00. Cover Harrison Prinsip-Prinsip Ilmu Penyakit Dalam Volume 4

Edisi 13 HarrisonPENYPARKINITSIDP-APILRLMIASMIUP Volume 4 Buku asli berstiker hologram

Kutipan Pasal 72: S2(1U..anncdp(BB(sl1eikadiiaapp)dmlsarrtiiiiaaannddkannaPgaiigtrnpggne-abissUaRltdiaiaauaapandntnsppan.edyguaja1anaaug.gkdnt0bdadaae0gaereRnn0rnanrpagNu.gpng0n.apaiao50gndUnin..a0a0nshh1,n0sp0e9)adae0ni0.snad.pTgi0gnla(eaa0asngjnpahj0aa-jateu.aUu0dlrpnamna0ajenun0den2pgt,naj0atag0aayn0la0rniri2agrnaupa()grpalnHmkiilmaahaaaHhnamaks)k,ai,anmkCmmag5iti-eCleapim(mlauiltapiraaakmptsmrauiiaudnke)paaagrttinnkaaaapauhhpnau)pe.lH,niernbanmdgkujaeaanrnsTt/aaigaennetrpgadkaskuaaelaiirbdttnkaegasg1nneadl,b(aiasammaapgttaaaaaunuli)7iamnmb(dagtunieubmlnajaaujannuhdkya)idslmauatkaadknhke/Rdausptapnuaal.ddua5dam0apd0nuaeP/.dm0anaat0dsua0aamual.y0p2da0sate0ualni,ay(n0d1taug0a)tPENTING DIKETAHUIPenmuenretbmuiktegadaditnaelgrabhhitarkkeaknpa.ennPauenhnpearetbnaigstakmraaernmagnpguuannntyunakyiamhdaekanneartbbaeisrtkhpaaenknesmrebebintuadanahpbbauutkkkuaun.teBrroseeyrbsaaultmti saaetrpatseanpdgeiasnrtjrauinabglua,snpinebynuaek,rubsnietdymaanedgnakcraiipnpteapnkeeanrngbaibrtu.aknugPerdhceaickteatkaapakannypaaud.naladhanpebruuksauhayaanngyadnicgemtaekmnyilaikkiemcueasliin ucpeatahk. Pdaenrcemtaeknajunaltijdaaska bpeerntcaentgagkuanng. Pjearwcaebtakaatans tiidsiakbumkuemyialinkgiPenmykgaaaenrrmygaaindlniigyktaui anhddjaauakrlkianphpyeenapnueeshnerbscauiittpaa,tsiasbkeasabutruaaaksniu-gbdaaeyntnaangnsyagayn,amknneeagtnmedynuiettneruanamhtnukekdananiynednradaalahaslmkkaamanhpnephreyajraakjnapujnienjaintnauenkr.PbePidtnieatgnneagrdbraaairtnnakgnad-gniPsbetdreniirebhrusabeskibitu.bmauehknudpnaeypnaaetrkkbeaiptn.adrPoaeypnaegltnaieraartbnaigstPemypnPpbeeaaerdsnamjkugjabaalniahkdjjiiaaamgtaknaadusntadlijdladeeaiaanrhkkigdhapaamnrnipinheayapmpykaieahpmhyaukkainaplnryimeehgannaaigmannhaaearjtniuakdpngdamugauknm.el.,ndBbeciiuldeliktinatkudikenu,pugnetnigmstdiuaabnmkcagojpmaapankyeirmidpdgaiehalrtrpiiskaiiktaaehpltpeaaabakunkiphmapurrenmaanncupgeregptaraaehjknan,ndkgjaaatiikrardeaanannnkag,pmmemdneeaegnnmraedrbkkiasaeantybrgtauii-brtdpuuaerhskoniaykenparaeblnbrti,iletu,.dladaPjmanaenremmmtmebipdnaaeajjsuarkysakailtaretabprikiukdkakaaatunk.tPEMBAJAKAN BUKU ADALAH KRIMINAL!Anda jangan menggunakan buku bajakan, demi menghargai jerih payah para pengarang yang notabene adalah paraguru.

A SALUTE TO ROBERT G. PETERSDORF By The Editors Of Harrison's.We dedicate this thirteenth edition of Harrison's Principles ofInternal Medicine to Robert G. Petersdorf.Dr. Petersdorf became an editor of Harrison's in 1968 for the preparation of the sixth edition andserved as Editor-in-Chief of the tenth edition. He was a powerful force for seven editions and morethan 20 years in establishing the pivotal role of this book in the education of students, residents andpractitioners of medicine. Dr Petersdorf is a graduate of Brown University and of Yale University Medical School. Hisgraduate training included residencies in medicine at Yale and at the Peter Bent Brigham Hospital anda research fellowship at Johns Hopkins. As Chair of the Department of Medicine at the University ofWashington he fashioned one of the truly great departments of intemal medicine in the nation, withwell-balanced and great strengths in education, clinical care, and research. His interests and contribu-tions broadened steadily and he served suicessively as the first President of the newly merged Brighamand Women's Hospital in Boston, as Vice Chancellor for Health Sciences and Dean of the School ofMedicine, University of California, San Diego, and most recently as President of the Association ofAmerican Medical Colleges. Dr. Petersdorf has, from the beginning of his career, made notable and outstanding contributionsin a number of areas in the field of Infectious Disease. He carried out a series of classic studies on thepathogenesis of fever, on pneumococcal meningitis and infective endocarditis, and on the chemopro-phylaxis and epidemiology of gram-negative infections, especially of the urinary tract.

PERINGATANIlmu kedokteran selalu berubah. Karena penelitian baru danp e n g a l a m a n klinife m e m p e r l u a s p e n g e t a h u a n kita, d i p e r l u k a nperubahan dalam pengobatan dan terapi obat. Para penyunting danpenerbit karya ini telah m e n g e c e k p a d a s u m b e r - s u m b e r y a n g diyakinidapat diandalkan dalam upaya menyajikan informasi yang lengkapdan secara u m u m sesuai dengan standar yang diterima pada saatbuku ini diterbitkan. W a l a u p u n demikian, k a r e n a a d a n y a k e m u n g k i n a nkesalahan manusiawi atau perubahan ilmu kedokteran, baikpenyunting, penerbit, m a u p u n pihak lain yang terlibat dalam persiapanatau penerbitan k a r y a ini tidak dapat m e n j a m i n b a h w a informasi y a n gdimuat di d a l a m n y a akurat d a n lengkap d a l a m s e m u a hal. P e m b a c adiminta m e n g k o n f i r m a s i k a n informasi y a n g t e r k a n d u n g di d a l a m n y adengan sumber lain. Misalnya dan teristimewa, pembaca dianjurkanuntuk mengecek lembar informasi produk yang disertakan padabungkus setiap obat yang mereka akan berikan untuk memastikanb a h w a informasi y a n g d i m u a t di d a l a m b u k u ini akurat d a n b e l u mpernah ada perubahan dalam hal dosis yang direkomendasikan ataukontraindikasi d a l a m p e m b e r i a n obat. R e k o m e n d a s i ini t e r u t a m apenting dalam kaitannya dengan obat yang baru atau jarangdigunakan. Pembaca juga harus berkonsultasi dengan laboratoriumm e r e k a sendiri untuk mengetahui nilai yang normal.

13Edisi PENYPARHKINIaSTIrPDr-PAIiRLLsINMAoSMUnff (Harrison's Principles of Intemal Medicine) Volume 4 Editor: Kurt J. Isselbacher, A.B.,MJ). MallincSkcrhoodot lP;MrPoahfseyssassiccohirauonsefattMnsdeGdDeiicnrieenrceat,olHrH,aoCrsvapanirtcadelrM, BeoCCse^ntaotednr Eugene Braunwald, A.B., M.D., MA. (Hon), M.D. (Hon), SCD. (Hon.) HerseHy MaPrrevodafirecdsisnMoer,edBoifrcitaghlheaSTmchheoaoonrldy; aWCnhodamiPremrna'ascntHi,cDoeseoppfiatMarlt,emdBeioncsitntooefn, Jean D. Wilson, M.D. Joseph BE.ndMPorCcohraPfieanrrsroosltfeloieosrnsgsCoy,ofarNaMmnoe.edfuDrISrnMo.oo,tnlueePomtStghahpaywb.rDloaeal.sgMni,tsudeFmeerCd.CnR,DiahcTM.liiCaishnfneto.eeiPdcrn;Uie.ngcCli(uanlaCohili,svri)She,Ce,faerMUedsnn.DiAnttCF.yiievvrrhoiea,saf(rniDHiTsorcienatoiayxslnnlcaao.odos)fsf Anthony S. Fauci, M.D. OfficDeisoefAasIeDsDS;irCReehcsiteeofarr,LcNahba, otNiroaanttiaoolrnyIanlosftIinItmusttimetuuotnefAosrloleefgrHugleyaatalitonhnd,;BIDneftiehrceetcsiotdouars, Dennis L. Kasper, M.D. * WBieMltlhieadImsicrEaaelllleSHrcyhoosCophli;taBanrClni;ghiCnhiegaofm-PDDraiiovrnfeiedscsitosWoonror,omoCffeIhnnMa'fsenecHndtiioinocsguipnsiLetDaa, lbHi,soaeBrraaovstsaoetrsrod,yn, Editor Edisi Baliasa Indonesia: Prof. Dr. Ahmad. H. Asdie, Sp.PD-KE PENERBIT BUKU KEDOKTERANUniversitas Gadjali MadGa/uRrSuUBPeDsra.rSIlamrdujiPtoen-yYaoldgtyaDl^aalartma

EGC 1295HARRISON'S PRINCIPLES OF INTERNAL MEDICINE. 13/EInternational edition. Copyright © 1994 by McGraw-Hill Inc.HPECHudoaAbpiktRlyoicsrReihpdeIetdiSdatioOstrbie,NyrbjdaeaPrhmr.rRaaaHsInhauNagrIneSinmaIdwIPeonan-ndPtteoiRswnHieaIiasNt:hriaPStaMrInoPtcfo.GI,DLrdarMaw.nA-UHRhiPmullsEamdBNioYyHoaA.ktiAKCsIodT.i,eD,SiSAnpLg.aPApDMo-rKe. EVOL. 4. E/13© 1995 Penerbit Buku Kedokteran EGCDesain kulit muka: Samson P. BarusHsDeaiilukarrucaihnpgtiasmidbeilunikgnuudtuiinnpgi, itmaUnepmnadpaieznribgna-Utneynratdukalnidsgadnarmi epneenrejerbmita.hkan sebagian atauCetakan I: tahun 2000Perpustakaan Nasional: Katalog Dalam Terbitan (KDT)Haxb3Eb5rxaa7GrvhhiivhoCaas,lioss,m.aan52;.8II0ip4nnIl0urngd0hisdgon.i.ern;msikiesp.2ss,-)1i(pKahr,xiuimnAr2ts.9hiJp,m1.75aIi0lscdms8me-Hu.l2b.0paA9ec1nsh)ydeair+ek..(i.t.8- [deEatdlaa. ml1. ]3/;-eeddJiiattkooarrreteaddii:ssii him. Lampiran &JIISSudBBuNNl a99s77li99:--H4444a88rr--i44s55o7n3'--s19 p((vnrioonl.c.ivp4ol)el.s leonfgiknatepr)nal medicine1. Penyakit dalam. I. Isselbacher, Kurt J. II. Asdie, Ahmad H.616Edisi Bahasa AsingJJCIItneeiarpdnlmioaannaegnsia (((EEEdddiiisssiii 1I1223)))---MPMeccnGGerrrbaawiwt --BHHuiillklluLBKiobeordkioIkCttaoelimraapnSa.nEr.yGl.-CS©in©g1a91p992o9r5e © 1994SPYPpoeurranatnaunyngcoiiilss (Edisi 1 l)-Hirokawa, © 1991 (Edisi 10)-Schwabe and Company, Ltd., © 1986 ((((EEEEddddiiiissssiiii 11112222))))----PEMFaldcariGmitsorsmraiaawanrG-ioHousnai,l,n©l/a©Ibn1at19rea99ra94Km2(oeeorsgitc.a)ann,aS.dAe.,E©spa1n9a9,2© 1992Isi di \M< tanggung lawab percetakan

DAFTAR ISI RINGKASDAFTAR KONTRIBUTOR XI S e k s i 11 Penyakit-penyakit virusKATA PENGANTAR Seksi 12 Virus DNA xxiii Seksi 13 Virus DNA dan RNA pada saluran napas VOLUME SATU Seksi 14 Virus RNA Seksi 15 Infeksi jamur BAGIAN SATU Seksi 16 Infeksi akibat protozoa dan cacing: PENGANTAR ILMU KEDOKTERAN KLINIS pertimbangan umum Seksi 17 Infeksi protozoa BAGIAN DUA Seksi 18 Infeksi helmintik (cacing) MANIFESTASI UTAMA PENYAKIT Seksi 19 EktoparasitSeksi 1 Nyeri VOLUME TIGASeksi 2 Perubahan suhu tubuhSeksi 3 Disfungsi sistem saraf BAGIAN TUJUHSeksi 4 Perubahan fungsi sirkulasi d a n respirasi GANGGUAN PADA SISTEM KARDIOVASKULERSeksi 5 Perubahan fungsi gastrointestinal Seksi 1 G a n g g u a n j a n t u n gSeksi 6 Perubahan fungsi berkemlh d a n elektrolit Seksi 2 G a n g g u a n p a d a s i s t e m v a s k u l e rSeksi 7 Perubahan dalam fungsi seksual d a n reproduksi BAGIAN DELAPANSeksi 8 Perubahan pada kulit GANGGUAN SISTEM PERNAPASANSeksi 9 Kelainan hematologik BAGIAN SEMBILAN BAGIAN TIGA PENYAKIT GINJAL DAN SALURAN KEMIH GENETIK DAN PENYAKIT BAGIAN EMPAT FARMAKOLOGI KLINIS VOLUME EMPAT BAGIAN LIMA BAGIAN SEPULUH GANGGUAN SISTEM SALURAN MAKANANIII; GIZI VOLUME DUA Seksi 1 Gangguan saluran makanan Seksi 2 Penyakit hati dan saluran empedu Seksi 3 Gangguan pankreasSeksi 1 BAGIAN ENAM BAGIAN S E B E L A SSeksi 2 GANGGUAN SISTEM IMUN,Seksi 3 PENYAKIT INFEKSI JARINGAN IKAT DAN SENDISeksi 4Seksi 5 Tinjauan dasar pada penyakit menular Seksi 1 Gangguan sistem imun SIndroma klinis didapat dari komunitas Seksi 2 Cidera yang dicetuskan oleh imunitas Sindroma klinis—infeksi nosokomial Seksi 3 Gangguan sendi Penyakit bakterial: tinjauan u m u mSeksi 6 Penyakit yang disebabkan oleh bakteri BAGIAN DUA B E L A S ^ gram-positif HEMATOLOGI DAN ONKOLOGI \"%Seksi 7 Penyakit yang disebabkan oleh bakteriSeksi 8 gram-negatif Seksi 1 Kelainan sistem hematopoitikSeksi 9 Infeksi bakteri lain Seksi 2 Gangguan pembekuanSeksi 10 Penyakit mikobakterium Seksi 3 Penyakit neoplastik Penyakit spiroketa Rickettsia, Mycoplasma, dan Chlamydia vii

DAFTAR ISIDAFTAR KONTRIBUTOR xi 267 HEPATITIS KRONIK 1659KATA PENGANTAR xxiii Jules L Dienstag / Kurt J. Isselbacher 1665 BAGIAN SEPULUH 268 PENYAKIT HATI YANG BERKAITAN 1678GANGGUAN SISTEM SALURAN MAKANAN DENGAN ALKOHOL DAN SIROSIS Daniel K. Podolsky / Kurt J. Isselbacher 1680Seksi 1: Gangguan Saluran Makanan 1684 269 T U M O R HATI248 PENDEKATAN PADA PASIEN D E N G A N 1508 Kurt J. Isselbacher / Jules L. Dienstag 1688 PENYAKIT SALURAN MAKANAN 270 PENYAKIT INFILTRATIF DAN Kurl J. Isselbacher / Daniel K. Podolsky249 DAMPAK BIOLOGI SELULER DAN METABOLIKYANG MENGENAI HATI Kurt J. Isselbacher / Daniel K. Podolsky MOLEKULER PADA PENYAKIT 1512 271 T R A N S P U \ N T A S i HATI 1517 Jules L. Dienstag SALURAN MAKANAN 1524 272 PENYAKIT K A N D U N G E M P E D U Daniel K. Podolsky / Kurt J. Isselbacher DANDUKTUSBILIARIS250 ENDOSKOPI SALURAN MAKANAN Norton J. Greenberger / Kurt J. Isselbacher Michael B. Kimmey / Fred E. Silverstein251 PENYAKIT E S O F A G U S Seksi 3: Gangguan Pankreas Raj K. Goyal 273 PENDEKATAN PADA PASIEN 1700252 ULKUSPEPTIKUM DAN GASTRITIS 1532 1704 James E. McGuigan PENYAKIT PANKREAS 1717 Phillip P. Toskes / Norton J. Greenbergerr253 N E O P L A S M A E S O F A G U S 1554 274 PANKREATITIS A K U T DAN KRONIK 1720 DAN LAMBUNG 1558 Norton J. Greenberger / Phillip P. Toskes / Kurt J. Isselbacher Robert J. Mayer 275 KANKER P A N K R E A S Robert J. Mayer254 KELAINAN A B S O R P S I 276 T U M O R ENDOKRIN SALURAN Norton J. Greenberger / Kurt J. Isselbacher MAKANAN DAN PANKREAS Lee M, Kaplan255 PENYAKIT RADANG USUS (KOLITISULSERATIVA DAN PENYAKIT CROHN) 1577Robert M. GUckman256 PENYAKIT U S U S HALUS DAN B E S A R 1591 BAGIAN SEBELAS J. Thomas LaMont / Kurt J. Isselbacher GANGGUAN SISTEM IMUN, JARINGAN IKAT DAN SENDI257 TUMOR USUS BESAR DAN KECIL 1600 Robert J. Mayer258 O B S T R U K S I U S U S A K U T 1607 Seksi 1: Gangguan Sistem Imun WilUam Silen259 APENDISITISAKUT 1610 277 DASAR S E L U L E R DAN M O L E K U L E R William Silen IMUNITAS 1729260 PENYAKIT PERITONEUM DAN M E S E N T E R I U M Barton F. Haynes / Anthony S. Fauci 1745 278 PENYAKIT IMUNODEFISIENSI PRIMER1612 Max D. Cooper / Alexander R. Lawton III 1753Kurt J. Isselbacher / J. Thomas LaMont 1807 Seksi 2: Penyakit Hati dan Saluran Empedu 279 PENYAKIT HUMAN IMMUNO- 1815261 P E N D E K A T A N T E R H A D A P PASIEN 1613 DEFICIENCY VIRUS (HIV): AIDS DAN 1617 DENGAN PENYAKIT HATI PENYAKIT TERKAIT Kurt J. Isselbacher / Daniel K. Podolsky 1623 Anthony S. Fauci / H. Clifford Lane262 PENCITRAAN HEPATOBILIARIS 1626 280 KELAINAN SEL PLASMA Lawrence S. Friedman / Laurence Needleman Dan L Longo 1633 281 AMILOIDOSIS263 T E S DIAGNOSTIK PADA PENYAKIT 1638 Alan S. Cohen HATI Seksi 2 : Cidera yang Dicetuskan oleh Imunitas Daniel K. Podolsky / Kurt J. Isselbacher264 KEKACAUAN METABOLISME HATI 282 PENYAKIT HIPERSENSITIVITAS 1820 Daniel K. Podolsky / Kurt J. Isselbacher 1829 TIPECEPAT265 METABOLISME BILIRUBIN DAN K. Frank Austen 283 PENYAKIT KOMPLEKS-IMUN HIPERBILIRUBINEMIA Michael M. Frank / Thomas J. Lawley Kurt J. Isselbacher266 HEPATITIS AKUT Jules L. Dienstag / Kurt J. Isselbacher

DAFTAR ISI ix284 LUPUS ERITEMATOSUS SISTEMIK 1834 302 PATOFISIOLOGI ANEMIA 1913 Bevra Hannahs Hahn H. Franklin Bunn 1917285 ARTRITIS REMATOID 1840 303 ANEMIA DENGAN METABOLISME 1922 Peter E. Lipsky 1929 BESITERGANGGU 1931286 SKLEROSIS SISTEMIK Kenneth R. Bridges / H. Franklin Bunn 1940 304 ANEMIA MEGALOBLASTIK(SKLERODERMA) 1847 Bernard M. Bahior/ H. Franklin Bunn 1952Bruce C. Gitliland 305 ANEMIA PADA PENYAKIT KRONIK 1956 H. Franklin Bunn 19632 8 7 P E N Y A K I T J A R I N G A N I K A T C A M P U R A N 1854 306 GANGGUAN HEMOGLOBIN 1973 Gordon C. Sharp H. Franklin Bunn 307 ANEMIA HEMOLITIK 1988288 SINDROMA SJOGREN 1855 Wendell Rosse/H. Franklin Bunn 1994 Haralampos M. Moutsopouhs 308 G A G A L S U M S U M T U L A N G : ANEMIA289 ANKILOSING SPONDILITIS, ARTRITIS APLASTIK DAN PENYAKIT SUMSUMREAKTIF, DAN SPONDILOARTROPATI TULANG PRIMERUNDIFFERENTIATED 1857 Joel M. Rappeport / H. Franklin BunnJoel D. Taurog / Peter E. Lipsky 309 PENYAKIT MIELOPROLIFERATIF David W. Golde / Suhhash C. Gulati290 SINDROMA BEHQET 1862 310 LEUKEMIA Haralampos M. Moutsopoulos David A. Scheinberg /David W. Golde 311 L I M F O M A M A L I G N A291 SINDROMA VASKULITIS 1863 Arnold S. Freedman /Lee M. Nadler Anthony S. Fauci 312 GOLONGAN DARAH DAN TRANSFUSI DARAH292 SARKOIDOSIS 1872 Harvey G. Klein Ronald G. Crystal 313 TRANSPLANTASI S U M S U M TULANG E. Donnall Thomas293 DEMAM MEDITERRANIA FAMILIAL Seksi 2: Gangguan Pembekuan(POLISEROSITIS PAROKSISMALFAMILIAL) 1878Sheldon M. Wolff294 GRANULOMA M/DL/A/E 1880 Sheldon M. WolffSeksi 3 : Gangguan Sendi295 PENDEKATAN TERHADAP PENYAKIT 314 GANGGUAN TROMBOSIT DANSENDI DAN MUSKULOSKELETAL 1881 DINDING PEMBULUH 2000John J. Cush/ Peter E. Lipsky Robert /. Handin 2006 2013296 OSTEOARTRITIS 1886 315 GANGGUAN PEMBEKUAN DAN Kenneth D. Brandt TROMBOSIS297 ARTRITIS AKIBAT PENGENDAPAN Robert I. HandinKRISTALKALSIUM 1892 316 TERAPI ANTIKOAGULAN,Garry S. Hoffman/Antonio J. Reginato FIBRINOLITIK, DAN ANTITROMBOSIT298 ARTRITIS PSORIATIK DAN ARTRITIS Robert I. HandinYANG BERKAITAN DENGAN PENYAKITSALURAN MAKANAN 1896Peter H. Schur Seksi 3: Penyakit Neoplastik299 POLIKONDRITIS BERULANG DAN 317 PRINSIP NEOPLASIABERBAGAI ARTRITIS LAIN 1898 John Mendelsohn 2017Bruce C. Gilliland 2030 318 PRINSIP TERAPI KANKER 2045 BAGIAN DUA BELAS Christopher A. Slapak / Donald W. KufeHEMATOLOGI DAN ONKOLOGI 2057 319 KANKER PAYUDARA 2060300 DAMPAK BIOLOGI MOLEKULER PADA 1906 /. Craig Henderson HEMATOLOGI 2065 Stuarl H. Orkin 320 T U M O R GANAS PADA KEPALA DAN LEHER 2069Seksi 1 : Kelainan Sistem Hematopoitik Robert S. Lehovics 2073301 HEMATOPOISIS M O L E K U L E R 1909 321 KANKER OVARIUM Robert C. Bast / Andrew Berchuck DAN SELULER Mark A. Goldberg/H. Franklin Bunn 322 KANKER TESTIS DAN PENYAKIT TROFOBLASTIK LAIN Marc B. Garnick 323 HIPERPLASIA DAN KARSINOMA PROSTAT Arthur /. Sagalowsky / Jean D. Wilson 324 KANKER KULIT Carl V. Washington, Jr.

X 325 MELANOMA DAN LESI KULIT 2074 328 SINDROMA NEUROLOGIK 2086 BERPIGMEN LAINNYA 2079 PARANEOPLASTIK Arthur J. Sober / Howard K. Koh 2083 Robert H. Brown, Jr 326 KANKER METASTATIK YANG LAMPIRAN: NILAI LABORATORIUM KLINIS L-1 YANG BERMAKNA l-i SUMBERNYA TIDAK DIKETAHUI Richard M. Stone Indeks 327 MANIFESTASI ENDOKRIN NEOPLASIA Lnwrence A. Frohnian

DAFTAR KONTRIBUTORELIAS ABRUTYN, M.D. ARTHUR L. BEAUDET, M.D.RA(APHrfdoAfmafoieYirnsnss,i.Mso)Mtr,raOeDatdinoNi.dcnSaDlAcMCs.eDsod(olHi.clceiaAagolteneDCo.eC)Afn,htPMeaMerin,rSnm.PsD,ahynil.Blv,aad(.MnAHeilaep.o;dh,inCicMa.ihn)i.eeA,f a.In,ndfMecVt.iioDcues.-,DDMeiasne.aAsfoe.sr, VVeetteerraannss CPInresoltlfietBusstieoo,lro,HgIyon,usBstitatouyntleorfCorolMleogleecouf lMe eGdiecnientei;csInavnedstiDgaetpoar,rtHmoewntasrdofHuPgehdeiastrMicesdaicnadlCdEBeuounnlLlisacaureuldstKaann.PtSnroehN,freievLsuesaroruorRsloaeongsfnieseatNr,cehMurCaosepsnaattcehhrouBlsooegsttytos,nG;EMemneeedrriiactluinsH,AoHdsjpaoiritvnatal;rLdE'HmMoeperidittaiucl,salCDaSnircteohcnotaoolrle,; JOHN E. BENNETT, M.D.MICHAEL J. AMINOFF, M.D. HBNeaettaihdoen,sadClalIinnsitcitaulteMofyAclolleorggyy anSdecItnifoenct.ioLusabDoirsaetaosreys, NofatCiolnianlicInasltitIuntvesesotfigHaetaioltnh,.Pverorsfietsysoorf CofalNifeournroialo, gSya;nDFirraecntcoirs,coClinical Neurophysiology Laboratories, Uni- ANDREW BERCHUCK, M.D.MICHAEL A. APICELLA, M.D. cAaslsoCceinatteer,PrDouferhssaoinr, Division of Gynecologic Oncology, Duke University Medi-PMreodfeicssinoer.aInodwHa eCaidt.yDepartment of Microbiology, University of Iowa College of MICHAEL S. BERNSTEIN, M.D.GORDON LEE ARCHER, M.D. cASaaslnsiCsFtaarranent cMPirseocdfoeicsisnoer,oUf Mnivedericsiitnye oanfdCAalniefostrhneiasiaa,t DSiavnisiFornanocfiPscuolmMoneadriycaalndCeCnrtietir-,oPUfrnoiIfvneefsresscoitrtiyo,oufsRMiDcehidsmeicoaisnnedes,aMndedMiciaclroCbioollloeggey/Iomf mVuirngoilnoiga,y VainrdginCihaaiCrmomanm, oDnwiveisailotnh DANIEL G. BICHET, M.D.ARTHUR K. ASBURY, M.D. sAesasrocchiaUteniPt.roHfeospsiotarl odfuMSeadcircei-nCeo.eUurnidveerMsitoyntorfeaMl.oMntroenatlr;eaDlirector. Clinical Re-oDRfuettahhneWfUorangRivneeesrresaiVtrycahno,fMUPenetinevnresraysniltvdyanJo.ifaR,PeaPnyhniVslyaadlnvealMpnhieaitaeSrchPoroofleossfoMr eodficNineeuraonldogHyo; sVpiitcael DAVID R. BICKERS, M.D.K. FRANK AUSTEN, M.D. HvPeroorssfpietisytsaolSrscahonfodoClClehovafeirlMamneaddn,i,cCiDnleeep;vaeDnlaminreedcnttoro,f DDeerpmarattmoleongty,ofCaDseerWmaetsotelorngyR, eUsenrviveeUrsnitiy-TmHhoaensop,ditDoarlee,paBBroetmsvtieoennrtBoafylReshePurmofaetsosloorgoyf ManeddiIcminmeu, nHoalrovgayr,d BMreigdhicaaml SacnhdooWl;oCmheanir's- EDWIN L. BIERMAN, M.D.ROBERT AUSTRIAN, M.D., D.Sci. (Hon.) NPruotfreitsisoonr, oUfniMveerdsiictiyneofaWndasHheinagdt,onDiSvcishiooonl ooff MMeetdaibcoinlies,mS,eEatntldeocrinology andJaPonhhdinlaCdHeeelllprurhliMaaruEssnegrinPeroefreinssgo,r UanndiveCrhsaitiyrmoafn PEemnnersiytulvsa, nDiaepSarcthmoeonlt ooff MMeodleicciunlaer, NEIL R. BLACKLOW, M.D.BERNARD BABIOR, M.D., Ph.D. cRiinceh,aUrdniMve.rHsiatyidaocfkMParsosfaecshsuosreottfsMMeeddicicinael SanchdoCohl,aiWrmoarcne,sDteerpartment of Medi-MHMeeeadddiic,ciinnDeei,vaiSsncidorinpMpoesfmCbBleiinro,icchDeaimnvdiissitRornyes, eoDafrecHpheamrFtoamutoennldotagtoyiofnaM,ndLolaOecJnuoclloalalrogayndDEepxapretrmimenetntoafl MARTIN J. BLASER, M.D.KAMAL E BADR, M.D. TCUInhenfneeivtceteAriro,sduiNdstyiasDsohSinsvceihlalBoseoe, sl SaocnfodvMPi lrelodefiecPsisnrooerf;eosSfstMoafrficorPofhbyiMosileocdigaiycni,anneVd;eItDmerimarneuscntooAlrof,fgayDi,rsiVv iaMsnideoednribcoialfltAVPrteoltafeenrstasano'rs oMf MedeidcaiclinCee, nEtmero;ryAtUtennivdeinrsgityP;hCyhsiiceifa, nD,ivEimsioonryofUNneipvherrsoiltoygyH, oAstplaitnatla, JEAN L. BOLOGNIA, M.D.DONALD S. BAIM, M.D. AsitsysoScciahtoeolProoffMesseodricoinfeD, eNrmewatoHloagvyen, Department of Dermatology, Yale Univer-CAasrsdoicoilaotegyPrSoefcetsisoonr, oBfeMtheIdsircaienle,HHosaprvitaarld, BMoesdtoicnal School; Chief, Interventional LAWRENCE E BORGES, M.D.ANN SULLIVAN BAKER, M.D. cAiassteocViaitseitiPnrgofNesesuorrosoufrSgeuorgne,ryMa(NsseaucrhoussuertgtesryG)e,nHeraarlvaHrdosMpiteadli,caBloSstcohnool; Asso-ADDsiissseeoaacssieeasteSSePrevrrovicfieecs,es,MoMrasoasfsasMcahceuhdsuiescteitntstesG, EeHnyaeerrvaaalnrddHoMEsaperidtiaIcnla.flirBmSocashrtoyon;olP; hDyisrieccitaonr., IInnffeeccttiioouuss RICHARD C. BOUCHER, Jr., M.D.ANDREA BALLABIO, M.D. CPUranorifeveesarsnsoidrtyOoofcfcMuNpeoadrtitichoinnCaeal raoMnlidendaDicHiirneoecs,tpoiUrt,anlisDv,eiCvrsihsiatiyopneolfoHfNiPlolurtlhmoCnaarroylinDaisaetaCsehsa,peClriHticilall;tAers,soBcaiyaltoerPCrooflelessgoer,ofInMsteitduitceinfeo,r HMooulsetcounlar Genetics and Human Genome Cen- AUBREY E. BOYD III, M.D.KENNETH J. BART, M.D., M.P.H. BDProioasfbteoesntseosr, MofetMabeodliiscmineanadndMNoleeucruolsacrieMnceed;icCinhei,efN, eDwivEisnigolnanodf MEenddioccarlinCoelnotgeyr,,DDierpeacrttomr,enNtatoifonHael aVltahccainnde HPruomgaranmS,eOrvfifcicees,oRf othcekvAilslseistant Secretary of Health, WALTER G. BRADLEY, D.M., F.R.C.P.ROBERT C. BAST, Jr., M.D. oPfroMfeesdsoicrinaen,dMCihaamiriman, Department of Neurology, University of Miami SchoolCRa. nWcearynCeenRteurndDleukPeroUfnesivsoerrsiotyf MMeeddiiccainleCaenntderD, iDreucrthoarm, Duke Comprehensive HUGH R. BRADY, M.D., Ph.D., F.R.C.RI.M. FLINT BEAL, M.D. ABBrrsoisgcishktataomnntAaPVnrdoesfWet sRsoomorxebonuf'srMyHeVodesictpeiinrtaaenl,,'sHBaAorfsvftaaorindrs MMeeddicicaallSCcehnotoelr;; CAhsiseof,ciRateenaPlhSyescictiioann,,Associate Professor of Neurology, Harvard Medical School; Assistant Neurolo-gist, Massachusetts General Hospital, Boston DAVID L. BRAFF, M.D. cPhroiaftersys,oUr CofSDPsyMchediaitcrayl, CUennivteerrsSitaynoDf iCeagloifornia at San Diego; Director of Psy-

xii DAFTAR KONTRIBUTORKENNETH D. BRANDT, M.D. BRUCE R. CARR, M.D.sMPirtuoysfec.SsucslhooorsokolefloeMft aMel deiDdciiicsneienaesae,nsdI nCHdeieanantdea,rp oRIlhni sed;ui aDmniaarteocUltonogirv,yeMrDsuiitlvytiispSiuocrnhp,oooIsnledoAi afrntMahreiUtdinisci vianenerd-, dTPoaecuxrlaisnCoS.looMugtayhc,wDDeoesntpaealmrdtmMPerenodtfiecosafsloOrCbeasnntetdetrrDi,cisDreaaclntloadrs,GDyniveicsoiolongyo,f TRheeprUodnuivcetirvseityEnof-EMInUd.iDaGn.aEp(oNHliEos nB.)R, SAcUDN.W(HAoLnD.), A.B., M.D., M.A. (Hon.), AGUSTIN CASTELLANOS, M.D.Hersey Professor of the Theory and Practice of Medicine, Harvard Medical Professor of Medicine, University of Miami School of Medicine; DirectorSchool; Chairman, Department of Medicine, Brigham and Women's Hospital, Clinical Electrophysiology, Jackson Memorial Hospital, MiamiBoston VERNE S. CAVINESS, Jr., M.D., Ph.D.IRWIN M. BRAVERMAN, M.D. Joseph P, and Rose F. Kennedy Professor of Child Neurology and MentalProfessor, Department of Dermatology, Yale University School of Medicine, Retardation, Harvard Medical School; Chief. Pediatric Neurology ServiceNew Haven Massachusetts General Hospital, BostonJAMES L. BREELING, M.D. JOHN S. CHILD, M.D.Associate Chief, Medical Service, West Roxbury VA Medical Center, Boston PArnogfeelsesso;r AosfsMoceidaitceinCeh,ieSfc,hDooivl isoifoMn eodfiCcianred,ioUlongivyerasnitdy DoifreCcatolirf,orAndiaulatt CLaors- diac Imaging and Hemodynamics Laboratories, UCLA Medical Center, LosJOEL G. BREMAN, M.D., D.T.P.H. AngelestBA(DeHtreAlpaofunRonttryaR.;)ICn,YVhfDieisecMif.tt,MiionM.ug.BsaSLl aRcDerc.iiEtasu(eNrBHaesrrNaeo, nsnEH,c h.aRC),revD,nairtMvedirssS.i oDcfnho.oro,ofADl Pio.asfMreaaPss.uietb(i clHCi cDooniHnsteer.oaa)sll,tehDas,,n.NdBSaocPtsit.rooenvnaelnCt i oe nn-, WALLACE A. CLYDE, Jr., M.D.SPahmysuiecliaAn .aLndevDinierePctroorf,esRsoernaolf DMivedisiicoinn,e,BHriagrhvaamrd aMneddiWcaolmSecnh'sooHl;oSspeintiaolr,Boston Professor of Pediatrics and Microbiology, University of North Caroline Chapel HillKENNETH R. BRIDGES, M.D. FREDRIC L. COE, M.D.Assistant Professor of Medicine, Harvard Medical School; Brigham andWomen's Hospital, Boston vPerorsfietsysoorf oCfhMiceadgiociPnreitaznkderPShychsiooollogoyf ManeddCichinieef,, NChepichargoology Program Uni-KAREN THATCHER BRITTON, M.D., Ph.D. ALAN S. COHEN, M.D.Professor of Psychiatry, University of California at San Diego, La Jolla Distinguished Professor of Medicine and Rheumatology; Director, Arthritis Center at Boston University School of Medicine, Boston University SchoolCLAIRE V. BROOME, M.D. of Medicine, BostonAssociate Director for Science, Centers for Disease Control and Prevention, WILSON COLUCCI, M.D.Atlanta ABrsisgohcaimateanPdroWfeosmsoern'sofHMosepdiitcailne, Harvard Medical School; Physician,MARTIN M. BROWN, M.A., M.D., M.R.C.P. PATRICIA C. COME, M.D.Senior Lecturer in Neurology, St. George's Hospital Medical School, London Associate Professor of Medicine, Harvard Medical School; Harvard Com-MICHAEL S. BROWN, M.D. munity Health Plan, BostonPaul J. Thomas Professor, Department of Molecular Genetics, The Univer- JOEL D. COOPER, M.D.sity of Texas Southwestern Medical Center, Dallas WPraosfheisnsgotronofUSnuivregresriyty aSncdhoHoel aodf, MSeedcitcioinne;oBf aGrneenserHalosTpihtoalr,acSitc. LSouurigsery,ROBERT H. BROWN, Jr., M.D., D.PhiL MAX D. COOPER, M.D.ADsirseocctioart,eCPe croi lfeBss. oDr,a yHLaar vbaorrda t oMr ye dfiocra lN Se ucrhoomo lu;s cAuslsaorcRi aetsee aNrecrhu, oMl oagsi ssta cahnud-setts General Hospital, Boston cParlofIenssstoitrutoef IMnveedsitciignaet,orP,eUdinaitvriecrssiatyndofMAiclraobbaimolaoagtyBainrmd iHnogwhaamrd, HBuirgmheinsgMhaemdi-H. FRANKLIN BUNN, M.D. LAWRENCE COREY, M.D.Professor of Medicine, Harvard Medical School; Senior Physician and Di- oPfroWfeassshoirngotfoLna, bSoeraatttolrey Medicine, Microbiology and Medicine, Universityrector, Hematology Research, Brigham and Women's Hospital, Boston MARK A. CREAGER, M.D.RONALD M. BURDE, M.D. Associate Professor of Medicine, Harvard Medical School; Director, Vascu-OIspidhothr aTlmacohlongaisPtroafnedssoNreuarnod-oCphhtahiarlmmaonl,ogDisetp,arAtmlbeenrtt EoifnsOtepihnthCaolmlleogloegoyf; lar Diagnostic Laboratory, Brigham and Women's Hospital, BostonMedicine/Montefiore Medical Center, New York RONALD G. CRYSTAL, M.D.JOAN R. BUTTERTON, M.D. Webster Professor of Medicine, Cornell University Medical College; AttendingCGleinneircaall aHnodspRiteasl,eaBrochstoFnellow. Infectious Diseases Unit, Massachusetts PMheydsiicciinaen,, NNeewwYYoorrkkHHoossppiittaall-;CCohrnieefl,l DMivedisiicoanl CofenPtuelrm, Noneawryyaonrkd Critical CareALFRED E. BUXTON, M.D. JOHN J. CUSH, M.D.Professor of Medicine and Cardiology, Temple University School of Medicine; Avesrssoitcyiaotef TPeroxfaesssSooruotfhwInetsetmemal MMeeddiiccianleC, eRnhteeurmatatDicalDlaiss,eaDsaelslaDsivision Uni-Associate Chief, Cardiology Section, Temple University Hospital, Philadelphia CHARLES A. CZEISLER, Ph.D., M.D.STEPHEN B. CALDERWOOD, M.D. AaDnisdrseocWctiooarmt,eLePna'rbsoofrHeasotsosorpryitaoflfo,rMBOeordsctiaocdinniaen, HanadrvSarledepMDedisicoardl eSrschMooeld;icPihnyes,icBiaringhaanmdAssociate Professor of Medicine, Harvard Medical School; Chief, Infec-tious Diseases Unit, Massachusetts General Hospital, Boston THOMAS M. DANIEL, M.D.CHARLES B. CARPENTER, M.D. HPreoaflethss,oCr WofRUMeSdcihcoinoel oafndMeIndtiecrinnaet,ioCnlaelveHlaenadlth, Center for InternationalnPorogfeensestoircsofanMdeTdircainnsep,laHnatravtaiordn,MBerdigichaalmScahnodoWl; oDmiraenc'tsorH, oLsapbiotarla,toBroysotofnImmu- GILBERT H. DANIELS, M.D. Associate Professor of Medicine, Harvard Medical School; Physician and Co-Director, Thyroid Clinic, Massachusetts General Hospital, Boston

DAFTAR KONTRIBUTOR xiiiROBERT B. DAROFF, M.D. KENNETH H. FALCHUK, M.D.AGWroidlelombsgteieyrnm,tisUWtRrnaietvHsieoeurrnmsvietpMyhUerHednoyiicsvpaPelirrtsoaCiflteseynsostSfeo-crrCh, loaeConvlldeelvoCaefnhldMaa;nierNdmdeiacunirn,oelDo; geDypiarSretecmrtvoeirnc,teDCoeflpeNvareetlumarnoedlnotVgoyef,teNCraaensu'es- AansdsoWcioatmeePnr'sofeHsossopritoafl,MBeodsitcoinne, Harvard Medical School; Physician, BrighamJOHN R. DAVID, M.D. FERRIC C. FANG, M.D.RHiecahlathrd, HPaeravrasrodn SScthroonogl oPfroPfuebssliocr HaneadltChh, aBimosatno,n Department of Tropical Public AtSacsl,iseiDnstceaennsvt eCPrernotfeers;soDriroefctMore, dCicliinniecaalnMd iPcartohboiloolgoyg,y ULnaibvoerrastiotyryo, fUCnoivloerrsaidtyo HHoesapltih-CHARLES EDWARD DAVIS, M.D. ANTHONY S. FAUCI, M.D.CSParanoliffeoDsrisneoigaro, oSfanPDatiheogolo;gDyireacntodr,MMeidcircoibnioe,logSychLoaobloroaftoMry,edUiCciSnDe,MUendiicvaelrsCiteyntoerf oHDfieraIemlcthtmo,ru,BnNoetrahetiegosundlaaaltiIonns;titDuitreecotfoAr,llOerfgfiyceanodfIAnfIeDcStioRusesDeaisrcehas, eNs;aCtihoineafl, ILnasbtioturatetooryfKENNETH DAVIS, M.D., F.A.C.R. MURRAY J. FAVUS, M.D.MPraosfseasscohrusoefttRsadGieonloegrayl, HHaorsvpaitradl,MBeodsictoanl School; Department of Neuroradiology, oPfroMfeesdsoicrinoef, MUendiviceirnseit,ySoefctCiohniscaogfoEPnrditozckreinr oSlcohgoyolanodf NMeepdhircoinloeg, yC, hDiceapgaortmentROBERT L. DERESIEWICZ, M.D. THOMAS F. FERRIS, M.D.aInnsdtrWucotomr einn'sMHedoiscpiintael,, HBaorsvtaornd Medical School; Associate Physician, Brigham Nsoetsab; iUtlnPivroefressitsyoroafnMdiCnnheasiromtaanH,oDspeiptaalrtmanedntColifnMicse,diMciinnen,eUapnoivliesrsity of Minne-ROBERT J. DESNICK, Ph.D., M.D. BERNARD N. FIELDS, M.D.oPfroMfeesdsoicrinaen;dACttheanidrminagn,PhDyespicairatmn,enMtooufntHSuimnaani; GHeonspetiitcasl,, NMeowunYt oSriknai; School AHMdaeredvlieacriLdneeMhamendadincCaPhlraoSifcremhsosaoonlr,, oDBfeoMpsatiorctnrmoebniot loofgyMaicnrdobMioolloegcuylaarndGeMnoetlieccsu,laPrroGfeesnseotricosf,MARC A. DICHTER, M.D , Ph.D. HOWARD L. FIELDS, M.D., Ph.D.MPreodfeicssinoer oafndNeGurraodlougatyeaHndosPphitaarlm, aPchoilloagdye,lpUhniaiversity of Pennsylvania School of rPorloofgeys,soUr noifveNrseiutryoloofgCyaalinfdorPnhiay.siSoalnogFyraanncdisVcioce Chairman. Department of Neu-JULES L. DIENSTAG, M.D. GREGORY A. FILICE, M.D.MAsassoscaicahteusPerttosfeGsseonreroafl MHeodsipciitnael;, BHoasrvtoanrd Medical School; Associate Physician sAitsysoocfiaMteinPnreosfoetsasoVr AofMMeeddiciaclinCe eanntedr,ChMieifn,nIenafpeocltiisous Disease Section, Univer-ALAN R. DIMICK, M.D. ROBERT W. FINBERG, M.D.PUrnoifveesrssoirtyofoSfuArglaebrya,mUaniHveorsspiittyalo,f BAilrambainmgahaamt Birmingham; Director, Bum Center AInsfseocctiioautes PDriosfeeassseo.r DoafnMa-eFdaircbineer.CHaanrcvearrdInMsteitduitcea,l BSocshtooonl; Chief, Laboratory ofCHARLES A. DINARELLO, M.D. STUART C. FINCH, M.D.gPrraopfehsiscoMr eodfiMcineediacnindeI,nTfeucfttisouUsnDiviesresaistyes,SNcheowolEonfglManeddiMciendei;caDliCviesniotenr,oBf oGsteoon- cRParolobfCeerestsnoWterro,oofdCaMJmoehddneiscnoinneM, eUdnicivael rSsicthyooolfaMndedthieciCneooapnedr HDoesnptiitsatrl/yUonfivNereswityJeMrseedyi--ROBERT G. DLUHY, M.D. J. STEPHEN FINK, M.D.ADisrseocctioarteofPtrhoefeCslsionricaolf RMeesdeaicrcinheC, eHnatervr,arBdriMgheadmicaalndSWchoomole;nA'ssHsoocsipaittealP, rBoogsrtaomn Aseststso,cGiaetenePrraolfeHsosospr,itHala, rvBaorsdtoMn edical School; Assistant Neurologist, Massachu-RAPHAEL DOLIN, M.D. DANIEL W. FOSTER, M.D.CvehrasritlyesoAf RDoecwheesytePrroSfcehsosoolr ooff MMeeddiicciinnee;anCdhaDire,nDtisetpryar,tmReoncht eosfteMr edicine, Uni- CpDaeornnttmaelred,ntWDoa.flSlaIensltdeirnnaDl iMstiendgiuciisnhee,dThCehaUirniivnerIsnitteymoafl TMeexdaisciSnoeuathnwdeCstheamir,mMane,dDicea-lDANIEL B. DRACHMAN, M.D. MICHAEL M. FRANK, M.D.TPrhoefeJsoshonrs oHf oNpekuinrosloUgnyivaenrsdityNeSucrhoosoclieonfceMseadnicdinDei,reBcatoltri,mNoreeuromuscular Unit, PCreonfteesrs,oDr uarnhdamChairman, Department of Pediatrics, Duke University MedicalJEFFREY M. DRAZEN, M.D. ARNOLD S. FREEDMAN, M.D.PmaornkaerryBD, iFvriasinocnis, BPrriogfheassmoranodf MWeodmiceinn'es, aHnadrvBaertdh MIsreadeilcaHloSspchitoaolsl,; BCohsietof,n Pul- AImssmoucniaotleogPyr,ofDesasnoar-FoafrbMeredCicainncee,r HInasrtviaturdte,MBeodsitcoanl School; Division of TumorJOHANNA T. DWYER, D.Sc, R.D. STANLEY D. FREEDMAN, M.D.cBPrtieirsoncots,tefot;eoUrs,PnsSroFDorrfAaeonsfscHoMersuemodSfaitcenNirnnuNetrNuaittunriitodtrniiCot,inooTmnuRfmCetssueennUatirnetcyrih,vHeNCreseeaiwntlyttheE,SrnTcoghunlofatonsAldgUoifnMnigNve,eduTritcsruiiafttlyitsoCnSUe;cnhnStoieevonreliroHosrifotySsMp;cieiDtedaniil---, CDliivniisciaoln PorfoIfnefsescotriooufs MDiesdeiacsien,eS, cUrinpipvseCrsliitnyicoafnCdaRliefsoeranricahaFt oSuanndaDtiioeng,oL; aHJeoaldla.VICTOR J. DZAU, M.D. MICHAEL FREISSMUTH, M.D.tWMalei,ldlSiiactmainnefGo, r,SdItarwnfionrdPrUofneisvseorrsiotyf MScehdoioclinoef aMndedCichiineef;, SDtiavnifsoiordn UofniCvaerrdsiitoyvaHsocusplai-r Lecturer, Department of Pharmacology, University of Vienna, ViennaBARRY I. EISENSTEIN, M.D. GERALD H. FRIEDLAND, M.D.LPrilolfyesRsoesreoarfcMh eLdaibcoinraet.oIrniedsi,anIandUiannivaperosliitsy School of Medicine; Vice President, Director, AIDS Program, Yale University School of Medicine, New HavenVIRGINIA L. ERNSTER, Ph.D. HARVEY MICHAEL FRIEDMAN, M.D.oPfroCfeaslisfoorrnaina,d SCahnaiFr,raDnecpisacrotment of Epidemiology and Biostatistics, University Csyhliveafn, iIanfSecchtiooouls oDf iMseeadseicDiniev,isPiohnil,aDdeelppahritament of Medicine, University of Penn- LAWRENCE S. FRIEDMAN, M.D. MAsassoscaicahteusPertotsfeGsseonreroafl MHeodsipciitnael,, HBaorsvtoanrd Medical School; Associate Physician,

xiv DAFTAR KONTRIBUTORPAUL J. FRIEDMAN, M.D. JOSEPH L. GOLDSTEIN, M.D.Professor of Radiology. University of California. San Diego; PUanuilveJrTsihtyomoafsTPexroafsesSsoourthawndesCtehranirMmaend,icDalepCaerntmteern. tDoafllMasolecular Genetics, TheWILLIAM E FRIEDMAN, M.D. RAJ K. GOYAL, M.D.JcDmeHpe a; NrUtimcnhievoneltrssooifntyPPeodrfoiaCfetarsilsciofsor, rUnoifnai,vPeLerdosisiattyArioncfgs eCl(aeclsairfMdoireondlioaic,gayLl)oCsaenAndtnegErexlLeeoscsuStcAivhneogoeCllehosfaiMrmeadni-, tRroaebnbtePrroolfoegsys.orBeotfhMIserdaieclinHeo.sHpiatarvl,arBdoMstoendical School; Chief. Division of Gas-LAWRENCE A. FROHMAN, M.D. JOHN W. GRAEF, M.D.EIldlimnouinsdatFCFhioclaegyo,PrCohfeiscsaogro and Head. Department of Medicine, University of TAhsesoLcieaatde/TColxinicicoalol gPyroCfelisnsiocr, TofhePCedhiialtdrriecsn,'sHHaorvsapridtalM, Bedoisctaoln School; DirectorROBERT K. GAGEL, M.D. HARRY B. GREENBERG, M.D.TPeroxfaess,soMr.Dof. AMneddeicrsionne aCnadncCehr ieCfenotferEnHdooucrsitnoonlogy Section, The University of PMreodfeicsasol rCoefntMere,dSictiannefoardnd Microbiology and Immunology, Stanford UniversityJOHN I. GALLIN, M.D. NORTON J. GREENBERGER, M.D., M.A.C.P.fDeicrteicotuosr.DDisiveaissieo,nNoaftiIonntarlamInusrtailtuRteesoefarHceha,ltNh,atBioentahlesIdnastitute of Allergy and In- PKeatnesraTs.MBeodhiacnalPCroefnetsesro,rKaanndsaCshaCiirtmy an. Department of Medicine, University ofROBERT C. GALLO, M.D. JOHN S. GREENSPAN, B.D.S, Ph.D., ER.C.Path.CInhsiteitfu.teLaobfoHraetaolrtyh, oBf eTthuemsodar Cell Biology, National Cancer Institute, National PSaronfeFsrsaonrciasncdo Chairman, Department of Stomatology, University of Dentistry,MARC B. GARNICK, M.D. JAMES E. GRIFFIN, M.D.AsHtisatsruvotaceri,datCeMamCedbliircniaidclgaeSl cPhoroofle;sVsoicre oPfreMsieddenictinfoer, CDlainniac-aFl aDrbeevrelCopamnceenrt,IGnsetniteuttiecsaInnd- CPreonfteesrs,oDr aolflaIsnternal Medicine, The University of Texas Southwestern MedicalJEFFREY A. GELFAND, M.D. J. McLEOD GRIFFISS, M.D.SUManeriadvieMcrasulirtryCaeySnJtcoehrro.dBoalonsoPtofrnoMfeessdoicr ianned; VAiscseoCcihaatiermPahny,sDiceiapna-ritnm-eCnhtieoff,MNedewicinEen,gTlaunftds cPirsocfoesVsoAr MofeLdiacbalM, eCdeinctienre. aSnadn MFreadnicciisnceo, University of California at San Fran-JAMES L. GERMAN HI, M.D. ROBERT C. GRIGGS, M.D.tPorroyfeosfsoHruomfaPneGdieantreitcics,s,CNoernwelYl oUrkniBvelorsoidtyCMenetderic, aNl eCwolYleogrke; Director, Labora- CfEUedenswnsivotaeerrrrdsoifRtAyoN. coaehfnuedrRsotoAleocrlghmyeastaeVnrodSllcMehrteosdoeinlciaRnneyd,kDeannebdnotieCsrthryaPi,rroUmfenasinsv,oerrDsoietfpyaNroetfmuRreonoptchhyoesfsitoeNlroeguMyro,eldoPigcroayl-,BRUCE C. GILLILAND, M.D. WILLIAM GROSSMAN, M.D.oPSfrcohMfoeiosclsrooorbfiooMfloeMgdyiec,diiancneidn, eSA,esPastrotolcfeieastseorDeoafnL, aCbloinraictoarlyAMffaeidrsic, iUneniavnedrsAitydjuofncWt aPsrhoifnegstsoonr DDiavniasioPnro, fBesesthorIsorfaeMl Hedoiscpinitea,l, HBaorsvtaornd Medical School; Chief, CardiovascularALFRED G. GILMAN, M.D., Ph.D. JOHN H. GROWDON, M.D.mRDaaeylnlmtasoofndPhWarilmliaecDoliosgtiyn,guTihseheUdnCivhearisritiyn MofoTleecxualsarSNouetuhrwopehstaerrmnaMcoeldoigcya;l DCeepnatertr-, MPreomfeosrsyorDoifsoNrdeeurrsolUongiyt., MHaasrsvaacrdhusMetetdsicGaelneSrcahloHolo;spNiteaulr,oBloogsitsotn and Director,SID GILMAN, M.D. SUBHASH C. GULATI, M.D., Ph.D.PArnonfeAssrobrorand Chairman, Department of Neurology, University of Michigan, MCAesensmotecbrie,artNeaenPwdroYAfeosssrskoocriaotfe MAetdteincidnien,g CPohrynseilcl iaUnn,ivMeersmitoyriMaledSilcoaaln-CoKlelettgeer;inAg sCsoacnicaeterRICHARD J. GLASSOCK, M.D. VLADIMIR HACHINSKI, M.D.PCroolfleesgseorofanMd eCdhicaiinnen,anL,eDxienpgatrotnment of Internal Medicine, University of Kentucky cRailchSacridenacneds,BUenryivl eIrvseityyPorfofWesessotreranndOnCthaariiorm. Uann,ivDeerspiatyrtmHeonstpiotfalC, lLinoincdaol nN. eOunrotalorigoi-ROBERT M. GLICKMAN, M.D. BEVRA HANNAHS HAHN, M.D.sHiceiramna-nin-LCuhdiwefi,g BBeltuhmIgsarartelPHroofsepssitoarl,ofBMosetodnicine, Harvard Medical School; Phy- vPerorsfietsysoorf CofalMifoerdniicai,neL,oDs eApnagrtemleesn, tLoofs MAendgiecliense; Chief of Rheumatology, Uni-MARK A. GOLDBERG, M.D. ROBERT I. HANDIN, M.D.Assistant Professor of Medicine, Harvard Medical School; Associate Physician, OAsnscooclioagtye PDriovfiessisoonr, oBfrMigehdaimcinaen,dHWarovmarednM's eHdoicsaplitSacl,hoBools;tDonirector HematologyBrigham and Women's Hosphal, Boston H. HUNTER HANDSFIELD, M.D.ARY GOLDBERGER, M.D. SPrToDfeCssoonrtroofl MPreodgircainme,, SUenativdeer-sKitiyngofCWouansthyinDgetopnartSmcehnotolofoPf uMbleidciHcienael;thD, iSreecattotlre,rAasesloHcioastpeitParlo, fBesossotronof Medicine, Harvard Medical School; Physician, Beth Is- STEPHEN L. HAUSER, M.D.DAVID W. GOLDE, M.D. oBfetCtyalAifonrkneira,FSifaenPrForfaenscsiosrcoand Chairman, Department of Neurology, UniversityNGlPDerreicovawufdilesausiYroasootnPerrhkoSaofrcfmhHMoaeocmelodlaoiotfcogiMlynoeega.dincCidcoaOTrlnnhSecelcorlaileopUngecnyuei,tvsic;MesrM,seimSetymloorbaMienar-le,KdSAieclttoattelaernnCi-dnKoignlelgDtetgeiPverhi;insyiPgsoirncoCifaoaenfns,scthoeaerrndCoCfoHernMentaeeodlrl-,, BARTON E HAYNES, M.D.LEE GOLDMAN, M.D. AFDrIierDedScetnoRcre, MsAearHrtchahrn,ietiDssuPCkreoenfUetsensrio;vreCroshfiiteyMf,SedcDhiciovionislei;oofnDMiRreehcdetioucrmi,naeBt,aosDliocugryRhaeamsnedarcIhm, mCuenntoelrogfyor;PMHroeosdfpeiicstsianole,r BoafnodsMtCoenhdiiecfi,neD, iHviasrivoanrdofMCeldinicicaallSEcphiodoelm; Vioilcoeg-yC,hBairrimghaanm, DaenpdarWtmoemnet no'sf STEVEN C. HERBERT, M.D. aAnsdsoWcioatmeePnr'sofHesossopritoafl,MBeodsitcoinne, Harvard Medical School; Physician, Brigham

DAFTAR KONTRIBUTOR XVI. CRAIG HENDERSON, M.D. LEWIS L. JUDD, M.D.PPrroofgersasmor, MofoMffietdt-iLcionneg; CHioiisepfitoaflsM, eSdaincaFl rOannccioslcoogy; Director, Clinical Oncology MvearsryityGoilfmCaanlifMoranrisatoant PSraonfeDssieogroa,nLdaCJhoalliarman, Department of Phychiatry, Uni-CHARLES B. HIGGINS, M.D. LEE M. KAPLAN, M.D., Ph.D.CPraoliffeosrsnoira oSfcRhoaodlioolfogMyeadnicdinCeh; iSeafnMFargannectiisccoResonance Imaging, University of cAisnsei,stGanatstrPorionfteessstoinralofUMniet,diMcianses,acHhaursveatrtds GMeendeircaall HSocshpoiotall;, ABsossistotannt in Medi-RAYMOND L. HINTZ, M.D. DENNIS L. KASPER, M.D.UPrnoifveesrssoirtyofScPheodoial torifcsMaenddicHineea;d,StDanivfoisridon of Pediatric Endocrinology, Stanford WLDaiivbllioisraiaomtnoEryol,lfeBrIynrifCgechhtaaimnonusianngDd PiWsreooafsmeesessn,o'rBsoeHfthoMsIpesidrtiaaceli,lneBH,ooHsstaporinvtaalr;d CMoe-DdiicraelctSocrh, oColh:aCnhniienfg,MARTIN S. HIRSCH, M.D. LLOYD H. KASPER, M.D.BProosfteosnsor of Medicine, Harvard Medical School; Massachusetts General Hospital, PHraonfoesvseorr of Medicine, Neurology and Microbiology, Dartmouth Medical School,FRED HOCHBERG, M.D. SATISH KATHPALIA, M.D., F.A.C.P.cAhsussoectitasteGPenroefreaslsoHroosfpiNtaelu, rBoloosgtyo,nHarvard Medical School; Neurologist, Massa- AtHesonssdopicnitigaaltePahnPydrsoiMfceiesasdnoi,craRolfeCnMeanletdeDirc,iivnCieshi,oiUcna.ngioDveerpsaitrytmoefnItllionfoiMs eSdcihcoionle.ofMMicehdaieclineR;eAeste-GARY S. HOFFMAN, M.D. DONALD KAYE, M.D.CFohuanirdmaatino,nD, eCplaervtmeleanntdof Rheumatic and Immunologic Diseases, Cleveland Clinic CKolilnleggheofofferPePnrnosfyelsvsaonriaa,ndPhCilhaadierlmphaina, Department of Medicine, The MedicalJOHN H. HOLBROOK, M.D. GERALD T. KEUSCH, M.D.CPriotyfessor of Internal Medicine, University of Utah School of Medicine, Salt Lake tPirooufsesDsoisreaosfeMs, eNdeicwinEenagnldanCd hMieefdiDcaivl iCsieonnteorf HGoesopgitraalp,hBicosMtoendicine and Infec-MICHAEL F. HOLICK, Ph.D., M.D. MICHAEL B. KIMMEY, M.D.DPBroioasfbteoesntseosUr naoinfvdeMrMseitdeyitcaSibncoehl,oisoPmlh,oyfsDiMoirleeodcgtiyocrinanoedf, BtDhoeesrtmGonaetnoelroaglyC; lCinhiiceafl oRf eEsenadrocchrinCoelnotgeyr,, AWsassohciinagtetonPrSocfehsosoolr ooffMMeeddicicininee; SanedattDleirector of Gl Endoscopy, University ofKING K. HOLMES, M.D., Ph.D. LOUIS V. KIRCHHOFF, M.D.PDriosfeeassseosr. UofniMveerdsiictiyneofaWndasDhiirnegcttoonr, SCcehnotoerl ofofrMAeIdDicSinaen;dSSeeaxttuleally Transmitted VAestseorcainasteAPffraoifreMssoedr icoafl ICnetenrtnearl, IMowedaicCinitey and Staff Physician, Department ofRANDALL K. HOLMES, M.D., Ph.D. J. PHILLIP KISTLER, M.D.CUhnaiviremrsainty, oDfetphaertHmeeanltthofScMieinccroebs,ioBloegthyesadnad Immunology, Unifonned Services Alosgsiostciaanted DPriorefecstosorrofofStNroekueroSloegrvyi,ceH,aMrvaasrsdacMhuesdeicttasl GSecnheoroall; HAossspoictiaalt,eBNosetuorno-THOMAS H. HOSTETTER, M.D. HARVEY G. KLEIN, M.D.DPriovfiessiosonrooffRMeneadlicDinisee,aUsensi,vUernsiivtyersoiftyMHinonsepsiotatal, SMchinonoelaopfolMisedicine; Director, CofhiHefeaDltehp, aBrtemtheenstdoaf Transfusion Medicine, Chnical Center, National InstitutesLYN J. HOWARD, B M., D.Ch., ER.C.P. JAMES P. KNOCHEL, M.D.CPrloinfiecsaslorNouftrMitieodni,cAinlebaannyd MAsesdoiccaialteCoPlrloefgees,soArlboafnPyediatrics; Head, Division of CPreonfteesrs;oCr hoafirImntaenrn, aDl eMpaerdtimciennet, oTfhMe eUdnicivineers,iPtyreosfbyTteexriaasn SHouotshpwiteals,teDrnallMasedicalHOWARD HU, M.D., M.P.H., ScD. HOWARD K. KOH, M.D.CAhssainsntainntg PLraobfeosrsaotorroyf, MBreidghicaimne,anHdarWvaormd eMn'esdHicoaslpSitcahlo, oBl;osAtossnociate Physician, SAUknsisinvoecOriasnitcteyolPoSrgocyhfeoPsosrloosrgoroaffmMD; eeDdrimirceaicnttoeolroa,gnCyd,aPnMcueberdhiPccrieHnveee,anlattnhiod,nBPaounsbdtloiCcnoHnteraollthC; eCntoe-rDiBroecsttoonrGARY W. HUNNINGHAKE, M.D. ANTHONY KOMAROFF, M.D.cPirnoef,esUsonrivoefrsIintyteronfaIloMwaedCicoilnleegaendofDMireedcitcoirn, eP,uIlomwoanaCriytyand Critical Care Medi- MPreodfeicssinoer, oBf rMighedamicinaen,d HWarovmaredn'sMHedoiscpailtaSl,chBoooslt;onDirector, Division of GeneralEDWARD P. INGENITO, M.D., Ph.D. STANLEY J. KORSMEYER, M.D.AtesnssiisvteanCt aPrreofUenssito,rBorfigMhaemdicainned, WHaormvaernd'sMHeodsipciatlalS, cBhoosotlo;nDirector, Medical In- PMreodfeiscsinore,; HSaoiwntarLdouHiusghes Medical Institute, Washington University School ofROLAND H. INGRAM, Jr., M.D. WILLIAM J. KOVACS, M.D.cPirnoef,esEsmororoyf-CMreawdifcoirnde, LEomngorHy oUspniitvael,rsAittylaSnctahool of Medicine; Chief of Medi- sAitsysoScciahtoeolProoffeMsseodricoifneM; eNdaicsihnvei,llDe ivision of Endocrinology, Vanderbilt Univer-CHARLES E. IRWIN, Jr., M.D. STEPHEN M. KRANE, M.D.oPfroPfeedssiaotrriocfs PSecdhioaotrlicosf; MDeirdeicctionre,;DUivniisvieornsitoyf oAfdColaehsfcoernntiaM; eSdainciFnera, nDciespcaortment PPehryssiisc,iCanyraansd, aCndhiMefarAlorwthrBitiHsaUrrnisiot,nMParosfseascshoursoefttMs eGdeinceinrael, HHaorsvpairldalM, BedoisctaolnSchool;KURT J. ISSELBACHER, M.D. DONALD KUFE, M.D.MDiarlelcitnocrk,rModGt HPrCofaenscseorr CoefnMtere,dMicianses,acHhuarsveattrsd GMeneedriaclalHSocsphiotoall,; BPhoystsoincian and Pturtoef,esBsoosrtoonf Medicine, Harvard Medical School; and Dana-Farber Cancer Insti-MARK E. JOSEPHSON, M.D. HELENA KUIVANIEMI, M.D., Ph.D.PErloecfetrsosoprhyosfioMloegdyicIinnseti,tuHtearavnadrdArMrheydtihcmaliaSScheorvoilc;eD, BireetchtoIrs,raeHlaHrvoasrpdi-tTalh,oBrnodstiokne lRoegsye,aJrecfhfeArssosnistManetdiPcraolfeCsosollre,geDeopf aTrthmoemnat s oJfefBfeiorscohnemUisntirvyerasintdy, MPohlielacduelalpr hBiaio-

xvi DAFTAR KONTRIBUTORJ. THOMAS La MONT, M.D. DAN L. LONGO, M.D.Chief. Section of Gastroenterology. The University Hospital. Boston DFNriaertediocetnroiacrl,kCBaionlcoegricIanlstRiteustpe,onFsreedMeroidcikfiCerasnPcerorgRraemse,aDrcihvisainodn DofevCealnocpemreTnrteaCtemnetnert,,LEWIS LANDSBERG, M.D. FREDERICK H. LOVEJOY, Jr., M.D.ItUarvln.iinvCgehrSsici.tayCguoMtteerdiPcraolfeSscshooroal;ndPhCyhsaiciriamna-nin.-DChepieafr,tmNeonrtthowf eMsteedrinciMnee.mNoorritahlwHesotseprin- WPhiyllsiiacmianB-ienr-eCnhbieerfg, PTrhoefeCsshoirldoref nP'sedHiaotsrpicista, lH, aBrovsatrodn Medical School; AssociateH. CLIFEORD LANE, M.D. SHEILA A. LUKEHART, Ph.D.CoInflsiIntmiitcumatleusnDooifrreeHgctueoalral.tthiNo; naCt.ihoNineaaftlioCInnlaisnltiiIctunatsletiMtoufotelAeocllfuelAraglryleRaregntydroaIvnnidfreoIclntoifgoeyucstiSoDeucistsieDoaniss,eesLa.asNebsoa,rtaiNotoInHrayl, RDeisseeaasrecsh, AUsnsiovceirastiety PorfofWesassohrinDgteopnarStmcheonotl ooff MMeeddiicciinnee,, DSeivaitstlieon of InfectiousBethesda LAWRENCE C. MADOFF, M.D.THOMAS J. LAWLEY, M.D. BAHrsoissgipshitataamnlt, PaBnroodsfteWosnsoomr oenf 'Ms eHdoicsipnieta,lH, aDrvivairsdioMn eodficIanlfSeccthiooousl; CDhisaenansiensg, LBaebthoraIstoraryel,oPfroMfeesdsoicrinaen,d ACthlaanintanan, Department of Dermatology, Emory University School JAMES HARVEY MAGUIRE, M.D.ALEXANDER R. LAWTON III, M.D. AansdsoWcioatmeePnr'sofHesossopritoafl,MBeodsitcoinne, Harvard Medical School; Physician, BrighamEafendsdwsoRarrhdoefuCPmSeadttaiohaltlormgicyasn, aVPnradonfdMeesriscborirlotbiniUoPnloeivgdeyiar;striHtiyceaPSdhc,yhDsoioiovllioosgifoyMnaeondfdiPcCaeeldl,liaNMtraiescthavIbmiolllmeisumn;olPorgoy- HENRY J. MANKIN, M.D.J. MICHAEL LAZARUS, M.D. OEdrtihthopMaeAdsichleSyerPvriocfeess,soMr aosfsOacrhthuospetatesdGiceSnuerrgaelryH,oHsparitvaalr,dBMosetdoincal School; Chief,pADisitraselo,cctiBoarotesotfPoCrnolfiensicsaolr Soef rMviecdeisc.iNnee.pHhraorlvoagryd DMievdisicioanl ,SBchriogohla;mSeannidorWPohymseicni'asnHaonsd- FRANCIS L. MARCHLINSKIROBERT SAMUEL LEBOVICS, M.D., F.A.C.S. CCJMloOi-.nDAiSciarE.elcP(PtHorHor,foePnsBsh.o.i)lraMdoefAlMphReiadTicHIineNaer,,tUIMnnsivt.ieDturst.ie,t,yPPohhfi.PlDaedn.en,lpsEyhlivRaan.Cia.SPc.ho(oCl o)f, Medicine;tCiohniefD, isOotrodlearrsy,nNgoaltoiognya,l NInastitoitnuatlesInosftiHtuetaeltohn, BDeetahfensedsas and Other Communica- Professor of Neurology and Chancellor, University of California, San FranciscoRICHARD T. LEE, M.D. JOEL B. MASON, M.D.CAasrsdisitaacntLParboofreastsooryr ,ofBMrigehdaicminaen, dHWarvoamrdenM'sedHiocsapl iStaclh,oBool;stDoinrector Noninvasive Atissts,iUstSanDtAPrHofuersasaour,NDuitvriitsiioonnsRoefseCalricnhicCalenNtuertroitnioAngainndg,GTausfttrsoUenntievreorlsoitgyy,; BSocsiteonn-PHILLIP I. LERNER, M.D. HENRY MASUR, M.D.CCPrlhoeifveeefs,lsaoDnrdivoifsiMonedoicfinIen,feCcatisoeuWs eDstiesrenasReess, eTrvhee UMniovuenrtsitSyinSacihoMoeldoifcaMl eCdiecnitneer;, Chief, Critical Care Medicine Department, National Institutes of Health, BethesdaNORMAN G. LEVINSKY, M.D. ROBERT J. MAYER, M.D.MoWfeaMddeicePadlriocCfienesens;toerPrhaHyndsoiscCpihiatanai-lr,imnB-aCnoh,stiDoenfepaBrotmsteonnt oCfitMy eHdiocsipniet,aBl oasntdonBUonstiovenrsUityniSvecrhsoiotyl PFraorbfeesrsoCranocferMIendsitcitiuntee,aBndosCtolninical Director, Department of Medicine, Dana-MATTHEW E. LEVISON, M.D. JOHN D. McCONNELL, M.D.lPergoefeosfsoPrenofnsMylevdainciian,e PahnidlaCdehlipehf,iaDivision of Infectious Diseases, Medical Col- ASosusothcwiaetestePrrnofMesesdoircaolf CSeunrtgeerr,y,DaDlilvasision of Urology, The University of TexasRICHARD W. LIGHT, M.D. E. R. McFADDEN, Jr., M.D.mPrionfiesstrsaotrioonf MHoesdpiictianle, ,LUonnigveBrseiatcyhof California, Irvine, Physician, Veterans Ad- CCArlreigtvyicelalaJlnBCdeaaremsMPerdoicfeinsseo,rCoafseMWedeisctienme aRnedseDrivreecUtonri,vDerisviitsyioSnchoof oPluolmf oMnaerdyicianned,CHRISTOPHER H. LINDEN, M.D., E.A.C.E.P. JAMES E. McGUIGAN, M.D.AAMssasssoosccaiicaahtteeusCPetrltiosnfiecMsaselodrDicioarfelcMCtoeernd,tieDcrie,npeWa;rotAmrcsesenosttceiorafteEDmierregcetonrc,yTMoxeidciocliongey, USnerivveicresistyanodf CGhaianiremsvainll,eDepartment of Medicine, University of Florida College of Medicine,PETER E. LIPSKY, M.D. NANCY K. MELLO, Ph.D.sDPirtioyvfieossfiosTonre; xoDafsirIeSnctoteuortrnh,awlHeMasrteoedlrdinciCMneeSdaiimncdamlMoCniecsnroAtebrritohalrtoitgDisya;lRlDaesis,reeDacrtacolhrl,aCsRehnetuemr, aTtihce DUisneiavseers- tPMerreo,dfMeicscasLol reSaconhfoHPools,sypcBihtoaosllt,oogBny;e,lCmDoo-enDptairretcmtoenr,t AolfcoPhsoylchainadtryDr(uNgeAurboussceieRnceese),arcHharCvaernd-LEO X. LIU, M.D., D.T.M.H. JERRY R. MENDELL, M.D.ADsisseisatsaenst, PDreopfeasrstmorenoft MofeMdiceidniec,inHe,arBvaerthd MIsreadeilcaHloSscphitoaol,l;BDoisvtiosnion of infectious CProolfleesgseorofanMdedCihcainirem, aCno,luDmepbaurstment of Neurology, The Ohio State UniversityBERNARD LO, M.D. JOHN MENDELSOHN, M.D.etParrltos,fWeUsosnooidrveJorofshiMtnyseodonficCiCnalelii;nfioDcrainrlieacS,tcoShrao, nlParrFosrgaPrnarcomigsrcianomM; ePdhiycasilcEiatnh,icMs;oCffoit-t-DLiroecntgorH, oRsopbi-- MWeindtihcrionpe, RMocekmeofreilalel rSClohaaui-rKinetMtereidnigcaCl aOnncceorloCgeyntaenrd Chairman, Department ofRICHARD M. LOCKSLEY, M.D. JACK H. MENDELSON, M.D.ASDasinvsiosFcioiraantneocfiPsIrcnooffeecstsioorusofDMiseeadsiecsin, eDeapnadrtMmiecnrtoobfioMloegdyicainned, IUmnmivuenrsoiltoygoyf aCnadlifCohrnieiaf,, APrlocfoehsosol ranofdPDsymcghiaAtrbyus(eNeRuersoesacricehncCe)enHtearr,vaMrdcLMeeadnicHalosSpcihtaolo,l,BBelomstoonnt; Co-Director, RICHARD A. MILLER, M.D. CAhssieofc,iaIntefePcrtoiofuesssoDrisoefaMseesdSiceicntieo,nU, nSievaetrtslietyVoAf MWeadshicianlgtConenStecrhoSoelaottfleMedicine;

DAFTAR KONTRIBUTOR xviiJOHN D. MINNA, M.D. DARWIN L. PALMER, M.D.TPrhoefeUssnoivr eorfsiMtyeodficTineexaasndSoPuhtahrwmeascteorlnogMy eadnidcaDl iCreecnttoerr,, SDimalmlaosns Cancer Center, NPreowfesMsoerxiocfoMofedMiceidniecianned, CAhlibeufq, uDeirvqiuseion of Infectious Diseases, University ofJEROME H. MODELL, M.D. JOSEPH E. PARRILLO, M.D.APFlrsoosrfoiedcsiasaotHreeoDafletAhannSefcsoiterhneCcslieionlCioceganylt,eArCfoAfalfliferisgl;ieaAtoiosfsnMosc,eidaGitceaiinnVeei,scveUilnPlierveesrisdietnyt offorFlUorniidvae;rsSiteynioofr JHCaaemradretisoIlBnosgHtyiet;urfCtiech,kiRePfursoShfe-ecPstrsieoosnrboyoftfeMCrireaidntii-ccSaitlneCL,auRrkeues'MsheMMdieecddiinicceaalal nCCdeoMnllteeegdreic;CaChlhiDcieaifrg,eocSteocrt,ioRnusohfJ. P. MOHR, M.D. RICHARD C. PASTERNAK, M.D.CScoilaurmrabPiaroUfensisvoerrsoitfyCNlienuicroalloNgiecuarlolIongsyti,tuCteo,llNegeewoYf oPrhkysicians and Surgeons of tBAivosessitsoCtnaanrtdiPorloofgeyssoanr dofCMardediaiccinRee, hHabairlviatartdioMn,edMicaaslsaScchhuosoelt;tsDGireecnteorralofHPorsepviteanl-,STEPHEN MORSE, Ph.D. PETER L. PERINE, M.D.ttDiiooirnnea,cltAoCtrl,eannDtteiarvifsoiornInoffecSteioxuusallDyisTeraasnessm, CitetendterDsisfeoarseDsisLeaabseorCatoonrtyroRl easnedarcPhre, vNena-- SSPereoravftetilcsese;osPrUroonffieEvspesriosdrietmoyfiooTflrotoghpyei,cHaCleeaPnlttuehbrlSifcocriHeAnecIaDeltsSh, aaBnneddthSMeTsedDda,icUinneivEermsietyritoufs,WUasnhifionrgmtoend,KENNETH M. MOSER, M.D. ROBERT G. PETERSDORF, M.D.PDriorefecstosor,r Pouf lMmeodniacriyn/eC, rSitcihcoaol lCoafrMe eDdiivciisnieo,nU, UniCveSrDsitMy oefdiCcaallifCoernnitaera,tSSaann DDiieeggoo; President, Association of American Medical Colleges, Washington, D C.ARNOLD M. MOSES, M.D. ELIOT A. PHILLIPSON, M.D.NPreowfesYsoorrkoHf eMaletdhicSincieenacned CDeinretecrt,orS, yCrlaicnuicsael Research, Unit, State University of cSiinreJ,oUhnniavnedrsLitaydoyfETaotroonntPor;ofPehsyssoircioafn-Mine-dCihciienfe, aMndouCnhtaiSri,nDaie;pHarotsmpeitnatl,oTf oMroendtio-HARALAMPOS M. MOUTSOPOULOS, M.D. GERALD B. PIER, Ph.D.lPoraonfensisnoar ManeddiHcaeladScohfoMole,dliocainnen,inDae, pGarrtemeceent of Intemal Medicine, University of tAosryso, cBiaritgehPamrofaenssdorWoofmMene'ds icHionsep, itHala,rvBaordstoMn edical School; Channing Labora-ROBERT E MUNFORD, M.D. DANIEL K. PODOLSKY, M.D.PwreosfteesrsnorMoefdIinctaelmCaelnMteer,diDcianlelaasnd Microbiology, The University of Texas South- AUsnsito,cMiataessParcohfeussseotrtsofGMeneedriaclinHeo, sHpaitravla,rdBoMsteodnical School; Chief, GastrointestinalDANIEL M. MUSHER, M.D. RONALD J. POLINSKY, M.D.oCMfheMideifecdiniIcneif,neecHtiaoonuudsstoPDnroifseesassoers oSfeMctiiocnro, bVioeltoegraynsanAdffIamirms uMnoeldoigcya,l BCaeynltoerr;CPorlloefgeessoofr SNSaeennwdiooJrzerARseseyssoecairacthe IDnsitrietuctteo,r,SaHnudmozanPhPahrmaramcaecuotilcoaglys,CDorrpuograStaiofent,yEaDstepHaratnmoevnert,,ROBERT J. MYERBURG, M.D. RONALD E. POLK, Pharm.D.PUrnoifveesrssoirty ooff MMeidamiciinSechaonodl PofhyMsieodliocgiyne,anMdiaDmiriector, Division of Cardiology, VPriorgfeinssiao,r VoifrgPihnaiarmCaocmy manodnwMeaeldtihcinUen,ivSecrhsoitoyl, oRficPhhmaromnadcy, Medical College ofLEE M. NADLER, M.D. MATTHEW POLLACK. M.D.oPgroyf,eDssaonra-oFfaMrbeedr iCciannec,eHr aIrnvsatirtduteM, eBdoicsatol nSchool; Division of Tumor Immunol- EPrdowfeasrsdorHoefbeMrtedSicchionoe,l UofniMfoerdmiceidneS,erBveictheessUdaniversity of the Health Sciences, F.THEODORE ELLIOT NASH, M.D. JOHN T. POTTS, Jr., M.D.BSeenthioersdSacientist, Laboratory of Parasitic Diseases, National Institutes of Health, JCahcikesfo, nMParsosfaecshsuosretotfs CGlienniecraall MHeodsipciitnael,, HBoasrvtoanrd Medical School; Physician-in-LAURENCE NEEDLEMAN, M.D. LAWRIE W. POWELL, M.D.AUlstsroacsioautnedP,rTofheosmsoarsoJfeRffaedrsioonlogUynaivnedrsAitsysoHcioastpeitDali,rePcthoirl,adDeilvpihsiiaon of Diagnostic sPtriotufteessoofr MofeMdiceadlicCineen,teTrh, eBUrinsibvaenresity of Queensland; Director Queensland; In-THOMAS B. NUTMAN, M.D. DARWIN J. PROCKOP, M.D.Senior Investigator, Laboratory of Parasitic Diseases, National Institute of Al- IJPnerfsoftfeietrusssoteonroMfanMeddoiClceahclauiClramorlalMneg,eedDiocefipnaTerh,tmoPmehnaitlsaodJfeelfpBfehiroisacohnemUinstirvyersaintdy;MDoirleecctuolra,r JBeifofelorsgoyn,lergy and Infectious Diseases, National Institutes of Health, Bethesda AMY PRUITT, M.D.JOHN GATES, M.D. cAisnseisatnandt GPrraodfeusastoerHoofspNietaulr,olPohgiyla, dUelnpihviearsity of Pennsylvania School of Medi-tParlo, fNesassohrvailnlde Chairman, Department of Medicine, Vanderbilt University Hospi- LOUIS J. PTACEK, M.D.JERROLD M. OLEESKY, M.D. CDietpyartment of Neurology, The University of Utah School of Medicine, Salt LakePSrcohfoeoslsoorf oMfeMdiecdinicei,nUe nainvdersHiteyado,f CDaivliifsoiornniaofatESnadnocDriiengoolo,gLya aJnodllaMetabolism, JOEL M. RAPPEPORT, M.D.ANDREW B. ONDERDONK, Ph.D. rPorwofeTsrsaonrsopflaMnteadtiiocnineP,roYgarlaemU,nYivaelersiNtyewScHhoavoel nofHMosepdiitcailn,eN; eDwireHctaovre,nBone Mar-AMsiscorocibaitoeloPgryofLesasboorraotofryP,atBhorilgohgaym, HanadrvWardomMeend'sicHalosSpcithaolo, lB; oDstiorenctor, Clinical NEIL H. RASKIN, M.D.STUART H. ORKIN, M.D. Professor of Neurology, University of California, San FransciscoLHeoisapnidtaFl,ikBesosPtroonf;essor Pediatric of Medicine, Harvard Medical School, Children's C. GEORGE RAY, M.D.ROBERT A O'ROURKE, M.D. oPfroMfeesdsoicrinaen,dSCt.hLaiorumisan, Department of Pediatncs, St, Louis University SchoolCTveehrxasaritlsyesHoeCfaoTlntehrxaaSdsciBHerneocaweltnhCDeSncitsieetirnncagetuiSCsahenendtAerPnTrtooenfaeicsohs;oinDrgiorfHecoMtoseprditoiacflisCn,eaS,radTnihoelAoUngtyno,invTieohrseitUy noif-

xviii DAFTAR KONTRIBUTORSHARON LEE REED, M.D. MATTHEW SAMORE, M.D.oADlsioesggoyociLataebPorraotfoersys,orDoifviPsaiothnoolofgIynfaencdtioMuesdiDciisneeasaensd, AUsCsoScDiatMe eDdiirceacltoCrenMteirc,roSbain- Instructor in Medicine, Harvard Medical School; New England Deaconess Hos- pital, BostonANTONIO J. REGINATO, M.D. JAY P. SANEORD, M.D.vRHeoerbasdeitr,ytDWMivoeiosdidiocnaJloohCfnResonhnteeurMmUeadtnoiiclvaoelgrsySi;ctyhPoroooffleMastseoCdraiocmifndMeenea,dniCdcianDmeed,neCtniostorpyerofHNosepwitaJl/erUsenyi-/ PDreoafnesEsomreorfitIunst,emUanlifMoremdeicdinSee,rUvincievserUsintyivoefrsTietyxaosfStohuethHweeasltthernScMieendciecsa,l DSaclhloaosl;RICHARD C. REICHMAN, M.D. DAVID A. SCHEINBERG, M.D., Ph.D.SPrcohfoeoslsoorfoMf eMdeicdiinceineanadndDHenetaisdt,ryIn, feRcoticohuesstDerisease Unit, University of Rochester Chief Leukemia Service, Memorial Sloan-Kettering Cancer Center New YorkNEIL M. RESNICK, M.D. I. HERBERT SCHEINBERG, M.DCCGAelesinsrnoitsienctrata,onllBtoCogPseyrtn,ootfnBeersn,sgohBrarmoofckaMntodendW-iWcoienmseet,nHR'saoHrxvobasurpdriylaMlV,eeGdtieecrraailantsrSiccAhRodoemsli;enaCirschthireafEt,idouDnciavtMiisoienodniacnoadfl SUenniivoerrsLiteyc;tSuerenrioirnRMeseedairccihneAsCsoolclieagtee, oSft LPuhkyes'isc/iRaonos seavnedltSHurogsepoitnasl,, NCeowlumYborikaHERBERT Y. REYNOLDS, M.D. W. MICHAEL SCHELD, M.D.TCMhheeadiirPcmeanlannCs.euDnlvteeaprn,aianHmSeertasnhtteeyoUfnMiveedrsicitiyn;eUannidveJr.siLtyloyHdosHpuitcakl, PTrhoefeMssioltronofSM. Hedeircsihneey, PRreosfiedsesnocry oPfroIgnrtaemrnsa,lUMnivederisciitnyeofanVdirgNineiuaroSscuhrogoelryof aMndediAcisnseo,ciCahtearlCohttaeisrviflolerSTUART RICH, M.D. ALAN L. SCHILLER, M.D.CPrhoifceasgsoorCoofllMegeediocfinMe eadnidciCneh,ieCf,hSiceacgtioon of Cardiology, University of Illinois at MHIreoonsupeniHttaelS,iinnNzaeGiw;ivSYecnohroakonld oJofhMn eLdaiPcoinrtee; GCihvaeinrmParonfeosfsoPr aatnhdolCoghya,irmThane oMf oPuantht oSloingayi,GARY S. RICHARDSON, M.D. ROBERT T. SCHOOLEY, M.D.IannsdtrWucotomreinn'sMHeodsicpiintael,, HBaorsvtaornd Medical School; Associate Physician, Brigham CProolfoersasdoor HoefaMlthedSicciienneceasndCeHnteeard;, DInenfevcetrious Disease Division, University ofHAL B. RICHERSON, M.D. JOHN SPEER SCHROEDER, M.D.sPirtoyfeosfsIoorwoaf IHnotesrpniatallsMaenddicCinlein, iUcsn.ivIoewrsaityCoitfyIowa College of Medicine; Univer- SPtraonfefosrsdor HoofspMiteadl,icSinteanf(oCradrdiology), Stanford University School of Medicine;JAMES M. RICHTER, M.D. ANNE SCHUCHAT, M.D.nAaslsiCstlainnitc,PrMofaessssaocrhuosfeMttsedGiceinneer.alHHarovsapridtaMl, eBdoicsatol nSchool; Chief, Gastrointesti- oMBfaecDdtieicsraeialalsEeapnCiddoeMnmtyriocololotaigncidsDtP,isrMeeavesenenisnt,igoNintai,stiAoantnlaadlnSCtapeenctiearl fPoartIhnofgecetnisouBsraDnicshea, sDesi,viCsieonnteorfsR. PAUL ROBERTSON, M.D. MARC A. SCHUCKIT, M.D.nPorolofegsysoarndofMMeetdaibcoilniesman. dUCneivllerBsiitoyloogfy;MDinirneecstoorta, ,DMiviinsinoenapoof lDisiabetes, Endocri- PCDreiornfeteecsrts,oorLr aAoflJcoPolslhyaoclhiRatersye,aSrcchhoColenotfeMr eSdainciDneie; gUoniVveetresritayn'osfACdamlifionrinsitaraatitoSnanMDeideigcoal;ALLAN H. ROPPER, M.D. PETER H. SCHUR, M.D.NPreoufreoslsoogryo, fSNt.eEurliozlaobgeyt,hT'sufMtsedUinciavleCrseintyteSr,chBooosltoonf Medicine; Chief, Division of BPrroigfehsasmor aonfdMWeodmiceinne's, HHaorsvpairtdal,MBeodsictoanl School; Department of Rheumatology,IRWIN H. ROSENBERG, M.D. DAVID S. SEGAL, Ph.D.PtiroonfeRsseoseraorfchMCedeinctienreo, nNuAtgriitniogn, TaunfdtsPUhynsiivoelrosgityy;, DBioresctotonr, USDA Human Nutri- Professor of Psychiatry, University of California at San Diego; La JollaLEON L. ROSENBERG, M.D. JULIAN I. SEIETER, M.D.President, Bristol Myers Squibb Pharmaceutical Research Institute, Princeton aAnsdsoWcioatmeePnr'sofHesossopritoafl,MBeodsitcoinne, Harvard Medical School; Physician, BrighamWENDELL E ROSSE, M.D. ANDREW P. SELWYN, M.D.FUlnoirveenrcseityReMyneaduicdalMCceAnltiesrt,erDPurrohfaemssor of Medicine and Medical Research, Duke CAastshoectieartiezaPtrioonfe,ssBorrigohfamMeadnidcinWeo, mHeanrv'sarHdoMspeitdailc,alBSoscthoonol; Director of CardiacDANIEL ROTROSEN, M.D. PETER A. SELWYN, M.D., M.P.H.MInfeedcitciaolusOfDfiicsee,asLeasb, oNraattoiornyalofInHsotisttutDe eoffenHseesa,lthN,atBioenthaelsIdnastitute of Allergy and AAHassssvooeccniiaattee PDriorfeecstsoor,r AofIDInStePrnraolgrMamed, icYinalee, UEpniidveemrsiitoyloSgcyhoanodl oPfubMliecdHiceinalet;h,NaenwdJODI ROY, M.S., R.D. MARY-ANN SHAFER, M.D.Frances Stem Nutntion Center, New England Medical Center Hospital, Boston FPDrreoapnfaecrsitssmocroenotf oPfedPieadtriaictsri;csA;ssSocchioaotel oDfirMecetdoirciDneiv;isUionniveorfsiAtydoolfesCceanlitfoMrneiad,icSinaen,ARTHUR H. RUBENSTEIN, M.D. GORDON C. SHARP, M.D.oLfowChelilcaTgoCoPgrigtezskhearlSl cPhrooofel sosforM; eCdhiaciinrme,anChDiceapgaortment of Medicine, University CMCDCMhouiiirsalrseusaiscromtomtououbrrarrsiinia'oHPffASoreIorcrsmthfphRemoirsteoiausstlloenisraoo&rlfacoRnhCgMde,ylhieDMnadaeibinicpcicdslhai,inratRteaCemh;tloieeoElDununimtinmrobeaRbfcetioetnIaolsndorete,gearymrAcD;anhiDltsiMtinairnuneegcdcdultieociTasrirhrnaAeenAd,ritUnnPhtgnrriiobitvfoiCseedesrCyssnioettrLeynrtaoo;ebfrfo;MAMrDaseitsidsorosierccoyciiutanoroteiref-;,JEREMY N. RUSKIN, M.D.AAsrrshoyctihatmeiaPrSoefrevsiscoer, oMfaMsseadchicuisneet,tsHGaervnaerrdal MHeodspiciatall,SBchoosotol;n Director, CardiacARTHUR I. SAGALOWSKY, M.D.vPerorsfietsysoorf oTfexUarsoSlooguythawnedstSeumrgiMcaeldiDcairlecCteonrteorf, RDeanlalalsTransplantation, The Uni-

DAFTAR KONTRIBUTOR xixELIZABETH M. SHORT, M.D. RUP TANDAN, M.D., M.R.C.P.AAfsfsaoicrsia. tWe CashhieinfgMtoend,icDaCl Director for Academic Affairs, Department of Veteran's AAtstseoncdiianteg PNreouferossloogr isotf, NMeeudrioclaolgyC,enUtneirvHerosistpyitaolf oVfeVrmeormntonCto, lBleugrelinofgtMonedicine;GEORGE R. SIBER, M.D. JOEL D. TAUROG, M.D.AMsassosaccihautesetPtsroPfuebslsiocrHeoafltMh eBdioicloigniec, LHabaorvraatrodrieMs,eJdaimcaailcaSPchlaoinol; Director, ACUM.nsesidSvoiieccmriaasmlitteCoynePHsnrotoeAfsrerp;stishAtoartriltt,,eisVnDdeReitpneeagsraertnaPmrshceyAhnsdtiCcmoieafinnntI,iensrPtt,reaamTrtkihaolleannMUdMneMeidvdieecimcrisnaoieltryiCaanelondfHteTIornes,vxpeDaistsaatillgl,SaaoSstuoatlrhe, wHLeiasprtseohrldnyWILLIAM SILEN, M.D. BAYU TEKLU, M.D.Jino-hCnhsoienf;aBndethJoIhsnraseolnHPorsopfietsaslo, rBoofstSounrgery, Harvard Medical School; Surgeon- PSKariounfdgeisSsAaourrdaabUniadniCvehrasiirtmy,aAn,bDhaepBarratnmcehn; tCoofnIsnutletamnatl PMhyesdiicciianne,, ACsoilrlCegeentorfalMHeodsipciitnael,;FRED E. SILVERSTEIN, M.D. STEPHEN F. TEMPLETON, M.D.TPrraoifneisnsgo,r UonfivMeresditiycinoef WanadshDinigrteocntorS,chGoaosltroofinMteesdtiicnianle,ESnedaotstlceopy Fellowship MAsesdisictainnet ,PArotfleasnstoar of Dermatology and Pathology, Emory University School ofKARL L. SKORECKI, M.D., F.R.C.P.(C) E. DONNALL THOMAS, M.D.vDeirrseicttyoro,f DTiovriosnioton, oTfoNroenpthorology, Department of Medicine and Pediatrics; Uni- PHruotfcehsisnosronofCaMnceedricRineeseaErmcherCiteunst,erU, nSievaetrtsleity of Washington; Member, FredTHOMAS L. SLAMOVITS, M.D. LUCY STUART TOMPKINS, M.D.NPMreeoudfreiocslasoolgrCyaennadntedrV,NiNceeeuwrCohsYuaoirrgrmkerayn,, ADlebpeartrtmEiennstteoinf OCpohlltehgaelmoofloMgyedaicnidneP/Mroofenstseofriooref DAaSntisadrsneofcMcotioraidrct,erCoPblirinooiflceoasglsyoMraioncfdroMbImieodmliocuginnyoelLo(aIgbnyfo,ercaSttitooarnuyfs,oSDrdtiasneUfaonsriedvseUrasnnidtiyvGeSrescoihtgyoraoMpl heoidcficMMaleeCddiieccniitnneeer);,CHRISTOPHER A. SLAPAK, M.D. PHILLIP P. TOSKES, M.D.AInssstiistutatne,t PBroosfetosnsor of Medicine, Harvard Medical School and Dana-Farber Cancer PFrloorfiedsas,orGoafinMesevdililceine and Chief, Division of Gastroenterology, University ofJAMES B. SNOW, JR., M.D. GERARD TROMP, M.DNDiarteioctnoarl, INnsattiitounteasl IonfsHtiteuatletho, nBDetehaefsndeass and Other Communication Disorders, JReefsfeerasrocnh AMsesidsitcaanlt CPorolfleesgseoro,fDTehpoamrtamseJnetfofefrBsoionchUenmivisetrrsyityan, dPMhiolaldeceulplahriaBiology,ARTHUR J. SOBER, M.D. E.P. TRULOCK, M.D.oAfssDoecrimataetoPlroogfye,ssMorasosfacDheursmetattsolGogenye, rHalarHvoarsdpitMale,dBicoasltoSnchool; Associate Chief ABasrsnoecsiaHteosPpriotfaels, sSotr LoofuMisedicine, Washington University School of Medicine;FRANK E. SPEIZER, M.D. KENNETH L. TYLER, M.D.ECdhwanandinHg LKaabsosraPtroorfye,ssBorrigohfamMeadnidciWneo, mHeanr'vsaHrdosMpietadli,caBl oSstcohnool; Co-Director, SPrcoiefenscseosr CoefnNteeru;roClhoigeyf,, NMeeudriocliongey, MSeicrrvoicbeio, lVogAy,MUendiivcaelrsCiteynotef rCoDleonravdeor HealthANDREW SPIELMAN, SD DAVID VALLE, M.D.PBroosfteosnsor of Tropical Public Health, Harvard Medical School of Public Health, vBPeraorlsftiietmsysoorSrecohfooPledoiaftrMicesdaicnidneM; oIlnevceuslatirgaBtioorl,ogHyowanadrdGeHnuetgihce, sJoMhnesdiHcaolpkIinnsstiUtuntei-,WALTER E. STAMM, M.D. MAURICE VICTOR, M.D.PfercotfieosussorDoisfeMaseedsi,cHinaer,bUornviiveewrsiMtyedoifcWalaCsheinntgerto, nSeSacthtloeol of Medicine; Head, In- tPirnogfueissshoerdoPfhMyseidciicainneof(NtheeurVoelotegrya)n,s DAadrmtminoiustthratMioend,icWalhiStcehRooivl,erHJaunnocvteior;n Dis-ALLEN C. STEERE, M.D. JAMES F. WALLACE, M.D.PMreodfeicsasol rCeonfteMr eadnidciTnueftasnUd nCivheiersf,ityRhSecuhmooaltoolfogMye/dImicminuen, oBloogstyo,n New England SAPersoastfotelcesisaoter PofhyMsiecidainc-iinne-,chUienfi,veUrsniitvyersoiftyWoafshiWngastohningStocnhooMl edoficaMl edCiecnitneer,,ROBERT S. STERN, M.D. RICHARD J. WALLACE, Jr., M.D,Professor, Department of Dermatology, Beth Israel Hospital, Boston TCyhlaeirrman, Department of Microbiology, University of Texas Health Center,DENNIS L. STEVENS, M.D., Ph.D. PETER D. WALZER, M.D.CPrhoifeefs,sIonrfeocftiMouesdiDciisneea,sUesn,ivVeArsiMtyedoifcaWl Casehnitnegrt,oBnoSiscehool of Medicine, Seattle; PfercotfieosussorDoisfeMaseedsicSiencet,ioUnn, iVveArsMityedoifcaClinCceinntneart,i CCionlcliengneatoif Medicine; Chief, In-GENE H. STOLLERMAN, M.D. LEONARD WARTOFSKY, M.D.BProosfteosnsor of Medicine and Public Health, Boston University; University Hospital, WHPreaoasflehthsinsSogrctoienon,fcDeMsC;eCdihcainiremaann,dDPehpyasritomloengty,ofUMneifdoircmineed, WSaesrhviincgestonUnHiovsepristiatly Coefnttehre,RICHARD M. STONE, M.D. CARL V. WASHINGTON, Jr. M.D.AInssstiistutatne,t PBroosfteosnsor of Medicine, Harvard Medical School and Dana-Farber Cancer AAtslsainsttaant Professor of Dermatology, Emory University School of Medicine,STEPHEN E. STRAUS, M.D.fCehciteiof,usLaDbiosreaatsoersy, oNfaCtiloinnaiclaIlnIsntivteustteisgaotfioHne, aNltaht,ioBneatlhIenssdtaitute of Allergy and In-DAVID H.P. STREETEN, M.D.PNreowfesYsoorrkoHf eMaletdhicSicnieenacnedCHeenatedr,, SSeycrtaiocnusoef Endocrinology, State University ofROBERT A. SWERLICK, M.D.Associate Professor, Department of Dermatology, Emory University School ofMedicine, Atlanta

XX DAFTAR KONTRIBUTORSTEVEN E. WEINBERGER, M.D. SHELDON M. WOLFE M.D.CfAorsristoiEccdaiulactCeaatPiroerno,DfeiDsvseiospriaoorntf,mMBeneettdhiocIfisnrMea,eelHdHiacroivnsaper,idtaalMn,deBdCoiclsiatnolincSaclhDooirle;cAtosrs,oPciualtme oCnhaaryirmanadn SEcnhdoicooltot fPMroefdeiscsionre;anPdhyCsihcaiairnm-iann-C, hDieefp,arNtmewenEt nogflaMndedMiceidniec,alTuCfetsnteUrniBvoesrstoitnyLOUIS WEINSTEIN, M.D., Ph.D. BEVERLY WOO, M.D.SHeonsipoirtaPl,hyBsoicstioann (Emeritus), Department of Medicine, Brigham and Women's aAnsdsisWtaonmt ePnr'osfeHssoosrpiotafl,MBeodsictoinne, Harvard Medical School; Physician, BrighamROBERT A. WEINSTEIN, M.D., EA.C.P. ALASTAIR J. J. WOOD, M.B.Ch.B., FRCP (Edin)sMPirteoydfeoicsfsiCnoerh,iocMfaMgicohedaIneiclfienRceteioeausnesd HDProiossegpariastaeml FaDenildrloeMcwtosehrd,iipcJoaTlinrCat ieUnnintneigvr,ePrCrsoihtgyircaoamgf oI,llDineopiasr/tmUennivt eorf- PNSrcaohsfohevosislloloer foMf Medeidciicnien;e AatntdenPdrionfgesPsohrysoifciaPnh,arVmaancdoelorbgiyl,t VUannidveerrbsiiltty UHnoivsepristiatly,PETER E WELLER, M.D. THEODORE E. WOODWARD, M.D., M.A.C.P.AtiosusoscDiaitseeaPsreo,fDesespoarrtomf eMnteodficMineed, iHcianrev,aBrdethMeIsdriaceall HSocshpoiotall;, DBiovsistoionn of Infec- PHroosfpeistsaolr, oBfaMltiemdoicriene Emeritus, University of Maryland School of Medicine andMICHAEL R. WESSELS, M.D. ROBERT L. WORTMANN, M.D.ABBresistghohcaIimasrteaeaPlndroHfWoessopsmoitreanlo;'fsDMHievodissipciioitnnael,,ofHBoaIrnsvtfoaenrcdtioMuesdiDcaisleSascehso,olC; hAasnsnoicnigateLPabhoyrsaictoiaryn,, oMPfreoMdfeiecsdsaoilcrCinaenend;teCCrhhioaefifrEmMaasentd,eirDcnaelCpaSarretomrvlieincnaet-,oPPfitiMtttCeCdooiucuninntytey,, EMGaresetmeCnoavrriiaolllleinHaoUspniitvael,rsUitynivSecrhsoitoylNICHOLAS J. WHITE, M.B., B.S., B.Sc, M.R.C.P. SHIRLEY H. WRAY, M.D., Ph.D., ER.C.P.WFaeclulcltoymoef MTraohpiidcoall UMneidviecrisnitey,,MOaxhfoidrdol TUronpivicearslitMy,edBicainngekoRkesearch Programme, pNAisetasuolr,coiBvaiotsesutaoPlnroDfeissosordrerosf, NDeeupraorltomgeyn,tHoafrvNaerudroMloegdyi,caMl aSscshaocohlu;seDttisrecGteonr,erUalniHt ofos-rRICHARD J. WHITLEY, M.D. PAUL W. WRIGHT, M.D.MLoiecbrobEimoliongeyn,t UScnhivoelrasritiyn oPfeAdilaatbriacms aanadt BPirromfeinssgohramof, PBeidrmiaitnrigchs,amMedicine and Professor of Family Practice, University of Texas Health Center, TylerGRANT R. WILKINSON, Ph.D. JOSHUA WYNNE, M.D,Professor of Pharmacology, Vanderbilt University School of Medicine, Nashville PDUrenotifrveoesirtssoirtyofScIhnoteorlnaolf MMeeddiicciinnee;aCndhiCefh,ieSfecDtioivnisoiofnCoafrdCioalrodgioyl.oHgya,rpWerayHnoespSittaatle,GORDON H. WILLIAMS, M.D. KIM B. YANCEY, M.D.DPriovfiessiosonr, BofriMgheadmicianned, HWaorvmaerdn'sMHedoiscpailtaSlc, hBooosl;toCnhief, Endocrine-Hypertension SInesntiioturteIsnvoefstHigeaatlothr,, DBeetrhmeastdoalogy Branch, National Cancer Institute, NationalJEAN D. WILSON, M.D. JAMES B. YOUNG, M.D.cCSiohnuaetr;hlCewsheiCsetfae,mrnDeirMvoinseidoSincparolafgCEueenndDtoecirsrtiiDnnoaglluolaigssyheadndCMhaeitraabnodlisPmro, fTehsseoUr noifveInrsteitmy aolf MTeexdais- sPircoifaens,soNroortfhMweesdtiecrinneM, NemorothriwalesHteomspUitanli,veCrhsiitcyagMoedical School; Attending Phy-BRUCE U. WINTROUB, M.D. DORIF. ZALEZNIK, M.D.PSaronfeFsrsaonrcaisncdoC; Ahasisromcaiant,eDDeepaanrtmUeCnStPo/fMDt.erZmioantolMogeyd,icUalniCveernstietry, oSfaCn aFlirfaonmciisacaot lAosgsiisstt,aBntetPhroIsfreaseslorHoosfpMitaeld,icBionset,onHarvard Medical School; Hospital Epidemio-

TIM EDITOR EDISI BAHASA INDONESIADr. PAULUS WIYONO, Ph.D., Sp. PD-KEKUnetiuvaerTsiitmas PGeandejlaithianM, aBdaag/RiaSnUIPlmDu rPeSnayradkjiittoDalam, Fakultas Kedokteran,Dr. TRIWIBOWO, DTMH, Sp.PD-KGerKa. Sub-Bagian/SMF Geriatri, Bagian Ilmu Penyakit Dalam,Fakultas Kedokteran, Universitas Gadjah Mada/RSUP Dr. SardjitoDr. PURWONO RAHARDJO, Sp.PD-KRKa. Sub-Bagian/SMF Rematologi, Bagian Ilmu Penyakit Dalam, FakultasKedokteran, Universitas Gadjah Mada/RSUP Dr SardjitoDr. Hj. SITINURDJANAH MARCHAM, Sp.PDKa. Sub-Bagian/SMF Gastroenterologi/Hepatologi, Bagian Ilmu PenyakitDDarl.amW, FAakHulYtasUKeDdoAktNerAanW, UAniTveIrsitas Gadjah Mada/RSUP Dr SardjitoStaf Pengajar, Bagian Ilmu Penyakit Dalam, Fakultas Kedokteran, UniversitasGadjah Mada/RSUP Dr Sardjito

ATLAS BERWARNAATLAS DERMATOLOGI Stephen F. Templeton / Thomas J. LawleyAAA1 lllL---71le3DsAieUkrdmnrteaiakvtniautrilipsgaaesrtniasAsyisal-Ak1il4At-2lKk-8uiAslDtkianteeerpmuroiamdsteairustmiesmaokiodnAtalAk-3la-l1Pers5goirKiaesArisalt-o9sAiLsli-sk4eebnoDpreolraimknuatsiAtislA-a1tlo6-plOilKcPeiltoiAridila-s5isAErllo-cs1see7amaHdAeimsll-ia1ind1rgoiVtoiikmtilaigmAoel-rA6ahl-D1e2rmAalotiptiessisaebaorreoaitkaAA2 22N--12e83oKpMelirakaostosmissisafuakkntguionliiikdtes A2A-129-24KeLraitmofaokmanatoNmoan-HAod2g-2k0inKaArs2in-o2m5 aKsealrsbiansoaml a Am2e-t2a1staKtiakrsinoma sel skuamosa A2-22 Sarkoma KaposiA3M3eL-l2ae6nsoNimebaveunrsopduigAlam3r -e27nA-3NJ-e3iv1ni ak dan G aAn3a-2s8 Melanoma yang menyebar secara superfisial A3-29 Melanoma maligna lentigo A3-30 displastik Melanoma lentiginosa akralT4AAARio444nPc---e3k53ek8y22onrMyVSIpmaiooefurrikpluineisikstttaaisgiienoAnkAfu4ken-4oA4kd-n334estar9-i4Tg8diiMonAaseoGa4anlo-uk5nsrk3kouAuukr4iKmlosi-kto3skn3eoAdmniF4ltioao-a4gmlid4ikoaiussTleluaimimttnaiisenaavtAAaAe44r4-s--54iAk340o44l-oLK4Erea9runikskMAiorpop4eeil-nlda4aikn5sigaAoSbkAk4eoa-r4k5ba-s5im3ee5sbmKuiHtoaAonefrdr4uapi-lllme4os6minAsaaEi4nmra-ikp4teul1emAmka4Kisn-ka5arn0todAani4diSk-oif3smi6ilisisgoVrpraraanilrmsipseserelaAud4Ao-A4m474-e5-mD31b7erSmaHinfaioemlirsspabeseserkbAzueo4nrsc-dt4aee2krrA5ASk55Pl--e65er66ondyeDLrauemprkmauitsatkieAtrui5istl-eih6tme1raipmtSeoktsuilufenosrroomsdlieisosrtmegmiasAik5A-65A7-56P2-5e7mErfLiitgeuompiduasmbeuurlliottisefamoramtoesusAd5i-s6k3oidEriteAm5a-5n8odDoseurmmatoAm5i-o6s4itiVs askAu5li-t5is9 DAe5r-m6a5toPmeimosfiigtiuss vuAlg5a-6ri0sPA6i6oM-d6ea8rnmAiafkegasannttogasrsiesinnokisguurmilkitanps adAa6-p6e9nMyaikksietdedmaalparamtibial A6-70 Sarkoid A6-71 Neurofibromatosis A6-72 Nekrosis kumarin A6-73ApdAAAnMuoa777eTdor---tmad211aLe0p6aknllAEuauKksKrsmSoaviooanfallanittoBtgouToinunsarramEsrgnCroaenmriMlrotloemihprnumUnaaomAdlarAal7A-eNA1sA7A2o7-7f2-7a-1UE1-8g72luNkKsPuEPooDsdoslleodilitOipnfuipasgoggSaaudiandlsessKetnteainesurdOroamertmeinfPgoaAbutkIAoer7agrs-r7aia9stt-ai1knn3MooAplmoaPe7lnapaf-top2irik2lmAAa aS7V7sAa--ai1r6t7k8ea-orLr3mntPaeoaomrKrilmKoaibpvruaaseplaninnodgaoseinAmnpoyo7aaarm-dmns1aaega4tllommssdKkueaeulakniamrpogsmusuaiatnolnitosigklampioaepbasllaotepetnkrareuenrlcisiraeAluAmrkg7a7posa--u2ile1ol3a0nrAiVAsP7a7iAr-l-i4o77sAre-usE17sU-9ks1oonl5flkAoaourgndPmsueagasnpaloiAmslkot7oaetA-norr2silm7l4iuin-iaa1ossGe1imdnsaadamBnokbusjAiokalnb7olroaau-p5nnksiDpArmAeir8itgTuik-mnsr1LeaoenanApSntaauoeSdrjusauaarfnisgsoPimpnsAEtdaairkr8Moa-dfm1Aao0Enp8WRt-rKi1eyket3IbirKnuaaRrtAnSoen-p8toMAia-rn6tmaioAspaNgoalNanetriuirsdAoFiAp8aUab8-A2te-i1N8tio6-Ok1pDk1tpCilUrkuioGnsilSiscilfkiaaenKeurrtmakeKOtoriiiakfmyPraeasnteIiAtrlne-e8arFmi-los1eper4iensntcrRghAaeel8orti-pn7ptAiiatkid8Asa-td3srpeoitenfOoingmkyoalanpeukgtsiiaaiktltvropWoevrfniiiimralusseroseernktpiuanndAada8see-Ar8nItDrGaASla8r-is1AA-2g88a--Rr41ies5tEaindnMoegapmiolafaitodinpmadpiaAaislb8iae-wt9airkatleRrdeieotAinvnge8iatn-i5nas(AmpADmAAao99iidT)aah--;a16blgiLemlareaAAAsuunopnnkuASfueoiell9osmhmaH-se(i1niiBmaat8iEd)koslaielMHmrkilatArisfihopkAoa9nebnb-iriolT1kstar5eAsmOgt9iamAPkA-Llr1e99ea2nO--kk7t2Auua2GMrst9Hsi-eoISe2trAmeagAlpA9orll9-laneai2-nuses15iumika9sleioPmtmasrKeaiimintaueeyenllmpoagaoaiaikarnddtmliiaoatknabHllleACaodush9Adikte-gise9k1dukm-3imi8ainaksAGA-upH9rmrnAa-ioen3gm9mua-sliP2Aioehae6ls9inosi-tey(s1LAlian6tisk)imopk;irtNufakmorhkeeamaluulatttiair(AnoAnaf9oiAnA)-l;d999Pdmu--eel42oUalng3nrgreAoeNarLsmnn-oiHeetingaumud-rkHa(aieeannom)Audtdlliei9gaamf-ski1iAUsfioi0ntem9osn-ikfSts2osif0Ansiekbiort9eioLr-ksms2iiimAk7atorlf9osoAM-ins1s9iiAi7tk-heSr9leeoNr-ae1mTAekd4atat9rilitoaf-emEf2srieo4lumslAditiSnAie9apoen-9elfig2-lnial11ltene1uLnrkbmoeAearuemmdnkdaeeaiinaa--l

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