Webster's New World Medical Dictionary



TM

Medical Dictionary

Third Edition

From the Doctors and Experts at WebMD





Webster's New WorldTM Medical Dictionary, Third Edition Copyright ? 2008 . All rights reserved. Published by Wiley Publishing, Inc., Hoboken, New Jersey No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the web at . Requests to the Publisher for permission should be addressed to the Legal Department, Wiley Publishing, Inc., 10475 Crosspoint Blvd., Indianapolis, IN 46256, (317) 572-3447, fax (317) 572-4355, or online at . The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation warranties of fitness for a particular purpose. No warranty may be created or extended by sales or promotional materials. The advice and strategies contained herein may not be suitable for every situation. This work is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If professional assistance is required, the services of a competent professional person should be sought. Neither the publisher nor the author shall be liable for damages arising here from. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. Trademarks: Wiley, the Wiley Publishing logo, Webster's New World, and all related trademarks, logos and trade dress are trademarks or registered trademarks of John Wiley & Sons, Inc. and/or its affiliates. All other trademarks are the property of their respective owners. Wiley Publishing, Inc. is not associated with any product or vendor mentioned in this book. For general information on our other products and services or to obtain technical support, please contact our Customer Care Department within the U.S. at 800-762-2974, outside the U.S. at 317-572-3993, or fax 317-572-4002. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, please visit our web site at . Library of Congress Cataloging-in-Publication Data is available from the publisher upon request. ISBN: 978-0-470-18928-3 Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 Book production by Wiley Publishing, Inc. Composition Services





TM

Medical Dictionary

Third Edition

From the Doctors and Experts at WebMD





Webster's New WorldTM Medical Dictionary, Third Edition Copyright ? 2008 . All rights reserved. Published by Wiley Publishing, Inc., Hoboken, New Jersey No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the web at . Requests to the Publisher for permission should be addressed to the Legal Department, Wiley Publishing, Inc., 10475 Crosspoint Blvd., Indianapolis, IN 46256, (317) 572-3447, fax (317) 572-4355, or online at . The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation warranties of fitness for a particular purpose. No warranty may be created or extended by sales or promotional materials. The advice and strategies contained herein may not be suitable for every situation. This work is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If professional assistance is required, the services of a competent professional person should be sought. Neither the publisher nor the author shall be liable for damages arising here from. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. Trademarks: Wiley, the Wiley Publishing logo, Webster's New World, and all related trademarks, logos and trade dress are trademarks or registered trademarks of John Wiley & Sons, Inc. and/or its affiliates. All other trademarks are the property of their respective owners. Wiley Publishing, Inc. is not associated with any product or vendor mentioned in this book. For general information on our other products and services or to obtain technical support, please contact our Customer Care Department within the U.S. at 800-762-2974, outside the U.S. at 317-572-3993, or fax 317-572-4002. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, please visit our web site at . Library of Congress Cataloging-in-Publication Data is available from the publisher upon request. ISBN: 978-0-470-18928-3 Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 Book production by Wiley Publishing, Inc. Composition Services





Acknowledgments

At , a part of the WebMD network, we continue to foster the concept that you, the readers, are truly interested in understanding health issues and medical concepts. Accordingly, we have addressed the medical terms in this dictionary with sensitivity to potential concerns of those who are acutely or chronically confronting disease or health concerns. We are grateful for your interest in health topics as it is a driving force for the development of the Webster's New World Medical Dictionary, Third Edition.

On behalf of the division of WebMD, we wish to thank the staff at Wiley Publishing, Inc., especially Roxane Cerda and Suzanne Snyder, for bringing this dictionary to those who need it. We also thank the officers of , particularly Gene Lu and David Sorenson, who have supported the development of this dictionary.

The excellence of the technical and editorial staffs at greatly facilitated this entire project. Dan Griffith and Michael Cupp provided the unique publishing software that made it all possible. Cynde Lee, Kelly McKiernan, and Tanya Buchanan have performed magnificently in managing the vast amount of content and communication between authors and editors. David Sorenson has been an inspirational catalyst for motivation and consistent superior quality.

William C. Shiel, Jr., MD, FACP, FACR, thanks his children, Cara Shiel Krenn, Daniel, and Timothy for their support. He also acknowledges the support and encouragement of his parents, William and Virginia Shiel, as well as his dear mother-in-law, Helen Stark. With infinite gratitude and love he thanks his wife, Catherine, for her support, love, and editing. With gratitude he acknowledges the Herculean efforts of Frederick Hecht, MD, FAAP, FACMG in developing previous editions of this dictionary. And, with admiration beyond words, he thanks his dear friend, colleague, and co-founder of , Dennis Lee, MD.

Melissa Conrad St?ppler, MD wishes to thank her husband, Hubert St?ppler, and her children, Johannes, Anna, and Tilman, for their enduring support, love, and patience. She also gratefully acknowledges the support and encouragement of her parents, Kathryn B. Conrad and the late Henry E. Conrad, Jr.

Thank you all.

?William C. Shiel, Jr., MD, FACP, FACR

?Melissa Conrad St?ppler, MD





Get Additional Free Content Online

As an added bonus to this fully revised third edition of the Webster's New WorldTM Medical Dictionary, you can visit the companion website at wnw.

You'll find a free PDF Healthcare Guide to help you get the most out of your personal medical care. You can also listen to podcasts from Dr. William Shiel and Dr. Melissa St?ppler, the co-editors of the Webster's New World Medical Dictionary, in which they discuss strategies to help you better communicate with your doctors and caregivers.

Editorial Staff

Co-Editors-in-Chief William C. Shiel, Jr., MD, FACP, FACR

Melissa Conrad St?ppler, MD

Assistant Editors Dennis Lee, MD

Jay W. Marks, MD

Ruchi Mathur, MD, FRCP(C)

Content Managers Cynde Lee Kelly McKiernan

Concept Development David Sorenson Gene Lu





About the Authors

William C. Shiel, Jr., MD, FACP, FACR, Co-Editor-in-Chief

William C. Shiel, Jr., MD, FACP, FACR, received a bachelor of science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his internal medicine residency and rheumatology fellowship at University of California, Irvine. He is board certified in internal medicine and rheumatology and is a fellow of the American Colleges of Physicians and Rheumatology. Dr. Shiel is in active practice in the field of rheumatology at the Arthritis Center of Southern Orange County, California. He is currently an active associate clinical professor of medicine at University of California, Irvine. He has served as chair of the Department of Internal Medicine at Mission Hospital Regional Medical Center in Mission Viejo, California. Dr. Shiel has authored numerous articles on subjects related to arthritis for prestigious peer-reviewed medical journals, as well as many expert medical-legal reviews. He has lectured in person and on television both for physicians and the community. He is a contributor for questions for the American Board of Internal Medicine and has reviewed board questions on behalf of the American Board of Rheumatology Subspecialty. He served on the Medical and Scientific Committee of the Arthritis Foundation, and he is currently on the Medical Advisory Board of Lupus International. Dr. Shiel is proud to have served as chief editor for since its founding in 1996. He was co-editor-in-chief of the first and second editions of Webster's New World Medical Dictionary.



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