, before the emergence of the lymphatic vessels. However, additional studies indicated that, during further development, the expression of Flt4 becomes restricted mainly to lymphatic vessels [Kaipainen, et al., Proc. Natl. Acad Sci. USA, 92: 3566-3570 (1995)]. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Use of lymphangiogenic agents to treat lymphatic disorders Inventor(s): Gravereaux, Edwin C.; (Brookline, MA), Isner, Jeffrey M.; (Weston, MA), Isner, Linda; (Weston, MA), Silver, Marcy; (Bolton, MA), Yoon, Young-Sup; (Watertown, MA) Correspondence: David G. Conlin; Dike, Bronstein, Roberts & Cushman; Intellectual Property Practice Group; P. O. Box 9169; Boston; MA; 02209; US Patent Application Number: 20020151489 Date filed: October 2, 2001 Abstract: The present invention provides methods for promoting the growth of new lymph vessels (lymphangiogenesis). Generally, such methods include administering at least one vascular endothelian factor (VEGF) such as VEGF-2. In one embodiment, therapeutic methods for treating lymphedema and related disorders in a human patient are disclosed. The VEGF can be provided by any suitable means including direct injection of a nucleic acid encoding same or an active fragment thereof. Also provided are pharmaceutical products for promoting lymphangiogenesis as well as a test system for screening compounds capable of inducing new lymph vessel growth. Excerpt(s): The present application is a continuation-in-part of U.S Provisional Application No. 60/237,171 filed on Oct. 2, 2000. The disclosure of said provisional application is incorporated herein by reference. The present invention generally relates to compositions and methods for modulating lymph vessel growth in a mammal. In one aspect, methods are provided for modulating new lymph vessel growth (lymphangiogenesis) that include administrating an effective amount of at least one vascular endothelian growth factor (VEGF) such as VEGF-2. Further provided are methods for treating lymphedema and other conditions impacting the lymphatic system. Also provided is a test system for screening compounds capable of inducing lymphangiogenesis. The invention has a wide spectrum of useful applications including promoting good lymphatic function in the mammal. There is recognition that lymphedema is a progressive, usually painless extremity swelling secondary to decreased transport capacity of the lymphatic system. The condition, despite being painless, can cause extreme distress and functional impairment, leading to frequent disability in those afflicted. In addition to the often massive size of the affected limb, secondary cellulitis and lymphangitis episodes complicate the condition. The late risk of lymphangiosarcoma arising in the lymphedematous limb remains a concern. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with lymphedema, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “lymphedema” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on lymphedema.
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You can also use this procedure to view pending patent applications concerning lymphedema. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON LYMPHEDEMA Overview This chapter provides bibliographic book references relating to lymphedema. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on lymphedema include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “lymphedema” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “lymphedema” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “lymphedema” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
A Primer on Lymphedema by Deborah G. Kelly (Author); ISBN: 0130224103; http://www.amazon.com/exec/obidos/ASIN/0130224103/icongroupinterna
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Coping With Lymphedema (Coping With.) by Joan Swirsky, et al (1998); ISBN: 0895298562; http://www.amazon.com/exec/obidos/ASIN/0895298562/icongroupinterna
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Lymphedema; ISBN: 3135449017; http://www.amazon.com/exec/obidos/ASIN/3135449017/icongroupinterna
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Lymphedema Handbook: Prevention and Management Strategies for People With Cancer by Ellen Carr, et al (2003); ISBN: 0944235417; http://www.amazon.com/exec/obidos/ASIN/0944235417/icongroupinterna
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Lymphedema: A Breast Cancer Patient's Guide to Prevention and Healing by Jeannie Burt, et al; ISBN: 0897932641; http://www.amazon.com/exec/obidos/ASIN/0897932641/icongroupinterna
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Podoconiosis: Non Filarial Elephantiasis by Ernest Woodward Price; ISBN: 0192620029; http://www.amazon.com/exec/obidos/ASIN/0192620029/icongroupinterna
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Silent Waves: Theory and Practice of Lymph Drainage Therapy, with Applications of Lymphedema, Chronic Pain and Inflammation by Bruno Chikly (2001); ISBN: 0970053053; http://www.amazon.com/exec/obidos/ASIN/0970053053/icongroupinterna
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Textbook of Lymphology: Textbook of Lymphology for Physicians and Lymphedema Therapists by M. Foeldi, et al (2003); ISBN: 0972953507; http://www.amazon.com/exec/obidos/ASIN/0972953507/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “lymphedema” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 •
A sixth venereal disease [microform]: climatic bubo, lymphogranuloma inguinale, esthiomene, chronic ulcer and elephantiasis of the genito-ano-rectal region, inflammatory stricture of the rectum Author: Stannus, Hugh Stannus,; Year: 1979; Baltimore: W. Wood and Co., 1933
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Lymphedema pumps: pneumatic compression devices Author: Hotta, S. S.; Year: 1973; Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, 1993
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Lymphedema: causes, complications and treatment of the swollen extremity. Author: Zieman, Stephen A.; Year: 1975; New York, Grune; Stratton, 1962
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Lymphedema: results from a workshop on breast cancer treatment-related lymphedema and lymphedema resource guide; Year: 1996; Atlanta, GA: American Cancer Society, 1998
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Medicare allowances for lymphedema pumps Author: United States. Dept. of Health and Human Services. Office of Inspector General. Office of Evaluation and Inspections.; Year: 1972; Atlanta: U.S. Dept. of Health and Human Services, Office of Inspector General, [1998]
11
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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•
Studies of the blood circulation in lymphedematous limbs. Author: Jacobsson, Sten,; Year: 1962; Stockholm [Distributed by Almqvist; Wiksell] 1967
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Surgical treatment of lymphedema of the lower extremities; a twenty year survey, 1934-1954. Author: Sanders, Edward J.,; Year: 1974; [Minneapolis] 1959
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The lymphatics and lymphedema. Author: Grobmyer, Albert,; Year: 1974; Des Moines, 1965
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Treatment of obstructive pulmonary insufficiency; guest editor: Edwin Rayner Levine. Treatment of lymphedema; guest editor: Alexander Schirger. Author: Levine, Edwin Rayner,; Year: 1962; [New York] Hoeber [c1969]
Chapters on Lymphedema In order to find chapters that specifically relate to lymphedema, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and lymphedema 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 “lymphedema” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on lymphedema: •
Lip Lesions Source: in Laskaris, G. Pocket Atlas of Oral Diseases. New York, NY: Thieme Medical Publishers, Inc. 1998. p. 257-272. Contact: Available from Thieme Medical Publishers, Inc. 333 Seventh Avenue, New York, NY 10001. (800) 782-3488. Fax (212) 947-1112. Website: www.thieme.com. PRICE: $22.00. ISBN: 0865776350. Summary: This chapter on lip lesions is from a desktop reference tool for otolaryngologists, dentists, dermatologists, and primary care practitioners which includes coverage of both local and systemic oral disease. The classification of the material in the book is based on the morphological presentation and the site at which the clinician first sees the lesions at examination. This chapter covers disorders that exclusively affect the lips, systemic diseases that produce characteristic lip lesions, and some other entities. Topics include cheilitis glandularis, cheilitis granulomatosa, Melkersson-Rosenthal syndrome, exfoliative cheilitis, contact cheilitis, actinic cheilitis, angular cheilitis, lip-licking dermatitis, median lip fissure, angioneurotic edema, lymphedema due to radiation, and systemic diseases such as Crohn's disease, sarcoidosis, tuberculosis, and cystic fibrosis. Each of the entities is provided with a representative color plate and a brief, concise description of the definition, etiology, clinical features, differential diagnosis, laboratory tests, and directions on treatment.
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CHAPTER 8. MULTIMEDIA ON LYMPHEDEMA Overview In this chapter, we show you how to keep current on multimedia sources of information on lymphedema. 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 lymphedema is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “lymphedema” 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 “lymphedema” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on lymphedema: •
Congenital Lymphedema of the Genitalia: A Surgical Approach Source: Purchase, NY: P.C. Communication, Inc. 1990. Contact: Available from VideoUrology Times Inc. 270 Madison Avenue, New York, NY 10016. (800) 342-8244. (One of six video presentations comprising a videocassette program representing Program 1 of Volume 3 of VideoUrology). PRICE: $59.95 for 6title set; $150 for 24-title set. Summary: This program, from a video journal on urology, presents the surgical procedures to correct congenital lymphedema. (AA-M).
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Bibliography: Multimedia on Lymphedema The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in lymphedema (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on lymphedema: •
Surgery of male genital lymphedema [motion picture] Source: Kaiser-Permanente Medical Center, Walnut Creek, California; Year: 1983; Format: Motion picture; Walnut Creek, Ca.: Kaiser Permanente Medical Corp., c1983
•
The Modified Charles procedure for lymphedema praecox [videorecording] Source: an OME production; Year: 1988; Format: Videorecording; Baltimore, Md.: Dept. of Surgery and the Office of Medical Education, School of Medicine, University of Maryland at Baltimore, c1988
•
The Surgical treatment of chronic lymphedema of the leg [motion picture] Source: United States Army; Year: 1967; Format: Motion picture; [Washington]: The Army; [Atlanta: for loan by National Medical Audiovisual Center], 1967
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CHAPTER 9. PERIODICALS AND NEWS ON LYMPHEDEMA Overview In this chapter, we suggest a number of news sources and present various periodicals that cover lymphedema.
News Services and Press Releases One of the simplest ways of tracking press releases on lymphedema 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 “lymphedema” (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 lymphedema. 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 “lymphedema” (or synonyms). The following was recently listed in this archive for lymphedema: •
Laser treatment seems to ameliorate post-mastectomy lymphedema Source: Reuters Medical News Date: October 10, 2003
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Pneumatic compression helpful in lymphedema related to breast cancer treatment Source: Reuters Industry Breifing Date: December 13, 2002
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Lymphedema negatively affects quality of life after surgery for breast cancer Source: Reuters Medical News Date: November 27, 2002
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Gene mutations for hereditary lymphedema-distichiasis syndrome identified Source: Reuters Medical News Date: December 26, 2000
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Lymphedema reduces quality of life after axillary lymph node dissection Source: Reuters Medical News Date: May 20, 1999
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Coumarin ineffective against arm lymphedema after breast cancer treatment Source: Reuters Medical News Date: February 04, 1999
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International Experts Tackle Breast Cancer-Related Lymphedema Source: Reuters Medical News Date: February 20, 1998 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 “lymphedema” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or
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you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “lymphedema” (or synonyms). If you know the name of a company that is relevant to lymphedema, 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 “lymphedema” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “lymphedema” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on lymphedema: •
Manual Lymph Drainage Massage Source: News from SPOHNC. News from Support for People with Oral and Head and Neck Cancer, Inc. 8(5): 6. February 1999. Contact: Available from Support for People with Oral and Head and Neck Cancer, Inc. (SPOHNC). P.O. Box 53, Locust Valley, NY 11560-0053. (516) 759-5333. E-mail:
[email protected]. Website: www.spohnc.org. Summary: This brief article on manual lymph drainage massage is from a newsletter for people with oral or head and neck cancer. The author first describes her training and background in lymphedema (excessive fluid in the lymph glands) management, then explains how facial and neck lymphedema can be managed by manual lymph drainage massage. This gentle massage technique facilitates the opening of collateral vessels (and the lymphatic vessels located on the back of the neck and shoulders) to increase drainage from obstructed areas into unobstructed areas. The author stresses that it is important for the clinician to teach the patient self massage, so that the patient can help to manage his or her lymphedema at home. 12 references.
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Massage Is More Than an Indulgence Source: Harvard Women's Health Watch. 9(7): 7. January 2002. Contact: Available from Harvard Women's Health Watch. Department SR, P.O. Box 380, Boston, MA 02117. (800) 829-5921. Email:
[email protected]. Summary: This newsletter article addresses the therapeutic benefits of massage. Most Western massage is based on Swedish massage, introduced in the United States in the early nineteenth century. Different massage strokes are used depending on the type of
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massage and its purpose. Deep tissue massage uses slow strokes and fingertip pressure and is used to improve lymph and blood circulation. Myofascial release uses gentle, stretching strokes to relieve posture and alignment problems. Sports massage uses stretches and movements against resistance to reduce injury and increase range of motion in the patient. Eastern techniques of massage with roots in Eastern philosophy and medicine, such as Shiatsu and acupressure, are described. Studies have shown that massage is beneficial in relieving back pain, lessening pain, nausea, and anxiety in cancer patients, enabling better sleep in older institutionalized patients, and relieving lymphedema (swelling due to the buildup of fluids in the arm) in patients with breast cancer. Although massage has proven beneficial for many health conditions, it should not be used for patients with deep venous thrombosis or anyone with an open wound, a rash, or an acute infection. Two professional organizations for massage therapists are listed. 1 figure.
Academic Periodicals covering Lymphedema Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to lymphedema. In addition to these sources, you can search for articles covering lymphedema 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 10. 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 lymphedema. 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 lymphedema. 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 lymphedema: Erythromycin •
Ophthalmic - U.S. Brands: Ilotycin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202220.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. 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 Institute12: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
12
These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 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:14 •
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
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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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
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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/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
13
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). 14 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
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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 Gateway15 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.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “lymphedema” (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 6506 83 832 10 1 7432
HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 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.19 Simply search by “lymphedema” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
15
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
16
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). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19
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 Biologists20 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.21 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.22 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/.
The Genome Project and Lymphedema In the following section, we will discuss databases and references which relate to the Genome Project and lymphedema. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).23 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 20 Adapted 21
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. 22 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. 23 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “lymphedema” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for lymphedema: •
Cholestasis-lymphedema Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?214900
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Ectodermal Dysplasia, Anhidrotic, with Immunodeficiency, Osteopetrosis, and Lymphedema Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?300301
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Hennekam Lymphangiectasia-lymphedema Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?235510
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Hypotrichosis-lymphedema-telangiectasia Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607823
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Lymphedema and Cerebral Arteriovenous Anomaly Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?152900
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Lymphedema and Ptosis Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?153000
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Lymphedema, Atrial Septal Defect, and Facial Changes Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601927
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Lymphedema, Congenital Recessive Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?247440
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Lymphedema, Hereditary, I Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?153100
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Lymphedema, Hereditary, Ii Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?153200
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Lymphedema, Microcephaly, Chorioretinopathy Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?152950
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Lymphedema-distichiasis Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?153400
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Lymphedema-hypoparathyroidism Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?247410 Genes and Disease (NCBI - Map)
The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed:
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Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html
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Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html
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Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html
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Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html
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Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html
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Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html
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Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez
Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •
3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
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Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
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NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
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Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
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OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
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Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “lymphedema” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database24 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html.
24
Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html.
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The Genome Database25 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “lymphedema” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).
25
Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.
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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 lymphedema 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 lymphedema. 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 lymphedema. 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 “lymphedema”:
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Other guides Breast Cancer http://www.nlm.nih.gov/medlineplus/breastcancer.html Breast Implants/Breast Reconstruction http://www.nlm.nih.gov/medlineplus/breastimplantsbreastreconstruction.html Hodgkin's Disease http://www.nlm.nih.gov/medlineplus/hodgkinsdisease.html Lymphatic Diseases http://www.nlm.nih.gov/medlineplus/lymphaticdiseases.html Parasitic Diseases http://www.nlm.nih.gov/medlineplus/parasiticdiseases.html Spleen Diseases http://www.nlm.nih.gov/medlineplus/spleendiseases.html Vision Disorders & Blindness http://www.nlm.nih.gov/medlineplus/visiondisordersblindness.html Vulvar Cancer http://www.nlm.nih.gov/medlineplus/vulvarcancer.html
Within the health topic page dedicated to lymphedema, the following was listed: •
Diagnosis/Symptoms Neck Swelling: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/514.html
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Specific Conditions/Aspects Choosing a Lymphedema Therapist Source: National Lymphedema Network http://www.lymphnet.org/choosing.html Lymphatic Filariasis Source: National Center for Infectious Diseases, Division of Parasitic Diseases http://www.cdc.gov/ncidod/dpd/parasites/lymphaticfilariasis/factsht_lymphati c_filar.htm Lymphatic Filariasis (Elephantiasis) Source: National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/newsroom/focuson/bugborne01/filar.htm Lymphedema (PDQ) Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/supportivecare/lymphedema/patient/ Painful, Swollen Lymph Nodes (Lymphadenitis) Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01039
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Tips for Travel and Aircraft Flight for Patients with Lymphedema Source: National Lymphedema Network http://www.lymphnet.org/lymphlink-travel.html What Is Castleman's Disease? Source: American Cancer Society http://www.cancer.org/docroot/CRI/content/CRI_2_4_1x_What_Is_Castlemans_ Disease.asp? What Is Lymphedema? Source: National Lymphedema Network http://www.lymphnet.org/whatis.html •
Law and Policy Lymphedema Legislation Source: National Lymphedema Network http://www.lymphnet.org/legislation.html
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Men Facts About Lymphangioleiomyomatosis (LAM) Source: National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health/public/lung/other/lam.htm Keeping the Blood and Lymphatic System Healthy Source: American Medical Women's Association http://www.amwa-doc.org/publications/WCHealthbook/bloodamwa-ch29.html Lymphangioleiomyomatosis (LAM) Source: American Lung Association http://www.lungusa.org/diseases/lam.html
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Organizations National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/ National Lymphedema Network http://www.lymphnet.org/
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Pictures/Diagrams Atlas of the Body: The Lymphatic System Source: American Medical Association http://www.medem.com/medlb/article_detaillb.cfm?article_ID=/ZZZG0S6CGJC &sub_cat=198
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Prevention/Screening Lymphedema Prevention Source: National Lymphedema Network http://www.lymphnet.org/prevention.html
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Teenagers Spleen and Lymphatic System Source: Nemours Foundation http://kidshealth.org/teen/your_body/body_basics/spleen.html
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Women Facts About Lymphangioleiomyomatosis (LAM) Source: National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health/public/lung/other/lam.htm Keeping the Blood and Lymphatic System Healthy Source: American Medical Women's Association http://www.amwa-doc.org/publications/WCHealthbook/bloodamwa-ch29.html Lymphangioleiomyomatosis (LAM) Source: American Lung Association http://www.lungusa.org/diseases/lam.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. Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
Lymphedema (PDQ®) Summary: Information and practice guidelines about lymphedema intended for use by doctors and other health care professionals. Source: National Cancer Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4271
•
Lymphedema Question Corner Summary: Browse this site for answers to questions from patients and the general public received by the National Lymphedema Network and featured in the NLN newsletter. Source: National Lymphedema Network, Inc. http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3828
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Lymphedema Resource Guide Summary: This web site contains listings of lymphedema treatment centers, diagnostic centers, physicians, drainage therapists, suppliers and therapist training programs in the US. Source: National Lymphedema Network, Inc. http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3830
•
Lymphedema: A Brief Overview Summary: This consumer health information fact sheet provides basic information about lymphedema -- includes causes, symptoms and treatment information, Source: National Lymphedema Network, Inc. http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3829 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 lymphedema. 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
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDHealth: http://my.webmd.com/health_topics
Associations and Lymphedema The following is a list of associations that provide information on and resources relating to lymphedema:
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Canadian Lymphedema Foundation/Lymphovenous Canada Telephone: 416-533-2428 Toll-free: 999-999-9999 Fax: 416-539-8348 Email:
[email protected] Web Site: http://www.lymphovenous-canada.ca Background: Lymphovenous Canada is a network of organizations, groups, and researchers across Canada interested in promoting scientific research, public awareness, and support services to help those with lymphatic disorders such as lymphedema, Klippel-Trenaunay (KT) syndrome, lymphangioma, hemangioma, and vascular malformations. Lymphovenous Canada is a partner in the Canadian Health Network. The web site, Lymphovenous Canada, established in 1996, the network (The National Resource Group on Lymphovenous and Lymphatic Research)and the quarterly newsletter, 'Lymphletters' are supported through voluntary not for profit efforts. In 2003 Lymphovenous Canada and the network became part of the Canadian Lymphedema Foundation which was established in 2002 to promote and support scientific research in the lymphatic system in Canada.
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Lymphoedema (Lymphedema) Association of Australia Telephone: 08 8271 2198 Fax: 08 8271 8776 Email:
[email protected] Web Site: http://www.lymphoedema.org.au Background: The Lymphoedema (Lymphedema) Association of Australia (LAA) is a not-for-profit international organization that was founded in 1982 to encourage research into lymphedema and its treatment and to disseminate such information among physicians, therapists, affected individuals, and family members. Lymphedema is a condition characterized by abnormal accumulation of lymph fluid in and associated swelling of certain body tissues due to lymphatic system abnormalities that cause obstruction of normal lymph flow into the bloodstream. Lymph is a bodily fluid that contains certain white blood cells (lymphocytes), fats, and proteins and functions as an essential part of the immune system. Individuals with lymphedema may experience swelling that increases over time; a feeling of heaviness, tightness, and discomfort in the affected area; tenderness or pain; susceptibility to infection; and, in some severe cases, loss of mobility. The Lymphoedema Association of Australia currently has approximately 2,000 members from Australia and other countries throughout the world. The Association publishes understandable information on lymphedema and its symptoms, causes, and treatment; offers books, videos, audiotapes, and other materials concerning lymphedema; publishes a regular newsletter; and provides referrals to therapists, treatment centers, and support groups.
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National Lymphedema Network Telephone: (510) 208-3200 Toll-free: (800) 541-3259 Fax: (510) 208-3110 Email:
[email protected] Web Site: http://www.lymphnet.org
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Background: The National Lymphedema Network (NLN) is a not-for-profit organization dedicated to providing education and support to affected individuals, health care professionals and the general public by disseminating information on the prevention and management of primary and secondary lymphedema. Established in 1988, the National Lymphedema Network provides a toll-free Infoline that offers 24hour recorded information. Through its direct-dial support line, the NLN offers guidance and education as well as referrals to health care professionals, treatment centers, and local support groups. The network is dedicated to supporting research into the causes of, and possible alternative treatments for, lymphedema and presents a large national educational conference every other year. NLN's long-term goal is to aid in the implementation of standardized quality treatment nationwide for those individuals affected by lymphedema. NLN offers a variety of educational materials, including an extensive quarterly news publication, LymphLink, and a Resource Guide that provides a listing of lymphedema treatment centers, therapists, diagnostic centers and suppliers across the country. Related video, audiotapes and CD ROMs are available for purchase. The network also maintains an informational Research Database on lymphedema. Relevant area(s) of interest: Lymphedema •
Tasmanian Lymphoedema (Lymphedema) Support Group Telephone: 03 62444634 Fax: 03 62444634 Email: None. Web Site: None Background: The Tasmanian Lymphoedema (Lymphedema) Support Group is a voluntary self-help organization in Australia dedicated to providing information and support to individuals affected by lymphedema, educating and supporting family members, and promoting professional and public awareness. Lymphedema is characterized by an abnormal accumulation of lymph fluid in and associated swelling of certain body tissues due to lymphatic system abnormalities that cause obstruction of normal lymph flow into the bloodstream. Lymph is a bodily fluid that contains certain white blood cells (lymphocytes), fats, and proteins and functions as an essential part of the immune system. It accumulates outside blood vessels in spaces between cells in tissues and flows back into the bloodstream via lymph vessels. Individuals with lymphedema may experience swelling that increases over time, a feeling of heaviness and discomfort in the affected area, pain, susceptibility to infection, and, in some severe cases, loss of mobility. The Tasmanian Lymphoedema Support Group was established in 1994 and currently has approximately 80 members. The Group engages in patient advocacy and lobbying efforts, promotes research, and provides referrals. In addition, the organization offers networking opportunities that enable affected individuals to exchange information, resources, and mutual support. The Tasmanian Lymphoedema Support Group also provides a variety of educational materials including brochures and publishes a regular newsletter.
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to lymphedema. By consulting all of associations listed
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in this chapter, you will have nearly exhausted all sources for patient associations concerned with lymphedema. 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 lymphedema. 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 “lymphedema” (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 “lymphedema”. 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 “lymphedema” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “lymphedema” (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.26
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
26
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)27: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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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
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
27
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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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
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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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
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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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
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on lymphedema: •
Basic Guidelines for Lymphedema Chf Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000158.htm Lymphedema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001117.htm
•
Signs & Symptoms for Lymphedema Edema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm
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•
Diagnostics and Tests for Lymphedema Albumin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003480.htm ANA Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003535.htm BUN Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003474.htm CT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003330.htm Differential Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm Liver function tests Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003436.htm
•
Background Topics for Lymphedema Distal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002346.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Malignancy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002253.htm Noninvasive Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002269.htm Proximal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002287.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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LYMPHEDEMA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Ablation: The removal of an organ by surgery. [NIH] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Rosacea: An acneiform eruption occurring mostly in middle-aged adults and appearing generally on the forehead, cheeks, nose, and chin. Three types are recognized: granulomatous, glandular hyperplastic with rhinophyma, and ocular. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [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]
Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]
Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the
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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 of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] 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] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alpha 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] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] 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]
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Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] 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] Angioneurotic: Denoting a neuropathy affecting the vascular system; see angioedema. [EU] Angioneurotic Edema: Recurring attacks of transient edema suddenly appearing in areas of the skin or mucous membranes and occasionally of the viscera, often associated with dermatographism, urticaria, erythema, and purpura. [NIH] Angiosarcoma: A type of cancer that begins in the lining of blood vessels. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anionic: Pertaining to or containing an anion. [EU] Ankle: That part of the lower limb directly above the foot. [NIH] Anklets: Brace that supports the ankle. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anthelmintic: An agent that is destructive to worms. [EU] 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] 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
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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] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aorta: The main trunk of the systemic arteries. [NIH] Aplasia: Lack of development of an organ or tissue, or of the cellular products from an organ or tissue. [EU] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arthropathy: Any joint disease. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Astrocytoma: A tumor that begins in the brain or spinal cord in small, star-shaped cells called astrocytes. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] 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] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Axilla: The underarm or armpit. [NIH]
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Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]
Axillary dissection: Surgery to remove lymph nodes found in the armpit region. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Basal cell carcinoma: A type of skin cancer that arises from the basal cells, small round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [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] Basophil: A type of white blood cell. Basophils are granulocytes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biopsy specimen: Tissue removed from the body and examined under a microscope to determine whether disease is present. [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]
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Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [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] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [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] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the
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interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [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] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [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] Causal: Pertaining to a cause; directed against a cause. [EU] Cecum: The beginning of the large intestine. The cecum is connected to the lower part of the small intestine, called the ileum. [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 Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cellular Structures: Components of a cell. [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] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [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]
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Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cheilitis: Inflammation of the lips. It is of various etiologies and degrees of pathology. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [NIH]
Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [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] 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] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [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] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]
Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of
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the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [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] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Communication Disorders: Disorders of verbal and nonverbal communication caused by receptive or expressive language disorders, cognitive dysfunction (e.g., mental retardation), psychiatric conditions, and hearing disorders. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such
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as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [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] Concomitant: Accompanying; accessory; joined with another. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] 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] Constriction: The act of constricting. [NIH] Contact dermatitis: Inflammation of the skin with varying degrees of erythema, edema and vesinculation resulting from cutaneous contact with a foreign substance or other exposure. [NIH]
Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]
Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cost-benefit: A quantitative technique of economic analysis which, when applied to radiation practice, compares the health detriment from the radiation doses concerned with
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the cost of radiation dose reduction in that practice. [NIH] Coumarin: A fluorescent dye. [NIH] Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with longitudinal studies which are followed over a period of time. [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] Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatosis: Any skin disease, especially one not characterized by inflammation. [EU] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diathermy: The induction of local hyperthermia by either short radio waves or highfrequency sound waves. [NIH] Diethylcarbamazine: An anthelmintic used primarily as the citrate in the treatment of filariasis, particularly infestations with Wucheria bancrofti or Loa loa. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel
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movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dose-limiting: Describes side effects of a drug or other treatment that are serious enough to prevent an increase in dose or level of that treatment. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysgenesis: Defective development. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Ectoderm: The outer of the three germ layers of the embryo. [NIH] Ectodermal Dysplasia: A group of hereditary disorders involving tissues and structures derived from the embryonic ectoderm. They are characterized by the presence of abnormalities at birth and involvement of both the epidermis and skin appendages. They are generally nonprogressive and diffuse. Various forms exist, including anhidrotic and hidrotic dysplasias, focal dermal hypoplasia, and aplasia cutis congenita. [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] Elastin: The protein that gives flexibility to tissues. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid
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morphological changes and the differentiation of basic structures. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [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] Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] 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]
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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] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erysipelas: An acute infection of the skin caused by species of streptococcus. This disease most frequently affects infants, young children, and the elderly. Characteristics include pink-to-red lesions that spread rapidly and are warm to the touch. The commonest site of involvement is the face. [NIH] Erysipeloid: An infection caused by Erysipelothrix rhusiopathiae that is almost wholly restricted to persons who in their occupation handle infected fish, shellfish, poultry, or meat. Three forms of this condition exist: a mild localized form manifested by local swelling and redness of the skin; a diffuse form that might present with fever; and a rare systemic form associated with endocarditis. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estrogen: One of the two female sex hormones. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Expander: Any of several colloidal substances of high molecular weight. used as a blood or plasma substitute in transfusion for increasing the volume of the circulating blood. called also extender. [NIH] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye socket: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Facial: Of or pertaining to the face. [EU] Fallopian Tubes: Two long muscular tubes that transport ova from the ovaries to the uterus. They extend from the horn of the uterus to the ovaries and consist of an ampulla, an
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infundibulum, an isthmus, two ostia, and a pars uterina. The walls of the tubes are composed of three layers: mucosal, muscular, and serosal. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] 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] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filariasis: Infections with nematodes of the superfamily Filarioidea. The presence of living worms in the body is mainly asymptomatic but the death of adult worms leads to granulomatous inflammation and permanent fibrosis. Organisms of the genus Elaeophora infect wild elk and domestic sheep causing ischaemic necrosis of the brain, blindness, and dermatosis of the face. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] 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] Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored
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in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] 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] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gemcitabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [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] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Screening: Searching a population or individuals for persons possessing certain genotypes or karyotypes that: (1) are already associated with disease or predispose to disease; (2) may lead to disease in their descendants; or (3) produce other variations not known to be associated with disease. Genetic screening may be directed toward identifying phenotypic expression of genetic traits. It includes prenatal genetic screening. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glioblastoma: A malignant form of astrocytoma histologically characterized by pleomorphism of cells, nuclear atypia, microhemorrhage, and necrosis. They may arise in any region of the central nervous system, with a predilection for the cerebral hemispheres,
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basal ganglia, and commissural pathways. Clinical presentation most frequently occurs in the fifth or sixth decade of life with focal neurologic signs or seizures. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]
Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granulomas: Small lumps in tissues caused by inflammation. [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] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gynecologic cancer: Cancer of the female reproductive tract, including the cervix, endometrium, fallopian tubes, ovaries, uterus, and vagina. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Hearing Disorders: Conditions that impair the transmission or perception of auditory impulses and information from the level of the ear to the temporal cortices, including the sensorineural pathways. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Helminths: Commonly known as parasitic worms, this group includes the acanthocephala, nematoda, and platyhelminths. Some authors consider certain species of leeches that can become temporarily parasitic as helminths. [NIH] Hematologic malignancies: Cancers of the blood or bone marrow, including leukemia and lymphoma. Also called hematologic cancers. [NIH] Hematopoietic Stem Cells: Progenitor cells from which all blood cells derive. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated
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hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorheology: The study of the flow of blood in relation to the pressures, flow, volumes, and resistances in blood vessels in macroscopic, microscopic, and submicroscopic dimensions. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hepatobiliary: Pertaining to the liver and the bile or the biliary ducts. [EU] Hepatocyte: A liver cell. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] 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]
Histiocytosis: General term for the abnormal appearance of histiocytes in the blood. Based on the pathological features of the cells involved rather than on clinical findings, the histiocytic diseases are subdivided into three groups: Langerhans cell histiocytosis, nonLangerhans cell histiocytosis, and malignant histiocytic disorders. [NIH] Homeobox: Distinctive sequence of DNA bases. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] 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] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU]
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Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrops Fetalis: Edema of the entire body due to abnormal accumulation of serous fluid in the tissues, associated with severe anemia and occurring in fetal erythroblastosis. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] 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] Imaging procedures: Methods of producing pictures of areas inside the body. [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] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunoglobulins: Glycoproteins present in the blood (antibodies) and in other tissue. They are classified by structure and activity into five classes (IgA, IgD, IgE, IgG, IgM). [NIH]
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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] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinentia Pigmenti: A genodermatosis occurring mostly in females and characterized by skin changes in three phases - vesiculobullous, verrucous papillomatous, and macular melanodermic. Hyperpigmentation is bizarre and irregular. Sixty percent of patients have abnormalities of eyes, teeth, central nervous system, and skin appendages. [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] Infantile: Pertaining to an infant or to infancy. [EU] 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]
Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infestation: Parasitic attack or subsistence on the skin and/or its appendages, as by insects, mites, or ticks; sometimes used to denote parasitic invasion of the organs and tissues, as by helminths. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical
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signs of pain, heat, redness, swelling, and loss of function. [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] 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] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] 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] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ipsilateral: Having to do with the same side of the body. [NIH] Irradiation: The use of high-energy radiation from x-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 from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [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] Kidney Disease: Any one of several chronic conditions that are caused by damage to the
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cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Language Development: The gradual expansion in complexity and meaning of symbols and sounds as perceived and interpreted by the individual through a maturational and learning process. Stages in development include babbling, cooing, word imitation with cognition, and use of short sentences. [NIH] Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and developmental disorders. [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] Laser therapy: The use of an intensely powerful beam of light to kill cancer cells. [NIH] Leg Ulcer: Ulceration of the skin and underlying structures of the lower extremity. About 90% of the cases are due to venous insufficiency (varicose ulcer), 5% to arterial disease, and the remaining 5% to other causes. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Light microscope: A microscope (device to magnify small objects) in which objects are lit directly by white light. [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] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [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] Lipoma: A benign tumor composed of fat cells. [NIH] Liposarcoma: A rare cancer of the fat cells. [NIH] Liposomal: A drug preparation that contains the active drug in very tiny fat particles. This fat-encapsulated drug is absorbed better, and its distribution to the tumor site is improved. [NIH]
Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood
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and aids in digestion by secreting bile. [NIH] Loa: A genus of parasitic nematodes found throughout the rain-forest areas of the Sudan and the basin of the Congo. L. loa inhabits the subcutaneous tissues, which it traverses freely. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] 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 connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphadenectomy: A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer. Also called lymph node dissection. [NIH] Lymphangiography: An x-ray study of the lymphatic system. A dye is injected into a lymphatic vessel and travels throughout the lymphatic system. The dye outlines the lymphatic vessels and organs on the x-ray. [NIH] Lymphangitis: Inflammation of a lymphatic vessel or vessels. Acute lymphangitis may result from spread of bacterial infection (most commonly beta-haemolytic streptococci) into the lymphatics, manifested by painful subcutaneous red streaks along the course of the vessels. [EU] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic Metastasis: Transfer of a neoplasm from its primary site to lymph nodes or to distant parts of the body by way of the lymphatic system. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphedema: Edema due to obstruction of lymph vessels or disorders of the lymph nodes. [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] Lymphography: Radiographic study of the lymphatic system following injection of dye or contrast medium. [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]
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Lymphoscintigraphy: A method used to identify the sentinel node (the first draining lymph node near a tumor). A radioactive substance that can be taken up by lymph nodes is injected at the site of the tumor, and a doctor follows the movement of this substance on a computer screen. Once the lymph nodes that have taken up the substance are identified, they can be removed and examined to see if they contain tumor cells. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malformation: A morphologic developmental process. [EU]
defect
resulting
from
an
intrinsically
abnormal
Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mammary: Pertaining to the mamma, or breast. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mastectomy: Surgery to remove the breast (or as much of the breast tissue as possible). [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]
Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH]
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Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
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] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microspheres: Small uniformly-sized spherical particles frequently radioisotopes or various reagents acting as tags or markers. [NIH]
labeled
with
Microsurgery: Surgical procedures on the cellular level; a light microscope and miniaturized instruments are used. [NIH] Microwaves: That portion of the electromagnetic spectrum lying between UHF (ultrahigh frequency) radio waves and heat (infrared) waves. Microwaves are used to generate heat, especially in some types of diathermy. They may cause heat damage to tissues. [NIH] Midazolam: A short-acting compound, water-soluble at pH less than 4 and lipid-soluble at physiological pH. It is a hypnotic-sedative drug with anxiolytic and amnestic properties. It is used for sedation in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. Because of its short duration and cardiorespiratory stability, it is particularly useful in poor-risk, elderly, and cardiac patients. [NIH]
Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH]
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Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Myxedema: A condition characterized by a dry, waxy type of swelling with abnormal deposits of mucin in the skin and other tissues. It is produced by a functional insufficiency of the thyroid gland, resulting in deficiency of thyroid hormone. The skin becomes puffy around the eyes and on the cheeks and the face is dull and expressionless with thickened nose and lips. The congenital form of the disease is cretinism. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU]
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Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [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] 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] 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] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nevus: A benign growth on the skin, such as a mole. A mole is a cluster of melanocytes and surrounding supportive tissue that usually appears as a tan, brown, or flesh-colored spot on the skin. The plural of nevus is nevi (NEE-vye). [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU]
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Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio 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] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oncology: The study of cancer. [NIH] Oncology nurse: A nurse who specializes in treating and caring for people who have cancer. [NIH]
Opacity: Degree of density (area most dense taken for reading). [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] Orofacial: Of or relating to the mouth and face. [EU] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] 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] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU]
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Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] PDQ: Physician Data Query. PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information is available on the CancerNet Web site, and more specific information about PDQ can be found at http://cancernet.nci.nih.gov/pdq.html. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] 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] Periorbital: Situated around the orbit, or eye socket. [EU] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH]
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Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] 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] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [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]
Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [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] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Pleura: The thin serous membrane enveloping the lungs and lining the thoracic cavity. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH]
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Pleural Effusion: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Povidone: A polyvinyl polymer of variable molecular weight; used as suspending and dispersing agent and vehicle for pharmaceuticals; also used as blood volume expander. [NIH] Povidone-Iodine: An iodinated polyvinyl polymer used as topical antiseptic in surgery and for skin and mucous membrane infections, also as aerosol. The iodine may be radiolabeled for research purposes. [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] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] 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
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in the population at a given time. [NIH] Primary tumor: The original tumor. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [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] Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va
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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] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [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] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] 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] Radical mastectomy: Surgery for breast cancer in which the breast, chest muscles, and all of the lymph nodes under the arm are removed. For many years, this was the operation most used, but it is used now only when the tumor has spread to the chest muscles. Also called
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the Halsted radical mastectomy. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH]
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Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reference point: The midpoint of a line connecting the centers of the two end faces of the acoustic test fixture. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [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] Relaxin: Hormone produced by the ovaries during pregnancy that loosens ligaments that hold the hip bones together. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Residual disease: Cancer cells that remain after attempts have been made to remove the cancer. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [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] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested
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as possible causes. [NIH] Rhinophyma: A manifestation of severe Acne rosacea resulting in significant enlargement of the nose and occurring primarily in men. It is caused by hypertrophy of the sebaceous glands and surrounding connective tissue. The nose is reddened and marked with numerous telangiectasias. [NIH] Rhusiopathiae: Causal agent of the anthropozoonosis called erysipeloid. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [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] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH]
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Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Seminal vesicles: Glands that help produce semen. [NIH] Sensory Thresholds: The minimum amount of stimulus energy necessary to elicit a sensory response. [NIH] Sentinel lymph node: The first lymph node that cancer is likely to spread to from the primary tumor. Cancer cells may appear first in the sentinel node before spreading to other lymph nodes. [NIH] Sentinel Lymph Node Biopsy: A diagnostic procedure used to determine whether lymphatic metastasis has occurred. The sentinel lymph node is the first lymph node to receive drainage from a neoplasm. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects
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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] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [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] Sodium Selenite: Selenious acid, disodium salt. It is used therapeutically to supply the trace element selenium. [NIH] 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] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] 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]
Dictionary 189
Sperm: The fecundating fluid of the male. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] 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] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [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]
Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] 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] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stump: The end of the limb after amputation. [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] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH]
190 Lymphedema
Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Tenosynovitis: Inflammation of a tendon sheath. [EU] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [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
Dictionary 191
multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Ticks: Blood-sucking arachnids of the order Acarina. [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] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] 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] Tourniquet: A device, band or elastic tube applied temporarily to press upon an artery to stop bleeding; a device to compress a blood vessel in order to stop bleeding. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH]
192 Lymphedema
Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] 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] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes and the genital tract in the male. It includes the specialty of andrology which addresses both male genital diseases and male infertility. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH]
Dictionary 193
Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vas Deferens: The excretory duct of the testes that carries spermatozoa. It rises from the scrotum and joins the seminal vesicles to form the ejaculatory duct. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venous: Of or pertaining to the veins. [EU] Venous Insufficiency: Inadequacy of the venous valves and impairment of venous return (venous stasis) usually from the legs, often with edema and sometimes with stasis ulcers at the ankle. [NIH] Venous Pressure: The blood pressure in a vein. It is usually measured to assess the filling pressure to the ventricle. [NIH] 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] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [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] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [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] Voice Disorders: Disorders of voice pitch, loudness, or quality. Dysphonia refers to impaired utterance of sounds by the vocal folds. [NIH] Vulva: The external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH]
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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] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
195
INDEX A Abdomen, 151, 156, 158, 167, 171, 172, 178, 189, 193 Abdominal, 40, 151, 161, 172, 175, 178, 179, 192 Abdominal Pain, 151, 192 Ablation, 14, 151 Abscess, 151, 187 Acetylcholine, 151, 177 Acne, 29, 151, 186 Acne Rosacea, 29, 151 Acoustic, 151, 185 Activities of Daily Living, 92, 151 Adenine, 151 Adenosine, 19, 151, 180 Adjustment, 13, 16, 151 Adjuvant, 7, 43, 151 Adjuvant Therapy, 43, 151 Adrenal Glands, 151, 152 Adverse Effect, 151, 187 Aerosol, 151, 181 Affinity, 151, 152, 188 Age of Onset, 10, 152 Agonist, 152, 190 Algorithms, 152, 155 Alkaline, 152, 156 Alpha Particles, 152, 183 Alternative medicine, 116, 152 Ameliorating, 14, 152 Amino Acids, 152, 166, 179, 181, 183, 186, 191 Amnestic, 152, 175 Ampulla, 152, 158, 163, 164 Amputation, 96, 152, 189 Amyloidosis, 53, 152 Anal, 14, 152, 163 Analog, 97, 152 Analogous, 10, 152, 191 Anaplasia, 153 Anastomosis, 40, 59, 153 Anatomical, 74, 153, 154, 158, 170, 186 Anemia, 129, 153, 169 Anesthesia, 153, 175 Angiogenesis, 9, 20, 35, 153 Angiography, 35, 153 Angioneurotic, 111, 153 Angioneurotic Edema, 111, 153 Angiosarcoma, 26, 31, 39, 58, 153
Animal model, 14, 103, 153 Anionic, 98, 153 Ankle, 153, 193 Anklets, 99, 153 Anomalies, 30, 153 Anthelmintic, 153, 161 Antibacterial, 153, 188 Antibiotic, 153, 179, 188 Antibodies, 153, 169, 173, 184 Antibody, 152, 153, 159, 170, 171, 176, 183, 184, 188, 194 Anticoagulant, 153, 182 Antigen, 20, 152, 153, 159, 166, 170 Antiseptic, 26, 154, 181 Anus, 152, 154, 156, 184 Anxiety, 5, 118, 154 Anxiolytic, 154, 175 Aorta, 4, 154, 193 Aplasia, 15, 101, 154, 162 Aqueous, 154, 155 Arachidonic Acid, 154, 182 Arginine, 154, 177 Arterial, 103, 154, 172, 183 Arteries, 154, 156, 160, 175 Arterioles, 154, 156, 175 Arteriovenous, 128, 154, 175 Arthropathy, 54, 64, 154 Articulation, 4, 154 Astrocytoma, 154, 166 Asymptomatic, 21, 154, 165 Ataxia, 129, 154, 190 Atrial, 51, 128, 154 Atrium, 154, 193 Atrophy, 129, 154, 172 Atypical, 52, 65, 68, 154 Autologous, 52, 154 Axilla, 25, 93, 154 Axillary, 47, 53, 57, 87, 116, 155 Axillary dissection, 47, 155 B Back Pain, 118, 155 Bacteria, 92, 104, 153, 155, 175, 180, 187, 188, 189, 191, 192 Bacterial Infections, 4, 155 Basal cell carcinoma, 47, 155 Basal cells, 155 Basal Ganglia, 154, 155, 167 Basal Ganglia Diseases, 154, 155
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Base, 6, 7, 8, 98, 151, 155, 161, 166, 171, 190 Basophil, 20, 155 Benign, 155, 172, 176, 177, 184 Benign tumor, 155, 172 Bilateral, 23, 30, 65, 155 Bile, 155, 165, 168, 169, 173 Biliary, 155, 158, 168 Biochemical, 10, 11, 155 Biopsy, 21, 57, 155 Biopsy specimen, 21, 155 Biotechnology, 21, 22, 110, 116, 125, 127, 128, 129, 130, 155 Bladder, 95, 156, 165, 182, 192 Blood Coagulation, 156, 190 Blood pressure, 94, 99, 156, 176, 188, 193 Blood Volume, 156, 181 Body Fluids, 156, 162, 188 Bone Marrow, 156, 167, 173, 188 Bowel, 7, 152, 156, 161, 171, 179, 189, 192 Bowel Movement, 156, 162, 189 Brachytherapy, 156, 171, 183, 194 Bradykinin, 156, 177 Branch, 147, 156, 173, 179, 188, 190 Breakdown, 156, 161, 166 Breeding, 92, 156 Burns, 42, 43, 156 Burns, Electric, 156 C Calcium, 12, 156, 159, 187 Capillary, 18, 29, 39, 74, 156, 193 Carcinogenic, 157, 171, 182 Carcinogens, 157, 178 Carcinoma, 32, 35, 38, 41, 42, 46, 52, 54, 58, 59, 157 Cardiac, 15, 101, 157, 163, 164, 175, 176 Cardiorespiratory, 157, 175 Cardiovascular, 6, 36, 56, 78, 80, 157 Carpal Tunnel Syndrome, 51, 157 Case report, 28, 53, 57, 58, 77, 157 Causal, 11, 157, 163, 186 Cecum, 157, 172 Cell Adhesion, 39, 157 Cell Differentiation, 157, 187 Cell Division, 129, 155, 157, 180 Cell proliferation, 103, 157, 187 Cellular Structures, 12, 157 Cellulitis, 37, 55, 83, 106, 157 Central Nervous System, 151, 157, 166, 170 Cerebellar, 154, 157, 184 Cerebral, 128, 154, 155, 157, 164, 165, 166 Cerebral hemispheres, 155, 157, 166
Cerebrum, 157, 192 Cervix, 158, 165, 167 Cheilitis, 111, 158 Chemotherapy, 21, 151, 158 Chest wall, 94, 158 Chin, 151, 158 Cholestasis, 19, 36, 46, 128, 158 Cholesterol, 155, 158, 190 Chromosomal, 11, 15, 158, 180 Chromosome, 23, 46, 47, 158, 172 Chronic Disease, 158, 159 Chronic renal, 158, 181 Circulatory system, 104, 105, 158 Clear cell carcinoma, 158, 161 Cleft Palate, 10, 37, 158 Clinical trial, 4, 5, 7, 14, 23, 73, 87, 89, 125, 158, 179, 183, 184 Clone, 15, 158 Cloning, 155, 158 Cofactor, 158, 183, 190 Cognition, 158, 172 Cohort Studies, 158, 163 Colitis, 159 Collagen, 101, 159, 165, 180, 182 Collagen disease, 101, 159 Communication Disorders, 4, 89, 124, 159 Complement, 159 Complementary and alternative medicine, 73, 84, 159 Complementary medicine, 73, 159 Compress, 160, 191 Computational Biology, 125, 127, 160 Concomitant, 32, 63, 160 Conduction, 102, 160 Confounding, 5, 160 Congenita, 160, 162 Congestive heart failure, 19, 160 Connective Tissue, 156, 157, 159, 160, 165, 173, 185, 186 Constriction, 18, 160, 171 Contact dermatitis, 42, 160 Continuum, 20, 160 Contractility, 103, 105, 160 Contraindications, ii, 160 Contralateral, 14, 160, 184 Conventional therapy, 35, 68, 76, 160 Conventional treatment, 160 Coronary, 103, 160, 175 Coronary Thrombosis, 160, 175 Corpus, 160, 179 Cortex, 154, 160, 165, 184 Cortical, 160, 186, 190
Index 197
Cost-benefit, 14, 160 Coumarin, 30, 39, 68, 69, 70, 81, 116, 161 Cross-Sectional Studies, 161, 163 Curative, 161, 190 Cutaneous, 31, 32, 36, 41, 46, 53, 56, 160, 161, 173 Cyclic, 19, 161, 167, 177, 182 Cytotoxic, 161, 184, 187 D Databases, Bibliographic, 125, 161 Deletion, 47, 161 Dendrites, 161 Dendritic, 69, 79, 161, 174 Density, 92, 103, 161, 178, 188 Dentists, 111, 161 Depolarization, 161, 187 Dermal, 35, 52, 161, 162 Dermatitis, 42, 111, 161 Dermatosis, 68, 161, 165 DES, 69, 161 Diagnostic procedure, 91, 116, 161, 187 Diaphragm, 161, 180 Diathermy, 15, 161, 175 Diethylcarbamazine, 69, 161 Digestion, 19, 155, 156, 161, 171, 173, 189 Digestive system, 89, 161 Digestive tract, 162, 188 Dilatation, 20, 162, 193 Direct, iii, 20, 98, 103, 106, 119, 139, 162, 181, 185 Dissection, 14, 34, 57, 76, 87, 116, 162, 173 Distal, 92, 93, 94, 96, 150, 162, 183 Dose-limiting, 62, 162 Drug Interactions, 120, 162 Drug Tolerance, 162, 191 Duct, 15, 98, 104, 105, 152, 162, 186, 193 Duodenum, 155, 162, 163, 189 Dysgenesis, 4, 162 Dysplasia, 47, 129, 162 Dystrophy, 129, 162 E Ectoderm, 162 Ectodermal Dysplasia, 50, 128, 162 Edema, 10, 15, 27, 33, 61, 83, 93, 94, 95, 96, 98, 102, 103, 149, 153, 160, 162, 169, 173, 193 Efficacy, 6, 14, 26, 30, 35, 68, 76, 88, 162 Elastin, 159, 162 Electrolyte, 162, 188 Electrons, 155, 162, 171, 183, 184 Embryo, 17, 157, 162, 170 Encapsulated, 163, 172
Endemic, 20, 163, 189 Endocarditis, 163, 164 Endometrium, 163, 167 Endoscopic, 163, 175 Endothelial cell, 8, 17, 19, 103, 163, 190 Endothelium, 12, 17, 103, 105, 163, 177 Endothelium, Lymphatic, 163 Endothelium, Vascular, 163 Endothelium-derived, 163, 177 End-stage renal, 35, 158, 163, 181 Environmental Exposure, 163, 178 Environmental Health, 124, 126, 163 Enzymatic, 156, 159, 163 Enzyme, 18, 97, 163, 167, 187, 190, 193, 194 Epidemiologic Studies, 11, 163 Epidermis, 155, 162, 163, 183 Epinephrine, 164, 192 Epithelium, 163, 164 Erectile, 164, 179 Erysipelas, 42, 58, 69, 164 Erysipeloid, 62, 164, 186 Erythema, 153, 160, 164, 192 Erythrocytes, 153, 156, 164 Esophagus, 3, 162, 164, 185, 189 Essential Tremor, 129, 164 Estrogen, 164, 186, 190 Eukaryotic Cells, 164, 170 Expander, 164, 181 External-beam radiation, 164, 171, 183, 194 Extracellular, 18, 98, 160, 164, 165, 188 Extracellular Matrix, 160, 164, 165 Eye socket, 164, 179 F Facial, 32, 36, 47, 51, 117, 128, 164, 179 Fallopian Tubes, 164, 167 Family Planning, 125, 165 Family Relations, 16, 165 Fat, 7, 8, 11, 15, 154, 156, 165, 172, 185, 188 Fatigue, 5, 165, 167 Fatty acids, 165, 182 Fibrin, 87, 88, 156, 165, 190 Fibrinogen, 165, 190 Fibroblasts, 103, 165 Fibrosis, 15, 20, 98, 111, 129, 165, 186 Filariasis, 20, 134, 161, 165 Filtration, 18, 95, 98, 165 Fissure, 111, 158, 165 Flexion, 93, 165 Fluorescence, 29, 35, 74, 165 Fold, 15, 16, 165, 175 Forearm, 100, 156, 165, 174
198 Lymphedema
Friction, 94, 165 Fundus, 165 G Gallbladder, 151, 155, 162, 165 Gamma Rays, 166, 183, 184 Gas, 166, 169, 177, 189, 193 Gastrin, 166, 168 Gastrointestinal, 3, 7, 97, 156, 164, 166, 189 Gastrointestinal tract, 97, 166, 189 Gemcitabine, 62, 166 Gene, 6, 10, 11, 15, 17, 19, 22, 23, 29, 33, 44, 49, 75, 102, 105, 110, 116, 130, 131, 155, 166, 172, 178 Gene Expression, 33, 75, 130, 166 Generator, 98, 166 Genetic Code, 166, 177 Genetic Screening, 105, 166 Genetics, 7, 10, 20, 23, 30, 33, 36, 37, 44, 45, 46, 47, 48, 49, 51, 56, 57, 63, 166, 179 Genital, 58, 61, 114, 158, 166, 192, 193 Genitourinary, 7, 166, 192 Genotype, 166, 179 Gestation, 31, 166 Giant Cells, 166, 186 Gland, 102, 166, 173, 178, 179, 182, 186, 189, 191 Glioblastoma, 6, 166 Glomerulus, 167, 177 Glucose, 129, 167, 168 Glutathione Peroxidase, 167, 186 Glycoprotein, 18, 165, 166, 167, 190 Governing Board, 167, 181 Graft, 58, 167, 168 Grafting, 167, 170 Granulocytes, 155, 167, 187, 194 Granulomas, 4, 167 Groin, 14, 88, 93, 167, 171 Growth, 4, 6, 8, 105, 106, 129, 153, 154, 155, 157, 167, 174, 176, 177, 178, 180, 186, 191, 192 Guanylate Cyclase, 167, 177 Gynecologic cancer, 60, 167 H Health Education, 30, 167 Health Status, 16, 167 Hearing Disorders, 159, 167 Heart failure, 167 Helminths, 167, 170 Hematologic malignancies, 7, 167 Hematopoietic Stem Cells, 6, 167 Hemoglobin, 153, 164, 167, 168 Hemoglobinuria, 129, 168
Hemorheology, 38, 168 Hemorrhage, 168, 183, 189 Hepatic, 15, 168 Hepatobiliary, 19, 168 Hepatocyte, 158, 168 Hereditary, 10, 11, 19, 22, 23, 25, 30, 37, 39, 41, 48, 105, 116, 128, 162, 168, 185 Heredity, 166, 168 Herpes, 24, 168 Herpes Zoster, 168 Heterogeneity, 11, 36, 37, 50, 56, 152, 168 Histiocytosis, 4, 168 Homeobox, 17, 168 Homeostasis, 11, 168 Homogeneous, 160, 168 Hormonal, 154, 168 Hormone, 4, 6, 97, 151, 161, 164, 166, 168, 171, 174, 176, 185, 187, 191 Hormone therapy, 151, 168 Host, 20, 60, 95, 98, 168 Humoral, 18, 168 Humour, 168, 169 Hybrid, 158, 169 Hydrogen, 155, 167, 169, 175, 177, 183 Hydrops Fetalis, 10, 36, 169 Hydroxylysine, 159, 169 Hydroxyproline, 159, 169 Hyperplasia, 15, 169 Hyperthermia, 63, 80, 161, 169 Hypertrophy, 64, 169, 186 Hypnotic, 169, 175 Hypoplasia, 15, 17, 101, 162, 169 Hypothyroidism, 46, 169 I Id, 71, 82, 134, 137, 146, 148, 169 Idiopathic, 169, 186 Imaging procedures, 169, 191 Immune response, 151, 153, 169, 193 Immune system, 10, 95, 98, 138, 139, 169, 170, 173, 192, 194 Immunity, 11, 20, 169 Immunodeficiency, 50, 128, 129, 169 Immunoglobulins, 57, 69, 79, 169 Immunologic, 170, 184 Immunology, 151, 152, 170 Impairment, 11, 16, 106, 154, 158, 170, 174, 175, 193 Implant radiation, 170, 171, 183, 194 Implantation, 37, 47, 103, 170 In situ, 11, 19, 103, 170 In Situ Hybridization, 19, 170 In vitro, 8, 9, 11, 103, 170
Index 199
In vivo, 9, 12, 19, 21, 103, 170 Incision, 170, 171 Incontinentia Pigmenti, 50, 170 Indicative, 109, 170, 179, 193 Induction, 161, 170 Infantile, 170, 172 Infarction, 160, 170, 175 Infertility, 170, 192 Infestation, 14, 170 Inflammation, 110, 151, 157, 158, 159, 160, 161, 165, 167, 168, 170, 173, 177, 185, 190, 192 Inguinal, 14, 171 Initiation, 171, 191 Insight, 19, 171 Intermittent, 29, 32, 34, 50, 78, 171 Internal radiation, 171, 183, 194 Interstitial, 20, 93, 95, 97, 156, 171, 177, 194 Intestinal, 9, 57, 171, 174 Intestine, 156, 171, 172, 189 Intracellular, 12, 170, 171, 174, 177, 182, 186, 187 Intravenous, 99, 171 Invasive, 14, 49, 169, 171 Involuntary, 155, 164, 171, 176 Iodine, 171, 181 Ionizing, 152, 163, 171, 184 Ions, 155, 162, 169, 171 Ipsilateral, 58, 171, 184 Irradiation, 14, 56, 171, 194 Ischemia, 154, 171 J Joint, 16, 97, 154, 171, 190 K Kb, 124, 171 Kidney Disease, 89, 124, 129, 171 L Language Development, 4, 172 Language Disorders, 159, 172 Large Intestine, 3, 157, 162, 171, 172, 184, 188 Laser therapy, 12, 62, 63, 102, 172 Leg Ulcer, 29, 172 Lesion, 46, 172, 173, 192 Lethargy, 169, 172 Leukemia, 129, 167, 172 Library Services, 146, 172 Ligament, 172, 182 Ligands, 9, 172 Light microscope, 172, 175 Linkage, 11, 15, 37, 56, 172 Lip, 111, 172
Lipid, 172, 175 Lipodystrophy, 65, 172 Lipoma, 65, 172 Liposarcoma, 46, 65, 172 Liposomal, 70, 81, 172 Liposomes, 102, 172 Liver, 3, 19, 150, 151, 152, 154, 155, 162, 165, 168, 172, 186 Loa, 161, 173 Localization, 19, 173 Localized, 14, 19, 46, 49, 152, 163, 164, 170, 172, 173, 180, 192 Loop, 6, 104, 173 Lumbar, 155, 173 Lupus, 159, 173 Lymphadenectomy, 14, 41, 53, 173 Lymphangiography, 27, 173 Lymphangitis, 54, 106, 173 Lymphatic Metastasis, 173, 187 Lymphocyte, 39, 154, 173 Lymphography, 27, 51, 105, 173 Lymphoid, 104, 153, 173 Lymphoma, 4, 42, 53, 78, 129, 167, 173 Lymphoscintigraphy, 24, 34, 35, 38, 55, 61, 64, 68, 69, 76, 80, 174 M Malabsorption, 129, 174 Malformation, 58, 174 Malignancy, 46, 150, 174 Malignant, 6, 78, 129, 166, 168, 174, 176, 184, 186 Malnutrition, 154, 174, 176 Mammary, 174, 190 Manifest, 3, 174 Mastectomy, 7, 92, 103, 115, 174, 184 Maxillary, 50, 174 Meat, 164, 174 Median Nerve, 157, 174 Medical Records, 5, 174, 185 MEDLINE, 125, 127, 129, 174 Melanin, 174, 179, 192 Melanocytes, 174, 177 Melanoma, 41, 53, 129, 174 Membrane, 159, 161, 164, 172, 174, 178, 180, 181, 187, 192 Membrane Proteins, 172, 174 Mental Disorders, 89, 174 Mental Retardation, 44, 57, 130, 159, 175 Mesenteric, 11, 12, 175 Mesentery, 12, 18, 53, 175, 179 Metastasis, 32, 59, 175 MI, 22, 23, 38, 150, 175
200 Lymphedema
Microbiology, 154, 175 Microcirculation, 10, 12, 18, 35, 69, 70, 175 Microorganism, 158, 175, 193 Microscopy, 12, 76, 175 Microspheres, 11, 175 Microsurgery, 12, 36, 37, 40, 41, 59, 61, 79, 175 Microwaves, 70, 81, 175, 184 Midazolam, 18, 175 Mobility, 103, 138, 139, 175 Modeling, 12, 175 Modification, 175, 183 Molecular, 7, 8, 10, 11, 17, 19, 37, 38, 63, 103, 105, 125, 127, 155, 160, 164, 165, 172, 175, 181 Molecule, 39, 154, 155, 159, 163, 175, 180, 184, 187, 193 Monitor, 8, 21, 95, 97, 176, 177 Monoclonal, 171, 176, 183, 194 Monophosphate, 19, 176 Morphological, 111, 163, 174, 176 Motion Sickness, 176 Mucus, 176, 192 Muscle Fibers, 176 Muscular Atrophy, 129, 176 Muscular Dystrophies, 162, 176 Myocardium, 175, 176 Myotonic Dystrophy, 129, 176 Myxedema, 101, 176 N Nausea, 118, 176 NCI, 1, 7, 88, 89, 123, 176, 179 Necrosis, 165, 166, 170, 175, 176, 186 Need, 3, 95, 111, 113, 117, 140, 158, 176, 191 Neonatal, 23, 33, 176 Neoplasia, 129, 176 Neoplasm, 173, 176, 186, 187 Neoplastic, 6, 153, 173, 176 Nephritis, 101, 177 Nephropathy, 172, 177 Nephrosis, 101, 177 Nerve, 153, 154, 158, 161, 174, 177, 179, 181, 186, 189, 193 Neural, 168, 177 Neurologic, 167, 177 Neuropathy, 153, 177 Neurotransmitters, 176, 177 Neutrons, 152, 171, 177, 183 Nevus, 37, 177 Nitric Oxide, 12, 177 Nonverbal Communication, 159, 177
Nuclear, 24, 37, 45, 46, 49, 52, 55, 61, 68, 69, 80, 155, 162, 164, 165, 166, 176, 177 Nuclear Family, 165, 177 Nucleic acid, 106, 166, 170, 177 Nucleus, 20, 155, 161, 164, 166, 177, 183, 190 O Ocular, 151, 177 Odds Ratio, 178, 185 Oncogene, 105, 129, 178 Oncology nurse, 8, 178 Opacity, 161, 178 Orbit, 164, 178, 179 Orofacial, 4, 178 Osmosis, 178 Osmotic, 18, 178 Outpatient, 13, 178 Ovaries, 4, 164, 167, 178, 185, 187 Ovum, 166, 178 P Palate, 158, 178 Palliative, 178, 190 Palpation, 21, 178 Pancreas, 151, 162, 178 Pancreatic, 129, 178 Pancreatic cancer, 129, 178 Parasite, 55, 178 Parasitic, 13, 134, 167, 170, 173, 178 Parietal, 178, 179, 180 Parotid, 179, 186 Paroxysmal, 129, 179 Pathogenesis, 11, 20, 38, 49, 60, 179 Pathologic, 155, 160, 179, 181 Pathologies, 21, 179 Pathophysiology, 11, 19, 20, 27, 49, 60, 69, 80, 105, 179 Patient Advocacy, 139, 179 Patient Compliance, 94, 179 PDQ, 134, 136, 179 Pelvic, 179, 182 Penicillin, 35, 179 Penis, 53, 179 Peptide, 9, 179, 181, 183, 191 Perfusion, 11, 179 Perioperative, 87, 179 Periorbital, 46, 179 Peritoneum, 175, 179 Pharmacologic, 18, 153, 179, 191 Phenotype, 10, 11, 15, 57, 179 Phenylalanine, 179, 192 Phospholipases, 180, 187 Phospholipids, 165, 180
Index 201
Phosphorus, 156, 180 Physical Therapy, 13, 18, 28, 29, 32, 42, 51, 64, 70, 74, 81, 92, 180 Physiologic, 14, 15, 152, 180, 182, 184 Pigment, 174, 180 Pilot study, 34, 41, 180 Pitch, 180, 193 Plants, 156, 167, 180, 191 Plasmid, 102, 180, 193 Platelet Activation, 180, 187 Platelet Aggregation, 177, 180 Platelets, 177, 180, 190 Platinum, 173, 180 Pleura, 180 Pleural, 40, 180, 181 Pleural cavity, 180, 181 Pleural Effusion, 40, 181 Poisoning, 176, 181 Polycystic, 129, 181 Polypeptide, 159, 165, 181, 194 Polysaccharide, 154, 181 Port, 8, 181 Port-a-cath, 181 Posterior, 152, 154, 155, 178, 181 Postnatal, 22, 181 Postoperative, 16, 23, 25, 34, 73, 76, 87, 181 Postoperative Complications, 87, 181 Postsynaptic, 181, 187 Post-traumatic, 58, 181 Potentiation, 181, 187 Povidone, 26, 181 Povidone-Iodine, 26, 181 Practice Guidelines, 22, 29, 74, 126, 136, 181 Preclinical, 6, 181 Precursor, 154, 163, 179, 181, 192 Prenatal, 31, 52, 162, 166, 181 Prevalence, 5, 6, 85, 178, 181 Primary tumor, 182, 187 Problem Solving, 16, 182 Prognostic factor, 54, 74, 182 Progression, 153, 182 Progressive, 106, 157, 158, 162, 167, 176, 180, 182 Proline, 159, 169, 182 Promoter, 7, 182 Prophylaxis, 54, 58, 69, 182 Prospective study, 32, 182 Prostaglandin, 39, 182 Prostaglandins A, 182 Prostate, 6, 7, 95, 129, 182 Protein C, 92, 97, 182
Protein S, 110, 129, 130, 155, 166, 183, 186 Proteins, 9, 95, 97, 102, 105, 138, 139, 152, 153, 159, 163, 174, 175, 179, 183, 187, 191 Protocol, 8, 14, 56, 79, 92, 183 Protons, 152, 169, 171, 183 Proximal, 92, 94, 96, 150, 162, 183, 187 Psychiatric, 159, 174, 183 Psychic, 183, 186 Puberty, 15, 17, 183 Public Policy, 125, 183 Publishing, 22, 183 Pulmonary, 36, 111, 156, 183, 193 Pulmonary Artery, 156, 183, 193 Pulse, 98, 103, 176, 183 Purpura, 153, 183 Q Quality of Life, 5, 13, 14, 16, 41, 60, 116, 183, 190 R Radiation therapy, 8, 12, 58, 80, 94, 95, 96, 151, 164, 171, 183, 194 Radical mastectomy, 77, 183 Radio Waves, 161, 175, 184 Radioactive, 169, 170, 171, 174, 177, 183, 184, 194 Radioimmunotherapy, 184 Radioisotope, 184, 191 Radiolabeled, 171, 181, 183, 184, 194 Radiological, 21, 184 Radiology, 9, 26, 32, 184 Radiopharmaceutical, 166, 184 Radiotherapy, 27, 156, 171, 183, 184, 194 Randomized, 6, 14, 15, 23, 32, 61, 62, 73, 81, 87, 88, 162, 184 Randomized clinical trial, 14, 87, 184 Receptor, 6, 38, 105, 154, 184, 187 Recombinant, 184, 193 Rectal, 110, 184 Rectum, 110, 154, 156, 162, 166, 172, 182, 184 Recurrence, 5, 184 Red Nucleus, 154, 184 Refer, 1, 159, 168, 173, 177, 184, 185 Reference point, 95, 185 Reflux, 58, 80, 185 Refraction, 185, 188 Regeneration, 17, 103, 185 Regimen, 13, 162, 179, 185 Relative risk, 5, 185 Relaxin, 97, 185 Reliability, 16, 185 Remission, 184, 185
202 Lymphedema
Research Design, 13, 185 Residual disease, 6, 185 Respiration, 176, 185 Restoration, 180, 185, 194 Retinoblastoma, 129, 185 Retrospective, 14, 24, 85, 185 Retrospective study, 24, 185 Rheumatism, 27, 185 Rheumatoid, 27, 159, 185 Rheumatoid arthritis, 159, 185 Rhinophyma, 151, 186 Rhusiopathiae, 164, 186 Ribose, 151, 186 Ribosome, 186, 191 Risk factor, 5, 6, 56, 163, 182, 185, 186 S Salivary, 162, 178, 186 Salivary glands, 162, 186 Sarcoidosis, 4, 23, 111, 186 Sarcoma, 56, 186 Sclerosis, 63, 101, 129, 159, 186 Screening, 105, 106, 158, 166, 179, 186 Scrotum, 186, 193 Secondary tumor, 175, 186 Secretion, 169, 176, 186, 187 Sedative, 175, 186 Seizures, 57, 167, 179, 186 Selective estrogen receptor modulator, 186, 190 Selenium, 40, 57, 186, 188 Self Care, 151, 186 Semen, 182, 187 Seminal vesicles, 187, 193 Sensory Thresholds, 16, 187 Sentinel lymph node, 41, 57, 187 Sentinel Lymph Node Biopsy, 41, 187 Sepsis, 31, 187 Septal, 51, 128, 187 Serous, 163, 169, 180, 187 Serum, 57, 69, 79, 98, 159, 187 Sex Characteristics, 183, 187 Sex Determination, 129, 187 Shock, 187, 192 Side effect, 119, 151, 162, 187, 190, 191 Signal Transduction, 102, 187 Signs and Symptoms, 17, 185, 187 Skeletal, 26, 59, 176, 187 Skeleton, 171, 182, 187, 188 Skull, 164, 178, 188, 190 Small intestine, 3, 157, 162, 168, 171, 188 Smooth muscle, 103, 188 Social Environment, 183, 188
Social Support, 6, 16, 188 Sodium, 58, 63, 69, 70, 81, 188 Sodium Selenite, 63, 70, 81, 188 Soft tissue, 14, 21, 94, 156, 187, 188 Solid tumor, 6, 153, 188 Solvent, 95, 97, 178, 188 Somatic, 168, 188 Sound wave, 160, 161, 188 Specialist, 140, 188 Species, 164, 167, 169, 176, 178, 188, 189, 192, 194 Specificity, 21, 152, 188 Spectrum, 12, 106, 175, 184, 188 Sperm, 158, 189 Spermatozoa, 187, 189, 193 Spleen, 134, 136, 152, 173, 186, 189 Sporadic, 185, 189 Staging, 21, 189 Stasis, 105, 189, 193 Stent, 103, 189 Stimulus, 160, 187, 189 Stomach, 3, 151, 162, 164, 165, 166, 168, 176, 185, 188, 189 Stool, 172, 189 Streptococcal, 31, 189 Streptococci, 173, 189 Streptococcus, 164, 189 Stress, 18, 21, 176, 185, 189, 192 Stricture, 110, 189 Stroke, 89, 124, 189 Stump, 96, 189 Subacute, 14, 170, 189 Subclinical, 170, 186, 189 Subcutaneous, 36, 58, 76, 93, 94, 96, 157, 162, 172, 173, 189 Suction, 165, 189 Support group, 138, 139, 189 Supportive care, 179, 190 Suppurative, 157, 190 Symphysis, 158, 182, 190 Synaptic, 187, 190 Synergistic, 15, 190 Systemic, 34, 101, 111, 152, 154, 156, 159, 164, 170, 171, 183, 186, 190, 194 Systemic disease, 101, 111, 190 T Tamoxifen, 7, 186, 190 Telangiectasia, 49, 128, 129, 190 Temporal, 11, 167, 190 Tenosynovitis, 32, 190 Thalamic, 154, 190 Thalamic Diseases, 154, 190
Index 203
Therapeutics, 20, 63, 77, 82, 120, 190 Thermal, 16, 177, 190 Thigh, 167, 190 Thoracic, 15, 58, 98, 104, 105, 155, 161, 174, 180, 190 Thrombin, 165, 180, 182, 190 Thrombomodulin, 182, 190 Thrombosis, 29, 183, 189, 190 Thrombus, 160, 170, 180, 190, 193 Thymus, 173, 190 Thyroid, 169, 171, 176, 191, 192 Thyroid Gland, 176, 191 Thyrotropin, 169, 191 Ticks, 170, 191 Tin, 157, 180, 191 Tissue, 9, 10, 14, 17, 21, 27, 28, 36, 76, 93, 95, 96, 97, 98, 101, 102, 104, 118, 153, 154, 155, 156, 157, 159, 160, 162, 163, 165, 167, 169, 171, 172, 173, 174, 176, 177, 179, 180, 181, 185, 187, 188, 190, 191, 192, 194 Tolerance, 13, 191 Tomography, 62, 191 Topical, 70, 81, 181, 191 Tourniquet, 37, 191 Toxic, iv, 163, 169, 177, 186, 191 Toxicity, 162, 191 Toxicology, 126, 191 Toxins, 153, 170, 184, 191 Trace element, 188, 191 Tracer, 14, 191 Transcription Factors, 9, 191 Transduction, 187, 191 Transfection, 155, 191 Translation, 14, 191 Translational, 8, 14, 192 Translocation, 23, 192 Transplantation, 6, 52, 69, 158, 192 Trauma, 92, 155, 176, 190, 192 Tryptophan, 159, 192 Tuberculosis, 4, 111, 173, 192 Tuberous Sclerosis, 129, 192 Tyrosine, 15, 30, 105, 192 U Ulcer, 110, 157, 172, 192, 193 Ulcerative colitis, 3, 192 Unconscious, 99, 169, 192 Urethra, 179, 182, 192 Urinary, 75, 166, 192 Urinary tract, 192
Urine, 18, 156, 168, 192 Urogenital, 166, 192 Urology, 24, 42, 53, 58, 113, 192 Urticaria, 153, 192 Uterus, 158, 160, 163, 164, 165, 167, 178, 192 V Vaccine, 151, 183, 192 Vagina, 158, 161, 167, 192, 193 Vaginal, 192, 193 Valves, 101, 192, 193 Varicose, 18, 61, 172, 193 Varicose vein, 18, 61, 193 Vas Deferens, 20, 193 Vascular endothelial growth factor, 103, 193 Vasodilators, 177, 193 VE, 36, 39, 193 Vector, 102, 191, 193 Vein, 61, 154, 171, 177, 179, 193 Venereal, 110, 193 Venous, 19, 21, 32, 36, 40, 64, 79, 94, 95, 96, 101, 104, 105, 118, 154, 172, 183, 193 Venous Insufficiency, 19, 172, 193 Venous Pressure, 79, 193 Venous Thrombosis, 118, 193 Ventricle, 183, 193 Venules, 156, 163, 175, 193 Veterinary Medicine, 125, 193 Virus, 24, 166, 191, 193 Viscera, 153, 175, 188, 193 Visceral, 9, 179, 193 Vitro, 9, 193 Vivo, 9, 12, 19, 193 Voice Disorders, 4, 193 Vulva, 87, 88, 193 W Weight Gain, 5, 97, 193 White blood cell, 138, 139, 153, 155, 173, 176, 194 Wound Healing, 20, 194 X Xenograft, 153, 194 X-ray, 165, 166, 171, 173, 177, 183, 184, 194 X-ray therapy, 171, 194 Y Yeasts, 179, 194 Z Zymogen, 182, 194
204 Lymphedema
