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INDEX 1

Part One INTRODUCTION TO CLINICAL MEDICINE 1

1 The Practice of Medicine [The Editors] 1

Appendix A: Laboratory Values of Clinical Importance 1

APPENDICES 1

2 Ethical Issues in Clinical Medicine [Bernard Lo] 5

3 Decision-Making in Clinical Medicine [Daniel B. Mark] 8

Appendix B: Instructions for Collection and Transport of Specimen Culture 11

4 Economic Issues in Clinical Medicine [Daniel B. Mark] 14

Contributors 19

5 Influence of Environmental and Occupational Hazards on Disease [Howard Hu/Frank E. Speizer] 19

6 Women s Health [Anthony L. Komaroff/ Celeste Robb-Nicholson/Andrea E.Dunaif] 21

7 Medical Disorders during Pregnancy [Robert L. Barbieri/John T. Repke] 25

Preface 31

8 Adolescent Health Problems [Mehul T. Dattani/ Charles G.D.Brook] 31

9 Geriatric Medicine [Neil M. Resnick] 36

10 Principles of Disease Prevention [Maureen T. Connelly/Thomas S. Inui] 46

11 Alternative Medicine [Adriane Fugh-Berman] 49

Part Two CARDINAL MANIFESTATIONS AND PRESENTATION OF DISEASES 55

SECTION 1 PAIN 55

12 Pain: Pathophysiology and Management [Howard L. Fields/ Joseph B. Martin] 55

13 Chest Discomfort and Palpitations [Thomas H. Lee] 60

14 Abdominal Pain [William Silen] 67

15 Headache, Including Migraine and Cluster Headache [Neil H. Raskin/ Stephen J.Peroutka] 70

16 Back and Neck Pain [John W. Engstrom] 79

17 Fever and Hyperthermia [Charles A. Dinarello/Jeffrey A. Gelfand] 91

SECTION 2 ALTERATIONS IN BODY TEMPERATURE 91

18 Fever and Rash [Elaine T. Kaye/Kennety M. Kaye] 95

19 Approach to the Acutely Ill Infected Febrile Patient [Tamar F. Barlam/Dennis L. Kasper] 102

20 Hypothermia and Frostbite [Daniel F. Danzl] 107

21 Faintness, Syncope, Dizziness, and Vertigo [Robert B. Daroff/Mark D. Carlson] 111

SECTION 3 NERVOUS SYSTEM DYSFUNCTION 111

23 Numbness, Tingling, and Sensory Loss [Arthur K. Asbury] 128

24 Acute Confusional States and Coma [Allan H. Ropper] 132

25 Aphasias and Other Focal Cerebral Disorders [M.-Marsel Mesulam] 140

26 Memory Loss and Dementia [Thomas D. Bird] 148

27 Sleep Disorders [Charles A. Czeisler/John W. Winkelman/Gary S. Richardson] 155

SECTION 4 DISORDERS OF EYES, EARS,NOSE, AND THROAT 164

28 Disorders of the Eye [Jonathan C. Horton] 164

29 Disorders of Smell, Taste, and Hearing [Anil K. Lalwani/James B. Snow,Jr.] 179

30 Infections of the Upper Respiratory Tract [Marlene Durand/Michael Joseph] 187

31 Oral Manifestations of Disease [John S. Greenspan] 193

32 Dyspnea and Pulmonary Edema [Roland H. Ingram, Jr./Eugene Braunwald] 199

SECTION 5 ALTERATIONS IN CIRCULATORY AND RESPIRATORY FUNCTIONS 199

33 Cough and Hemoptysis [Steven E. Weinberger/Eugene Braunwald] 203

34 Approach to the Patient with a Heart Murmur [Patrick T. O Gara/Eugene Braunwald] 207

35 Approach to the Patient with Hypertension [Gordon H. Williams] 211

36 Hypoxia and Cyanosis [Eugene Braunwald] 214

37 Edema [Eugene Braunwald] 217

38 Shock [Ronald V. Maier] 222

39 Cardiovascular Collapse, Cardiac Arrest, and Sudden Cardiac Death [Robert J. Myerburg/Agustin Castellanos] 228

40 Dysphagia [Raj K. Goyal] 233

SECTION 6 ALTERATIONS IN GASTROINTESTINAL FUNCTION 233

41 Nausea, Vomiting, and Indigestion [William L. Hasler] 236

42 Diarrhea and Constipation [David A. Ahlquist/ Michael Camilleri] 241

43 Weight Loss [Carol M. Reife] 250

44 Gastrointestinal Bleeding [Loren Laine] 252

45 Jaundice [Daniel S. Pratt/Marshall M. Kaplan] 255

46 Abdominal Swelling and Ascites [Robert M. Glickman] 260

SECTION 7 ALTERATIONS IN RENAL AND URINART TRACT FUNCTION 262

47 Azotemia and Urinary Abnormalities [Bradley M. Denker/Barry M.Brenner] 262

48 Incontinence and Lower Urinary Tract Symptoms [Philippe E. Zimmern/John D. McConnell] 268

49 Fluid and Electrolyte Disturbances [Gary G. Singer/Barry M. Brenner] 271

50 Acidosis and Alkalosis [Thomas D. DuBose, Jr.] 283

51 Erectile Dysfunction [Kevin T. McVary] 291

SECTION 8 ALTERATIONS IN SEXUAL FUNCTION AND REPRODUCTION 291

52 Disturbances of Menstruation and Other Common Gynecologic Complaints in Women [Bruce R. Carr/Karen D. Bradshaw] 295

53 Hirsutism and Virilization [David A. Ehrmann] 297

54 Infertility and Fertility Control [Janet E. Hall] 301

SECTION　9　ALTERATIONS　IN　THE　SKIN 305

55 Approach to the Patient with a Skin Disorder [Thomas J. Lawley/Kim B.Yancey] 305

56 Eczema, Psoriasis,Cutaneous Infections, Acne, and Ohter Common Skin Disorders [Robert A. Swerlick/Thomas J. Lawley] 309

57 Skin Manifestations of Internal Disease [Jean L. Bolognia/Irwin M. Braverman] 315

58 Immunologically Mediated Skin Diseases [Kim B. Yancey/Thomas J. Lawley] 331

59 Cutaneous Drug Reactions [Robert S. Stern/Olivier M. Chosidow/Bruce U. Wintroub] 336

60 Photosensitivity and Other Reactions to Light [David R. Bickers] 342

61 Anemia and Polycythemia [John W. Adamson/Dan L. Longo] 348

SECTION 10 HEMATOLOGIC ALTERATIONS 348

62 Bleeding and Thrombosis [Robert I. Handin] 354

63 Enlargement of the Lymph Nodes and Spleen [Patrick H. Henry/Dan L. Longo] 360

64 Disorders of Granulocytes and Monocytes [Steven M. Holland/John I.Gallin] 366

Nobel Prize in Physiology or Medicine, 1990[Joseph Edward Murray/Edward Donnall Thomas] 374

Part Three GENETICS AND DISEASE 375

65 Principles of Human Genetics [J. Larry Jameson/Peter Kopp] 375

66 Chromosome Disorders [Terry Hassold/Stuart Schwartz] 396

67 Diseases Caused by Genetic Defects of Mitochondria [Donald R. Johns] 404

68 Screening, Counseling, and Prevention of Genetic Disorders [Susan Miesfeldt/J. Larry Jameson] 407

69 Gene Therapy [Mark A. Kay/Daivd W. Russell] 412

Nobel Prize in Physiology or Medicine,1905[Robert Koch] 418

Part Four CLINICAL PHARMACOLOGY 419

70 Principles of Drug Therapy [John A. Oates/Dan M. Roden/ Grant R. Wilkinson] 419

71 Adverse Reactions to Drugs [Alastair J J. Wood] 430

72 Physiology and Pharmacology of the Autonomic Nervous System [Lewis Landsberg/James B. Young] 438

Part Five NUTRITION 451

73 Nutritional Requirements and Dietary Assessment [Johanna Dwyer] 451

74 Malnutrition and Nutritional Assessment [Charles H. Halsted] 455

75 Vitamin and Trace Mineral Deficiency and Excess [Robert M. Russell] 461

76 Enteral and Parenteral Nutrition Therapy [Lyn Howard] 470

77 Obesity [Jeffrey S. Flier] 479

78 Eating Disorders [B. Timothy Walsh] 486

Part Six ONCOLOGY AND HEMATOLOGY 491

SECTION 1 NEOPLASTIC DISORDERS 491

79 Approach to the Patient with Cancer [Dan L. Longo] 491

80 Prevention and Early Detection of Cancer [Otis W. Brawley/Brnett S. Kramer] 497

81 Cancer Genetics [Francis S. Collins/Jeffrey M. Trent] 503

82 Cell Biology of Cancer [Robert G. Fenton/Dan L. Longo] 509

83 Angiogenesis [Judah Folkman] 517

84 Principles of Cancer Treatment [Edward A. Sausville/Dan L. Longo] 530

85 Infections in Patients with Cancer [Robert Finberg] 547

86 Melanoma and Other Skin Cancers [Arthur J. Sober/Howard K. Koh/Gregory P. Wittenberg/Carl V. Washington, Jr.] 554

87 Head and Neck Cancer [Everett E. Vokes] 559

88 Neoplasms of the Lung [John D. Minna] 562

89 Breast Cancer [Marc E. Lippman] 571

90 Gastrointestinal Tract Cancer [Robert J. Mayer] 578

91 Tumors of the Liver and Biliary Tract [Jules L. Dienstag/Kurt J. Isselbacher] 588

92 Pancreatic Cancer [Robert J. Mayer] 591

93 Endocrine Tumors of the Gastrointestinal Tract and Pancreas [Robert T. Jensen] 593

94 Bladder and Renal Cell Carcinomas [Howard I. Scher/Robert J. Motzer] 604

95 Hyperplastic and Malignant Diseases of the Prostate [Howard I. Scher] 608

96 Testicular Cancer [Robert J. Motzer/George J. Bosl] 616

97 Gynecologic Malignancies [Robert C. Young] 620

98 Soft Tissue and Bone Sarcomas and Bone Metastases [Shreyaskumar R. Patel/Robert S. Benjamin] 625

99 Metastatic Cancer of Unknown Primary Site [Richard M. Stone] 628

100 Paraneoplastic Syndromes [Bruce E. Johnson] 632

101 Paraneoplastic Neurologic Syndromes [Muhammad T. Al-Lozi/Alan Pestronk] 636

102 Oncologic Emergencies [Rasim Gucalp/Janice Dutcher] 642

103 Late Consequences of Cancer and Its Treatment [Michael C. Perry/Dan L. Longo] 650

SECTION 2 DISORDERS OF HEMATOPOIESIS 653

104 Hematopoiesis [Peter J. Quesenberry/Gerald A. Colvin] 653

105 Iron Deficiency and Other Hypoproliferative Anemias [John W. Adamson] 660

106 Hemoglobinopathies [Edward J. Benz,Jr] 666

107 Megaloblastic Anemias [Bernard M. Babior/H. Frankin Bunn] 674

108 Hemolytic Anemias and Acute Blood Loss [H.Franklin Bunn/Wendell Rosse] 681

109 Aplastic Anemia, Myelodysplasia, and Related Bone Marrow Failure Syndromes [Neal S. Young] 692

110 Polycythemia Vera and Other Myeloproliferative Diseases [Jerry L. Spivak] 701

111 Acute and Chronic Myeloid Leukemia [Meir Wetzler/John C.Byrd/Clara D. Bloomfield] 706

112 Malingancies of Lymphoid Cells [James O. Armitage/Dan L.Longo] 715

113 Plasma Cell Disorders [Dan L. Longo] 727

114 Transfusion Biology and Therapy [Jeffery S. Dzieczkowski/Kenneth C. Anderson] 733

115 Bone Marrow and Stem Cell Transplantation [Frederick R. Appelbaum] 739

SECTION 3 DISORDERS OF HEMOSTASIS 745

116 Disorders of the Platelet and Vessel Wall [Robert I. Handin] 745

117 Disorders of Coagulation and Thrombosis [Robert I. Handin] 751

118 Anticoagulant, Fibrinolytic, and Antiplatelet Therapy [Robert I. Handin] 758

Nobel Prize in Physiology or Medicine, 1930 [Karl Landsteiner] 761

Nobel Prize in Physiology or Medicine, 1962 [Francis Harry Compton Crick/James Dewey Watson/Maurice Hugh Frederick Wilkins] 762

Part Seven INFECTIOUS DISEASES 763

SECTION 1 BASIC CONSIDERATIONS IN INFECTIOUS DISEASES 763

119 Introduction to Infectious Diseases: Host-Parasite Interactions [Lawrence C. Madoff/ Dennis L. Kasper] 763

120 Molecular Mechanisms of Microbial Pathogenesis [Gerald B. Pier] 767

121 Laboratory Diagnosis of Infectious Diseases [Andrew B. Onderdonk] 775

122 Immunization Principles and Vaccine Use [Gerald T. Keusch/Kenneth J. Bart] 780

123 Health Advice for International Travel [J. S. Keystone/P. E. Kozarsky] 793

124 Sepsis and Septic Shock [Robert S. Munford] 799

SECTION 2 CLINICAL SYNDROMES: COMMUNITY-ACQUIRED INFECTIONS 799

125 Fever of Unknown Origin [Jeffrey A. Gelfand] 804

126 Infective Endocarditis [Adolf W. Karchmer] 809

127 Infectious Complications of Bites and Burns [Lawrence C. Madoff] 817

128 Infections of the Skin, Muscle, and Soft Tissues [Dennis L. Stevens] 821

129 Osteomyelitis [James H. Maguire] 825

130 Intraabdominal Infections and Abscesses [Dori F. Zalezink/Dennis L. Kasper] 829

131 Acute Infectious Diarrheal Diseases and Bacterial Food Poisoning [Joan R. Butterton/Stephen B. Calderwood] 834

132 Sexually Transmitted Diseases: Overview and Clinical Approach [King K. Holmes] 839

133 Pelvic Inflammatory Disease [King K. Holmes/Robert C. Brunham] 848

134 Infection Control in the Hospital [Robert A. Weinstein] 853

SECTION 3 CLINICAL SYNDROMES:NOSOCOMIAL INFECTIONS 853

135 Hospital-Acquired and Intravascular Device-Related Infections [Dori F. Zaleznik] 857

136 Infections in Transplatnt Recipients [Robert Finberg/Joyce D. Fingeroth] 860

SECTION 4 APPROACH TO THERAPY FOR BACTERLAL DISEASES 867

137 Trcatment and Prophylaxis of Bacterial Infections [Gordon L. Archer/Ronald E. Polk] 867

138 Pneumococcal Infections [Daniel M. Musher] 882

SECTION 5 DISEASES CAUSED BY GRAM-POSITIVE BACTERIA 882

139 Staphylococcal Infections [Jeffrey Parsonnet/Robert L. Deresiewicz] 889

140 Streptococcal and Enterococcal Infections [Michael R. Wessels] 901

141 Diphtheria, Other Corynebacterial Infections, and Anthrax [Randall K. Holmes] 909

142 Infections Caused by Listeria monocytogenes [Anne Schuchat/Glaire V. Broome] 915

143 Tetanus [Elias Abrutyn] 918

144 Bothlism [Elias Abrutyn] 920

145 Gas Gangrene, Antibiotic-Associated Colitis, and Other Clostridial Infections [Dennis L. Kasper/Dori F. Zaleznik] 922

146 Meningococcal Infections [Robert S. Munford] 927

SECTION 6 DISEASES CAUSED BY GRAM-NEGATIVE BACTERIA 927

147 Gonococcal Infections [Sanjay Ram/Peter A. Rice] 931

148 Moraxella catarrhalis and Other Moraxella Species [Daniel M. Musher] 938

149 Haemophilus Infections [Timothy F. Murphy] 939

150 Infections due to the HACEK Group and Miscellaneous Gram-Negative Bacteria [Dennis L. Kasper/Tamar F. Barlam] 942

151 Legionella Infection [Feng-Yee Chang/Victor L. Yu] 945

152 Pertussis and Other Bordetella Infections [Soctt A. Halperin] 949

153 Diseases Caused by Gram-Negative Enteric Bacilli [Thomas A. Russo] 953

154 Helicobacter pylori Infections [John C. Atherton/Martin J. Blaser] 960

155 Infections due to Pseudomonas Species and Related Organisms [Chirstopher A. Ohl/Matthew Pollack] 963

156 Salmonellosis [Cammie F. Lesser/Samuel I.Miller] 970

157 Shigellosis [Gerald T. Keusch] 975

158 Infections due to Campylobacter and Related Species [Martin J. Blaser] 978

159 Cholera and Other Vibrioses [Gerald T. Keusch/Robert L. Deresiewicz Matthew K. Waldor] 980

160 Brucellosis [M. Monir Madkour/Dennis L. Kasper] 986

161 Tularemia [Richard F. Jacobs] 990

162 Plague and Other Yersinia Infections [Grant L. Campbell/David T. Dennis] 993

163 Bartonella Infections, Including Cat-Scratch Disease [Lucy Stuart Tompkins] 1001

164 Donovanosis [Gavin Hart] 1004

165 Nocardiosis [Gregory A. Filice] 1006

SECTION 7 MISCELLANEOUS BACTERIAL INFECTIONS 1006

166 Actinomycosis [Thomas A. Russo] 1008

167 Infections due to Mixed Anaerobic Organisms [Dennis L. Kasper] 1011

SECTION 8 MYCOBACTERIAL DISEASES 1017

168 Antimycobacterial Agents [Paul/W. Wright/Richard J. Wallace, Jr.] 1017

169 Tuberculosis [Mario C. Raviglione/Richard J. O Brien] 1024

170 Leprosy(Hansen s Disease) [Robert H. Gelber] 1035

171 Infections due to Nontuberculous Mycobacteria [Bernard Hirschel] 1040

SECTION 9 SPIROCHETAL DISEASES 1044

172 Syphilis [Sheila A. Lukehart] 1044

173 Endemic Treponematoses [Sheila A. Lukehart] 1053

174 Leptospirosis [Peter Speelman] 1055

175 Relapsing Fever [David T. Dennis/Grant L. Campbell] 1058

176 Lyme Borreliosis [Allen C. Steere] 1061

SECTION 10 RICKETTSIA, MYCOPLASMA, AND CHLAMYDIA 1065

177 Rickettsial Diseases [David Walker/Didier Raoult/ J. Stephen Dumler/Thomas Marrie] 1065

178 Mycoplasma Infections [William M. McCormack] 1073

179 Chlamydial Infections [Walter E. Stamm] 1075

SECTION 11 VIRAL DISEASES 1084

180 Medical Virology [Fred Wang/Elliott Kieff] 1084

181 Antiviral Chemotherapy, Excluding Antiretroviral Drugs [Raphael Dolin] 1092

182 Herpes Simplex Viruses [Lawrence Corey] 1100

SECTION 12 DNA VIRUSES 1100

183 Varicella-Zoster Virus Infections [Richard J. Whitley] 1106

184 Epstein-Barr Virus Infections, Including Infectious Mononucleosis [Jeffrey I. Cohen] 1109

185 Cytomegalovirus and Human Herpesvirus Types 6, 7, and 8 [Martin S. Hirsch] 1111

186 Smallpox, Vaccinia, and Other Poxviruses [Fred Wang] 1115

187 Parvovirus [Neil R. Blacklow] 1117

188 Human Papillomaviruses [Richard C. Reichman] 1118

SECTION 13 DNA AND RNA RESPIRATORY VIRUSES 1120

189 Common Viral Respiratory Infections [Raphael Dolin] 1120

190 Influenza [Raphael Dolin] 1125

SECTION 14 RNA VIRUSES 1131

191 The Human Retroviruses [Anthony s. Fauci/Dan L. Longo] 1131

192 Viral Gastroenteritis [Harry B. Greenberg] 1135

193 Enteroviruses and Reoviruses [Jeffrey Ⅰ. Cohen] 1138

194 Measles(Rubeola) [Anne Gershon] 1143

195 Rubella(German Measles) [Anne Gershon] 1145

196 Mumps [Anne Gershon] 1147

197 Rabies Virus and Other Rhabdoviruses [Lawrence Corey] 1149

198 Infections Caused by Arthropod-and Rodent-Borne Viruses [C J. Peters] 1152

199 Filoviridae (Marburg and Ebola Viruses) [C J. Peters] 1166

Celor Atlases/1168 1168

SECTION 15 FUNGAL AND ALGAL INFECTIONS 1168

200 Diagnosis and Treatment of Fungal Infections [John E. Bennett] 1168

201 Histoplasmosis [John E. Bennett] 1171

202 Coccidioidomycosis [John E. Bnnett] 1172

203 Blastomycosis [John E. Bennett] 1173

204 Cryptococcosis [John E. Bennett] 1174

205 Candidiasis [John E. Bennett] 1176

206 Aspergillosis [John E. Bennett] 1178

207 Mucormycosis [John E. Bennett] 1179

208 Miscellaneous Mycoses and Algal Infections [John E. Bennett] 1180

209 Pneumocystis carinii Infection [Peter D. Walzer] 1182

210 Approach to the Patient with Parasitic Infection [Peter F. Weller] 1185

SECTION 16 PROTOZOAL AND HELMINTHIC INFECTIONS: GENERAL CONSIDERATIONS 1185

211 Laboratory Diagnosis of Parasitic Infections [Charles E. Davis] 1186

212 Therapy for Parasitic Infections [Thomas A. Moore] 1192

SECTION 17 PROTOZOAL INFECTIONS 1199

22 Weakness, Myalgias, Disorders of Movement, and Imbalance [Richard K. Olney/Michael J Aminoff] 1199

213 Amebiasis and Infection with Free-Living Amebas [Sharon L. Reed] 1199

214 Malaria and Babesiosis: Diseases Caused by Red Blood Cell Parasites [Nicholas J. White/Joel G. Breman] 1203

215 Leishmaniasis [Barbara L. Herwaldt] 1213

216 Trypanosomiasis [Louis V. Kirchhoff] 1218

217 Toxoplasma Infection [Lloyd H. Kasper] 1222

218 Protozoal Intestinal Infections and Trichomoniasis [Peter F. Weller] 1227

SECTION 18 HELMINTHIC INFECTIONS 1231

219 Trichinella and Other Tissue Nematodes [Leo X. Liu/Peter F. Weller] 1231

220 Intestinal Nematodes [Peter F. Weller/Thomas B. Nutman] 1233

221 Filariasis and Related Infections(Loiasis, Onchocerciasis, and Dracunculiasis) [Thomas B. Nutman/Peter F. Weller] 1237

222 Schistosomiasis and Other Trematode Infections [Adel A. F. Mahmoud] 1242

223 Cestodes [A. Clinton White, Jr./Peter F. Weller] 1248

Nobel Prize in Physiology of Medicine, 1945 [Alexander Fleming/Howard Florey/Ernst Chain] 1252

224 Approach to the Patient with Heart Disease [Eugene Braunwald] 1253

SECTION 1 DIAGNOSIS 1253

Part Eight DISORDERS OF THE CARDIOVASCULAR SYSTEM 1253

225 Physical Examination of the Cardiovascular System [Robert A. O Rourke/Eugene Braunwald] 1255

226 Electrocardiography [Ary L. Goldberger] 1262

227 Noninvasive Cardiac Imaging: Echocardiography and Nuclear Cardiology [Rick A. Nishimura/Raymond J. Gibbons/A. Jamil Tajik] 1271

228 Diagnostic Cardiac Catheterization and Angiography [Donald S. Baim/William Grossman] 1277

SECTION 2 DISORDERS OF RHYTHM 1283

229 The Bradyarrhythmias: Disorders of Sinus Node Function and AV Condition Disturbances [Mark E. Josephson/Peter Zimetbaum] 1283

230 The Tachyarrhythmias [Mark E. Josephson/Peter Zimetbaum] 1292

SECTION 3 DISORDERS OF THE HEART 1309

231 Normal and Abnormal Myocardial Function [Eugene Braunwald] 1309

232 Heart Failure [Eugene Braunwald] 1318

233 Cardiac Transplantation [John S. Schroeder] 1329

234 Congenital Heart Disease in the Adult [William F. Friedman/John S. Child] 1331

235 Rheumatic Fever [Edward L. Kaplan] 1340

236 Valvular Heart Disease [Eugene Braunwald] 1343

237 Cor Pulmonale [Eugene Braunwald] 1355

238 The Cardiomyopathies and Myocarditides [Joshua Wynne/Eugene Braunwald] 1359

239 Pericardial Disease [Eugene Braunwald] 1365

240 Cardiac Tumors, Cardiac Manifestations of Systemic Diseases, and Traumatic Cardiac Injury [Wilson S. Colucci/Daniel T. Price] 1372

SECTION 4 VASCULAR DISEASE 1377

241 The Pathogenesis of Atherosclerosis [Peter Libby] 1377

242 Prevention and Treatment of Atherosclerosis [Peter Libby] 1382

243 Acute Myocardial Infarction [Elliott M. Antman/Eugene Braunwald] 1386

244 Ischemic Heart Disease [Andrew P. Selwyn/Eugene Braunwald] 1399

245 Percutaneous Coronary Revascularization [Donald S. Baim] 1410

246 Hypertensive Vascular Disease [Gordon H. Williams] 1414

247 Diseases of the Aorta [Victor J. Dzau/Mark A. Creager] 1430

248 Vascular Diseases of the Extremities [Mark A. Creager/Victor J. Dzau] 1434

SECTION 1 DIAGNOSIS 1443

249 Approach to the patient with Disease of the Respiratory System [Jeffrey M. Drazen/Steven E. Weinberger] 1443

Part Nine DISORDERS OF THE RESPIRATORY SYSTEM 1443

250 Disturbances of Respiratory Function [Steven E. Weinberger/Jeffrey M. Drazen] 1446

251 Diagnostic Procedures in Respiratory Disease [Steven E. Weinberger/Jeffrey M. Drazen] 1453

SECTION 2 DISEASES OF THE RESPIRATORY SYSTEM 1456

252 Asthma [E. R. McFadden, Jr.] 1456

253 Hypersensitivity Pneumonitis and Pulmonary Infiltrates with Eosinophilia [Joel N. Kline/Gary W. Hunninghake] 1463

254 Environmental Lung Diseases [Frank E. Speizer] 1467

255 Pneumonia, Including Necrotizing Pulmonary Infections(Lung Abscess) [Matthew E. Levison] 1475

256 Bronchiectasis [Steven E. Weinberger] 1485

257 Cystic Fibrosis [Richard C. Boucher] 1487

258 Chronic Bronchitis, Emphysema, and Airways Obstruction [Eric G. Honig/Roland H. Ingram, Jr.] 1491

259 Interstitial Lung Diseases [Talmadge E. King, Jr.] 1499

260 Primary Pulmonary Hypertension [Stuart Rich] 1506

261 Pulmonary Thromboembolism [Samuel Z. Goldhaber] 1508

262 Disorders of the Pleura, Mediastinum, and Diaphragm [Richard W. Light] 1513

263 Disorders of Ventilation [Eliot A. Phillipson] 1517

264 Sleep Apnea [Eliot A. Phillipson] 1520

265 Acute Respiratory Distress Syndrome [Marc Moss/Roland H. Ingram, Jr.] 1523

266 Mechanical Ventilatory Support [Edward P. Ingenito/Jeffrey M. Drazen] 1526

267 Lung Transplantation [Janet R. Maurer] 1531

Nobel Prize in Physiology or Medicine, 1985 [Michael Stuart Brown/Joseph Leonard Goldstein] 1534

Part Ten DISORDERS OF THE KIDNEY AND URINARY TRACT 1535

268 Disturbances of Renal Function [Robert M. Brenner/Barry M. Brenner] 1535

269 Acute Renal Failure [Hugh R. Brady/Barry M. Brenner] 1541

270 Chronic Renal Failure [Karl Skorecki/Jacob Green/Barry M. Brenner] 1551

271 Dialysis in the Treatment of Renal Failure [Ajay K. Singh/Barry M. Brenner] 1562

272 Transplantation in the Treatment of Renal Failure [Charles B. Carpenter/Edgar L. Milford/Mohamed H. Sayegh] 1567

273 Pathogenesis of Glomerular Injury [Hugh R. Brady/Barry M. Brenner] 1572

274 The Major Glomerulopathies [Hugh R. Brady/Yvonne M. O Meara/Barry M. Brenner] 1580

275 Glomerulopathies Associated with Multisystem Diseases [Yvonne M. O Meara/Hugh R. Brady/Barry M. Brenner] 1590

276 Hereditary Tubular Disorders [John R. Asplin/Fredric L. Coe] 1598

277 Tubulointerstitial Diseases of the Kidney [Alan S. L. Yu/Barry M. Brenner] 1606

278 Vascular Injury to the Kidney [Kamal F. Badr/Barry M. Brenner] 1610

279 Nephrolithiasis [John R. Asplin/Fredric L. Coe/Murray J. Favus] 1615

280 Urinary Tract Infections and Pyelonephritis [Walter E. Stamm] 1620

281 Urinary Tract Obstruction [Julian L. Seifter/Barry M. Brenner] 1627

Nobel Prize in Physiology or Medicine, 1956 [Werner Theodor Otto Forssmann/André Frédéric Cournand/Dickinson Woodruff Richards, Jr.] 1630

Part Eleven DISORDERS OF THE GASTROINTESTINAL SYSTEM 1631

SECTION 1 DISORDERS OF THE ALIMENTARY TRACT 1631

282 Approach to the Patient with Gastrointestinal Disease [Daniel K. Podolsky/Kurt J. Isselbacher] 1631

283 Gastrointestianl Endoscopy [Mark Topazian] 1635

284 Diseases of the Esophagus [Raj K. Goyal] 1642

285 Peptic Ulcer Disease and Related Disorders [John Del Valle] 1649

286 Disorders of Absorption [Henry J. Binder] 1665

287 Inflammatory Bowel Disease [Sonia Friedman/Richard S. Blumberg] 1679

288 Irritable Bowel Syndrome [Chung Owyang] 1692

289 Diverticular, Vascular, and Other Disorders of the Intestine and Peritoneum [Kurt J. Isselbacher/Alan Epstein] 1695

290 Acute Intestinal Obstruction [William Silen] 1703

291 Acute Appendicitis [William Silen] 1705

SECTION 2 LIVER AND BILIARY TRACT DISEASE 1707

292 Approach to the Patient with Liver Disease [Marc Ghany/Jay H. Hoofnagle] 1707

293 Evaluation of Liver Function [Daniel S. Pratt/Marshall M. Kaplan] 1711

294 Bilirubin Metabolism and the Hyperbilirubinemias [Paul D. Berk/Allam W. Wolkoff] 1715

295 Acute Viral Hepatitis [Jules L. Dienstag/Kurt J. Isselbacher] 1721

296 Toxic and Drug-Induced Hepatitis [Jules L. Dienstag/Kurt J. Isselbacher] 1737

297 Chronic Hepatitis [Jules L. Dienstag/Kurt. J. Isselbacher] 1742

298 Alcoholic Liver Disease [Mark E. Mailliard/Michael F. Sorrell] 1752

299 Cirrhosis and Its Complications [Raymond T. Chung/Daniel K. Podolsky] 1754

300 Infiltrative, Genetic, and Metabolic Diseases Affecting the Liver [Daniel K. Podolsky] 1767

301 Liver Transplantation [Jules L. Dienstag] 1770

302 Diseases of the Gallbladder and Bile Ducts [Norton J. Greenberger/Gustav Paumgartner] 1776

303 Approach to the Patient with Pancreatic Disease [Phillip P. Toskes/Norton J. Greenberger] 1788

SECTION 3 DISORDERS OF THE PANCREAS 1788

304 Acute and Chronic Pancreatitis [Norton J. Greenberger/Phillip P. Toskes] 1792

Part Twelve DISORDERS OF THE IMMUNE SYSTEM,CONNECTIVE TISSUE, AND JOINTS 1805

305 Introduction to the Immune System [Barton F. Haynes/Anthony S. Fauci] 1805

SECTION 1 DISORDERS OF THE IMMUNE SYSTEM 1805

306 The Major Histocompatibility Gene Complex [Gerald T. Nepom/Joel D.Taurog] 1830

307 Autoimmunity and Autoimmune Diseases [Peter E. Lipsky/Betty Diamond] 1839

308 Primary Immune Deficiency Diseases [Max D. Cooper/Harry W. Schroeder, Jr.] 1843

309 Human Immunodeficiency Virus(HIV) Disease: AIDS and Related Disorders [Anthony S. Fauci/H. Clifford Lane] 1852

310 Allergies, Anaphylaxis, and Systemic Mastocytosis [K. Frank Austen] 1913

SECTION 2 DISORDERS OF IMMUNE-MEDIATED INJURY 1913

311 Systemic Lupus Erythematosus [Bevra Hannahs Hahn] 1922

312 Rheumatoid Arthritis [Peter E. Lipsky] 1928

313 Systemic Sclerosis(Scleroderma) [Bruce C. Gilliland] 1937

314 Sjǒgren s Syndrome [Haralampos M. Moutsopoulos] 1947

315 Ankylosing Spondylitis, Reactive Arthritis, and Undifferentiated Spondyloarthropathy [Joel D. Taurog/Peter E. Lipsky] 1949

317 The Vasculitis Syndromes [Anthony S. Fauci] 1956

316 Behcet s Syndrome [Haralampos M. Moutsopoulos] 1956

318 Sarcoidosis [Ronald G. Grystal] 1969

319 Amyloidosis [Jean D. Sipe, Alan S. Cohen] 1974

320 Approach to Articular and Musculoskeletal Disorders [John J. Cush/Peter E. Lipsky] 1979

SECTION 3 DISORDERS OF THE JOINTS 1979

321 Osteoarthritis [Kenneth D. Brandt] 1987

322 Gout and Other Crystal Arthropathies [Antonio J. Reginato] 1994

323 Infectious Arthritis [Scott J. Thaler/James H. Maguire] 1998

324 Psoriatic Arthritis and Arthritis Associated with Gastrointestinal Disease [Peter H. Schur] 2003

325 Relapsing Polychondritis and Other Arthritides [Bruce C. Gilliland] 2005

326 Periarticular Disorders of the Extremities [Bruce C. Gilliland] 2016

327 Principles of Endocrinology [J. Larry Jameson] 2019

SECTION 1 ENDOCRINOLOGY 2019

Part Thirteen ENDOCRINOLOGY AND METABOLISM 2019

328 Disorders of the Anterior Pituitary and Hypothalamus [Shlomo Melmed] 2029

329 Disorders of the Neurohypophysis [Gary L. Robertson] 2052

330 Disorders of the Thyroid Gland [J. Larry Jameson/Anthony P. Weetman] 2060

331 Disorders of the Adrenal Cortex [Gordon H. Williams/Robert G. Dluhy] 2084

332 Pheochromocytoma [Lewis Landsberg/James B. Young] 2105

333 Diabetes Mellitus [Alvin C. Powers] 2109

334 Hypoglycemia [Philip E. Cryer] 2138

335 Disorders of the Testes [James E. Griffin/Jean D. Wilson] 2143

336 Disorders of the Ovary and Female Reproductive Tract [Bruce R. Carr/Karen D. Bradshaw] 2154

337 Endocrine Disorders of the Breast [Jean D. Wilson] 2168

338 Disorders of Sexual Differentiation [Jean D. Wilson/James E. Griffin] 2172

339 Disorders Affecting Multiple Endocrine System [StevenⅠ. Sherman/Robert F. Gagel] 2184

SECTION 2 DISORDERS OF BONE AND MINERAL METABOLISM 2192

340 Introduction to Bone and Mineral Metabolism [Michael F. Holick/Stephen M. Krane] 2192

341 Diseases of the Parathyroid Gland and Other Hyper-and Hypocalcemic Disorders [John T. Potts, Jr.] 2205

342 Osteoporosis [Robert Lindsay/Felicia Cosman] 2226

343 Paget s Disease and Other Dysplasias of Bone [Stephen M. Krane/Alan L. Schiller] 2237

SECTION 3 DISORDERS OF INTERMEDIARY METABOLISM 2245

344 Disorders of Lipoprotein Metabolism [Henry N. Ginsberg/Ira J. Goldberg] 2245

345 Hemochromatosis [Lawrie W. Powell/Kurt J. Isselbacher] 2257

346 The Porphyrias [Robert J. Desnick] 2261

347 Disorders of Purine and Pyrimidine Metabolism [Robert L. Wortmann] 2268

348 Wilson s Disease [Ⅰ. Herbert Scheinberg] 2274

349 Lysosomal Storage Diseases [Gregory A. Grabowski] 2276

350 Glycogen Storage Diseases and Other Inherited Disorders Of Carbohydrate Metabolism [Yuan-Tsong Chen] 2281

351 Inherited Disorders of Connective Tissue [Darwin J. Prockop/Helena Kuivaniemi/Gerard Tromp/Leena Ala-Kokko] 2290

352 Inherited Disorders of Amino Acid Metabolism and Storage [Nicola Longo] 2301

353 Inherited Defects of Membrane Transport [Nicola Longo] 2309

354 The Lipodystrophies and Other Primary Disorders of Adipose Tissue [Abhimanyu Garg] 2316

Nobel Prize in Physiology or Medicine, 1923 [Frederick G. Banting/John J. R. Macleod] 2320

Part Fourteen NEUROLOGIC DISORDERS 2321

SECTION 1 DIAGNOSIS OF NEUROLOGIC DISORDERS 2321

355 Neurobiology of Disease [Stephen L. Hauser/M. Flint Beal] 2321

356 Approach to the Patient with Neurologic Disease [Joseph B. Martin/Stephen L. Hauser] 2326

357 Electrophysiologic Studies of the Central and Peripheral Nervous Systems [Michael J. Aminoff] 2331

358 Neuroimaging in Neurologic Disorders [William P. Dillon] 2337

359 Molecular Diagnosis of Neurologic Disorders [Joseph B. Martin/Frank M. Longo] 2342

SECTION 2 DISEASES OF THE CENTRAL NERVOUS SYSTEM 2354

360 Seizures and Epilepsy [Daniel H. Lowenstein] 2354

361 Cerebrovascular Diseases [Wade S. Smith/Stephen L. Hauser/J. Donald Easton] 2369

362 Alzheimer s Diseaes and Other Primary Dementias [Thomas D. Bird] 2391

363 Parkinson s Disease and Other Extrapyramidal Disorders [Michael J. Aminoff] 2399

364 A taxic Disorders [Roger N. Rosenberg] 2406

365 A myotrophic Lateral Sclerosis and Other Motor Neuron Diseases [Robert H. Brown, Jr.] 2412

366 Disorders of the Autonomic Nervous System [John W. Engstrom/Joseph B. Martin] 2416

367 Common Disorders of the Cranial Nerves [M. Flint Beal/Stephen L. Hauser] 2421

368 Diseases of the Spinal Cord [Stephen L. Hauser] 2425

369 Traumatic Injuries of the Head and Spine [Allan H. Ropper] 2434

370 Primary and Metastatic Tumors of the Nervous System [Stephen M. Sagar/Mark A. Israel] 2442

371 Multiple Sclerosis and Other Demyelinating Diseases [Stephen L. Hauser/Donald E. Goodkin] 2452

372 Bacterial Meningitis and Ohter Suppurative Infections [Karen L. Roos/Kenneth L. Tyler] 2462

373 Viral Meningitis and Encephalitis [Kenneth L. Tyler] 2471

374 Chronic and Recurrent Meningitis [Walter J. Koroshetz/Morton N. Swartz] 2481

375 Prion Diseases [Stanley B. Prusiner/Patrick Bosque] 2486

376 Critical Care Neurology [J. Claude Hemphill/M. Flint Beal/Daryl R. Gress] 2491

377 Approach to the Patient with Peripheral Neuropathy [Arthur K. Asbury] 2498

SECTION 3 DISORDERS OF NERVE AND MUSCLES 2498

378 Guillain-Barré Syndrome and Other Immune-Mediated Neuropathies [Arthur K. Asbury/Stephen L. Hauser] 2507

379 Charcot-Marie-Tooth Disease and Other Inherited Neuropathies [Phillip F. Chance/Thomas D. Bird] 2512

380 Myasthenia Gravis and Other Diseases of the Neuromuscular Junction [Daniel B. Drachman] 2515

381 Approach to the Patient with Muscle Disease [Jerry R. Mendell] 2520

382 Polymyositis, Dermatomyositis, and Inclusion Body Myositis [Marinos C. Dalakas, Jr.] 2524

383 Muscular Dystrophies and Other Muscle Diseases [Robert H. Brown, Jr./Jerry R. Mendell] 2529

384 Chronic Fatigue Syndrome [Stephen E. Straus] 2541

SECTION 4 CHRONIC FATIGUE SYNDROME 2541

385 Mental Disorders [Victor I. Reus] 2542

SECTION 5 PSYCHIATRIC DISORDERS 2542

SECTION 6 ALCOHOLISM AND DRUG DEPENDENCY 2557

386 Biology of Addiction [Robert O. Messing] 2557

387 Alcohol and Alcoholism [Marc A. Schuckit] 2561

388 Opioid Drug Abuse and Dependence [Marc A. Schuckit/David S. Segal] 2567

389 Cocaine and Other Commonly Abused Drugs [Jack H. Mendelson/Nancy K. Mello] 2570

390 Nicotine Addiction [David M. Burns] 2574

Nobel Prize in Physiology or Medicine, 1924 [Willem Einthoven] 2577

Nobel Prize in Physiology or Medicine, 1929 [Christiaan Eijkman, Jr./Frederick Gowland] 2578

Part Fifteen ENVIRONMENTAL AND OCCUPATIONAL HAZARDS 2579

SECTION 1 SPECIFIC ENVIRONMENTAL AND OCCUPATIONAL HAZARDS 2579

391 Specific Environmental and Occupational Hazards[Howard Hu/Frank E. Speizer] 2579

392 Drowning and Near-Drowning [Jerome H. Modell] 2581

393 Electrical Injuries [Raphael C. Lee] 2583

394 Radiation Injury [Stephen M. Hahn/Eli Glatstein] 2585

395 Heavy Metal Poisoning [Howard Hu] 2590

396 Poisoning and Drug Overdosage [Christopher H. Linden/Michael J. Burns] 2595

SECTION 2 ILLNESSES DUE TO POISONS, DRUG OVERDOSAGE, AND ENVENOMATION 2595

397 Disorders Caused by Reptile Bites and Marine Animal Exposures [Robert L. Norris/Paul S. Auerbach] 2616

398 Ectoparasite Infestations, Arthropod Bites and Stings [James H. Maguire/Andrew Spielman] 2622

Nobel Prize in Physiology or Medicine,1977 [Roger Guillemin/Andrew Victor Schally/Rosalyn Sussman Yalow] 2629