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INDEX1

Part One INTRODUCTION TO CLINICAL MEDICINE1

1 The Practice of Medicine [The Editors]1

Appendix A: Laboratory Values of Clinical Importance1

APPENDICES1

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 Culture11

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

Contributors19

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

Preface31

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 DISEASES55

SECTION 1 PAIN55

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 TEMPERATURE91

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 DYSFUNCTION111

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 THROAT164

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 FUNCTIONS199

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 FUNCTION233

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 FUNCTION262

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 REPRODUCTION291

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　SKIN305

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 ALTERATIONS348

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 DISEASE375

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 PHARMACOLOGY419

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 NUTRITION451

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 HEMATOLOGY491

SECTION 1 NEOPLASTIC DISORDERS491

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 HEMATOPOIESIS653

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 HEMOSTASIS745

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 DISEASES763

SECTION 1 BASIC CONSIDERATIONS IN INFECTIOUS DISEASES763

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 INFECTIONS799

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 INFECTIONS853

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 DISEASES867

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 BACTERIA882

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 BACTERIA927

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 INFECTIONS1006

166 Actinomycosis [Thomas A. Russo]1008

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

SECTION 8 MYCOBACTERIAL DISEASES1017

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 DISEASES1044

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 CHLAMYDIA1065

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 DISEASES1084

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 VIRUSES1100

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 VIRUSES1120

189 Common Viral Respiratory Infections [Raphael Dolin]1120

190 Influenza [Raphael Dolin]1125

SECTION 14 RNA VIRUSES1131

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/11681168

SECTION 15 FUNGAL AND ALGAL INFECTIONS1168

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 CONSIDERATIONS1185

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

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

SECTION 17 PROTOZOAL INFECTIONS1199

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 INFECTIONS1231

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 DIAGNOSIS1253

Part Eight DISORDERS OF THE CARDIOVASCULAR SYSTEM1253

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 RHYTHM1283

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 HEART1309

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 DISEASE1377

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 DIAGNOSIS1443

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

Part Nine DISORDERS OF THE RESPIRATORY SYSTEM1443

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 SYSTEM1456

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 TRACT1535

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 SYSTEM1631

SECTION 1 DISORDERS OF THE ALIMENTARY TRACT1631

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 DISEASE1707

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 PANCREAS1788

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

Part Twelve DISORDERS OF THE IMMUNE SYSTEM,CONNECTIVE TISSUE, AND JOINTS1805

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

SECTION 1 DISORDERS OF THE IMMUNE SYSTEM1805

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 INJURY1913

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 JOINTS1979

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 ENDOCRINOLOGY2019

Part Thirteen ENDOCRINOLOGY AND METABOLISM2019

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 METABOLISM2192

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 METABOLISM2245

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 DISORDERS2321

SECTION 1 DIAGNOSIS OF NEUROLOGIC DISORDERS2321

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 SYSTEM2354

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 MUSCLES2498

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 SYNDROME2541

385 Mental Disorders [Victor I. Reus]2542

SECTION 5 PSYCHIATRIC DISORDERS2542

SECTION 6 ALCOHOLISM AND DRUG DEPENDENCY2557

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 HAZARDS2579

SECTION 1 SPECIFIC ENVIRONMENTAL AND OCCUPATIONAL HAZARDS2579

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 ENVENOMATION2595

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