900000000000508004: Great Britain English language reference set (foundation metadata concept)

SNOMED CT Concept\SNOMED CT Model Component\Foundation metadata concept (foundation metadata concept)\Reference set\Language type reference set (foundation metadata concept)\English [International Organization for Standardization 639-1 code en] language reference set (foundation metadata concept)\GB English

Status: current, Not sufficiently defined by necessary conditions definition status (core metadata concept). Date: 31-Jan 2002. Module: SNOMED CT model component module (core metadata concept)

Descriptions:

Expanded Value Set

Outbound Relationships	Type	Target	Active	Characteristic	Refinability	Group	Values
GB English	Is a	English [International Organization for Standardization 639-1 code en] language reference set (foundation metadata concept)	true	Inferred relationship	Some

Members	acceptabilityId
A grouping of primary and secondary sites of somatic dysfunction describing a three-segment complex fundamental to dysfunction in a mobile system. Each adjacent segment, above and below the primary locus, demonstrates opposing asymmetries to that locus.	Preferred (foundation metadata concept)
A grouping term for a collective of languages known as the Altaic languages.	Preferred (foundation metadata concept)
A haematological neoplasm characterised by clonal proliferation of myeloid precursors in the bone marrow, blood and other tissues (spleen, liver), with clinical, morphological and molecular features of myeloproliferative neoplasms (MPN), failing to meet criteria of a specific MPN. The presentation is nonspecific and variable and often includes leukocytosis, thrombocytosis and anaemia. Splenomegaly, hepatomegaly as well as fatigue, malaise or weight loss may appear in advanced stages.	Preferred (foundation metadata concept)
A health examination for a member of a population with limited access to healthcare services, such as those on low income, those from a minority ethnic background or those with a language barrier.	Preferred (foundation metadata concept)
A healthcare professional that possesses expertise in a clinical domain and provides advice on the diagnosis and management of individuals with conditions related to that domain.	Preferred (foundation metadata concept)
A helmet that is worn as protection for the head in the event of a vehicular accident	Preferred (foundation metadata concept)
A hereditary demyelinating motor and sensory neuropathy with characteristics of slowed nerve conduction velocities in the absence of clinically apparent neurological deficits, gait abnormalities or muscular atrophy, associated with a germline mutation in the ARGHEF10 gene.	Preferred (foundation metadata concept)
A hereditary disorder associated with impaired DNA double-strand break repair mechanisms with characteristics of microcephaly, unusual facial features, growth and developmental delay, skin anomalies, and pancytopenia, which is associated with combined immunodeficiency. Caused by mutations in the LIG4 gene (13q22-q34). The resulting defect of DNA ligase IV, a component of the classical non-homologous end-joining (NHEJ) pathway, affects the major mechanism of DNA double-strand break repair. Transmission is autosomal recessive.	Preferred (foundation metadata concept)
A hereditary neurological disorder with characteristics of excessive startle responses. The disease manifests shortly after birth with violent jerking to noise and touch, and massive and sustained stiffening of the trunk and limbs, clenching fists, and attacks of a high frequency trembling. Motor milestones are often mildly delayed, but intellectual development is usually normal. Mutations in the GLRA1 gene (5q32) are found in about 30% of patients. These mutations are transmitted as an autosomal dominant or recessive trait. The GLRA1 gene encodes the alpha1 subunit of the juvenile neuronal receptor for the inhibitory neurotransmitter, glycine. Mutations of this subunit cause a variety of dysfunctions of the neuronal chloride (Cl-) channel. Mutations in the GLRB, GPHN and SLC6A5 genes (4q31.3, 14q24 and 11p15.2-p15.1) have also been observed.	Preferred (foundation metadata concept)
A hereditary neurological disorder with early and severe involvement of both the peripheral and central nervous systems. It has only been described in Finnish families. Some patients show intellectual deficit. Epilepsy is a late manifestation and seizures may be life threatening. Caused by mutations in the C10orf2 gene (10q24) encoding the mitochondrial helicase Twinkle. The c.1523A>G (p.Y508C) causative mutation has been postulated to be a founder mutation. The mutations lead to mtDNA depletion in the brain and the liver but not in the muscle. Inherited in an autosomal recessive manner.	Preferred (foundation metadata concept)
A hereditary palmoplantar keratoderma with characteristics of the combination of bilateral mutilating transgredient palmoplantar keratoderma and periorificial keratotic plaques.	Preferred (foundation metadata concept)
A hereditary renal cancer syndrome defined as development of hereditary clear cell renal cell carcinoma (ccRCC) in two or more family members without evidence of constitutional chromosome 3 translocation, von Hippel-Lindau disease or other neoplasm predisposing syndromes associated with ccRCC, such as tuberous sclerosis or Birt-Hogg-Dubbe syndrome.	Preferred (foundation metadata concept)
A hereditary renal phosphate-wasting disorder characterised by hypophosphataemia and hypercalciuria associated with rickets and/or osteomalacia. Other features include slow growth, short stature, skeletal deformities, muscle weakness and bone pain that are associated with normal or elevated plasma levels of calcitriol and hyperphosphaturia. Caused by homozygous or compound heterozygous mutations in the SLC34A3 gene encoding a sodium-dependent phosphate transporter (NaPi-IIc/NPT2c). Transmission is autosomal recessive.	Preferred (foundation metadata concept)
A heterogeneous group disorders characterised by short, brittle hair with low-sulphur content (due to an abnormal synthesis of the sulphur containing keratins). The abnormalities are usually obvious at birth, with variable clinical expression. Trichothiodystrophy is an autosomal recessive disorder. In the photosensitive group 95% have mutations within the XPD (ERCC2) gene (localised to 19q13.2-q13.3). The remaining cases are caused by mutations within the XPB gene. So far, no gene has been isolated for the nonphotosensitive group. The variants of Trichothiodystrophy depending on their different associations are: BIDS syndrome, IBIDS syndrome, PIBIDS syndrome, Sabinas syndrome, SIBIDS syndrome, Itin syndrome and Pollitt syndrome.	Preferred (foundation metadata concept)
A heterogeneous group of autosomal recessive disorders of childhood that disrupt bile formation and present with cholestasis of hepatocellular origin. Three types of PFIC have been identified and are related to mutations in hepatocellular transport system genes involved in bile formation. Main clinical manifestations include cholestasis, pruritus and jaundice.	Preferred (foundation metadata concept)
A heterogeneous group of cases that are clinically diagnosed as Werner syndrome (WS) but do not carry WRN gene mutations. Similar to classical WS caused by WRN mutations, patients generally exhibit an aged appearance and common age-related disorders at earlier ages compared to the general population.	Preferred (foundation metadata concept)
A heterogeneous group of disorders associated with walking and growth disturbances that become evident during the second year of life. Characteristics are platyspondyly (flattened vertebrae) and marked hip and knee metaphyseal lesions. The different forms of spondylometaphyseal dysplasia are distinguished by the localisation and severity of involvement of the affected metaphyses.	Preferred (foundation metadata concept)
A heterogeneous group of endocrine disorders with characteristics of normal renal function and resistance to the action of parathyroid hormone (PTH), manifesting with hypocalcaemia, hyperphosphataemia and elevated PTH levels and that includes the subtypes PHP type 1a (PHP-1a) , PHP type 1b (PHP-1b), PHP type 1c (PHP-1c), PHP type 2 (PHP-2) and pseudopseudohypoparathyroidism (PPHP). PHP-1a, PPHP, and PHP-1b are all due to molecular defects in the same locus of the GNAS (20q13.2-q13.3) gene coding the alpha sub-unit of the stimulatory G protein. PHP can be sporadic or inherited autosomal dominantly with parental imprinting.	Preferred (foundation metadata concept)
A histological subtype of C3 glomerulopathy with characteristics of C3 deposition in renal tissue in the absence or near-absence of immunoglobulin deposits, in a patient with the classic clinical features of glomerulonephritis and electron microscopic findings of highly electron-dense intra-membranous, osmiophilic deposits.	Preferred (foundation metadata concept)
A history taken by a self-administered questionnaire	Preferred (foundation metadata concept)
A horizontal misalignment in which one eye moves inward, towards the nose, only noticeable when binocular vision is disrupted, such as when one eye is closed or covered.	Preferred (foundation metadata concept)
A horizontal misalignment in which one eye moves outward, away from the nose, only noticeable when binocular vision is disrupted, such as when one eye is closed or covered.	Preferred (foundation metadata concept)
A horizontal streak found on the inner surface of the cheek at the level of the biting plane. It usually extends from the commissure to the posterior teeth and can extend to the inner lip mucosa and corners of the mouth. It is a common finding and most likely associated with pressure, frictional irritation, or sucking trauma from the facial surfaces of the teeth.	Preferred (foundation metadata concept)
A hospital that has an established transplant programme and performs transplant surgery.	Preferred (foundation metadata concept)
A hypersensitivity condition of skin or mucous membranes at the site of direct surface contact with irritants or allergens. A general class that includes both immunologic and non-immunologic conditions.	Preferred (foundation metadata concept)
A keratinisation disorder characterised by focal or diffuse palmoplantar keratoderma. A patchy distribution is observed with accentuation on the thenar, hypothenar and the arches of the feet. The disease becomes apparent in infancy and is associated with sensorineural hearing loss that shows a variable age of onset. The disease is transmitted in an autosomal dominant manner with incomplete penetrance. Caused by heterozygous mutation in the gene encoding connexin-26 (GJB2; 121011) on chromosome 13q12.	Preferred (foundation metadata concept)
A keratotic cutaneous polyp containing abundant connective tissue.	Preferred (foundation metadata concept)
A landmark point defined as the tip of the bony anterior nasal spine at the inferior margin of the piriform aperture, in the midsagittal plane.	Preferred (foundation metadata concept)
A large organ in the thorax, abdomen, or pelvis	Preferred (foundation metadata concept)
A large, local allergic reaction following a mosquito bite often accompanied by systemic symptoms such as a fever. Symptoms usually occur within hours of the mosquito bite and are caused by an immunologic response to proteins in mosquito saliva.	Preferred (foundation metadata concept)
A laryngo-tracheo-esophageal cleft (LC) is a congenital malformation characterised by an abnormal, posterior, sagittal communication between the larynx and the pharynx, possibly extending downward between the trachea and the oesophagus.	Preferred (foundation metadata concept)
A legal order for a diet regime.	Preferred (foundation metadata concept)
A legal order for a parenteral nutrition infusion.	Preferred (foundation metadata concept)
A legal order for an enteral nutrition infusion via a feeding tube.	Preferred (foundation metadata concept)
A legal order to dispense and possibly prepare a substance or physical object	Preferred (foundation metadata concept)
A lesion as a result of galvanic current in the oral cavity due to the presence of two or more dissimilar metals in dental restorations that are bathed in saliva, or a single metal restoration and two electrolytes, saliva and pulp tissue fluid, thus producing an electrolytic cell and an electric current. When such restorations touch each other, the current may be high enough to irritate the dental pulp and cause sharp pain. The anodic restoration or areas of a restoration are subject to electrolytic corrosion.	Preferred (foundation metadata concept)
A less aggressive and self-limited pathologic process that can develop without any obvious eliciting factor and is characterised by exposed necrotic bone involving the lingual mandible approximately at the level of the mylohyoid ridge.	Preferred (foundation metadata concept)
A less common type of cerebral palsy defined by decreased and/or fluctuating muscle tone; multiple forms of non-spastic cerebral palsy are each characterised by particular impairments; one of the main characteristics of non-spastic cerebral palsy is involuntary movement. Subtypes include ataxic and dyskinetic forms.	Preferred (foundation metadata concept)
A lethal bone dysplasia with characteristics of low birth weight, rhizomelic dwarfism, bent femora and short chest producing asphyxia. The disease has been described in three siblings from healthy, non-consanguineous parents of Finnish origin and in four siblings from non-consanguineous parents of French origin with no family history of dwarfism. There has been no further description of this disease in the literature since 1988.	Preferred (foundation metadata concept)
A lethal combination of manifestations including short stature, congenital cataracts, encephalopathy with epileptic fits and postmortem confirmation of nephropathy (renal tubular necrosis). The combination has been described in 2 female infant children of first cousin parents. The infants did not survive beyond 4 and 8 months respectively. There have been no further descriptions in the literature since 1963.	Preferred (foundation metadata concept)
A lethal form of pontocerebellar hypoplasia with characteristics of prenatal onset of microcephaly, hypoplasia of the cerebellum, brainstem, and spinal cord, dysmorphic craniofacial features such as sloping forehead and micrognathia, and multiple contractures. Supratentorial atrophy has also been reported.	Preferred (foundation metadata concept)
A lethal skeletal dysplasia with characteristics of cloverleaf skull anomaly, facial dysmorphism, limb shortness, splenic hypo/aplasia and radiological anomalies including thin tubular bones with flared metaphyses and deficient calvarial mineralisation. First described in 1989, less than 30 cases have been reported so far. Aetiology is not well known, but some histological findings report growth plate disorganisation and adjacent diaphyseal ossification. There is evidence that the disease is caused by heterozygous mutation in the FAM111A gene (615292) on chromosome 11q12.	Preferred (foundation metadata concept)
A lethal skeletal osteochondrodysplasia characterised by severe generalised osteosclerosis.	Preferred (foundation metadata concept)
A life-threatening disorder, believed to be a cardiovascular clinical variant manifestation of Behcet disease, with the association of multiple pulmonary artery aneurysms and peripheral venous thrombosis. Prevalence is unknown but fewer than 30 cases have been reported in the literature since its first description in 1959 by Hughes and Stovin. Patients (mostly men aged 12-40 years) generally present with the nonspecific signs of pulmonary artery aneurysms, following a history of peripheral venous thrombosis. Other associated signs may include fever and intracranial hypertension. Aneurysms can occur anywhere in the systemic circulation. Recurrent phlebitis also commonly involves the large vessels, resulting in thrombus formation. In general, there is a predisposition for thrombus formation affecting the peripheral veins. It is assumed the disease is a form of vasculitis following a similar mechanism of pathogenesis to that thought to be involved in Behcet disease.	Preferred (foundation metadata concept)
A life-threatening multi organ disorder which develops in the first months of life, presenting with respiratory distress and proteinuria in the nephrotic range, and leading to severe interstitial lung disease and renal failure. Some patients additionally display cutaneous alterations, ranging from blistering and skin erosions to an epidermolysis bullosa-like phenotype, with toe nail dystrophy and sparse hair. There is evidence this disease is caused by homozygous mutation in the ITGA3 gene on chromosome 17q21.	Preferred (foundation metadata concept)
A life-threatening rapidly progressive thrombotic disorder affecting mainly neonates and children that has characteristics of purpuric skin lesions and disseminated intravascular coagulation. The disease may progress rapidly to multi-organ failure caused by thrombotic occlusion of small and medium-sized blood vessels. There are two forms of acquired purpura fulminans that are classified according to triggering mechanisms: acute infectious (the most common form) and idiopathic.	Preferred (foundation metadata concept)
A ligation where the surgical suture serves as a ligature.	Preferred (foundation metadata concept)
A limb girdle muscular dystrophy caused by caveolin-3 deficiency with characteristics of weakness in limb-girdle muscles, calf muscle hypertrophy and lack of respiratory and cardiac involvement.	Preferred (foundation metadata concept)
A limb girdle muscular dystrophy caused by myotilin deficiency with characteristics of limb-girdle weakness in combination with dysarthria.	Preferred (foundation metadata concept)
A limb girdle muscular dystrophy with characteristics of muscular weakness, primarily affecting the pelvic and shoulder girdles with no bulbar weakness or dysarthria.	Preferred (foundation metadata concept)
A limb malformation syndrome, where the thumb is replaced by one or two triphalangeal digits with dermatoglyphic pattern specific of the index finger. Two forms of PPD3 have been described, unilateral and bilateral. There have been no further descriptions in the literature since 1962.	Preferred (foundation metadata concept)
A limb-girdle muscular dystrophy with characteristics of skeletal and cardiac myopathy with cardiac conduction defects and muscle cytoplasmic inclusions.	Preferred (foundation metadata concept)
A line connecting the anterior nasal spine to the posterior nasal spine.	Preferred (foundation metadata concept)
A line connecting the midpoint of the sella turcica (Sella) to the most anterior inferior point of chin (Gnathion).	Preferred (foundation metadata concept)
A line extending from a constructed point representing the intersection of the inferior surface of the cranial base and the posterior outlines of the mandibular condyles to the most posterior inferior point on the outline of the angle of the mandible.	Preferred (foundation metadata concept)
A line extending from the incisal tip of the most protrusive lower incisor thru the root tip.	Preferred (foundation metadata concept)
A line extending from the intersection of the internasal and frontonasal sutures, in the midsagittal plane (nasion) and the anterior limit of the mandibular basal bone (b point).	Preferred (foundation metadata concept)
A line extending from the intersection of the internasal and frontonasal sutures, in the midsagittal plane (nasion) and the junction of frontal bone and nasal bone (a point).	Preferred (foundation metadata concept)
A line extending from the intersection of the internasal and frontonasal sutures, in the midsagittal plane (nasion) and the most anterior point of bony chin (pogonion).	Preferred (foundation metadata concept)
A line extending from the intersection of the internasal and frontonasal sutures, in the midsagittal plane (nasion) and the most anterior point of the alveolar process of the mandible (infradentale).	Preferred (foundation metadata concept)
A line extending from the intersection of the internasal and frontonasal sutures, in the midsagittal plane (nasion) and the most inferior anterior point on the maxillary alveolar process, between the central incisors (prosthion).	Preferred (foundation metadata concept)
A line extending from the intersection of the internasal and frontonasal sutures, in the midsagittal plane (nasion) and the most posterior inferior point on the outline of the angle of the mandible (gonion).	Preferred (foundation metadata concept)
A line extending from the most inferior point of the mandibular symphysis in the midsagittal plane (menton) to the most posterior inferior point on the outline of the angle of the mandible (gonion).	Preferred (foundation metadata concept)
A line joining points sella and nasion.	Preferred (foundation metadata concept)
A line segment connecting anterior pole of cornea to posterior pole of sclera	Preferred (foundation metadata concept)
A liquid dose form consisting an alcoholic extract of plant or animal material.	Preferred (foundation metadata concept)
A liquid dose form consisting of a pure substance in its liquid state.	Preferred (foundation metadata concept)
A liquid dose form consisting of a suspension of fine particles in a suitable vehicle.	Preferred (foundation metadata concept)
A liquid dose form consisting of a system of non-miscible liquids where droplets of the discrete phase are distributed in the continuous phase (usually oily in aqueous but can also be aqueous in oily).	Preferred (foundation metadata concept)
A liquid dose form consisting of active substance(s) dissolved in a high concentration solution of sugar or sweetening agents.	Preferred (foundation metadata concept)
A liquid dose form consisting of active substance(s) dissolved in a hydrophobic base.	Preferred (foundation metadata concept)
A liquid dose form consisting of active substance(s) dissolved in a single phase solvent liquid.	Preferred (foundation metadata concept)
A liquid dose form consisting of active substance(s) in a mixture of pyroxylin or similar in ether and ethanol.	Preferred (foundation metadata concept)
A liquid dose form consisting of active substance(s) in an alcohol.	Preferred (foundation metadata concept)
A liquid dose form consisting of semi-solid, gaseous, or small (less than 1 micron) liquid particles dispersed in a suitable vehicle.	Preferred (foundation metadata concept)
A liquid dose form usually presented in a pressurised multi-dose container equipped with an applicator suitable for delivery of a foam consisting of large volumes of gas dispersed in a liquid containing active substance(s).	Preferred (foundation metadata concept)
A liquid dose form where active substance(s) are suspended or dissolved in a volatile liquid which evaporate to leave them in a hard coating.	Preferred (foundation metadata concept)
A listening of the sounds produced in response to tapping the body surface	Preferred (foundation metadata concept)
A listening to spontaneously generated body sounds	Preferred (foundation metadata concept)
A local anaesthetic injection into the thoracic paravertebral space in the region of the thoracic spinal nerves close to their emergence from the intervertebral foramen.	Preferred (foundation metadata concept)
A low velocity/moderate to high amplitude activating force using pressure and motion applied repeatedly against the restrictive barrier of a dysfunctional structure.	Preferred (foundation metadata concept)
A lysosomal storage disease belonging to the group of sphingolipidoses. It is very rare with less than 10 cases reported in the literature so far. Clinically, it is a severe neurovisceral disease manifesting immediately after birth and following a rapidly progressive fatal course. The neurological signs and symptoms include hypotonia, massive myoclonic bursts, abnormal ocular movements and dystonia. Grand mal seizures and seizures triggered by tactile stimuli have been described. Patients also develop hepatosplenomegaly. Death usually occurs from respiratory failure following repeated pulmonary infections. The disease is caused by mutations in the PSAP gene (10q21) leading to absence or non-functionality of the prosaposin protein. The mode of inheritance is autosomal recessive.	Preferred (foundation metadata concept)
A lysosomal storage disease with characteristics of coarse facial features, macular cherry red spot, and dysostosis multiplex. Clinical presentation can be heterogenous ranging from a severe, early-onset, rapidly progressive infantile form to late onset, slowly progressive juvenile/adult form.	Preferred (foundation metadata concept)
A lysosomal storage disease with clinical characteristics of psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration or strabismus. The disease is rare in the general population but is more prevalent among Ashkenazi Jews. First signs appear during the first year of life or later, but clinical progression is usually slow. In this disease phospholipids, gangliosides and mucopolysaccharides accumulate in lysosomal inclusions, some of which resemble membranous cytoplasmic bodies found in gangliosidoses. The condition seems to be caused by anomalies in the endocytosis of membrane components towards the lysosomes. The causative gene, MCOLN1, is located in the 19p13.3-p13.2 region and encodes mucolipin-1 (MLN1), a membrane protein from the transient receptor potential (TRP) channel family. The disease is transmitted as an autosomal recessive trait.	Preferred (foundation metadata concept)
A lysosomal storage disease, belonging to the group of oligosaccharidosis or with a wide clinical spectrum that is divided into two main clinical subtypes: sialidosis type I, the milder, non dysmorphic form of the disease with characteristics of gait abnormalities, progressive visual loss, bilateral macular cherry red spots and myoclonus, that presents in adolescence or adulthood (second or third decade of life); and sialidosis type II (see this term) the more severe, early onset form, with characteristics of progressive and severe mucopolysaccharidosis-like phenotype with coarse facies, visceromegaly, dysostosis multiplex, and developmental delay. Bilateral macular cherry red spots are also present. Sialidosis type II has been further divided into congenital (with hydrops fetalis), infantile and juvenile presentations.	Preferred (foundation metadata concept)
A macroscopic waste clearance system that utilises a unique system of perivascular channels, formed by astroglial cells, to promote efficient elimination of soluble proteins and metabolites from the central nervous system.	Preferred (foundation metadata concept)
A male with two or more X chromosomes.	Preferred (foundation metadata concept)
A malformation disorder with characteristics of complete or incomplete absence of nose, choanal atresia, microphthalmia, anophthalmia and cleft or high palate.	Preferred (foundation metadata concept)
A malformation disorder with characteristics of sagittal craniosynostosis, Dandy-Walker malformation, hydrocephalus, craniofacial dysmorphism (including dolichocephaly, hypertelorism, micrognathia, positional ear deformity) and variable developmental delay. The inheritance pattern appears to be autosomal dominant.	Preferred (foundation metadata concept)
A malformation syndrome involving the abnormal growth of the facial skeleton as well as its soft tissue structure and organs. The syndrome has characteristics of mild facial asymmetry with unaffected neurocranium and eyeballs, along with esotropia, amblyopia and/or convergent strabismus and occasionally submucous cleft palate. Transmission is autosomal dominant. There have been no further descriptions in the literature since 1979.	Preferred (foundation metadata concept)
A malformation syndrome reported in offspring (children and grandchildren) of women exposed to diethylstilbestrol (DES) during pregnancy and is characterised by reproductive tract malformations, decreased fertility and increased risk of developing clear cell carcinoma of the vagina and cervix in young women. Reproductive malformations reported in DES syndrome include small, T-shaped uteri and other uterotubal anomalies that increase the risk of miscarriages in women and epididymal cysts, microphallus, cryptorchidism, or testicular hypoplasia in men. DES, a synthetic nonsteroidal estrogen was widely prescribed from 1940-1970 to prevent miscarriage.	Preferred (foundation metadata concept)
A malformative syndrome due to the teratogenic effect of mycophenolate mofetil (MMF), an effective immunosuppressive agent widely used for the prevention of organ rejection after organ transplantation. To date the majority of cases have been offspring of women who received a solid organ transplant. The newborn or fetus generally has external ear anomalies. Cleft lip-palate with micrognathia is frequently observed. Aberrant orofacial cleft has been observed in one case. Ocular anomalies, such as microphthalmia and iris or chorioretinal coloboma are also frequent. Distal limbs anomalies as well as congenital malformations of the heart, kidneys and/or central nervous system may also be observed.	Preferred (foundation metadata concept)
A manipulation done by a chiropractor	Preferred (foundation metadata concept)
A manipulation done by a physiatrist.	Preferred (foundation metadata concept)
A manipulative technique in which the goal of treatment is to balance the tension in opposing ligaments where there is abnormal tension present.	Preferred (foundation metadata concept)
A manipulative treatment in which the restrictive barrier is disengaged and the dysfunctional body part is moved away from the restrictive barrier.	Preferred (foundation metadata concept)
A manufactured skin graft consisting of an outer epidermal layer and/or a dermal layer embedded into an acellular matrix or dermal template forming a biological skin substitute either grown from the patient's own cells, or from other allogeneic or xenogeneic sources, and/or synthetic materials, for example, silicone graft, or combined sources.	Preferred (foundation metadata concept)
A mass	Acceptable (foundation metadata concept)
A mature wine is a wine that has reached a point of peak complexity, quality in the mouth and flavour, and before it starts to decay. The maturity can happen at different ages depending on the wine.	Preferred (foundation metadata concept)
A meal plan that offers comparable carbohydrate content from day to day at all meals and snacks. Not based on a set number of calories; intended to meet individuals' nutritional needs and facilitate improved metabolic control.	Preferred (foundation metadata concept)
A measure of the age of a pregnancy which is taken from the woman's last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method if available. It is typically expressed in weeks and days.	Preferred (foundation metadata concept)

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Reference Sets

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Id	Description	Lang	Type	Status	Case?	Module
900000000001112010	Great Britain English language reference set	en	Synonym (core metadata concept)	Active	Entire term case sensitive (core metadata concept)	SNOMED CT model component module (core metadata concept)
900000000001113017	GB English	en	Synonym (core metadata concept)	Active	Entire term case sensitive (core metadata concept)	SNOMED CT model component module (core metadata concept)
900000000001114011	Great Britain English language reference set (foundation metadata concept)	en	Fully specified name	Active	Entire term case sensitive (core metadata concept)	SNOMED CT model component module (core metadata concept)