PDR MEDICAL DICTIONARY
`
`YRRii
`
`y
`
`DDP
`Diont
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`HOTORMATIA TTASDARE
`ORMPDIGANIARMINOROON
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`MPI EXHIBIT 1099 PAGE 1
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`

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`PDR MEDICAL DICIIONARY
`
`FIRSTEDI TION
`
`PDR
`
`Medical
`Dictionary
`
`MPI EXHIBIT 1099 PAGE 2
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`

`

`PDR M EDICAL
`
`DICTIONARY
`
`FIRS T EDIT ION
`
`tiiH , isllik
`
`1 )
`
`PDR
`
`Medical
`Dictionary
`
`MEDICAL ECONOMICS
`MONTVALE, NEW JERSEY
`
`MPI EXHIBIT 1099 PAGE 3
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`

`

`MO1Tig3 T291?
`
`Editor: Marjory Spraycar
`Senior Editor: Elizabeth Randolph
`Editorial Assistant: Maureen Barlow Pugh
`Copy Editors: Christopher Muldor, Jane Sellman, Barbara Werner
`On-Line Editors: Kathryn J. Cadle, Barbara L. Ferretti, Catherine N. Kelly, Leslie Simpson
`Editorial Proofreaders: Peter W. Binns, Jolanta Obrebska, Carol Sorgen
`Medical Proofreaders: Alfred Jay Bollet, M.D.; John H. Dirckx, M.D.; Thomas W. Filardo, M.D.; Robert Hogan, M.D.; EdwardStim.MD
`Database Programmers: Dennis P. Smithers, Dave Marcus, Lexi-Comp Inc., Hudson, OH
`Production Coordinator: Paula K. Huber
`Printing Coordinator: Brian Smith
`llustration Planning: Wayne J. Hubbel
`Design: Robert C. Och, Dan Pfisterer
`Cover Design: Sharon Reuter, Reuter & Associates
`
`Copyright O 1995
`Williams & Wilkins
`351 W. Camden Street
`Baltimore, MD 21201, USA
`
`İst ed.: 1912, 2nd ed.: 1914,3rd ed.; 1916, 4th ed.; 1918, Sth ed: 1920, 6th ed: 192,Th8:
`Copyright © by William Wood and Company: 1911,
`1924, 8th ed.; 1926, 9th ed.; 1928, 10th ed.; 1930, 11th ed.
`
`Copyright © by Williams & Wilkins: 1933, 12th ed.; 1935, 13th ed.: 1939, 14th ed., 1942, 1Sth ed; 1946, 16th ed.; 1949, 17th ed: 1953,1sthe4:
`1957, 19th ed.; 1961, 20th ed.; 1966, 21st ed.; 1972, 22nd ed.; 1976, 23rd ed.; 1982, 24th ed.; 1990, 25th ed.
`
`Guide to Pharmaceutical Names copyright ©1995 by Medical Economics Company Inc., S Paragon Drive, Montvale, NJ 07645.
`
`rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or byanymzs
`All
`including photocopying, or utilized by any information storage and retrieval system without written permissionfromhe a:
`right owner.
`
`Stedman's is a registered trademark of Williams & Wilkins.
`
`Physician 's Desk Reference® and PDR® are registered trademarks used herein under license.
`
`Indications, adverse reactions and dosage schedules for drugs set forth in this dictionary are provided by the authors. Williams & Wilkinstasat
`independently verified the accuracy of that
`information and does not make any representation in regard to its accuracy. The readershouldres
`the package information data of the manufacturers of the medications mentioned.
`
`Database design by Lexi-Comp Inc., Hudson, OH
`Printed in the United States of America by R.R. Donnelley & Sons Company
`
`ISBN 1-56363-1 17-2
`
`3!AVIOM
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`MPI EXHIBIT 1099 PAGE 4
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`

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`CONTENTS
`
`Preface
`
`Consultants
`
`Contributors
`
`.
`
`Illustration Credits
`
`Illustrations in This Edition
`
`High Profile Terms in This Edition ..
`
`How to Use This Dictionary
`
`Building Blocks of Medical Language
`
`Common Medical Abbreviations ..
`
`Guide to Pharmaceutical Names
`
`WordFinder
`
`A-Z Vocabulary
`
`IndextotheAnatomicalPlates ..
`
`Color Anatomical Plates
`
`Table of Contents to the Appendices
`
`..
`
`vii
`
`ix
`
`xii
`
`xii
`
`xii
`
`xvi
`
`xvii
`
`XXX
`
`XXxii
`
`GPN-1
`
`WF
`
`1
`
`1-1976
`
`1013
`
`1019
`
`1979
`
`••
`
`V
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`MPI EXHIBIT 1099 PAGE 5
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`472
`
`SYN right-handed.
`
`dextromanual
`dex tro-man-u al(deks-trõ-man'yū-ăl).
`[dextro- + L. manus, hand]
`dex-tro meth-or-phan hydro-bro- mide(dekstrô-meth-ör
`fan hĩ-drõ-broʻmĩd).
`Hydrobromide of d-racemethorphan; d-3-
`methoxy-N-methylmorphinan
`hydrobromide; a synthetic mor-
`phine
`derivative used as an antitussive agent.
`It has weak central
`depressant action, and appears to have little addiction liability.
`tar-trate (deks-trõ-mõră-mīd). A narcot-
`dex-tro-mor-a-mide
`ic analgesic related chemically and pharmacologically to metha-
`done.
`(deks-trop'&-dăl).
`Denoting one who uses the
`dex-trop-e-dal
`right
`leg in preference to the left. sYN right-footed.
`[dextro- + L.
`pes (ped-), foot]
`(dekstrõ-põ-zi'shůn). Abnormal right-sided
`dex-tro-po-si-tion
`location or origin of a normally left-sided structure, e.g., origin
`of the aorta from the right ventricle.
`d. of the heart, sEEdextrocardia.
`dex-tro-pro-pox:y-phene hy-dro-chlo-ride(deks'trõ-prõ-pok'
`sẽ-fen). sYN propoxyphene hydrochloride.
`dex-tro-pro-poxyphene
`nap-syl·ate.
`napsylate.
`(dekstrõ-rõ-tấ'shũn). A turming or twisting to
`dex-tro-ro-ta-tion
`the right;
`especially,
`the clockwise twist given the plane of
`plane-polarized light by solutions of certain optically active sub-
`stances. Cf.
`levorotation.
`(deks-trõ-rốʻtắ-tõr-ē). Denotingdextrorota-
`dex-tro-rota-to-ry
`tion, or certain crystals or solutions capable of so doing; as a
`chemical prefix, usually abbreviated d-. Cf. levorotatory.
`dex-trose
`(dekstrõs). SEE D-glucose.
`(deks'trõ-si-nis'trăl).
`dex-tro-si-nis-tral
`to left.
`[dextro- + L. sinister,
`left]
`(deks-trõ-sűʻrē-ă). Obsolete term for glycosuria.
`dex-tro-su-ria
`so-di-um (deks-trõ-thi-roks'ēn). D-Thy-
`dex-tro-thy-rox-ine
`roxine sodium salt; an antihypercholesterolemic agent.
`(deks-trõ-tõr'shũn ). 1. A twisting to the right.
`dex-tro-tor-sion
`2.
`In
`ophthalmology,
`a seldom-used term for a conjugate rotation
`of the upper pole of both corneas to the right. sYN dextroclina-
`tion.
`[dextro- + L.
`torsio, a twisting]
`dex-tro-tro-p-ic
`(dek-trõ-trop'ik).
`Tuning to the right. [dextro-
`+G.
`tropos, a turn)
`dex-tro-ver-sion (deks'trõ-ver'zhũn).
`toward the
`1. Version
`right. 2.
`In
`ophthalmology, a conjugate rotation of both eyes to
`the right.
`[dextro-+ L. verto, pp. versus, to turn]
`d. of the heart, sYNCOrrected dextrocardia.
`d.f.. Abbreviation for degrees of frecdom, underdegree.
`df, DF Abbreviation for decayed and filled teeth. sYN df caries
`index.
`DFP Abbreviation for diisopropyl fluorophosphate.
`dGlc Abbreviation for2-deoxyglucose.
`1,4-0-D-glu can branch-ing en zyme.
`amylo-(1,4-→1,6)-
`transglucosylase or
`transglucosidase; an enzyme in muscle and in
`plants (Q enzyme)
`that cleaves a-1,4 linkages in glycogen or
`starch,
`transferring the fragments into a-1,6 linkages, creating
`branches in the polysaccharide molecules;
`in plants,
`it converts
`amylose to amylopectin;
`this enzyme is deficient
`in individuals
`with glycogen storage disease type IV. sYN a-glucan branching
`glycosyltransferase, amylo-1,4:1,6-glucantransferase, amylo-
`(14→1,6)-transglucosidase, amylo-(1,4→1,6)-transglucosylase,
`branching enzyme.
`dGMP Abbreviation for deoxyguanylic acid.
`DHAP Abbreviation for dihydroxyacetonephosphate.
`Dharmendra
`an-ti-gen. See under antigen.
`d'Herelle,
`Felix H., Canadian physician and bacteriologist,
`1873-1949. SEE d'H. phenomenon; Twort-d'H. phenomenon.
`DHF Abbreviation for dihydrofolic acid.
`DHFR Abbreviation for dihydrofolate reductase.
`D. Hy. Abbreviation for Doctor of Hygiene.
`DI Abbreviation for dental index.
`Bdi-,
`1. Two,
`twice. 2.
`In chemistry, often used in place of bis-
`
`sYN propoxyphene
`
`In a direction from right
`
`Aal
`
`diabels
`
`likely to be confusing: e.g., dichloro- compoundsu
`when not
`bi-, bis-. [G. dis,
`two]
`dia-. Through, throughout. completely. (G. dia,through)
`(di-ă-bë'tēz).
`di-a-be-tes
`Either d.
`insipidus or d. mellitus A
`eases having in common the symptom polyuria; whenusedw
`[G. diabētēs, acombase.
`out qualification,
`refers to d. mellitus.
`siphon, diabetes]
`
`diabetes mellitus: etiologic classification
`
`I.
`
`type l = insulin-
`familiar diabetes)
`Primary (essential,
`dependent d.m.
`(|DDM) and type ll = non insulin-
`dependent d.m. (NIDDM)
`
`I. Secondary(nonessential) diabetes
`
`A. pancreatic diabetes:
`- after total or partialpancreatectomy
`- with extensivedestruction ofpancreas
`through tumor or wound
`- pancreatitis;hemochromatosis
`extrapancreaticlendocrine diabetes
`- withhypersomatotropisn(acromegaly)
`with hyperadrenalism (Cushing syndrome;Conn
`syndrome, pheochromocytoma)
`with hyperthyroidism
`with glucagonoma
`
`B.
`
`C. drug-induced diabetes
`- after exogenous hormone intake (STH;ACTH
`Corticoid hormone [steroid diabetes]: thyroid
`hormone)
`after benzothiadiazides
`
`IlI. Rare, exceptional forms of diabetes
`
`lipoatrophic diabetes (Lawrence); myatonicdiabetes
`e.g.,
`(Prader-Labhart-Willi;
`disturbance of insulinreceptors:
`d.m. with certain genetic syndromes
`
`adult-onset d., non-insulin-dependent d. mellitus.
`alimentary d., sYN alimentary glycosuria.
`alloxan d.,
`experimental
`d. mellitus
`produced in animalsbytk
`administration of alloxan, which damages theinsulin-producing
`islet cells of the pancreas.
`brittle d., d. mellitus
`in which there are marked fluctuationsia
`blood glucose concentrations that are difficult
`to control.
`bronze d., d. mellitus
`associated with hemochromatosis,wit
`iron deposits in the skin,
`liver, pancreas, and otherviscera,ofta
`with severe liver damage and glycosuria. sEEALSOhemochrom:
`tosis. sYN bronzed d., bronzed disease.
`bronzed d., sYN bronze d.
`calcinuric d., sYN hypercalciuria.
`chemical d., sYN latent d.
`galactose d., sYN galactosemia.
`gestational d., carbohydrate intolerance duringpregnancys
`ally resolving after delivery.
`growth-onset d., sYN insulin-dependent d. mellitus.
`d. in'nocens, sYN renal glycosuria.
`ofruk
`d.
`insipidus,
`chronic excretion of very large amounts
`extre
`urine of
`low specific
`gravity,
`causing dehydration ande
`thirst; ordinarily results from inadequate output ofpituitary
`nickeds
`diuretic hormone;
`the urine abnormalities may be mimic
`olydinsi
`result of excessive fluid intake, as in psychogenic pola
`Several types exist: central, neurohypophyseal, and nephro.
`Autosomal dominant
`[MIM*12570o.
`*125800, *192340,
`linked [MIM*304800 and *304900], andevenautoson rt
`sive forms
`[MIM*222000]
`have been described. sEEAL50
`rogenic d.
`insipidus.
`
`MPI EXHIBIT 1099 PAGE 6
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`

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`diabetes
`
`473
`
`diacetonuria
`
`stages of diabetes melitus
`
`stage
`
`prediabetes
`
`latent diabetes
`pregnancy diabetes
`
`manifest diabetes
`(hyperglycemia
`120 mg/dl, glycosuria)
`
`glucose tolerance test
`
`normal
`
`pathological by now
`(or sooner)
`
`not required
`
`di
`
`insulin-dependent d. mellitus (IDDM), severe d. mellitus, often
`britle, usually of abrupt onset during the first two decades of life
`but can develop at any age; characterized by polydipsia,
`polyu-
`ria. increased appetite, weight
`loss,
`low plasma insulin levels,
`and episodic ketoacidosis;
`immune-medicated
`destruction of
`pancreatic B cells;
`insulin
`therapy and dietary
`regulation are
`necessary. sYN growth-onset d.,
`juvenile-onset
`d.,
`type I d.
`insulinopenic d., any form of d. mellitus resulting from inade-
`quatesecretion of insulin.
`d.
`intermit'tens, d. mellitus in which there are periods of rela-
`tively normal carbohydrate metabolism followed by relapses to
`the previous diabetic state.
`juvenile d., d. mellitus appearing in a child or adolescent; often
`fatal, usually of abrupt onset during first or second decaces of
`life; characterized by polyuria, polydipsia, weight
`loss; usually
`severe, insulin-dependent and prone to periods of ketoacidosis;
`can be familial,
`follow a viral
`infection such as mumps;
`thought
`to be due to viral-induced or
`immune destruction of pancreatic
`islets. sYN type I d. mellitus.
`juvenile-onset d., sYN insulin-dependent d. mellitus.
`ketosis-prone d.,
`type I or
`juvenile d. mellitus,
`in which inade-
`quate treatment leads to development of ketoacidosis.
`ketosis-resistant d.,
`type II or adult onset d. mellitus,
`episodes of ketoacidosis rarely occur.
`latent d., a mild form of d. mellitus in which the patient displays
`no overt symptoms, but displays certain abnormal
`responses to
`diagnostic procedures, such as an elevated fasting blood glucose
`concentration or reduced glucose tolerance. sYN chemical d.
`lipoatrophic d., sYN lipoatrophy.
`lipogenous d., d. and obesity combined.
`maturity-onset d., non-insulin-dependent d. mellitus.
`maturity onset d. of youth, a relatively mild, non-insulin requir-
`ing form of d. mellitus
`beginning at a younger age than usual.
`
`in which
`
`(DM), a metabolic disease in which carbohydrate
`d. mel'litus
`utilization is reduced and that of
`lipid and protein enhanced; it is
`caused by an absolute or
`relative
`deficiency of
`insulin and is
`characterized, in more severe cases, by chronic hyperglycemia,
`glycosuria, water and electrolyte loss, ketoacidosis, and coma;
`long-term complications include development of neuropathy, ret-
`inopathy, nephropathy, generalized degenerative changes in large
`and small blood vessels, and increased susceptibility to infection.
`SEEALSO insulin-dependent
`d. mellitus,
`non-insulin-dependent
`d.
`mellitus. [L. sweetened with honey]
`Of the 14 million Americans with diabetes, roughly 90%
`have Type II
`(noninsulin-dependent)
`and roughly 10%
`have Type I
`(insulin-dependent)
`disease. Previously,
`it
`was thought diabetics were bound to suffer from chronic
`complications. However,
`in 1993, the results of a 10-year
`multicenter study found that by rigorously managing
`blood sugar levels, diabetics could substantially minimize
`long-term complications,
`including retinopathy, neuropa-
`thy, and nephropathy. The American Diabetes Associa-
`tion now recognizes that
`there can be no universal guide-
`lines;
`rather,
`it
`recommends that dietary regimens and
`weight goals be tailored for each diabetic. This requires
`both greater commitment on the part of diabetics them-
`selves, and greater involvement of medical professionals,
`particularly dieticians.
`
`inosituria with excretion of large quantities of wa-
`
`metahypophysial d., (1) d. mellitus caused by large quantities of
`endogenous or exogenous pituitary growth hormone;
`(2) term
`used to designate the irreversible phase of d. mellitus in acro-
`megaly.
`Mosler's d.,
`ter
`insipidus due to
`d.
`(MIM*304800),
`insipidus
`nephrogenic d.
`inability of
`the kidney tubules to respond to antidiuretic hor-
`mone; X-linked inheritance, with full expression in males and
`partial defect
`in heterozygous females. sYN vasopressin-resistant
`d.
`
`(NIDDM), an often mild
`non-insulin-dependent d. mellitus
`1Om of d. mellitus of gradual onset, usually in obese individuals
`
`to high,
`over age 35; absolute plasma insulin levels are normal
`but relatively low in relation to plasma glucose levels; ketoacido-
`sis is rare, but hyperosmolar coma can occur;
`responds well
`to
`dietary regulation and/or oral hypoglycemic agents, but diabetic
`complications and degenerative changes can develop.
`pancreatic d.,
`(1) d. mellitus demonstrably dependent upon a
`pancreatic lesion; (2) d.
`following removal of the pancreas in an
`animal.
`(flõ-rid'zin), sYN phlorizin glycosuria.
`phlorizin d.
`phosphate d., excessive secretion of phosphate in the urine due
`to a defect
`in tubular
`reabsorption; usually part of a more gener-
`alized abnormality, such as Fanconi syndrome.
`piqüre d., sYN puncture d.
`[Fr.]
`pregnancy d., SEE subclinical d.
`puncture d., experimental d. produced in animals by puncture of
`the floor of the fourth ventricle of the brain. sYN piqûre d.
`renal d., sYN renal glycosuria.
`starvation d., after prolonged fasting, glycosuria following the
`ingestion of carbohydrate or glucose because of reduced output
`of
`insulin and/or
`reduced rate of glucose metabolism with a
`reduced ability to form glycogen.
`steroid d., d. mellitus produced by pharmacological doses of
`steroid hormones, particularly glucocorticoids or estrogens; char-
`acterized by one or more of
`the typical manifestations of d.
`mellitus.
`steroidogenic d., abnormal glucose tolerance, often frank d. mel-
`litus,
`induced by the metabolic effects of adrenocortical steroid
`hormones such as cortisone or
`therapeutic
`analogues such as
`prednisone. The effect may be temporary,
`resolving when the
`steroid therapy is discontinued, or d. mellitus may persist.
`subclinical d., a form of d. mellitus that is clinically evident only
`under
`certain
`circumstances,
`such as pregnancy or extreme
`stress; persons so afflicted may,
`in time, manifest more severe
`forms of the disease.
`thiazide d.,
`impaired carbohydrate metabolism associated with
`the use of
`thiazide diuretic drugs; severe manifestations are seen
`in persons having d. mellitus, but
`impairment
`is mild or absent in
`nondiabetic individuals.
`type I d., sYN insulin-dependent d. mellitus.
`type II d.,non-insulin-dependentd. mellitus.
`type I d. mellitus, sYN juvenile d.
`insipidus.
`Vasopressin-resistant d., sYN nephrogenic d.
`(di-ă-betik). 1. Relating to or suffering from diabetes.
`di-a-bet-ic
`2. One who suffers from diabetes.
`dia-be-to-gen-ic (di'ă-bet-õ-jen'ik, -bē-tö-jen'ik). Causing dia-
`betes.
`di a-be-tog en-ous (diă-bě-toj'en-ŭs). Caused by diabetes.
`di a-be-tol-o-gy (dră-be-tol'ö-je). The field of medicine con-
`cerned with diabetes.
`di-a-cele (dră-sēl).
`sYN third ventricle.
`koilia, a hollow]
`di ac-e-tal (di-asē-tal).SEEdiacetyl.
`(di-as'ě-tāt).
`di-ac-e-tate
`1. sYN acetoacetate.
`containing two acetate residues.
`di ace-te-mia(di-as-č-tế'mẽ-ă). A form of acidosisresulting
`from the presence of acetoacetic (diacetic) acid in the blood.
`di·a-ce-tic ac-id (di-ă-sē tik, -set'ik). SYNacetoacetic acid.
`diac-e-ton-u-ria (di-as'ě-tö-nūʻrē-ă). sYN diaceturia.
`
`[G. dia-,
`
`through, +
`
`2. A compound
`
`MPI EXHIBIT 1099 PAGE 7
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