Posts 16 to 20 December 2014

By way of explanation

This is the first completely new medical dictionary to come to the market since the Tabers Medical Dictionary was published in the 1940s.*

*It seems appropriate to discount The International Dictionary of Medicine and Biology, which was published by John Wiley and Sons in the mid-1980s and never made it to a second edition.

After trying to produce this as a text-based work, it became obvious that a lexicon that serves the needs of physicians and health care workers in the 21st century must be designed and developed from the ground up as a database.

This explains the poor implementation (and virtual unusability) of the electronic versions of the standard medical dictionaries (the Dorland’s, Stedman’s and Taber’s medical dictionaries).

For the record, this was the main complaint of my own Concise Dictionary of Modern Medicine, which was an iOS App from 2010 until I had it removed. To access information from a text-based work, a computer has the daunting task of sifting through ALL the information in the text, a problem that doesn’t occur with relational database searches.  

The Concise Dictionary of Medicine and a handful of other text-based eBooks I’ve written over the last few decades are still available on the various eBook stores (iTunes, Kindle, Nook, etc) for those who like the text format and want them on their iPads, tablets, etc. However, database apps are the future and as I go online with the database version of each, I will retire the eBook versions.

I began collecting new medical terms as a hobby in 1984, premised on my belief that the standard medical dictionaries were losing touch with the spoken and working language of medicine.

You’ll find my musings on medical lexicography on the page titled:

New Medical Dictionary

I went live with in May, 2012 and blog about 5 terms/day, which derive from a growing database that now has 183,213 entries*

*The Dorland’s has less than 124,000 entries.

I’ll be making portions of the database available as iOS/Android apps…the first product, Medical Abbreviations, will be out soon…stay tuned.

Most of the terms blogged herein fall into one of three general categories:

• Popular terms–e.g., champagne bottle leg, Michael Jackson syndrome(s), Mickey Mouse sign(s), soap bubble pattern, Sutton’s law, etc. I’ve tried to include something for everyone, in particular as relates to the cultural savvy that doctors are expected to have vis-à-vis music, literature, the arts and the world in general. Even if you’re not in health care, the material is “edutaining”, occasionally droll…

• New biomedical terms–e.g., from genomics and molecular biology, evidence-based medicine, informatics, managed care, sport medicine, etc

• Old terms due for burial with comments on usage

I encourage the reader to look over the 4500+ terms now found on this website. When I started in 2012, I thought it was a good idea to arrange the material chronologically. 

What was I thinking? WHO looks up a term by date?????? So each page has about 25 terms with no unifying theme (yeah, it’s a mess). 

Soooooooo, I consulted a SEO (search engine optimisation) expert to ask why the traffic had stagnated. He said that the website was largely invisible to search engines (Google, Bing, Yahoo), and suggested that I separate each entry into its own page, which I’m now doing, a process that I hope to finish by mid-2015. What that means for the visitor is that un-reworked terms are arranged by date and pretty difficult to find, whilst the reworked terms pop right up when you type the term in the search bar located at the top right corner of this website. 

I plan to offer this growing pool of blogged terms as an annual subscription, updated monthly.

One change you’ll see soon is the disappearance of the original files, which will result in the dreaded 404 error

Format of entries Whilst I believe the format is self-explanatory, I am biased and may be assuming too much. The following few lines are meant to explain the elements found in most of the terms blogged on this website.

•  Entry name bailout 

•  Area of interest SURGERY 

•  Synonyms Bailout procedure, damage control surgery 

•  Definition The immediate closure… 

•  Reference

A lexicon written in the 21st Century cannot, given of the diverse sources from which its material derives, escape some tongue-in-cheek and even outright comedy.

I tried to confine the jocularity to the choice of illustrations so as to not diminish the value of the work. For most of the terms, the illustration is on point. For others, I took liberties, such as those taken for genes–e.g., HOMER2, which got a mugshot of Homer Simpson and HIP2, which got an illustration from hipster artist Josh Agle.

Small minds, as they say, easily amused…

If you have a new term that you feel has gotten short shrift in a medical dictionary, shoot me an email at and I’ll add it if I agree. And feel free to back-link to this website.

I will correct the inconsistencies in the typography when I transfer the blogged material to the permanent pages. 

The reader will note that the spelling follows that extant on the other side of the pond. Unless they change the name of the language we speak to American, orthographic principles should follow received pronunciation (Queen’s English).

20 December 2014

chemical shift 

IMAGING-MRI In nuclear magnetic resonance, a chemical shift is the resonant frequency of a nucleus relative to a standard. In MR imaging is corresponds to the change in Larmor frequency of a given nucleus when bound to different sites in a molecule, due to magnetic shielding effects of electron orbitals.

Chemical shifts are responsible for differences among various molecules, and different sites in the molecules in high-resolution magnetic resonance spectra. The chemical shift is proportional to strength of the magnetic field strength and usually specified in ppm of resonance frequency, relative to a standard. 


Club of Rome 

club_romeENVIRONMENT, GLOBAL VILLAGE A group of academicians, civil servants, business leaders which first met in 1972 and proposed limits to population growth.

The Club of Rome hypothesis, based on computer simulations of human activities, holds that limits to population growth on the planet would be breached within a century; at that point, there would be an uncontrollable decline in the population and industrial capacity. 


confined space 

OCCUPATIONAL MEDICINE An occupational health term of art for a vertically or horizontally limited access space in which an employee carries out a specified task.

Examples, confined spaces Boilers, furnaces, manholes, pipelines, pits, vessels, sewers, silos, storage tanks, and utility vaults.

Half of confined space deaths—hundreds of workers die/year in the US—occur in would-be rescuers; because of the risks associated with working in confined spaces, OSHA has proposed regulations (29 CFR 1910.146)  governing how employees should work in such spaces.   


conserved synteny 

EVOLUTIONARY BIOLOGY Shared synteny  The co-localisation of orthologous genes on chromosomes of different species. Some authors qualitatively distinguish macrosynteny–preservation of synteny over long segments of a chromosome, and microsynteny–preservation of synteny over short segments of a chromosome. 

During evolution, rearrangements on chromosomes may separate gene loci, resulting in the loss of synteny. Conserved synteny between rat and human doesn’t extend over an entire chromosome, with the notable exception of the X chromosome. 



CELL BIOLOGY Enhancer of polycomb homolog 1 (Drosophila) A gene on chromosome 10p11 that encodes a nuclear protein belonging to the NuA4 histone acetyltransferase–HAT complex, which can up- and down-regulate transcription. EPC1 has been linked to apoptosis, DNA repair, skeletal muscle differentiation, gene silencing, and adult T-cell leukaemia/lymphoma.  


19 December 2014

coffin lid crystal 

CHEMICAL PATHOLOGY, LABORATORY MEDICINE A descriptive term for 3-6-sided colourless prism-shaped crystals seen in various fluids which have been fancifully likened to the lids on coffins. Urine Ammonium magnesium phosphate–triple phosphate (struvite) crystals, seen in neutral or alkaline urine, and linked to urinary tract infections of urea-splitting bacteria. coffinLids

Synovial fluid Coffin lid crystals are associated with acromegaly, hyperparathyroidism, haemochromatosis, hypomagnesaemia, hypophosphatasia, myxedema, ochronosis, Wilson’s disease

Differential diagnosis Other arthritic conditions–e.g., gout, osteoarthritis, rheumatoid arthritis, chondrocalcinosis

conplastic strain 

GENOMICS A strain of organism generated by backcrossing the nuclear genome from one inbred strain into the mitochondrial genome (cytoplasm) of another, i.e., the mitochondrial parent is always the female parent whilst backcrossing.

Nomenclature The strain designation is nuclear genome-mtcytoplasmic genome. For example, C57BL/6J-mtBALB/c is a strain with the nuclear genome of C57BL/6J and the cytoplasmic genome of BALB/c. It was developed by crossing male C57BL/6J mice with BALB/c females, followed by repeated backcrossing of female offspring to male C57BL/6J. As with congenic strains, a minimum of 10 backcross generations is required, counting the F1 generation as generation 1. 


fat halo sign 

fat_halo_signGASTROENTEROLOGY, IMAGING An abdominal CT finding consisting of a thickened bowel wall with three layers: an innermost layer corresponding to the mucosa, surrounded by a layer of fatty attenuation, which is in turn surrounded by the muscularis propria and serosa.

First described as typical of inflammatory bowel disease–Crohn’s disease and ulcerative colitis, it has also been reported as an acute finding in graft-versus-host disease and cytoreductive surgery

Reference Radiology 2007; 242:945–946 10.1148/radiol.2423041600 


MOLECULAR BIOLOGY Lin-28 homolog A (C. elegans), LIN28, zinc finger CCHC domain-containing protein 1, CSDD1, RNA-binding protein LIN-28, ZCCHC1 A gene on chromosome 1p35.3 that encodes a protein which enhances translation, driving specific mRNAs to polysomes, increasing the efficiency of protein synthesis. Its association with the translational machinery and target mRNAs results in an increased number of initiation events per molecule of mRNA and, indirectly, in mRNA stabilisation. LIN28A binds IGF2 mRNA, MYOD1 mRNA, ARBP/36B4 ribosomal protein mRNA and its own mRNA. It is essential for skeletal muscle differentiation by up-regulating IGF2 expression.

It suppresses microRNA (miRNA) biogenesis by binding the precursor let-7 (pre-let-7), a miRNA precursor, and recruiting ZCCHC11/TUT4 uridylyltransferase, leading to pre-let-7’s terminal uridylation Uridylated pre-let-7 miRNAs are not processed by Dicer and undergo degradation, an event which, in embryonic stem (ES) cells contributes to maintenance of ES cells. In contrast, LIN28A down-regulation in neural stem cells by miR-125 allows the processing of pre-let-7. 


Lopatka, Sharon Rina 

FORENSICS, SEXOLOGY An American woman who died from consensual homicide committed by a Robert Glass whom she had contacted to torture and kill her, to which Glass obliged, during what was a several-day orgy of allegedly mutual sexual gratification. 


18 December 2014

cognitive dissonance 

PSYCHOLOGY, SOCIOLOGY The mental discomfort experienced by a person when information is acquired that is incongruent or contradictory to what the person knew or believed before the new information was obtained. 


cognitive distortion 

FORENSIC PSYCHIATRY Cognitive errors, thinking errors A term of art for unconventional exaggerated or irrational thought patterns or processes that appear to perpetuate the effects of psychopathological states, especially depression and anxiety.

Cognitive distortion plays a role in helping sexual offenders justify to themselves the commission of a particular offence, including rape. 


Heimlich maneuver 

HeimlichEMERGENCY MEDICINE, QUACKERY Abdominal thrust, Heimlich manoeuvre The most widely used name for a manoeuvre used to dislodge an obstruction–usually food–of the upper airway, which consists of abrupt compression on the upper abdomen.

Henry Heimlich, MD (1920- ) is best known for popularising a method for treating upper airway obstruction. He got a Lasker prize in 1984. He is living proof that the person who manages–by sheer dumb luck–to contribute something important to the world–and even that is questionable–should shut up and stay low key. Shortly after his report in 1974, he was dismissed as chief of surgery at the Cincinnati Jewish Hospital and never worked again as a surgeon. Virtually all of his work has been called into question, especially his quack theory that  malariotherapy–the deliberate infection of a person with malaria–is effective against cancer, Lyme disease and HIV. Now 92, Heimlich continues to promote his–the Heimlich-maneuver/abdominal thrust for drowning and asthma–which flies in the face of recommendations by American Heart Association and the American Red Cross. The National Council Against Health Fraud has asked Heimlich repeatedly for details on his allegedly successful cases…and gotten bupkis. According to research by his son, a journalist, much of Heimlich’s work was fraudulent. 


METABOLISM A common term referring to the loss of height with age caused by osteoporosis and collapse of the vertebral column.

UROLOGY, VOX POPULI A popular term for the marked decrease in penile length that follows exposure to cold water.  

vaginal rejuvenation surgery 

GYNAECOLOGY, SEXOLOGY, SURGERY Non-constructive/non-reconstructive cosmetic vaginoplasty A “cosmetic” procedure consisting of both labiaplasty and vaginoplasty in which the mucocutaneous tissue of the labia and lower vagina are tightened surgically or allegedly by laser.

Risks and complications Haemorrhage, infection, reduced or heightened sensitivity in the region, dyspareunia (uncomfortable sex).

Per Dr TG Stovall, a past president of the Society of Gynecologic Surgeons. “There is absolutely zero scientific literature that supports . . . the notion that firing a laser of any kind will tighten vaginal  muscles.” 


17 December 2014


agoraphobiaPSYCHOLOGY Morbid fear of open spaces, crowded, public places (markets, malls, crowds) or fear of leaving home.

Agoraphobia differs from phobic states which are more limited evoked by a specific palette of animals or situations. It is characterised by generalised anxiety and associated with panic attacks, has an early adult onset, 2:1 female:male ratio, often arises in an abnormal physiologic and psychologic substrate and responds poorly to therapy.


PSYCHOLOGY, SEXOLOGY Contreltophobia Morbid fear of sexual abuse

Note: Whilst agraphobia got 358,000 hits on 17/12/2013 compared to the synonym contreltophobia’s 11,400 hits, it can be compellingly argued that the latter would be preferred in the working medical parlance, given that potential for confusion of the former with agoraphobia. 

chemical transfection 

MOLECULAR BIOLOGY A method of inserting foreign nucleic acids (RNA, DNA) into a cell of interest by chemical means–e.g., with cationic polymer, calcium phosphate, cationic lipid (the most popular method), and cationic amino acids.

Principle Positively charged chemicals make nucleic acid/chemical complexes with negatively charged nucleic acids. The positively charged nucleic acid/chemical complexes are attracted to the negatively charged cell membrane. The mechanism by which nucleic acid/chemical complexes pass through the cell membrane is unknown but endocytosis and phagocytosis are thought to be involved in the process. 

References Bio/Technology 1995; 13:222 Anal Bioanal Chem. 2010 August; 397(8): 3173–3178. Published online 2010 June 13. doi:  10.1007/s00216-010-3821-6 


ENDOCRINOLOGY A popular term for any of several intracellular proteolytic enzymes that remove the pre- and pro- portions of a hormone.

Example PTH, a 25-residue polypeptide is “clipped” from the 115-residue pre-pro-parent, yielding a 90-residue pre-PTH; a 6-residue segment is then removed by tryptic clipase from the pre-PTH, yielding mature 84-residue PTH. 


hunter gatherer diet  hunter_gatherer_diet

NUTRITION Caveman diet, paleo diet, paleodiet, paleolithic diet, Stone Age diet  A popular term for a diet rich in foraged fruits, plants, and game meats, but no “domesticated” foods–e.g., grains or dairy products.

The diet was the fare of primitive man; consumption of grains and use of dairy products translate as the ability to cultivate and harvest plants and domesticate milk-producing animals, both of which represent development of early humans. Some alternative health care providers believe that the allergies now commonly seen in modern man may be due to changes in the human diet wrought by domestication. 


16 December 2014

A couple of times per month, the entire blog will be genes/proteins. To be fair, the genome is the future of medicine; a medical dictionary with the word modern in its title can’t give the 60+ thousand genes short shrift. This is the first “genes only” blog for December


CELL BIOLOGY BRCA1 associated RING domain 1, EC 6.3.2.- A gene on chromosome 2q34-q35 that encodes a protein which binds to BRCA1, forming a putative E3 ubiquitin-protein ligase. The BRCA1-BARD1 heterodimer mediates formation of  “Lys-6’-linked polyubiquitin chains and coordinates a diverse range of cell activities–e.g., ubiquitination, transcriptional regulation to maintain genomic stability and in DNA repair, playing a central role in controlling the cell cycle response to DNA damage. 



CELL BIOLOGY Breast cancer metastasis suppressor 1 A gene on chromosome 11q13-q13.2 that encodes a putative mediator of metastasis suppression in breast carcinoma, which downregulates transcription activation by NF-kappa-B by promoting the deacetylation of RELA at ‘Lys-310′. It also downregulates expression of anti-apoptotic genes controlled by NF-kappa-B. BRMS1 promotes apoptosis in cells that have inadequate adherence to a substrate, a process called anoikis, and thus inhibits metastasis.  



CELL BIOLOGY Calpain 8, new calpain 2, stomach-specific M-type calpain, NCL2, EC 3.4.22, EC A gene on chromosome 1q41 that encodes a calcium-regulated non-lysosomal thiol-protease which is involved in membrane trafficking in the gastric mucus (pit) cells and possibly also in membrane trafficking of mucus cells via interactions with coat protein. 



CELL BIOLOGY Mediator complex subunit 22, MED24, SURF5, mediator of RNA polymerase II transcription subunit 22, surfeit locus protein 5, surfeit 5 A gene on chromosome 9q34.1 that encodes a nuclear protein belonging to the mediator complex, which plays a role in regulating transcription by bridging interactions between gene-specific regulatory factors, RNA polymerase II, and general transcription factors. 



CELL BIOLOGY Rap guanine nucleotide exchange factor 2, PDZ domain-containing guanine nucleotide exchange factor 1, PDZGEF1, neural RAP guanine nucleotide exchange protein, NRAPGEP, PDZ-GEF1, RA-GEF, KIAA0313 A gene on chromosome 4q32.1 that encodes a guanine nucleotide exchange factor–GEF which activates Rap and Ras family of small GTPases by exchanging bound GDP for free GTP in a cAMP-dependent manner. It serves as a link between cell surface receptors and Rap/Ras GTPases in intracellular signaling cascades as a GTP/GDP-regulated switch that cycles between inactive GDP- and active GTP-bound states.