Ch.6 Lymphatic And Immune Systems Flashcards
Lymph/o
Fluid that removes cell waste, pathogens, and dead cells from tissue
lymphangi/o
capillaries, vessels, and ducts that return lymph from the tissues to the venous bloodstream
Tonsill/o,
Lymphoid structures that protect the entry to the respiratory system
Adenoid/o
lymphoid structures that protect the respiratory system
Splen/o
spleen, sac-like mass of lymphoid tissue with protective roles in both the immune and lymphatic systems
Bone marrow makes
lymphocytes, which are specialized leukocytes (white blood cells
lymphocyt/o
Lymphocytes, Specialized leukocytes
Thym/o
Thymus, gland in the upper chest that works with the immune and lymphatic system
Immun/o
Protection, immunity
Adeno/o
Gland
Lymphaden/o
Lymph gland, or lymph node
Anis/o
Unequal
Lip/o
fat
Megaly
Enlargement
Emia
Blood condition or something in the blood
-Penia
deficiency
O/rrhagia
hemorrhage
-Poiesis
production or formation of
-pathy
disease
lysis
destruction or breaking apart
-osis
abnormal condition
-oma
tumor
Sarcoma
Malignant tumor of connective tissue
Pan
all
Hyperlipemia
too much fat in blood
Carcin/o
Cancerous
neo-, ne/o
new, strange
onc/o
tumor
phag/o
eat, swallow
-plasm
formative material of cells
sarc/o
flesh
-tic
pertaining to
tox/o
poison
acquired immunodeficiency syndrome
most advanced and fatal stages of HIV, AIDS
allergen
something that provokes allergic reaction
anaphylaxis
severe response to an allergen in which the symptoms develop quickly and could kill
antibiotics
medication capable of killing pathogenic invaders in you
antibody
disease fighting protein
antifungals
medication capable of killings fungus
Antigen
anything that the body considers foreign
antigen–antibody reaction
binding of antigens to antibodies.
autoimmune disorder
large group of diseases characterized by a condition in which the immune system produces antibodies to work against its own tissues, mistaking healthy cells, tissues, or organs for antigens.
bacilli
Rod-shaped spore-forming bacteria.
bacteria
group of one-celled microscopic organisms, some of which are pathogenic
benign
Not life-threatening
candidiasis
infection caused by yeast, a type of fungus
carcinoma
malignant tumor that occurs in epithelial tissue.
carcinoma in situ
malignant tumor in its original position that has not yet disturbed or invaded the surrounding tissues
complement system
group of proteins that normally circulate in the blood in an inactive form. When needed, these cells complement the ability of antibodies to ward off pathogens by combining with them to dissolve and remove pathogenic bacteria and other foreign cells.
cytokines
group of proteins such as interferons and interleukins released primarily by the T cells that act as intracellular signals to begin the immune response
cytomegalovirus
group of large herpes-type viruses found in most body fluids and most often causing an infection without signs or symptoms. Can cause a serious illness when the individual has a weakened immune system or when passed from mother to unborn child.
cytotoxic drug
Medication that kills or damages cells.
ductal carcinoma in situ
Breast cancer at its earliest stage, before the cancer has broken through the wall of the milk duct.
hemolytic
Describes the function of destroying worn-out erythrocytes (red blood cells) and releasing their hemoglobin for reuse.
herpes zoster
acute viral infection characterized by painful skin eruptions that follow the underlying route of the inflamed nerve.
Hodgkin’s lymphoma
malignancy of the lymphatic system that is distinguished from non-Hodgkin’s lymphoma by the presence of large, cancerous lymphocytes
human immunodeficiency virus
A bloodborne infection in which the virus damages or kills the T cells of the immune system
immunoglobulins
Bind with specific antigens in the antigen-antibody response
immunosuppressant
A substance that prevents or reduces the body’s normal immune response
immunotherapy
treatment of disease by either stimulating or repressing the immune response
infectious mononucleosis
infection caused by the Epstein-Barr virus (EBV) that is characterized by fever, a sore throat, and enlarged lymph nodes
infiltrating ductal carcinoma
Breast cancer that starts in the milk duct, breaks through the wall of that duct, and invades the surrounding fatty breast tissue; also known as invasive ductal carcinoma.
interferons
Produced in response to the presence of antigens, particularly viruses or tumor cells. They activate the immune system, fight viruses, and signal other cells to increase their defenses.
lymphadenopathy
Any disease process affecting a lymph node or nodes.
lymphangioma
benign tumor formed by an abnormal collection of lymphatic vessels due to a congenital malformation of the lymphatic system.
lymphedema
Swelling due to an abnormal accumulation of lymph fluid within the tissues
lymphocytes
One of three types of cells that are formed in bone marrow as stem cells that act as specialized antibodies.
lymphoma
general term applied to malignancies affecting lymphoid tissues.
lymphoscintigraphy
diagnostic test to detect damage or malformations of the lymphatic vessels.
macrophage
type of leukocyte that surrounds and kills invading cells
malaria
A disease caused by a parasite that lives in certain mosquitoes and is transferred to humans by the bite of an infected mosquito.
malignant
Becoming progressively worse and life-threatening.
mammography
A radiographic examination of the breasts to detect the presence of tumors or precancerous cells.
metastasis
process by which cancer is spread to a new site; may refer to the tumor itself.
metastasize
To spread from one place to another.
myoma
benign tumor made up of muscle tissue
myosarcoma
malignant tumor derived from muscle tissue.
non-Hodgkin’s lymphoma
term used to describe all lymphomas other than Hodgkin’s lymphoma
opportunistic infection
Caused by a pathogen that normally does not cause illness in healthy humans, but is able to cause an infection in a weakened host.
osteosarcoma
ard-tissue sarcoma usually involving the upper shaft of long bones, the pelvis, or the knees
parasite
plant or an animal that lives on or within another living organism at the expense of that organism
rabies
acute viral infection transmitted to humans through the bite or saliva of an infected animal.
rickettsia
Small bacteria that live in lice, fleas, ticks, and mites that transmit infection to humans.
rubella
viral infection characterized by a low-grade fever, swollen glands, inflamed eyes, and a fine, pink rash; also known as German measles or 3-day measles.
sarcoma
malignant tumor that arises from connective tissue; plural, sarcomas or sarcomata.
spirochetes
Long, slender spiral-shaped bacteria that have flexible walls and are capable of movement
splenomegaly
Abnormal enlargement of the spleen.
staphylococci
Group of about 30 species of bacteria that form irregular groups or clusters resembling grapes
streptococci
Bacteria that form a chain
systemic reaction
severe reaction to an allergen; also described as anaphylaxis or anaphylactic shock.
teletherapy
Radiation therapy administered at a distance from the body that is precisely targeted with the use of three-dimensional computer imaging.
toxoplasmosis
parasite that is most commonly transmitted from pets to humans by contact with contaminated animal feces.
varicella
highly contagious disease caused by a herpes virus characterized by a fever and rash; also known as chickenpox.
Pathogens
disease-producing microorganisms
Malignant cells
potentially life-threatening cancer cells
Intact skin
first line of defense in the lymphatic system
respiratory system
second line of defense that traps foreign matter in mucous membranes or hair, coughing and sneezing helps too.
digestive system
destroys invader’s with acids
Tolerance
refers to an acquired unresponsiveness to a specific antigen
antibody
disease-fighting protein created by the immune system in response to the presence of a specific antigen
Immunoglobulin G (IgG)
most abundant class of antibodies, and they are found in blood serum and lymph. These antibodies are active against bacteria, fungi, viruses, and foreign particles.
Immunoglobulin A (IgA)
class of antibodies produced predominantly against ingested antigens. These antibodies are found in body secretions such as saliva, sweat, or tears, and they function to prevent the attachment of viruses and bacteria to the epithelial surfaces that line most organs.
Immunoglobulin M (IgM)
the class of antibodies that are found in circulating body fluids. These are the first antibodies to appear in response to an initial exposure to an antigen
Immunoglobulin D (IgD)
the class of antibodies found only on the surface of B cells. These antibodies are important in B cell activation
Immunoglobulin E (IgE)
the class of antibodies produced in the lungs, skin, and mucous membranes. These antibodies are responsible for allergic reactions
Phagocytes
specialized leukocytes that act as part of the antigen–antibody reaction by destroying substances such as cell debris, dust, pollen, and pathogens by the process of phagocytosis
Monocytes
leukocytes that provide immunological defenses against many infectious organisms
macrophage
type of leukocyte that surrounds and kills invading cells . Macrophages also remove dead cells and stimulate the action of other immune cells.
Dendritic cells
specialized leukocytes that patrol the body searching for antigens that produce infections
complement system
group of proteins that normally circulate in the blood in an inactive form. When needed, these cells complement the ability of antibodies to ward off pathogens by combining with them to dissolve and remove pathogenic bacteria and other foreign cells
Immunity
the state of being resistant to a specific disease. This resistance can be present naturally, or it can be acquired
Natural immunity
known as passive immunity, is resistance to a disease present without the administration of an antigen or exposure to a disease
Acquired immunity
obtained by having had a contagious disease. Being vaccinated against a contagious disease provides protection against that disease, such as measles or polio, without having been exposed to the risk of actually having the disease
vaccine
preparation containing an antigen, consisting of whole or partial disease-causing organisms, which have been killed or weakened
Vaccination
provides protection against the disease; however, for some conditions a periodic booster is required to maintain the effectiveness of the immunization
CBC
Complete blood count
RBC
red blood cell count
WBC
White blood cell count
DIFF
differential of each type of white blood cell present
HCT
percentage of RBC
HGB
percentage of hemoglobin present
Leukemia
blood cancer where too much white blood cells present
Anemia
lack of red blood cells
allergic reaction
occurs when the body’s immune system reacts to a harmless allergen such as pollen, food, or animal dander as if it were a dangerous invader
allergy
also known as hypersensitivity, is an overreaction by the body to a particular antigen
allergen
a substance that produces an allergic reaction in an individual
localized allergic response
includes redness, itching, and burning where the skin has come into contact with an allergen. For example, contact with poison ivy can cause a localized allergic response in the form of an itchy rash
systemic reaction
a severe response to an allergen. As shown in Figure 6.7, the symptoms of this response develop quickly. Without prompt medical aid, the patient can die within a few minutes.
autoimmune disorder
is any of a large group of diseases characterized by a condition in which the immune system produces antibodies against its own tissues, mistaking healthy cells, tissues, or organs for antigens
Myasthenia gravis
autoimmune disorder affects nerve and muscle synapses
Pernicious anemia
autoimmune disorder that affects the red blood cells
Crohn’s disease
autoimmune disorder that affects the intestines, ileum, or the colon.
Multiple sclerosis
autoimmune disorder that affects the brain and spinal cord
Scleroderma
autoimmune disorder that affects the skin and connective tissues
Graves’ disease
autoimmune disorder that affects the thyroid gland
immunodeficiency disorder
occurs when the immune response is compromised
Severe combined immunodeficiency (SCID)
inherited condition in which abnormalities in the immune system cause an increased susceptibility to infection and failure to thrive as a result of infections
human immunodeficiency virus HIV
bloodborne infection in which the virus damages or kills the T cells of the immune system, causing it to progressively fail, thus leaving the body at risk of developing many life-threatening opportunistic infections
Kaposi’s sarcoma
an example of an opportunistic infection that is frequently associated with HIV. This cancer causes patches of abnormal tissue to grow under the skin; in the lining of the mouth, nose, and throat; or in other organs
ELISA
the acronym for enzyme-linked immunosorbent assay, is a blood test used to screen for the presence of HIV antibodies, as well as Lyme disease and other infectious conditions
western blot test
a blood test that produces more accurate results than the ELISA test. The western blot test is performed to confirm the diagnosis when the results of the ELISA test are positive for HIV. This is necessary because the ELISA test sometimes produces a false positive result in which the test erroneously indicates the presence of HIV.
Synthetic immunoglobulins
known as immune serum, are used as a post-exposure preventive measure against certain viruses, including rabies and some types of hepatitis.
Synthetic interferon
is used in the treatment of multiple sclerosis, hepatitis C, and some cancers.
Monoclonal antibodies
any of a class of antibodies produced in the laboratory by identical offspring of a clone of specific cells. These artificially produced antibodies are used to enhance the patient’s immune response to certain malignancies, including some non-Hodgkin’s lymphoma, melanoma, breast cancer, and colon cancer
Immunosuppression
treatment to repress or interfere with the ability of the immune system to respond to stimulation by antigens
immunosuppressant
a substance that prevents or reduces the body’s normal immune response
corticosteroid drug
a hormone-like preparation administered primarily as an anti-inflammatory and immunosuppressant
Bacilli
rod-shaped, spore forming bacteria. pathogenic
Anthrax
contagious disease that can be transmitted through livestock infected with Bacillus anthracis. Spores grown in laboratories have been used in biological warfare
rickettsia
small bacterium that lives in lice, fleas, ticks, and mites (plural, rickettsiae). Rocky Mountain spotted fever is caused by a rickettsia that is transmitted to humans by the bite of an infected tick.
Spirochetes
long, slender, spiral-shaped bacteria that have flexible walls and are capable of movement
Lyme disease
transmitted to humans by the bite of a tick that has had contact with a deer infected with the spirochete Borrelia burgdorferi. It is named for Old Lyme, Connecticut, where it was first diagnosed. Symptoms of Lyme disease include fever, headache, fatigue, and a characteristic skin rash known as erythema migrans. If untreated, Lyme disease can spread to the joints, heart, and nervous system. Syphilis is also caused by spirochetes
Staphylococci
a group of about 30 species of bacteria that form irregular groups or clusters resembling grapes ( staphyl/o means clusters or bunches of grapes, and -cocci means spherical bacteria). (The singular is staphylococcus.) Most staphylococci are harmless and reside normally on the skin and mucous membranes of humans and other organisms; however, others are capable of producing very serious infections
Staphylococcus aureus
also known as staph aureus, is a form of staphylococcus that often infects wounds and causes serious problems such as toxic shock syndrome or food poisoning.
Streptococci
bacteria that form a chain ( strept/o means twisted chain, and -cocci means spherical bacteria). (The singular is streptococcus.) Many streptococcal species are harmless; however, other members of this group are responsible for serious illnesses such as strep throat, meningitis (see Chapter 10), endocarditis (see Chapter 5), and necrotizing fasciitis
Antibiotic-resistant bacteria
occur when antibiotics fail to kill all of the bacteria they target. When this occurs, the surviving bacteria become resistant to this particular drug. As more and more bacteria become resistant to first-line antibiotics, the consequences are severe because the illness lasts longer, and the risk of complications and death increases
Methicillin-resistant Staphylococcus aureus
commonly known as MRSA, is one of several types of bacteria that are now resistant to most antibiotics.
fungus
simple parasitic organism
Tinea pedis
athlete’s foot, is a fungal infection that develops between the toes
candidiasis
Yeast infections occur on the skin or mucous membranes in warm, moist areas such as the vagina or mouth and are caused by the pathogenic yeast
Oral thrush
yeast infection that occurs in the mouth
vaginal candidiasis
occurs in the vagina
Toxoplasmosis
parasite that is most commonly transmitted from pets to humans by contact with contaminated animal feces. Can cause birth defects
Viruses
very small infectious agents that live only by invading other cells. After invading the cell, the virus reproduces and then breaks the wall of the infected cell to release the newly formed viruses. These viruses spread to other cells and repeat the process
Influenza
commonly known as the flu, is a highly contagious viral respiratory infection that usually occurs in seasonal epidemics. Flu symptoms include fever, sore throat, muscle aches, cough, runny nose, and fatigue. Complications can include pneumonia. A vaccine is available annually to protect against the most common strains of influenza
Measles
an acute, highly contagious infection that is transmitted by respiratory droplets of the rubeola virus. Symptoms include a red, itchy rash over the entire body, a high fever, runny nose, and coughing. Serious complications of measles can include photophobia, which is a severe sensitivity to light
Mumps
an acute viral infection that is characterized by the swelling of the parotid glands, which are the salivary glands located just in front of the ears. In adults, mumps can also cause painful swelling of the ovaries or testicles
Rubella
also known as German measles or three-day measles, is a viral infection characterized by a low-grade fever, swollen glands, inflamed eyes, and a fine, pink rash. Although not usually severe or long-lasting, rubella is serious in a woman during early pregnancy because it can cause defects in a developing fetus
Rubella
also known as German measles or three-day measles, is a viral infection characterized by a low-grade fever, swollen glands, inflamed eyes, and a fine, pink rash. Although not usually severe or long-lasting, rubella is serious in a woman during early pregnancy because it can cause defects in a developing fetus.
measles, mumps, and rubella vaccination MMR
immunization can prevent these three viral illnesses and should be administered in early childhood.
Rabies
an acute viral infection that is transmitted to humans through the bite or saliva of an infected animal. An infected animal is said to be rabid. If risk is suspected, it is necessary to undergo testing immediately so that post-exposure treatment can be started as quickly as possible. Without testing and treatment, the signs and symptoms of rabies usually occur 30 to 90 days after the bite, and once symptoms have developed, rabies is almost always fatal
West Nile virus
spread by mosquito. Mild symptoms are flue. A more severe variety spreads to the spinal cord and brain. West Nile virus is a member of the Flavivirus genus, which also includes the viruses that cause the mosquito-borne tropical disease dengue fever
Cytomegalovirus
is found in most body fluids ( cyt/o means cell, megal/o means large, vir means virus, and -us is a singular noun ending). It is most often present as a silent infection in which the individual has no signs or symptoms of the infection, although it can potentially cause a serious illness when the individual has a weakened immune system, or when it is transmitted from the mother to her unborn child. This transmission can cause serious congenital disabilities to the child
Varicella
lso known as chickenpox, is caused by the herpes virus Varicella zoster and is highly contagious. The condition is characterized by a fever and a rash consisting of hundreds of itchy, fluid-filled blisters that burst and form crusts
bactericide
a substance that causes the death of bacteria
bacteriostatic
agent slows or stops the growth of bacteria ( bacteri means bacteria, and -static means causing control). This group of antibiotics includes tetracycline, sulfonamide, and erythromycin
antifungal
n agent that destroys or inhibits the growth of fungi ( anti- means against, fung means fungus, and -al means pertaining to). Lotrimin is an example of a topical antifungal that is applied to treat or prevent athlete’s foot. This type of medication is also known as an antimycotic
antiviral drug
such as acyclovir, is used to treat viral infections or to provide temporary immunity
Oncology
the study of the prevention, causes, and treatment of tumors and cancer ( onc means tumor, and -ology means study of). Most cancers are named for the part of the body where the cancer originated. Cancer can attack all body systems and is the second leading cause of death in the United States after heart disease
neoplasm
tumor
an abnormal growth of body tissue. Within this mass, the multiplication of cells is uncontrolled, abnormal, rapid, and progressive
neoplasm
benign tumor
not a form of cancer, and it is not life-threatening
myoma
an example of a benign tumor made up of muscle tissue
myosarcoma
example of a malignant tumor derived from muscle tissue
Angiogenesis
the process through which a tumor supports its growth by creating its own blood supply
Antiangiogenesis
form of treatment that disrupts the blood supply to the tumor
Cancer
class of diseases characterized by the uncontrolled division of cells and the ability of these cells to invade other tissues
metastasize
means to spread from one place to another. Cancer sometimes moves from its primary site and metastasizes (spreads) to a secondary site, often through the circulatory or lymphatic system
Metastasis
describes the process by which cancer is spread to a new site, and the term is also used to describe the tumor itself (plural, metastases). A metastasis can be in the same body system or within another body system at a distance from the primary site. Metastasis is a Latin word meaning transition
carcinoma
a malignant tumor that occurs in epithelial tissue
adenocarcinoma
any one of a large group of carcinomas derived from glandular tissue
sarcoma
a malignant tumor that arises from connective tissues
Hard-tissue sarcomas
arise from bone or cartilage
Soft-tissue sarcomas
cancers of the muscle, fat, fibrous tissue, blood and lymphatic vessels, or other supporting tissue, including the synovial tissues that line the cavities of joints. For example, a synovial sarcoma
Liquid-tissue sarcomas
arise from blood and lymph. For example, leukemia (loo-KEE-mee-ah) is a cancer of the white blood-forming cells in the bone marrow
Staging
the process of classifying tumors by how far the disease has progressed, the potential for its responding to therapy, and the patient’s prognosis. Stages can be indicated by letters, numbers or Roman numerals. Specific staging systems are used for different types of cancer
Stage 1 cancer
The cancerous tumor has formed within a polyp inside the colon but has not yet invaded the surrounding tissue
Stage 2 cancer
The cancer has invaded the underlying tissue
Stage 3 cancer
spread to the underlying tissues and nearby lymph nodes
Lymphoma
a general term applied to malignancies affecting lymphoid tissues ( lymph means lymph, and -oma means tumor). This includes lymph nodes, the spleen, liver, and bone marrow. The two most common types of lymphomas are Hodgkin’s lymphoma and non-Hodgkin’s lymphoma
Breast cancer
carcinoma that develops from the cells of the breast and can spread to adjacent lymph nodes and other body sites
ER-positive
growth in response to the hormone estrogen
BRCA1, BRCA2 genes
abnormal genes that carry a higher risk of breast, ovarian, and certain other cancers
Ductal carcinoma in situ
breast cancer at its earliest stage before the cancer has broken through the wall of the milk duct. At this stage, the cure rate is nearly 100%
infiltrating ductal carcinoma
starts in the milk duct and invades the fatty breast tissue outside the duct. This is the most common form of breast cancer
Inflammatory breast cancer
rare but aggressive form of breast cancer in which the cancer cells block the lymphatic vessels in the skin of the breast. IBC grows rapidly, and the symptoms include pain, rapid increase in breast size, redness or a rash on the breast, and swelling of nearby lymph nodes
Male breast cancer
can occur in the small amount of breast tissue that is normally present in men
Breast self-examination
is a self-care procedure for the early detection of breast cancer. The focus of self-examination is checking for a new lump or for changes in an existing lump, the shape of the nipple, or the skin covering the breast
Palpation of the breast
a test performed by a trained health care provider to check the texture, size, and consistency of the breast. Palpation is explained in
Mammography
radiographic examination of the breasts to detect the presence of tumors or precancerous cells
Molecular breast imaging (MBI)
a nuclear medicine technique (see Chapter 15) using gamma radiation to detect potential tumors in particularly dense breast tissue
breast MRI
uses magnets and radio waves, and the insertion of a contrast medium via IV, to get more detailed information for those already diagnosed with cancer or to look for signs of cancer in patients at high risk
needle breast biopsy
a technique in which an x-ray or MRI guided needle is used to remove small samples of tissue from the breast for diagnosis and the planning of treatment
surgical biopsy
the removal of a small piece of tissue for examination to confirm a diagnosis. After a diagnosis has been established, treatment is then planned based on the stage of the cancer
sentinel node biopsy
a biopsy of the first lymph node to come into contact with cancer cells as they leave the organ of origination and start spreading into the rest of the body
Lymph node dissection
a surgical procedure in which all of the lymph nodes in a major group are removed to determine or slow the spread of cancer in this area
lumpectomy
the surgical removal of only the cancerous tissue with the surrounding margin of normal tissue
mastectomy
the surgical removal of the entire breast and nippl
radical mastectomy
the surgical removal of an entire breast and many of the surrounding tissues
modified radical mastectomy
surgical removal of the entire breast and all of the axillary lymph nodes under the adjacent arm
Immediate breast reconstruction
begins during the same surgery as the mastectomy when an “expander” is placed to replace the tissue that was removed
Delayed breast reconstruction
may be necessary if the surgery is to be followed by radiation treatment. Several different techniques are used to restore the size and shape of the missing breast
Chemotherapy
the use of chemical agents and drugs in combinations selected to destroy malignant cells and tissues
Chemoprevention
is the use of natural or synthetic substances such as drugs or vitamins to reduce the risk of developing cancer or to reduce the chance that cancer will recur. Chemoprevention may also be used to reduce the size or slow the development of an existing tumor
antineoplastic
a medication that blocks the development, growth, or proliferation of malignant cells
Cytotoxic drugs
which are also used for both immunosuppression and chemotherapy
radiation therapy
With the goal of destroying only the cancerous tissues while sparing healthy tissues
Brachytherapy
the use of radioactive materials in contact with or implanted into the tissues to be treated
Teletherapy
radiation therapy administered at a distance from the body. With the assistance of three-dimensional computer imaging, it is possible to aim doses more precisely
Tomotherapy
the combination of tomography with radiation therapy to precisely target the tumor being treated.
Targeted therapy
a developing form of anticancer drug therapy that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. A monoclonal antibody is a type of targeted therapy.
Adjuvant therapy
sometimes used after the primary cancer treatments have been completed to decrease the chance that a cancer will recur
Clinical trials
involve testing new and promising cancer treatments that have not yet received Food and Drug Administration (FDA) approval on patients who agree to be part of the research
