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13Edisi Harrison PRINSIP-PRINSIP ILMU PENYAKIT DALAM ( H a r r i s o n ' s Principles of I n t e r n a l M e d i c i n e ) Volume 5 Editor: Kurt J . Isselbacher, A.B., M.D. Mallinckrodt Professor of M e d i c i n e , H a r v a r d M e d i c a l School; Physician a n d D i r e c t o r , Cancer Center, Massachusetts G e n e r a l Hospital, Boston Eugene Braunwaid, A.B., M.D., M.A. (Hon), M.D, (Hon), SCD. (Hon.) Hersey Professor of the Theory a n d Practice of Medicine, H a r v a r d M e d i c a l School; Chairman, D e p a r t m e n t of M e d i c i n e , Brigham a n d Women's Hospital, Boston Jean D. Wilson, M.D. C h a r l e s C a m e r o n Sprague Distinguished C h a i r a n d Professor of Internal M e d i c i n e ; Chief D i v i s i o n of Endocrinology a n d M e t a b o l i s m , The University of Texas Southwestern M e d i c a l Center, D a l l a s Joseph B . Martin, M.D., Ph.D., F.R.C.P. (C), M.A. (Hon.) Professor of Neurology a n d Chancellor, University of California, San F r a n c i s c o Anthony S. Fauci, M.D. D i r e c t o r , N a t i o n a l Institute of Allergy a n d Infectious Diseases; Chief L a b o r a t o r y of Immunoregulation; Director, Office of AIDS Research, N a t i o n a l Institutes of Health, Bethesda Dennis L . Kasper, M.D. William Ellery Channing Professor of M e d i c i n e , H a r v a r d M e d i c a l School; Chief D i v i s i o n of Infectious Diseases, Beth Israel Hospital; Co-Director, Channing L a b o r a t o r y , B r i g h a m a n d Women's Hospital, Boston Editor Edisi Bahasa Indonesia: Prof. Dr. Ahmad. H. Asdie, Sp.PD-KE Guru Besar Ilmu Penyakit Dalam Universitas Gadjah Mada/RSUPDr. Sardjito - YogyakartaPENERBIT BUKU KEDOKTERAN EGC

E G C 775H A R R I S O N ' S P R I N C I P L E SO FI N T E R N A L M E D I C I N E . 13/EInternational edition. Copyright © 1994 by M c G r a w - H i l l Inc.H A R R I S O N P R I N S I P - P R I N S I P I L M U P E N Y A K I T D A L A M . V O L . 5. E/13Published byarrangement with M c G r a w - H i l lBook Co., SingaporeEditor edisi bahasa Indonesia; Prof. Dr. A h m a d H . Asdie, S p . P D - K ECopy editor, d r . V i v i S a d i k i n . d r . H u r i a w a t i H a r t a n t o , d a n R u s m i y a t iH a k cipta terjemahan Indonesia© 1995 Penerbit B u k u Kedokteran E G CDesain kullt muka: Samson P. BarusH a k cipta dilindungi Undang-UndangDilarang mcngutip, memperbanyak danmenerjemahkan sebagian atauseluruh isi buku ini tanpa izin tertulis dari penerbit.C e t a k a n 1: t a h u n 2 0 0 0Perpustakaan Nasional: Katalog Dalam Terbitan ( K D T )H a r r i s o n prinsip-prinsip ilmu penyakit dalam / editor edisi bahasa Inggris, K u r t J. Isselbacher... [etal.] ; editor edisi bahasa Indonesia, A h m a d H . Asdie. - Ed. 13- Jakarta : EGC, 2000. xxii, 651 him. (him. 2092-2742) + (8him. Lampiran & 26 him. Indeks) 5 vol. ; ilus.; 2 1 x 29,7 cm. J u d u l a s l i : H a r r i s o n ' s principles of internal medicine I S B N 979-448-453-9 (no. vol. lengkap) ISBN 979-448-458-X (vol.5) 1. P e n y a k i t d a l a m . I . Isselbacher, K u r t J. II. A s d i e , A h m a d H .616Edisi Bahasa AsingClna (Edisi 12)-McGraw-HillBook Company-Singapore © 1994Indonesia (Edisi 13)-Penerbit B u k u Kedokteran E G C © 1995Itall (Edisi 1 2 ) - M c G r a w - H i l lLibri Italia S.r.l. © 1992Jepang ( E d i s i 11 ) - H i r o k a w a , © 1991Jerman (Edisi 10)-Schwabe andCompany, Ltd., © 1986Perancis (Edisi l2)-Flammarion. © 1992Portugis (Edisi 12)-Editora Guanabara Koogan, S.A., © 1992Spanyol (Edisi l2)-McGraw-Hill/Interamericanade Espana, © 1992Yunani {Edisi 12)-Parissianos. © 1994 (est.)Isi di luar langgung jawab percelakan

A SALUTE TO ROBERT G. PETERSDORF By T h e Editors Of H a r r i s o n ' s .W e d e d i c a l e t h i s t h i r t e e n t h e d i t i o n o f H a r r i s o n ' s Principles o f l i u e r n a l M e d i c i n e t o R o b e r t G . P e t e r s d o r f .Dr. Petersdorf became an editor o f Harrison's in 1968for the preparation o f the sixth edition andserved as E d i t o r - i n - C h i e f o f the tenth edition. H e w a s a powerful force f o rseven editions a n d m o r ethan 2 0 years i n establishing the pivotal role o f this book i n the education o f students, residents andpractitioners o f medicine. Dr. Petersdorf is a graduate o f B r o w n University and o f Yale University Medical School. H i sgraduate training included residencies i nmedicine at Yale a n d at the Peter Bent B r i g h a m Hospital a n da research fellowship at Johns Hopkins. A s Chair o fthe Department o f Medicine at the Universityo fWashington he fashioned one o f the truly great departments o f internal medicine i n the nation, withwell-balanced a n d great strengths i n education, clinical care, a n d research. H i sinterests a n d contribu-tions broadened steadily a n d he served suicessively as the first President o fthe n e w l y merged B r i g h a mand W o m e n ' s Hospital i n B o s t o n , as V i c e Chancellor f o r H e a l t h Sciences a n d D e a n o f the S c h o o l o fMedicine, University o f California, S a n Diego, a n d most recently as President o f the Association o fAmerican Medical Colleges. Dr. Petersdorf has, from the beginning o f his career, made notable a n d outstanding contributionsin a number o fareas i nthe field o f Infectious Disease. H e carried o u ta series o fclassic studies o n thepathogenesis o ffever, o n pneumococcal meningitis and infective endocarditis, and o n the chemopro-phylaxis a n d epidemiology o f gram-negative infections, especially o f the urinary tract.

vi PERINGATAN Ilmu kedokteran selalu berubah. Karena penelitian baru dan pengalaman klinis memperluas pengetahuan kita, diperlukan perubahan dalam pengobatan dan terapi obat. Para penyunting dan penerbit karya ini telah m e n g e c e k pada s u m b e r - s u m b e r y a n g diyakini dapat diandalkan dalam upaya menyajikan informasi yang lengkap dan secara u m u m sesuai dengan standar yang diterima pada saat buku ini diterbitkan.Walaupundemikian, karena a d a n y a k e m u n g k i n a n kesalahan manusiawi atau perubahan ilmu kedokteran, baik penyunting, penerbit, maupun pihak lain yang terlibat dalam persiapan atau penerbitan karya ini tidak dapat m e n j a m i n b a h w a informasi yang dimuat di d a l a m n y a akurat dan lengkap dalam s e m u a hal. P e m b a c a diminta mengkonfirmasikan informasi yang terkandung di d a l a m n y a dengan sumber lain. Misalnya dan teristimewa, pembaca dianjurkan untuk mengecek lembar informasi produk yang disertakan pada bungkus setiap obat yang mereka akan berikan untuk memastikan b a h w a informasi yang dimuat di d a l a m buku ini akurat dan b e l u m pernah ada perubahan dalam hal dosis yang direkomendasikan atau kontraindikasi d a l a m pemberian obat. R e k o m e n d a s i ini t e r u t a m a penting dalam kaitannya dengan obat yang baru atau jarang digunakan. Pembaca juga harus berkonsultasi dengan laboratorium mereka sendiri untuk mengetahui nilai yang normal.

DAFTAR ISI RINGKASDAFTAR KONTRIBUTOR xi VOLUME TIGAKATA PENGANTAR xxi BAGIAN TUJUH VOLUME SATU GANGGUAN PADASISTEM KARDIOVASKULER Seksi 1 Gangguan jantung BAGIANSATU Seksi 2 Gangguan pada sistem vaskuler PENGANTAR ILMU KEDOKTERAN KLINISSeksi BAGIANDUA BAGIAN DELAPANSeksi GANGGUAN SISTEM PERNAPASANSeksi MANIFESTASI UTAMA PENYAKITSeksi BAGIAN SEMBILANSeksi 1 Nyeri PENYAKIT GINJAL DAN SALURAN KEMIHSeksi 2 Perubalian suhu tubutiSeksi 3 Disfungsi sistem saraf VOLUME EMPAT 4 Perubahan fungsi sirl<ulasi dan respirasiSeksi 5 Perubalian fungsi gastrointestinal BAGIAN SEPULUHSeksi 6 Perubahan fungsi berkemih dan elektrolit GANGGUAN SISTEM SALURAN MAKANAN 7 Perubahan dalam fungsi seksual dan reproduksi 8 Perubahan pada kulit 9 Kelainan hematologik BAGIANTIGA Seksi 1 Gangguan saluran makanan GENETIK DAN PENYAKIT Seksi 2 Penyakit hati dan saluran empedu Seksi 3 Gangguan pankreas BAGIAN EMPAT BAGIAN SEBELAS FARMAKOLOGI KLINIS GANGGUAN SISTEM IMUN, JARINGAN IKAT DAN SENDI BAGIAN LIMA GIZI Seksi 1 Gangguan sistem imun Seksi 2 Cidera yang dicetuskan oleh imunitas Seksi 3 Gangguan sendi VOLUME DUA BAGIAN DUA BELAS HEMATOLOGI DAN ONKOLOGI BAGIAN ENAM Seksi PENYAKIT INFEKSI Seksi 1 Kelainan sistem hematopoitik Seksi 2 Gangguan pembekuan 3 Penyakit neoplastikSeksi 1 Tinjauan dasar pada penyakit menularSeksi 2Seksi 3 Sindroma klinis didapat dari komunitas VOLUME LIMASeksi 4Seksi 5 Sindroma klinis—infeksi nosokomial Penyakit bakterial: tinjauan umum Penyakit yang disebabkan oleh bakteri gram- BAGIAN TIGA BELAS ENDOKRINOLOGI DAN METABOLISME positifSeksi 6 Penyakit yang disebabkan oleh bakteri gram- Seksi 1 Endrokrinologi Seksi 2 Gangguan metabolisme antara negatif Seksi 3 Gangguan metabolisme tulang dan mineralSeksi 7 Infeksi bakteri lainSeksi 8Seksi 9 Penyakit mikobakteriumSeksi 10Seksi 11 Penyakit spiroketa BAGIAN EMPAT BELASSeksi 12 GANGGUAN NEUROLOGISeksi 13 Rickettsia, Mycoplasma, dan C h l a m y d i aSeksi 14 Sistem saraf pusatSeksi 15 Penyakit-penyakit virus Gangguan saraf dan ototSeksi 16 Sindroma kelelahan kronik Virus DNA Seksi 1 Gangguan psikiatrik Seksi 2 Alkoholisme dan ketergantungan obat Virus DNA dan RNA pada saluran napas Seksi 3 Seksi 4 Virus RNA Seksi 5 Infeksi jamur Infeksi akibat protozoa dan cacing: pertimbangan umumSeksi 17 Infeksi protozoa BAGIAN LIMA B E L A SSeksi 18 BAHAYA LINGKUNGAN DAN PEKERJAANSeksi 19 Infeksi helmintik (cacing) Ektoparasit

DAFTAR ISIDAFTAR KONTRIBUTOR XI 349 PENYAKIT PENIMBUNAN LISOSOMAL 2312KATA PENGANTAR 2321 xxi Arthur L. Hcaiidet 2327 2339 350 PENYAKIT PENIMBUNAN GLIKOGEN 2348 Arthur L. Beaudet 2353 351 PENYAKIT HEREDITER JARINGAN IKAT 2354 BAGIAN TIGA BELAS Darwin J. Pruckop / Helena Kuivaniemi/GerardENDOKRINOLOGI DAN METABOLISME Tromp 352 PENYAKIT HEREDITER METABOLISME SeksM: Endokrinologi DAN PENYIMPANAN ASAM AMINO Leon E. Rosenberi; 353 PENYAKIT HEREDITER T R A N S P O R329 H O R M O N D A N K E R J A H O R M O N 2092 MEMBRANA Jean D. Wilson Leon E. Rosenberg / Elizabeth M. Short330 PENILAIAN FUNGSI ENDOKRIN 2098 354 DEFISIENSIGALAKTOKINASE, Jean D. WUsim GALAKTOSEMIA, DAN PENYAKIT331 REGULASI N E U R O E N D O K R I N D A N METABOLISME KARBOHIDRAT LAIN PENYAKIT HIPOFISIS ANTERIOR DAN HIPOTALAMUS 2100 YANG JARANG DIJUMPAI Gilbert H. Daniels / Joseph B. Martin Kurt J. Isselbacher 355 LIPODISTROFI DAN PENYAKIT332 KELAINAN PERTUMBUHAN 2130 JARINGAN LEMAKLAIN RiiyuiomI L Hintz YANG JARANG DITEMUKAN333 KELAINAN NEUROHIPOFISIS 2134 Daniel W. Foster Arnold M. Moses / David H. R Strccfeen334 PENYAKITTIROID* 2144Leonard Wartofsky Seksi 3: Gangguan metabolisme tulang dan mineral335 PENYAKIT K O R T E K S ADRENAL 2168 Gordon //. Williams / Robert G DIuhy 356 METABOLISME KALSIUM, FOSFOR,336 FEOKROMOSITOMA 2192 DAN TULANG: HORMON PENGATUR- Lewis iMndsber^ / James B. Young KALSIUM 2359337 DIABETES MELLITUS 2196 Michael F. Holick / Stephen M. Krone / John T. Fotis, Jr. Daniel W Foster338 HIPOGLIKEMIA 2218 357 PENYAKIT KELENJAR PARATIROID Daniel W. Foster / Arthur //. Hubenstein DAN KELAINAN HIRER- DAN339 GANGGUAN TESTIS 2224 HIPOKALSEMIKLAIN 2375 James F.. Griffin / Jean D. Wilson John T. Pom, Jr.340 GANGGUAN OVARIUM DAN SALURAN 358 PENYAKITTUUVNGMETABOLIK 2398REPRODUKSI PEREMPUAN 2236 Stephen M. Krone / Michael F. HolickIlrnce K. Curr / Jean I). Wil.mn 359 KELAINAN METABOLISME FOSFOR 2411341 G A N G G U A N ENDOKRIN PAYUDARA 2255 James F Knochel Jean D. Wilson 360 KELAINAN METABOLISME MAGNESIUM 2415342 GANGGUAN DIFERENSIASI SEKSUAL 2259 James F Knochel Jean D. Wilson / James E. Griffin 361 PENYAKIT P A G E T PADA T U L A N G 2418343 G A N G G U A N SISTEM ENDOKRIN GANDA 2272 Stephen M. Krone Auhny E. ISayd / Roben F. G t i n e l 362 HIPEROSTOSIS, NEOPLASMA, DAN KELAINAN LAIN PADASeksi 2: Gangguan metabolisme antara TUU\NG DAN KARTILAGO 2421 Stephen M. Krane / Alan L Schiller344 HIPERLIPOPROTEINEMIADAN 2278 BAGIAN EMPAT BELAS BERBAGAI GANGGUAN 2290 GANGGUAN NEUROLOGI 2293 METABOLISME LIPID LAIN 363 PENDEKATAN PADA PASIEN 2300 PENYAKIT NEUROLOGI Michael S. Brown / Joseph L. Goldstein 2309 Joseph B. Martin345 HEMOKROMATOSIS 364 DAMPAK NEUROBIOLOGI D A N Uiwric W. I'owell / Kurt J. Isselbacher GENETIKA MOLEKULER PADA NEUROLOGI346 PORFIRIA 2432 Joseph 8. Martin 2435 Roherl J. Desnick347 GOUT DAN GANGGUAN METABOLISME PURIN LAIN Robert L. Wortmann348 PENYAKIT WILSON/. Herbert Scheinber^j

DAFTAR ISI ix Seksi 1: Sistem saraf pusat 385 MIOPATI HEREDITER, METABOLIK, ENDOKRIN, DAN TOKSIK365 PENCITRAAN S I S T E M S A R A F 2441 2627 Jerry R. Mcndell / Robert C. Griggs 2638 Kenneth R. Davi.s / Joseph B. Martin 2641 386 MIASTENIA GRAVIS366 UJI ELEKTROFISIOLOGIK 2447 2644 SISTEM SARAF PUSAT DAN PERIFER 2453 Daniel B. Draclunan Michael J. Aminoff 387 PARALISISPERIODIK367 EPILEPSI DAN GANGGUAN KEJANG Louis J. Piacek / Robert C. Griggs Mem- A. Dichler Seksi 3 : Sindroma kelelahan kronik368 PENYAKIT S E R E B R O V A S K U L E R 2464 388 SINDROMA KELELAHAN KRONIK 2488 J. Pphillip Kistler / Allan //. Rapper / Joseph B. Martin Stephen E . Straus369 PENYAKIT NEOPLASTIK SISTEM SARAF PUSAT Seksi 4 : Gangguan psikiatrik Fred Ilochher / Amy Fruit370 PENYAKIT ALZHEIMER D A NDEMENSIALAIN 2502 2646M. Flini Beal / Edward P. Richardson. Jr / 2509Joseph B. Martin 2514 2521 389 GANGGUAN MENTAL371 P E N Y A K I T P A R K I N S O N D A N SLeewkissi L5. J:uAi l dlkI oK ahr eonliTshamtcheer daB nr i t tko netIergantungan obatGANGGUAN EKSTRAPIRAMIDALLAIN D a v i d L . IIraff in. Flint Beal / J . Stephen Fink/ JM. Flint Beal 390 ALKOHOL D A N ALKOHOLISME 2667 2674372 PENYAKIT N E U R O N M O T O R DAN Marc A. Schuckit 2678ATAKSIAPROGRESIF 391 P E N G G U N A A N O B A T OPIOID 2683Robert II. Brown, J r Marc A. Schuckit / David S. Segal373 MULTIPEL SKLEROSIS DAN 392 KOKAIN D A N OBAT LAIN YANG S E R I N G DISAU\HGUNAKANPENYAKIT DEMIELINASI LAIN Jack II. Mendclson / Nancy K. MelloStephen L Hauser 393 KETERGANTUNGAN NIKOTIN374 MENINGITIS BAKTERIAL D A N John II. HolbrookABSES OTAK 2531W. Michael Schelil375 PENYAKIT VIRUS D A N PRION 2546 BAGIAN LIMA B E L A S DARI SISTEM SARAF 2558 BAHAYA LINGKUNGAN DAN PEKERJAAN Kenneth L Tyler 394 D O K T E R D A N BAHAYA LINGKUNGAN DANTEMPATKERJA376 T R A U M A KERALA D A N T U L A N G BELAKANG Howard Hu / Frank E. Speizer Allan //. Ropper 2568 395 K E R A C U N A N A K U T D A N K E L E B I H A N 2688377 PENYAKIT NUTRISIONAL D A N DOSIS OBAT II. Linden 2691 2713 METABOLIK SISTEM SARAF Frederick //. Lovejoy. J r / Christopher 2719 Maurice Victor / Joseph B. Martin 2726378 SINDROMA N E U R O K U T A N E U S D A N 2732 2734GANGGUAN P E R K E M B A N G A N LAIN 396 KERACUNAN LOGAM BERAT 2736PADA SISTEM SARAF PUSAT 2579 John W. GraffVerne S. Caviness, J r 397 G A N G G U A N YANG DISEBABKAN379 G A N G G U A N S I S T E M S A R A F A U T O N O M 2585 OLEH BISA, GIGITAN, DAN SENGATAN Ronald J. Folinsky / Joseph B. Martin James F. Wallace380 GANGGUAN SARAF KRANIALIS 2588 398 HIPOTERMIADANHIPERTERMIA Maurice Victor / Joseph B. Martin Robert G. Petersdorf381 PENYAKIT M E D U L A SPINALIS 2594 399 T E N G G E L A M D A N Allan II. Ropper / Joseph B. Martin HAMPIRTENGGELAM Jerome H. ModellSeksi 2 : Gangguan saraf dan otot 400 CEDERALISTRIK Alan R. Dimick382 PENDEKATAN T E R H A D A P PASIEN 401 C E D E R A R A D I A S IDENGAN PENYAKIT NEUROMUSKULER 2602 Stuart C. FinchRobert C. Griggs / Waller G. Bradley383 PENYAKIT S I S T E M S A R A F P E R I F E R 2611 LAMPIRAN: NILAI LABORATORIUM KLINIS YANGBERMAKNA Arthur K. Asbury Indeks384 DERMATOMIOSITIS D A N POLIMIOSITIS 2622 L-1 1-1 Rup Tandan / Walter G. Bradley

X ATLAS BERWARNA ^ATLAS DERMATOLOGI Stephen F . Templeton / Thomas J. Lawley1 Lesi dan penyakit kulit umumA l - 1 Alcnc vulgaris A l - 2 Aknerosasea A l - 3 Psoriasis A l - 4 Dermatitis atopik A l - 5 Eksemadishidrotik A l - 6 Dermatitis seboroikA l - 7 Dermatitis stasis A l - 8 Dermatitis kontakalergi A l - 9 Liken planus Al-lOPitiriasis rosea A l - 1 1 Vitiligo A l - 1 2 A l o p e s i a areataA l - 1 3 Urtikaria A l - 1 4 Kista epidermoid A l - 1 5 Keratosis seboroik A l - 1 6 Keloid A l - 1 7 Hemangioma merah2 Neoplasma kulit A2-22 Sarkoma KaposiA2-18 Keratosis aktinik A2-19 Keratoakantoma A2-20 Karsinoma sel basal A2-21 KarsinomaselskuamosaA2-23 Mikosis fungoides A2-24 LimfomaNon-Hodgkin A2-25 Karsinoma metastatik3 Lesi berpigmen-Jinak dan Ganas A3-29 Melanoma maligna lentigo A3-30A3-26 Nevus A3-27 Nevi displastik A3-28 Melanoma yang menyebar secara superfisialMelanoma nodular A3-31 Melanoma lentiginosa akral4 Penyakit infeksi dan kulitA4-32 Impetigo kontagiosa A4-33 Folikulitis A4-34 Erisipelas A4-35 Herpes simpleks A4-36 Varisela A4-37 Herpes zosterA4-38 Veruka A4-39 Moluskum kontagiosum A4-40 Leukoplakia berambut oral A 4 - 4 I Kandidosis oral pseudomembranosa A4-42Tinekorporis A4-43 Tinea kruris A4-44 Tinea versikolor A4-45 Skabies A4-46 Eritema kronik migrans A4-47 Demam berbereakRocky Mountain A4-48 Gonokoksemiadiseminata A4-49 Meningokoksemia fulminan A4-50 Sifilis primer A4-51 Sifilis sekunderA4-52 Sifilis sekunder A4-53 Kondilomalata A4-54 Kankroid A4-55 Kondilomaakuminata5 Penyakit kulit imunologisA5-56 Lupus eritematosus sistemik A5-57 Lupus eritematosus diskoid A5-58 Dermatomiositis A5-59 Dermatomiositis A5-60Skieroderma A5-61 Sklerodcrma A5-62 Eritema multiforme A5-63 Eritema nodosum A5-64 Vaskulitis A5-65 Pemfigus vulgarisA5-66 Dermatitis herpetiformis A5-67 Pemfigoid bulosa6 Manifestasi kulit pada penyakit dalam A6-70 Sarkoid A6-71 Neurofibromatosis A6-72 Nekrosis kumarin A6-73A6-68 Akantosis nigrikans A6-69 Miksedema pratibialPioderma gangrenosumATLAS TEMUAN ENDOSKOPIA7-1 Esofagus normal A7-2 Esofagistis regurgitan peptik A7-3 Karsinoma sel skuamosaberulserasi A7-4 Esofagus moniliasis A7-5Metaplasia Barret pada esofagus dengan adenokarsinoma A7-6 Lambung normal dengan lipatan rugae A7-7 Ulkus gasterluas dan jinakpada kurvatura minor A7-8 Polip gaster A7-9 Malformasi arteriovena pada mukosa gaster A7-10 Pilorus normal A7-11 Bulbusduodenum normal A7-12 Ulkus duodenum A7-13 PapilaVater normal A7-14 Karsinoma periampularis A7-15 Papilotomi endoskopiA7-16 Kolon normal A7-17 Polip adenomatosa kolon A7-18 Polip adenomatosamultipel kecil kolon A7-19 Adenokarsinoma kolonA7-20 Kolitis Crohn A7-21 Kolitisulseratif berat A7-22 Sarkoma Kaposi yang meliputi kolon A7-23 Varises kolon A7-24 Gambarannormal kantong ileumATLAS PEMERIKSAAN FUNDUSKOPIA8-1 Sarafoptik dan retina normal A 8 - 2 Oklusi arteri retina sentral A8-3 Oklusi vena retina sentral A8-4 Edema papil awal A8-5DrMje/iujung saraf optik A8-6 Neuropati optik iskemik anterior A8-7 Atrofi optik primer A8-8 Garis-garis angioid A8-9 Retinitispigmentosa A8-10 Keratopati garis A8-11 Glaukoma lempeng optik dengan atrofi sekunder A8-12 Retinopati diabetik denganmikroaneurisma A8-13 Retinopati diabetik proliferatif A8-14 Retinitis sitomegalovirus pada A I D S A8-15 Malformasi arteriovenaretina pada sindrom Wyburn-Mason A8-16 Cincin Kayser-Fleischer pada penyakit WilsonATLAS HEMATOLOGIA9-1 Apusan darah normal A9-2 Anemia megaloblastik A9-3 Penyakit hati A9-4 Anemia defisiensi besi A9-5 Talasemia intermediaA9-6 Anemia sel sabit A9-7 Hemolisistraumatik A9-8 Anemia sel jpw/- A9-9 Uremia A9-10 Sferositosis herediter A9-11 Ane-mia imunohemolitik A9-12 Metaplasia mieloid A9-13 Granulosit normal (A); monosit dan limfosit normal A9-14 Eosinofil normal(A); basofil (B) A9-15 Prekursor granulosit normal di sumsum A9-16 Neutrofil dengan granulasi toksik A9-17 Netrofil dengan badanDohle A9-18 Hipersegmentasi A9-19 Kelainan Chcdiak-Higashi (A); kelainan Pelger-Hu(e)t A9-20 Limfosit reaktif A9-21 Leuke-mia granulositik kronik A9-22 Sel leukemia pada leukemia promielositik akut A9-23 Leukemia limfositik kronik A9-24 Sel leukemiapada leukemia limfoblastikakut A9-25 Penyakit Hodgkin A9-26 Limfoma nodular Non-Hodgkin A9-27 Mieloma multipel

xiDAFTAR KONTRIBUTORELIAS ABRUTYN, M.D. ARTHUR L. BEAUDET, M.D.Professor and Associate Chairman, Medicine, andVice-Dean for Veterans Professor, Institute f o r Molecule Genetics and Departments o fPediatrics andAffairs, Medical College o f Pennsylvania; Chief, Infectious Diseases, Veterans Cell Biology, Baylor College o fMedicine; Investigator, Howard Hughes MedicalAdministration Medical Center, Philadelphia Institute, HoustonRAYMOND D. ADAMS, B.A., M.A., M.D., M.A. JOHN E. BENNETT, M.D.(Hon.), D.Sc. (Hon.), M.D. (Hon.) Head, Clinical Mycology Section, Laboratory o fClinical Investigation,Bullard Professor o fNeuropathology, Emeritus, Harvard Medical School; National Instituteof Allergy and Infectious Diseases, National Institutes o f Health,Consultant Neurologist, Massachusetts General Hospital; Emeritus Director, BethesdaEunice K . Shriver Research Center, Boston; Medicin AdjointL'Hopital, Cantonalede Lausanne, Lausanne ANDREW BERCHUCK, M.D.MICHAEL J. AMINOFF, M.D. Associate Professor, Division o fGynecologic Oncology, Duke University Medi- cal Center, D u r h a mProfessor o f Neurology; Director, Clinical Neurophysiology Laboratories, Uni-versity o fCalifornia, S a n Francisco MICHAEL S. BERNSTEIN, M.D.MICHAEL A. APICELLA, M.D. Assistant Professor o fMedicine andAnesthesia, Division o fPulmonary and Criti- cal Care Medicine, University o fCalifornia at S a n Francisco Medical Center,Professor and Head, Department o fMicrobiology, University o fIowa College o f San FranciscoMedicine, Iowa City DANIEL G. BICHET, M.D.GORDON L E E ARCHER, M.D. Associate Professor o fMedicine, University o fMontreal; Director, ClinicalR e -Professor o f Medicine and Microbiology/Immunology and Chairman, Division search Unit, Hopital d uSacre-Coeur de Montreal, Montrealof Infectious Diseases, Medical College o fVirginia, Virginia CommonwealthUniversity, Richmond DAVID R. BICKERS, M.D.ARTHUR K. ASBURY, M.D. Professor andChairman, Department o f Dermatology, Case Western Reserve Uni- versity School o fMedicine; Director, Department o fDermatology, UniversityRuth Wagner Van Meter and J. R a y V a nMeter Professor o fNeurology; Vice Hospitals o fCleveland, ClevelandDean for Research, University o fPennsylvania School o fMedicine and Hospitalof theUniversity o fPennsylvania, Philadelphia EDWIN L. BIERMAN, M.D.K. FRANK AUSTEN, M.D. Professor o fMedicine and Head, Division o fMetabolism, Endocrinology and Nutrition, University o f Washington School o fMedicine, SeattleTheodore Bevier Bayles Professor o fMedicine, Harvard Medical School; Chair-man, Department o fRheumatology and Immunology, Brigham and Women's NEIL R. BLACKLOW, M.D.Hospital, Boston Richard M , Haidack Professor o fMedicine and Chairman, Department o f Medi-ROBERT AUSTRIAN, M.D., D.Sci. (Hon.) cine, University o f Massachusetts Medical School, WorcesterJohn Herr Musser Professor and Chairinan Emeritus, Department o f Molecular MARTIN J. BLASER, M.D.and Cellular Engineering, University o f Pennsylvania School o f Medicine,Philadelphia The Addison B . Scoville Professor o f Medicine; Director, Division o f Infectious Diseases and Professor o f Microbiology and Immunology, VanderbiltBERNARD BABIOR, M.D., Ph.D. University School o fMedicine; Staff Physician, Veterans Affairs Medical Center, NashvilleHead, Division o fBiochemistry, Department o fMolecular and ExperimentalMedicine and Member, Division o fHematology and Oncology, Department o f JEAN L. BOLOGNIA, M.D.Medicine, Scripps Clinic and Research Foundation, L a Jolla Associate Professor o fDermatology, Department o f Dermatology, Yale Univer-KAMAL R BADR, M.D. sity School o fMedicine, N e w HavenProfessor o fMedicine, E m o r y University; Chief, Division o f Nephrology, Adanta LAWRENCE F. BORGES, M.D.Veteran's Medical Center; Attending Physician, E m o r y University Hospital,Adanta Associate Professor o fSurgery (Neurosurgery), Harvard Medical School; Asso- ciate Visiting Neurosurgeon, Massachusetts General Hospital, BostonDONALD S. BAIM, M.D. RICHARD C. BOUCHER, Jr., M.D.Associate Professor o fMedicine, Harvard Medical School; Chief, InterventionalCardiology Section, Beth Israel Hospital, Boston Professor o fMedicine and Director, Division o fPulmonary Diseases, Critical Care and Occupational Medicine, University o f North Carolina atChapel Hill;ANN SULLIVAN BAKER, M.D. University o fNorth Carolina Hospitals, Chapel HillAssociate Professor o f Medicine, Harvard Medical School; Director, Infectious AUBREY E. BOYD III, M.D.Diseases Service, Massachusetts E y e and Ear Infirmary; Physician, InfectiousDisease Service, Massachusetts General Hospital, Boston Professor o fMedicine a n dNeuroscience; Chief, Division o f Endocrinology, Diabetes, Metabolism and Molecular Medicine, N e w England Medical Center,ANDREA BALLABIO, M.D. BostonAssociate Professor, Institute forMolecular Genetics and H u m a n Genome Cen- WALTER G. BRADLEY, D.M., F.R.C.P.ter, B a y l o r College o f Medicine, H o u s t o n Professor andChairman, Department o fNeurology, University o fM i a m i SchoolKENNETH J. BART, M.D., M.P.H. of Medicine, MiamiDirector, National Vaccine Program, Office o fthe Assistant Secretary o f Health, HUGH R. BRADY, M.D., Ph.D., F.R.C.P.I.Department o f Health and H u m a n Services, Rockville Assistant Professor o fMedicine, Harvard Medical School; Chief, Renal Section,ROBERT C. BAST, Jr., M.D. BrocktonAVest Roxbury Veteran's Affairs Medical Center; Associate Physician, Brigham and Women's Hospital, BostonR. Wayne Rundle Professor o fMedicine and Director, Duke ComprehensiveCancer Center, Duke University Medical Center, Durham DAVID L. BRAFF, M.D.M. FLINT BEAL, M.D. Professor o f Psychiatry, University o fCalifornia atSanDiego; Director o f Psy- chiatry, U C S D Medical Center San DiegoAssociate Professor o fNeurology, Harvard Medical School; Assistant Neurolo-gist, Massachusetts General Hospital, Boston

x i i DAFTAR KONTRIBUTORKENNETH D. BRANDT, M.D. BRUCE R. CARR, M.D.Professor o fMedicine and Head, Rlieumatology Division, Indiana Univer- Paul C. MacDonald Professor and Director, Division o f Reproductive E n -sity Scliool o fMedicine, Indianapolis; Director, Multipurpose Arthritis and docrinology, Departinent o fObstetrics and Gynecology, T h eUniversity o fMusculoskeletal Diseases Center. Indiana University School o f Medicine, Texas Southwestern Medical Center, DallasIndianapolis AGUSTIN CASTELLANOS, M.D.EUGENE BRAUNWALD, A.B., M.D., M.A. (Hon.), Professor o f Medicine, University o f M i a m i School o f Medicine; Director Clinical Electrophysiology, Jackson Memorial Hospital, MiamiM.D. (Hon.), ScD. (Hon.) ^ VERNE S. CAVINESS, Jr., M.D., Ph.D.Hersey Professor o ftheTheory and Practice o fMedicine, Harvard MedicalSchool; Chairinan, Department o fMedicine, B r i g h a m a n dW o m e n ' s Hospital, Joseph P. a n d Rose F. K e n n e d y Professor o f C h i l d N e u r o l o g y a n d M e n t a lBoston Retardation, Harvard Medical School; C h i e f Pediatric Neurology Service Massachusetts General Hospital, BostonIRWIN M. BRAVERMAN, M.D. JOHN S. CHILD, M.D.Professor, Department o fDermatology, Yale University School o f Medicine,New Haven Professor o fMedicine, School o f Medicine, University o fCalifornia atL o s Angeles; Associate Chief, Division o fCardiology and Director, Adult Car-JAMES L. BRE^ELING, M.D. diac liTiaging andHemodynamics Laboratories, U C L A Medical Center, L o s AngelesAssociate Chief, Medical Service, West Roxbury V A Medical Center, Boston WALLACE A. CLYDE, Jr., M.D.JOEL G. BREMAN, M.D., D.T.P.H. Professor o f Pediatrics and Microbiology, University o f North CarolineD e p u t y Chief, M a l a r i a Branch, D i v i s i o n o fParasitic Diseases, National C e n - Chapel Hillter f o r Infectious Diseases, Centers f o r Disease Control a n d Prevention,Atlanta; Visiting Lecturer, Harvard School o f Public Health, Boston FREDRIC L . COE, M.D.BARRY M. BRENNER, M.D., A.M. (Hon.), D.Sc. Professor o fMedicine andPhysiology a n dChief, Nephrology Program Uni-(Hon.), D.M.Sc. (Hon.) versity o fChicago Pritzker School o fMedicine, ChicagoSamuel A . Levine Professor o f Medicine, Harvard Medical School; Senior ALAN S. COHEN, M.D.Physician and Director, Renal Division, Brighain and Women's Hospital,Boston Distinguished Professor o fMedicine and Rheumatology; Director, Arthritis Center at Boston University School o fMedicine, Boston University SchoolKENNETH R. BRIDGES, M.D. of Medicine, BostonAssistant Professor o f Medicine, Harvard Medical School; Brigham and WILSON COLUCCI, M.D.Women's Hospital, Boston Associate Professor o f Medicine, Harvard Medical School; Physician,KAREN THATCHER BRITTON, M.D., Ph.D. Brigham andWomen's HospitalProfessor o fPsychiatry, University o fCalifornia at S a nDiego, L a Jolla PATRICIA C. COME, M.D.CLAIRE V. BROOME, M.D. Associate Professor o f Medicine, Harvard Medical School; Harvard C o m - munity Health Plan, BostonAssociate Director for Science, Centers f o rDisease Control and Prevention,Atlanta JOEL D. COOPER, M.D.MARTIN M. BROWN, M.A., M.D., M.R.C.P.Senior Lecturer in Neurology, St. George's Hospital Medical School, London Professor o f Surgery and Head, Section o f General Thoracic Surgery, Washington University School o fMedicine; Barnes Hospital, St. LouisMICHAEL S. BROWN, M.D. MAX D. COOPER, M.D.Paul J. T h o m a s Professor, Department o f Molecular Genetics, T h e Univer- Professor o f Medicine, Pediatrics andMicrobiology andHoward Hughes Medi-sity o fTexas Southwestern Medical Center, Dallas cal Institute Investigator, University o fA l a b a m a at Biriningham, B i r m i n g h a mROBERT H. BROWN, Jr., M.D., D.PhiL LAWRENCE COREY, M.D.Associate Professor, Harvard Medical School; Associate Neruologist a n d Professor o fLaboratory Medicine, Microbiology and Medicine, UniversityDirector, Cecil B . D a yLaboratory for Neuromuscular Research, Massachu- of Washington, Seattlesetts General Hospital, Boston MARK A. CREAGER, M.D.H. FRANKLIN BUNN, M.D. Associate Professor o fMedicine, Harvard Medical School; Director, Vascu-Professor o fMedicine, Harvard Medical School; Senior Physician and D i - lar Diagnostic Laboratory, Brigham a n d Women's Hospital, Bostonrector, Hematology Research, B r i g h a m a n d W o m e n ' s Hospital, Boston RONALD G. CRYSTAL, M.D.RONALD M. BURDE, M.D. Webster Professor of Medicine, Cornell University Medical College; AttendingIsidor Tachna Professor and Chairman, Department o f Ophthalmology; Physician, N e w York Hospital; Chief, Division o fP u l m o n a r y a n dCritical CareOphthalmologist and Neuro-ophthalmologist, Albert Einstein College o f Medicine, N e w York Hospital-Cornell Medical Center, N e w yorkMcdicine/Montefiore Medical Center, N e w York JOHN J. CUSH, M.D.JOAN R. BUTTERTON, M.D. Associate Professor o fInternal Medicine, Rheumatic Di.seases Division U n i -Clinical and Research Fellow. Infectious Diseases Unit, Massachusetts versity o fTexas Southwestern Medical Center at Dallas, DallasGeneral Hospital, Boston CHARLES A. CZEISLER, Ph.D., M.D.ALFRED E. BUXTON, M.D. Associate Professor o f Medicine, Harvard Medical School; Physician andProfessor o fMedicine a n dCardiology, T e m p l e University School o f Medicine; Director, Laboratory for Orcadian andSleep Disorders Medicine, BrighamAssociate Chief, Cardiology Section, Temple University Hospital, Philadelphia and Women's Hospital, BostonSTEPHEN B. CALDERWOOD, M.D. THOMAS M. DANIEL, M.D.Associate Professor o f Medicine, Harvard Medical School; Chief, Infec- Professor o f Medicine and International Health, Center for Internationaltious Diseases Unit, Massachusetts General Hospital, Boston Health, C W R U School o fMedicine, ClevelandCHARLES B. CARPENTER, M.D. GILBERT H. DANIELS, M.D.Professor o f Medicine, Harvard Medical School; Director, Laboratory o f Immu- Associate Professor o f Medicine, Harvard Medical School; Physician andnogenetics andTransplantation, Brigham andWoman's Hospital, Boston Co-Director, Thyroid Clinic, Massachusetts General Hospital, Boston

DAFTAR KONTRIBUTOR xiiiROBERT B. DAROFF, M.D. KENNETH H. FALCHUK, M.D.Gilbert W Humphrey Professor and Chairman, Department o f Neurology, Case Associate Professor o f Medicine, Harvard Medical School; Physician, BrighamWeslem Reserve University School o fMedicine; Director, Department o f Neu- and Women's Hospital, Bostonrology, University Hospitals o f Cleveland; Neurology Service Cleveland Veteran'sAdministration Medical Center, Cleveland FERRIC C. FANG, M.D.JOHN R. DAVID, M.D. Assistant Professor o f Medicine and Pathology, University o f Colorado Health Sciences Center; Director, Clinical Microbiology Laboratory, University Hospi-Richard Pearson Strong Professor and Chaiman, Department o fTropical Public tal, DenverHealth, Harvard School o fPublic Health, Boston ANTHONY S. FAUCI, M.D.CHARLES EDWARD DAVIS, M.D. Director, National Institute o fAllergy and Infectious Diseases; Chief, LaboratoryProfessor o f Pathology and Medicine, School o f Medicine, University o f of Immunoregulation; Director, Office o f A I D S Research, National Institute o fCalifornia, SanDiego; Director, Microbiology Laboratory, U C S D Medical Center, Health, BethesdaSan Diego MURRAY J. FAVUS, M.D.KENNETH DAVIS, M.D., EA.C.R. Professor o f Medicine, Sections o f Endocrinology and Nephrology, DepartmentProfessor o fRadiology, Harvard Medical School; Department o f Neuroradiology, of Medicine, University o fChicago Pritzker School o fMedicine, ChicagoMassachusetts General Hospital, Boston THOMAS R FERRIS, M.D.ROBERT L. DERESIEWICZ, M.D. Nesbitt Professor and Chairman. Department o fMedicine, University o f Minne-Instructor i n Medicine, Harvard Medical School; Associate Physician, Brigham sota; University o f Minnesota Hospital and Clinics, Minneapolisand Women's Hospital, Boston BERNARD N. FIELDS, M.D.ROBERT J. DESNICK, Ph.D., M.D. Adele Lehman Professor o fMicrobiology and Molecular Genetics, Professor o fProfessor and Chairman, Department o f Human Genetics, Mount Sinai; School Medicine and Chainnan, Department o f Microbiology and Molecular Genetics,of Medicine; Attending Physician, Mount Sinai; Hospital, N e w York Harvard Medical School, BostonMARC A. DICHTER, M.D , Ph.D. HOWARD L. FIELDS, M.D., Ph.D.Professor o fNeurology andPharmacology, University o fPennsylvania School o f Professor o fNeurology and Physiology andVice Chairman, DeparlmenI o f Neu-Medicine and Graduate Hospital, Philadelphia rology, University o fCalifornia, San FranciscoJULES L. DIENSTAG, M.D. GREGORY A. FILICE, M.D.Associate Professor o fMedicine, Harvard Medical School; Associate Physician Associate Professor o f Medicine and Chief, Infectious Disease Section, Univer-Massachusetts General Hospital; Boston sity o f Minnesota V AMedical Center, MinneapolisALAN R. DIMICK, M.D. ROBERT W. FINBERG, M.D.Professor o fSurgery, University of Alabama at Birmingham; Director, Burn Center Associate Professor o fMedicine, Harvard Medical School; Chief, Laboratory o fUniversity o fAlabama Hospital, Birmingham Infectious Disease, Dana-Farber Cancer Insdtute, BostonCHARLES A. DINARELLO, M.D. STUART C. FINCH, M.D.Professor o f Medicine, Tufts University School o f Medicine; Division o f Geo- Professor o f Medicine, University o f Medicine and Dentistry o f N e w Jersey-graphic Medicine and Infectious Diseases, N e w England Medical Center, Boston Robert W o o d Johnson Medical School andtheCooper Hospital/ University Medi- cal Center, CamdenROBERT G. DLUHY, M.D. J. STEPHEN FINK, M.D.Associate Professor o f Medicine, Harvard Medical School; Associate ProgramDirector o fthe Clinical Research Center, Brigham a n dWomen's Hospital, Boston Associate Professor, Harvard Medical School; Assistant Neurologist, Massachu- setts, General Hospital, BostonRAPHAEL DOLIN, M.D. DANIEL W. FOSTER, M.D.Charles A Dewey Professor o f Medicine; Chair, Department o f Medicine, Uni-versity o fRochester School o fMedicine and Dentistry, Rochester Donald W .Seldin Distinguished Chair in Internal Medicine and Chairman, D e - partment o f Internal Medicine, T h e University o fTexas Southwestern, MedicalDANIEL B. DRACHMAN, M.D. Center, DallasProfessor o f Neurology and Neurosciences and Director, Neuromuscular Unit, MICHAEL M. FRANK, M.D.The Johns Hopkins University School o fMedicine, Baltimore Professor and Chairman, Department o f Pediatrics, Duke University MedicalJEFFREY M. DRAZEN, M.D. Center, DurhamParker B . Francis Professor o f Medicine, Harvard Medical School; Chief, Pul- ARNOLD S. FREEDMAN, M.D.monary Division, Brigham and Women's and Beth Israel Hospitals, Boston Associate Professor o f Medicine, Harvard Medical School; Division o f T u m o rJOHANNA T. DWYER, D.Sc, R.D. Immunology, Dana-Farber Cancer Institute, BostonProfessor o fMedicine andC o m m u n i t y Health, Tufts University School o f Medi- STANLEY D. FREEDMAN, M.D.cine; Professor o f Nutrition, Tufts University School o fNutrition; Senior Scien-tist, U S D A H u m a n Nutrition Research Center o n A g i n g , Tufts University; D i - Clinical Professor o f Medicine, University o f California at S a n Diego; Head,rector, Frances Stern Nutrition Center, N e w England Medical Center Hospital, Division o fInfectious Disease, Scripps Clinic and Research Foundation, L a JollaBoston MICHAEL FREISSMUTH, M.D.VICTOR J. DZAU, M.D. Lecturer, Department o fPharmacology, University o fVienna, ViennaWilliam G , Irwin Professor o f Medicine and Chief, Division o f CardiovascularMedicine, Stanford University School o fMedicine; Stanford University Hospi- GERALD H. FRIEDLAND, M.D.tal, Stanford Director, A I D S Program, Yale University School o fMedicine, N e w HavenBARRY I . EISENSTEIN, M.D. HARVEY MICHAEL FRIEDMAN, M.D.Professor o f Medicine, Indiana University School o f Medicine: Vice President,Lilly Research Laboratories, Indianapolis Chief, Infectious Disease Division, Department o fMedicine, University o f Penn- sylvania School o fMedicine, PhiladelphiaVIRGINIA L. ERNSTER, Ph.D. LAWRENCE S. FRIEDMAN, M.D.Professor and Chair, Department o f Epidemiology and Biostatistics, Universityof California, San Francisco Associate Professor o fMedicine, Harvard Medical School; Associate Physician, Massachusetts General Hospital, Boston

xiv DAFTAR KONTRIBUTORPAUL J. FRIEDMAN, M.D. JOSEPH L. GOLDSTEIN, M.D.Professor o fRadiology, Universily o fCalifornia, San Diego; Paul J Thomas Professor and Chairman, Department o fMolecular Genetics, T h e University o fTexas Southwestern Medical Center, DallasWILLIAM F. FRIEDMAN, M.D. RAJ K. GOYAL, M.D.J H Nicholson Professor o f Pediatrics (cardiology) and Executive Chairman,Department o fPediatrics, University o fCalifornia, Los Angeles School o f Medi- Rabb Professor o f Medicine, Harvard Medical School; Chief, Division o f Gas-cine; University o fCalifornia, L o sAngeles Medical Center, L o s Angeles troenterology, Beth Israel Hospital, BostonLAWRENCE A. FROHMAN, M.D. JOHN W. GRAEF, M.D.Edmund F Foley Professor and Head, Department o f Medicine, University o f Associate Clinical Professor o f Pediatrics, Harvard Medical School; Director,Illinois at Chicago, Chicago The Lead/Toxicology Clinic, T h eChildren's Hospital, BostonROBERT K. GAGEL, M.D. HARRY B. GREENBERG, M.D.Professor o f Medicine and Chief o f Endocrinology Section, T h e University o f Professor o f Medicine and Microbiology and Immunology, Stanford UniversityTexas, M . D . Anderson Cancer Center, Houston Medical Center, StanfordJOHN I . GALLIN, M.D. NORTON J. GREENBERGER, M.D., M.A.C.P.Director, Division o f Intramural Research, National Institute o f Allergy and In- Peter T. Bohan Professor and Chairman, Department o f Medicine, University o ffectious Disease, National Institute o f Health, Bethesda Kansas Medical Center, Kansas CityROBERT C. GALLO, M.D. JOHN S. GREENSPAN, B.D.S, Ph.D., ER.C.Path.Chief, Laboratory o f Tumor Cell Biology, National Cancer Institute, National Professor and Chairman, Department o f Stomatology, University o f Dentistry,Institute o f Health. Bethesda San FranciscoMARC B. GARNICK, M.D. JAMES E. GRIFFIN, M.D.Associate Clinical Professor o f Medicine, Dana-Farber Cancer Institute and Professor o f Internal Medicine, T h e University o fTexas Southwestern MedicalHarvard Medical School; Vice President for Clinical Development, Genetics In- Center, Dallasstitute, Cambridge J. McLEOD GRIFFISS, M.D.JEFFREY A. GELFAND, M.D. Professor o f L a b Medicine and Medicine, University o f California at San Fran-Sara Murray Jordan Professor andVice Chairman, Department o fMedicine, Tufts cisco V A Medical , Center, San FranciscoUniversity School o f Medicine; Associate Physician-in-Chief, N e w EnglandMedical Center,Boston ROBERT C. GRIGGS, M.D.JAMES L. GERMAN HI, M.D. Edward A . and A l m a Vollertsen Rykenboer Professor o f Neurophysiology, Pro- fessor o f Neurology and Medicine, and Chairman, Department o f Neurology,Professor o f Pediatrics, Cornell University Medical College; Director, Labora- University o f Rochester School and Dentistry, University o fRochester Medicaltory o fH u m a n Genetics, N e wYork Blood Center, N e w York Center, RochesterBRUCE C. GILLILAND, M.D. WILLIAM GROSSMAN, M.D.Professor o fMedicine, Professor o fLaboratory Medicine and Adjunct Professor Dana Professor o f Medicine, Harvard Medical School; Chief, Cardiovascularof Microbiology, andAssociate Dean, Clinical Affairs, University o f Washington Division, Beth Israel Hospital, BostonSchool o fMedicine, Seattle JOHN H. GROWDON, M.D.ALFRED G. GILMAN, M.D., Ph.D. Professor o f Neurology, Harvard Medical School; Neurologist and Director,Raymond Willie Distinguished Chair i nMolecular Neuropharmacology: Depart- Memory Disorders Unit, Massachusetts General Hospital, Bostonment o f Pharmacology, T h e University o fTexas Southwestern Medical Center,Dallas SUBHASH C. GULATI, M.D., Ph.D.SID GILMAN, M.D. Associate Professor o fMedicine, Cornell University Medical College; Associate Member and Associate Attending Physician, Memorial Sloan- Kettering CancerProfessor and Chairman, Department o f Neurology, University o f Michigan, Center, N e w YorkAnn Arbor VLADIMIR HACHINSKI, M.D.RICHARD J. GLASSOCK, M.D. Richard and Beryl Ivey Professor andChairman, Department o fClinical Neurologi-Professor and Chairman, Department o f Internal Medicine, University o f Kentucky cal Sciences, University o fWestern Ontario, University Hospital, London, OntarioCollege o fMedicine, Lexington BEVRA HANNAHS HAHN, M.D.ROBERT M. GLICKMAN, M.D. Professor o f Medicine, Department o f Medicine; Chief o f Rheumatology, Uni-Herman Ludwig Blumgart Professor o fMedicine, Harvard Medical School; Phy- versity o fCalifornia, L o sAngeles, L o s Angelessician-in-Chief, Beth Israel Hospital, Boston ROBERT I . HANDIN, M.D.MARK A. GOLDBERG, M.D. Associate Professor o fMedicine, Harvard Medical School; Director, HematologyAssistant Professor o f Medicine, Harvard Medical School; Associate Physician, Oncology Division, Brigham and Women's Hospital, BostonBrigham and Women's Hosphal, Boston H. HUNTER HANDSFIELD, M.D.ARY GOLDBERGER, M.D. Professor o f Medicine, University o f Washington School o f Medicine; Director,Associate Professor o f Medicine, Harvard Medical School: Physician, Beth Is- S T D Control Program, Seattle-King County Department o fPublic Health, Seattlerael Hospital, Boston STEPHEN L. HAUSER, M.D.DAVID W. GOLDE, M.D. Betty Anker Fife Professor andChairman, Department o fNeurology, UniversityProfessor o f Medicine, Cornell University Medical College; Professor o f M o - of California, San Franciscolecular Pharmacology andTherapeutics, Sloan-Kettering Division o fthe CornellGraduate School o fMedical Sciences; Member, Attending Physician, and Head, BARTON F. HAYNES, M.D.Division o f Hematologic Oncology, M e m o r i a l Sloan-Kettering Cancer Center,New York Director, Arthritis Center; Chief, Division Rheumatology and Immunology: Frederic M Hanes Professor o f Medicine; Director, Basic Research, Center forL E E GOLDMAN, M.D. A I D S Research, Duke University School o fMedicine, DurhamProfessor o fMedicine, Harvard Medical School; Vice-Chairman, Department o f STEVEN C. HERBERT, M.D.Medicine andChief, Division o fClinical Epidemiology, Brigham and Women'sHospital, Boston Associate Professor o f Medicine, Harvard Medical School; Physician, Brigham and Women's Hospital, Boston

DAFTAR KONTRIBUTOR XVI. CRAIG HENDERSON, M.D. LEWIS L. JUDD, M.D.Professor o fMedicine; Chief o fMedical Oncology; Director, Clinical Oncology Mary Oilman Marston Professor and Chairman, Department o fPhychiatry, Uni-Program, Moffitt-Long Hospitals, San Francisco versity o fCalifornia at S a n Diego, L a JollaCHARLES B. HIGGINS, M.D. L E E M. KAPLAN, M.D., Ph.D.Professor o f Radiology and Chief, Magnetic Resonance Imaging, University o f Assistant Professor o f Medicine, Harvard Medical School; Assistant in Medi-California School o fMedicine; San Francisco cine, Gastrointestinal Unit, Massachusetts General Hospital, BostonRAYMOND L. HINTZ, M.D. DENNIS L. KASPER, M.D.Professor o fPediatrics and Head, Division o fPediatric Endocrinology, Stanford William Ellery Channing Professor o fMedicine, Harvard Medical School; Chief,University School o fMedicine; Stanford Division o f Infectious Diseases, Beth Israel Hospital; Co-Director, Channing Laboratory, Brigham and Women's Hospital, BostonMARTIN S. HIRSCH, M.D. LLOYD H. KASPER, M.D.Professor o fMedicine, Harvard Medical School; Massachusetts General Hospital,Boston Professor o fMedicine, Neurology andMicrobiology, Dartmouth Medical School, HanoverFRED HOCHBERG, M.D. SATISH KATHPALIA, M.D., RA.C.RAssociate Professor o fNeurology, Harvard Medical School; Neurologist, Massa-chusetts General Hospital, Boston Associate Professor o f Medicine, University o f Illinois School o fMedicine; A t - tending Physician, Renal Division, Department o f Medicine, Michael ReeseGARY S. HOFFMAN, M.D. Hospital and Medical Center. ChicagoChairman, Department o fRheumatic andImmunologic Diseases, Cleveland Clinic DONALD KAYE, M.D.Foundation, Cleveland Klinghoffer Professor and Chairman, Department o f Medicine, T h e MedicalJOHN H. HOLBROOK, M.D. College o fPennsylvania, PhiladelphiaProfessor o f Internal Medicine, University o fUtah School of Medicine, Salt Lake GERALD T. KEUSCH, M.D.City Professor of'Medicine and Chief, Division o f Geographic Medicine and Infec-MICHAEL R HOLICK, Ph.D., M.D. tious Diseases, N e wEngland Medical Center Hospital, BostonProfessor o f Medicine, Physiology and Dermatology; Chief o f Endocrinology, MICHAEL B. KIMMEY, M.D.Diabetes and Metabolism, Director o f the General Clinical Research Center,Boston University School o fMedicine, Boston Associate Professor o f Medicine and Director o f G I Endoscopy, University o f Washington School o f Medicine; SeattleKING K. HOLMES, M.D., Ph.D. LOUIS V. KIRCHHOFF, M.D.Professor o f Medicine and Director, Center forA I D S and Sexually TransmittedDiseases, University o f Washington School o f Medicine; Seattle Associate Professor o f Internal Medicine and Staff Physician, Department o f Veterans Affair Medical Center, Iowa CityRANDALL K. HOLMES, M.D., Ph.D. J. PHILLIP KISTLER, M.D.Chairman, Department o f Microbiology and Immunology, Uniformed ServicesUniversity o f the Health Sciences, Bethesda Associate Professor o f Neurology, Harvard Medical School; Associate Neuro- logist and Director o fStroke Service, Massachusetts General Hospital, BostonTHOMAS H. HOSTETTER, M.D. HARVEY G. KLEIN, M.D.Professor o f Medicine, University o f Minnesota School o f Medicine; Director,Division o f Renal Diseases, University Hospital, Minneapolis Chief Department o fTransfusion Medicine, Clinical Center, National Institutes of Health, BethesdaLYN J. HOWARD, B M., D.Ch., RR.C.P. JAMES R KNOCHEL, M.D.Professor o fMedicine and Associate Professor o f Pediatrics; Head, Division o fClinical Nutrition, Albany Medical College, Albany Professor o f Internal Medicine, T h eUniversity o fTexas Southwestern Medical Center; Chairman, Department o f Medicine, Presbyterian Hospital, DallasHOWARD HU, M.D., M.RH., Sc.D. HOWARD K. KOH, M.D.Assistant Professor o fMedicine, Harvard Medical School; Associate Physician,Channing Laboratory, Brigham and Women's Hospital, Boston Associate Professor o fDermatology, Medicine, and Public Health; Co-Director, Skin Oncology Program; Director, Cancer Prevention andControl Center, BostonGARY W. HUNNINGHAKE, M.D. University Schools o fMedicine and Public Health, BostonProfessor o fInternal Medicine andDirector, Pulmonary andCritical Care Medi- ANTHONY KOMAROFF, M.D.cine, University o fIowa College o fMedicine, Iowa City Professor o f Medicine, Harvard Medical School; Director, Division o f GeneralEDWARD R INGENITO, M.D., Ph.D. Medicine, Brigham and Women's Hospital, BostonAssistant Professor o fMedicine, Harvard Medical School; Director, Medical In- STANLEY J. KORSMEYER, M.D.tensive Care Unit, Brigham and Women's Hospital, Boston Professor, Howard Hughes Medical Institute, Washington University School o fROLAND H. INGRAM, Jr., M.D. Medicine; Saint LouisProfessor o f Medicine, E m o r y University School o f Medicine; Chief o f Medi- WILLIAM J. KOVACS, M.D.cine, Emory-Crawford Long Hospital, Atlanta Associate Professor o fMedicine. Division o fEndocrinology, Vanderbilt Univer-CHARLES E. IRWIN, Jr., M.D. sity School o fMedicine; NashvilleProfessor o fPediatrics; Director, Division o f Adolescent Medicine, Department STEPHEN M. KRANE, M.D.of Pediatrics School o fMedicine; University o fCalifornia; San Francisco Persis, Cyrus, andM a r l o w B Harrison Professor o f Medicine, Harvard Medical School;KURT J. ISSELBACHER, M.D. Physician andChief, Arthritis Unit, Massachusetts General Hospital, BostonMallinckrodt Professor o f Medicine, Harvard Medical School; Physician and DONALD KUFE, M.D.Director, M G H Cancer Center, Massachusetts General Hospital, Boston Professor o fMedicine. Harvard Medical School; and Dana-Farber Cancer Insti-MARK E. JOSEPHSON, M.D. tute, BostonProfessor o f Medicine, Harvard Medical School; Director, Harvard-Thorndike HELENA KUIVANIEMI, M.D., Ph.D.Electrophysiology Institute andArrhythmia Service, Beth Israel Hospital, Boston Research Assistant Professor, Department o f Biochemistry and Molecular Bio- logy, Jefferson Medical College o fThomas Jefferson University, Philadelphia

xvi DAFTAR KONTRIBUTORJ. THOMAS La MONT, M.D. DAN L. LONGO, M.D.Chief, Section o fGastroenterology, The University Hospital, Boston Director, Biological Response Modifiers Program, Division o f Cancer Treatment, National Cancer Institute, Frederick Cancer Research and Development Center,LEWIS LANDSBERG, M.D. FrederickIrving S. Cutter Professor and Chairman, Department o fMedicine, Northwestern FREDERICK H. LOVEJOY, Jr., M.D.University Medical School; Physician-in-Chief, Northwestern Memorial Hospi-tal, Chicago William Berenberg Professor o f Pediatrics, Harvard Medical School; Associate Physician-in-Chief, T h eChildren's Hospital, BostonH. CLIFFORD LANE, M.D. SHEILA A. LUKEHART, Ph.D.Clinical Director, National Institute o fAllergy and Infectious Diseases, NationalInstitutes o fHealth; Chief, Clinical Molecular Rctrovirology Section, Laboratory Research Associate Professor Department o f Medicine, Division o f Infectiousof Immunoregulation, National Institute o f Allergy andInfectious Diseases. N I H . Disea.ses. University o f Washington School o f Medicine, SeattleBethesda LAWRENCE C. MADOFF, M.D.THOMAS J. LAWLEY, M.D. Assistant Professor o fMedicine, Harvard Medical School; Channing Laboratory,Professor andChairman, Department o fDermatology. E m o r y University School Brigham and Women's Hospital, Division o f Infectious Diseases, Beth Israelof Medicine, Atlanta Hospital, BostonALEXANDER R. LAWTON III, M.D. JAMES HARVEY MAGUIRE, M.D.Edward C Stahlman Professor in Pediatric Physiology andCell Metabolism; Pro- Associate Professor o f Medicine, Harvard Medical School; Physician, Brighamfessor o fPediatrics and Microbiology; Head, Division o fPediatric Immunology and Women's Hospital, Bostonand Rheumatology, Vanderbilt University School o fMedical, Nashville HENRY J. MANKIN, M.D.J. MICHAEL LAZARUS, M.D. Edith M Ashley Professor of Orthopaedic Surgery, Harvard Medical School; Chief,Associate Professor o fMedicine, Harvard Medical School; Senior Physician and Orthopaedic Services, Ma.ssachusetts General Ho.spilal, BostonDirector of Clinical Services, Nephrology Division, Brigham andWomen's Hos-pital, Boston FRANCIS L. MARCHLINSKIROBERT SAMUEL LEBOVICS, M.D., RA.C.S. Clinical Professor o fMedicine, Universily o fPennsylvania School o f Medicine; Co-Director, Philadelphia Heart Institute, PhiladelphiaChief, Otolaryngology, National Institute o n Deafness and Other Communica-tion Disorders, National Institutes o f Health, Bethesda JOSEPH B. MARTIN, M.D., Ph.D., RR.C.R (C), M.A. (Hon.)RICHARD T. L E E , M.D. Professor o fNeurology and Chancellor, University o fCalifornia, San FranciscoAssistant Professor of Medicine, Harvard Medical School; Director, NoninvasiveCardiac Laboratory, Brigham and Women's Hospital, Boston JOEL B. MASON, M.D.PHILLIP I. LERNER, M.D. Assistant Professor, Divisions o f Clinical Nutrition andGastroenterology; Scien- tist. U S D A H u m a u Nutrition Research Center o n A g i n g , Tufts University, BostonProfessor o fMedicine, Case Western Reserve University School o f Medicine;Chief, Division o f Infectious Diseases, T h e M o u n t Sinai Medical Center, HENRY MASUR, M.D.Cleveland Chief, Critical Care Medicine Department, National Institutes o f Health, BethesdaNORMAN G. LEVINSKY, M.D. ROBERT J. MAYER, M.D.Wade Professor and Chairman, Department o f Medicine, Boston University Schoolof Medicine; Physician-in-Chief, Boston City Hospital and Boston University Professor o f Medicine and Clinical Director, Department o f Medicine, Dana-Medical Center Hospital, Boston Farber Cancer Institute, BostonMATTHEW E. LEVISON, M.D. JOHN D. McCONNELL, M.D.Professor o fMedicine andChief, Division o fInfectious Diseases, Medical Col- Associate Professor o f Surgery, Division o f Urology, T h e University o f Texaslege o fPennsylvania, Philadelphia Southwestern Medical Center, DallasRICHARD W. LIGHT, M.D. E. R. McFADDEN, Jr., M.D.Professor o fMedicine, University o fCalifornia, Irvine, Physician, Veterans A d - Argyl J Beams Professor o fMedicine and Director, Division o fPulmonary andministration Hospital, Long Beach Critical Care Medicine, Case Western Reserve University School o f Medicine, ClevelandCHRISTOPHER H. LINDEN, M.D., RA.C.E.R JAMES E. McGUIGAN, M.D.Associate Professor o f Medicine; Associate Director, Toxicology Services andAssociate Clinical Director, Department o fEmergency Medicine, University o f Chairman, Department o fMedicine, Universily o fFlorida College o f Medicine,Massachusetts Medical Center, Worcester GainesvillePETER E. LIPSKY, M.D. NANCY K. MELLO, Ph.D.Professor o fInternal Medicine and Microbiology; Director, Rheumatic Diseases Professor o f Psychology, Department o f Psychiatry (Neuroscience). HarvardDivision; Director, Harold C Simmons Arthritis Research Center, T h e Univer- Medical School, Boston; Co-Director, Alcohol and Drug Abuse Research Cen-sity o fTexas Southwestern Medical Center at DaUas, Dallas ter, M c L e a n Hospital, B e l m o n tLEO X. LIU, M.D., D.T.M.H. JERRY R. MENDELL, M.D.Assistant Professor o fMedicine, Harvard Medical School; Division o f Infectious Professor and Chairman, Department o f Neurology, T h eOhio State UniversityDiseases, Department o fMedicine, Beth Israel Hospital, Boston College o fMedicine, ColumbusBERNARD LO, M.D. JOHN MENDELSOHN, M.D.Professor o fMedicine; Director, Program in Medical Ethics; Co- Director, Rob- Winthrop Rockefeller Chair inMedical Oncology andChairman, Department o fert W o o d Johnson Clinical Scholars Program; Physician, Molfitt- L o n g Hospi- Medicine, Memorial SIoau-Kettering Cancer Centertals, University o fCalifornia, S a n Francisco JACK H. MENDELSON, M.D.RICHARD M. LOCKSLEY, M.D. Professor of PsychiaU7 (Neuroscience) Harvard Medical School, Boston; Co-Director,A.ssociate Professor o f Medicine and Microbiology a n d I m m u n o l o g y and Chief, Alcohol andDrug Abuse Research Center, McLean Hospital, BelmontDivision of Infectious Diseases, Department o f Medicine, University o f California,San Francisco RICHARD A. MILLER, M.D. Associate Professor o fMedicine, University o fWashington School o f Medicine; Chief, Infectious Diseases Section, Seatde V A Medical Center, Seattle

DAFTAR KONTRIBUTOR xviiJOHN D. MINNA, M.D. DARWIN L. PALMER, M.D.Professor o fMedicine and Pharmacology andDirector, Simmons Cancer Center, Professor o fMedicine andChief, Division o fInfectious Diseases, Universilyo fT h e Universily o fTexas Southwestern Medical Center, Dallas New Mexico o fMedicine, AlbuquerqueJEROME H. MODELL, M.D. JOSEPH E. PARRILLO, M.D.Professor o fAnesthesiology, College o fMedicine, University o fFlorida; Senior James B Herrick Professor o fMedicine, Rush Medical College; Chief, Section o fAssociate Dean forClinical Affairs; Associate Vice President forUniversity o f Cardiology; Chief, Section o fCritical Care Medicine andMedical Director, RushFlorida Health Science Center AfTiliations, Gainesville Heart Institute, Rush-Presbyterian-St Luke's Medical Center, ChicagoJ. P. MOHR, M.D. RICHARD C. PASTERNAK, M.D.Sciarra Professor o fClinical Neurology, College o fPhysicians and Surgeons o f Assistant Professor o f Medicine, Harvard Medical School; Director o f Preven-Columbia University Neurological Institute, N e w York tive Cardiology and Cardiac Rehabilitation, Massachusetts General Hospital, BostonSTEPHEN MORSE, Ph.D. PETER L. FERINE, M.D.Director, Division o f Sexually Transmitted Diseases Laboratory Research, N a -tional Center forInfectious Diseases, Centers forDisease Control and Preven- Professor o fEpidemiology, Center for A I D S andS T D , University o f Washington,tion, Atlanta Seattle; Professor o fTropical Public Health and Medicine Emeritus, Uniformed Services University o fthe Health Sciences, BethesdaKENNETH M. MOSER, M.D. ROBERT G. PETERSDORF, M.D.Professor of Medicine, School o f Medicine, University of California at San Diego;Director, Pulmonary/Critical Care Division, U C S D Medical Center, San Diego President, Association o fAmerican Medical Colleges, Washington, D C.ARNOLD M. MOSES, M.D. ELIOT A. PHILLIPSON, M.D.Professor o fMedicine and Director, Clinical Research, Unit, State University o f Sir John andLady Eaton Professor o fMedicine andChair, Department o f Medi-N e w York Health Science Center, Syracuse cine, University o fToronto; Physician-in-Chief, M o u n t Sinai; Hospital, TorontoHARALAMPOS M. MOUTSOPOULOS, M.D. GERALD B. PIER, Ph.D.Professor andHead o fMedicine, Department o fIntemal Medicine, University o f Associate Professor o f Medicine, Harvard Medical School; Channing Labora-loannina Medical School, loannina, Greece tory, Brigham and Women's Hospital, BostonROBERT F. MUNFORD, M.D. DANIEL K. PODOLSKY, M.D.Professor o fIntemal Medicine andMicrobiology, T h e University of Texas South- Associate Professor o f Medicine, Harvard Medical School; Chief, Gastrointestinalwestern Medical Center, Dallas Unit, Massachusetts General Hospital, BostonDANIEL M. MUSHER, M.D. RONALD J. POLINSKY, M.D.Chief, Infectious Diseases Section, Veterans Affairs Medical Center; Professor Senior Associate Director, Human Pharmacology, Drug Safety Department,of Medicine andProfessor o fMicrobiology andImmunology, Baylor College o f Sandoz Research Institute, Sandoz Pharmaceuticals Corporation, East Hanover,Medicine, Houston N e w JerseyROBERT J. MYERBURG, M.D. RONALD E. POLK, Pharm.D.Professor o f Medicine and Physiology and Director, Division o f Cardiology, Professor o fPharmacy and Medicine, School o f Pharmacy, Medical College o fUniversity o fMiami School o fMedicine, Miami Virginia, Virginia Commonwealth University, RichmondL E E M. NADLER, M.D. MATTHEW POLLACK. M.D.Professor o f Medicine, Harvard Medical School; Division o fT u m o r I m m u n o l - Professor o fMedicine, Uniformed Services University o fthe Health Sciences, F.ogy, Dana-Farber Cancer Institute, Boston Edward Hebert School o fMedicine, BethesdaTHEODORE ELLIOT NASH, M.D. JOHN T. POTTS, Jr., M.D.Senior Scientist, Laboratory o fParasitic Diseases, National Institutes o f Health, Jackson Professor o fClinical Medicine, Harvard Medical School; Physician-in-Bethesda Chief, Massachusetts General Hospital, BostonLAURENCE NEEDLEMAN, M.D. LAWRIE W. POWELL, M.D.Associate Professor o fRadiology andAssociate Director, Division o f Diagnostic Professor o fMedicine, The University o fQueensland; Director. Queensland; In-Ultrasound, Thomas Jefferson University Hospital, Philadelphia stitute o f Medical Center, BrisbaneTHOMAS B. NUTMAN, M.D. DARWIN J. PROCKOP, M.D.Senior Investigator, Laboratory o f Parasitic Diseases, National Institute o fA l - Professor and Chairman, Department o f Biochemistry and Molecular Biology,lergy and Infectious Diseases, National Institutes o fHealth, Bethesda Jefferson Medical College o f Thomas Jefferson University; Director, Jefferson Institute o f Molecular Medicine, PhiladelphiaJOHN GATES, M.D. AMY PRUITT, M.D.Professor andChairman, Department o fMedicine, Vanderbilt University Hospi-tal, Nashville Assistant Professor o fNeurology, University o f Pennsylvania School o f Medi- cine and Graduate Hospital, PhiladelphiaJERROLD M. OLEFSKY, M.D. LOUIS J. PTACEK, M.D.Professor o f Medicine and Head, Division o f Endocrinology and Metabolism,School o fMedicine, University o fCaUfornia at S a n Diego, L a Jolla Department o fNeurology, T h e University o fUtah School o f Medicine, Salt Lake CityANDREW B. ONDERDONK, Ph.D. JOEL M. RAPPEPORT, M.D.Associate Professor o f Pathology, Harvard Medical School; Director, ClinicalMicrobiology Laboratory, Brigham andWomen's Hospital, Boston Professor o fMedicine, Yale University School o f Medicine; Director, Bone Mar- row Transplantation Program, Yale N e w Haven Hospital, New HavenSTUART H. ORKIN, M.D. NEIL H. RASKIN, M.D.Leiand Fikes Professor Pediatric of Medicine, Harvard Medical School, Children'sHospital, Boston; Professor o fNeurology, University o fCalifornia, San FransciscoROBERT A O'ROURKE, M.D. C. GEORGE RAY, M.D.Charles Conrad B r o w n Distinguished Professor o fMedicine, T h eUniversity o f Professor and Chairman, Department o fPediatrics, St. Louis University SchoolTexas Health Science Center at S a n Antonio; Director o fCardiology, T h e Uni- of Medicine, St. Louisversity o fTexas Health Science Center Teaching Hospitals, San Antonio

xviii DAFTAR KONTRIBUTORSHARON L E E REED, M.D. MATTHEW SAMORE, M.D.Associate Professor o f Pathology andMedicine andAssociate Director, Microbi- Instructor inMedicine, Harvard Medical School; N e w England Deaconess Hos-ology Laboratory, Division o f Infectious Diseases, U C S D Medical Center, San pital, BostonDiego JAY P. SANFORD, M.D.ANTONIO J. REGINATO, M.D. Professor o f Internal Medicine, University ofTexas Southwestern Medical School;Head, Division o fRheumatology; Professor o fMedicine, Cooper Hospital/ Uni- Dean Emeritus, Unifonned Services University o fthe Health Sciences, Dallasversity Medical Center, University o f Medicine and Dentistry o f N e w Jersey/Robert W o o d Johnson Medical School at Camden, Camden DAVID A. SCHEINBERG, M.D., Ph.D.RICHARD C. REICHMAN, M.D. Chief, Leukemia Service, M e m o r i a l Sloan-Kettering Cancer Center, N e w YorkProfessor o f Medicine andHead, Infectious Disease Unit, University o f Rochester I. HERBERT SCHEINBERG, M.DSchool o fMedicine andDentistry, Rochester Senior Lecturer in Medicine College o f Physicians and Surgeons, ColumbiaNEIL M. RESNICK, M.D. University; Senior Research Associate, St Luke's/Roosevelt Hospital, N e w YorkAssistant Professor o f Medicine, Harvard Medical School; Chief, Division o f W. MICHAEL SCHELD, M.D.Gerontology, Brigham andWomen's Hospital, Geriatric Research Education andClinical Center, Brockton-West Roxbury Veterans Administration Medical Professor o f Internal Medicine and Neurosurgery and Associate Chair forCenter, Boston Residency Programs, University o fVirginia School o fMedicine, CharlottesvilleHERBERT Y. REYNOLDS, M.D. ALAN L . SCHILLER, M.D.Chairman, Department o f Medicine and J. L l o y d Huck Professor o f Medicine, Irene Heinz Given andJohn LaPorte Given Professor and Chairman o f Pathology,The Pennsulvania State University; University Hospital, The Milton S. Hershey Mount Sinai; School o f Medicine; Chairman o f Pathology, T h e Mount SinaiMedical Center, Hershey Hospital, N e w YorkSTUART RICH, M.D. ROBERT T. SCHOOLEY, M.D.Professor o fMedicine a n dChief, Section o f Cardiology, University o fIllinois at Professor o f Medicine and Head, Infectious Disease Division, University o fChicago College o fMedicine, Chicago Colorado Health Sciences Center; DenverGARY S. RICHARDSON, M.D. JOHN SPEER SCHROEDER, M.D.Instructor i n Medicine, Harvard Medical School; Associate Physician, Brigham Professor o f Medicine (Cardiology), Stanford University School o f Medicine;and Women's Hospital, Boston Stanford Hospital, StanfordHAL B. RICHERSON, M.D. ANNE SCHUCHAT, M.D.Professor o f Internal Medicine, University o fIowa College o fMedicine; Univer- Medical Epidemiologist, Meningitis and Special Pathogens Branch, Division o fsity o fIowa Hospitals andClinics, Iowa City Bacterial andMycotic Diseases, National Center for Infectious Diseases, Centers of Disease Control and Prevention, AtlantaJAMES M. RICHTER, M.D. MARC A. SCHUCKIT, M.D.Assistant Professor o fMedicine, Harvard Medical School; Chief, Gastrointesti-nal Clinic, Massachusetts General Hospital, Boston Professor o f Psychiatry, School o f Medicine; University o f California at San Diego; Director, Alcohol Research Center, SanDiego Veteran's Administration MedicalR. PAUL ROBERTSON, M.D. Center, L a JollaProfessor o f Medicine andCell Biology; Director, Division o f Diabetes, Endocri- PETER H. SCHUR, M.D.nology andMetabolism, University o fMinnesota, Minneapolis Professor o fMedicine, Harvard Medical School; Department o f Rheumatology,ALLAN H. ROPPER, M.D, Brigham and Women's Hospital, BostonProfessor o fNeurology, Tufts University School o fMedicine; Chief, Division o f DAVID S. SEGAL, Ph.D.Neurology, St.Elizabeth's Medical Center, Boston Professor o fPsychiatry, Universily o fCalifornia at S a nDiego; L a JollaIRWIN H. ROSENBERG, M.D. JULIAN I. SEIFTER, M.D.Professor o f Medicine, Nutrition andPhysiology; Director, U S D A H u m a n Nutri-tion Research Center on Aging, Tufts University, Boston Associate Professor o fMedicine, Harvard Medical School; Physician, Brigham and Women's Hospital, BostonLEON L. ROSENBERG, M.D. ANDREW P. SELWYN, M.D.President, Bristol Myers Squibb Pharmaceutical Research Institute, Princeton Associate Professor o fMedicine, Harvard Medical School; Director o f CardiacWENDELL E ROSSE, M.D. Catheterization, Brigham and Women's Hospital, BostonFlorence Reynaud McAlister Professor o f Medicine and Medical Research, Duke PETER A. SELWYN, M.D., M.P.H.University Medical Center, D u r h a m Associate Professor o fInternal Medicine, Epidemiology andPublic Health, andDANIEL ROTROSEN, M.D. Associate Director, A I D S Program, Yale University School o f Medicine; N e w HavenMedical Office, Laboratory o fHost Defenses, National Institute o fAllergy andInfectious Diseases, National Institute o f Health, Bethesda MARY-ANN SHAFER, M.D.JODI ROY, M.S., R.D. Professor o f Pediatrics; Associate Director, Division o f Adolescent Medicine, Department o f Pediatrics; School o f Medicine; University o f California, S a nFrances Stem Nutrition Center, N e w England Medical Center Hospital, Boston FranciscoARTHUR H. RUBENSTEIN, M.D. GORDON C. SHARP, M.D.Lowell T Coggeshall Professor; Chairman Department o f Medicine, University Curators' Professor and Michael Einbender Distinguished Professor of Medicine;of Chicago Pritzker School o fMedicine, Chicago Director o fImmunology andRheumatology; Director. Arthritis Center; Director, Missouri Arthritis Rehabilitation Research and Traning Center; AssociateJEREMY N. RUSKIN, M.D. Chairman for Research, Department o f Internal Medicine, University of Missouri- Columbia School o f Medicine; Director, Antinuclear Antibody Laboratory o fAssociate Professor o f Medicine, Harvard Medical School; Director, Cardiac Missouri Hospital & Clinics, ColumbiaArrhythmia Service, Massachusetts General Hospital, BostonARTHUR I. SAGALOWSKY, M.D.Professor o fUrology and Surgical Director o fRenal Transplantation, T h e Uni-versity o fTexas Southwestern Medical Center, Dallas

DAFTAR KONTRIBUTOR xixELIZABETH M. SHORT, M.D, RUP TANDAN, M.D., M.R.C.P.Associate Chief Medical Director for Academic Affairs, Department o f Veteran's Associate Professor o fNeurology, University o fVermont College o f Medicine;Affairs, Washington, D C Attending Neurologist, Medical Center Hospital o fVermont, BurlingtonGEORGE R. SIBER, M.D. JOEL D. TAUROG, M.D.Associate Professor o f Medicine, Harvard Medical School; Director, Associate Professor, Department o f Internal Medicine and Investigator, HaroldMassachusetts Public Health Biologic Laboratories, Jamaica Plain C. Simmons Arthritis Research Center, T h e University o f Texas Southwestern Medical Center; Attending Physician, Parkland Memorial Hospital, Sale LipshyWILLIAM SILEN, M.D. University Hospital, Veterans Administration Medical Center, DallasJohnson and Johnson Professor o f Surgery, Harvard Medical School; Surgeon- BAYU TEKLU, M.D.in-Chief; Beth Israel Hospital, Boston Professor andChairman, Department o fIntemal Medicine, College o f Medicine;FRED E. SILVERSTEIN, M.D. King Saud University, Abha Branch; Consultant Physician, Asir Central Hospital, Saudi ArabiaProfessor o f Medicine and Director, Gastrointestinal Endoscopy FellowshipTraining, University o fWashington School o fMedicine, Seatde STEPHEN F. TEMPLETON, M.D.KARL L. SKORECKI, M.D., F.R.C.P.(C) Assistant Professor o fDermatology and Pathology, E m o r y University School o f Medicine, AtlantaDirector, Division o fNephrology, Department o fMedicine and Pediatrics; Uni-versity o f Toronto, Toronto E. DONNALL THOMAS, M.D.THOMAS L. SLAMOVITS, M.D. Professor o f Medicine Emeritus, University o f Washington; Member, Fred Hutchinson Cancer Research Center, SeattleProfessor and Vice Chairman, Department o f Ophthalmology and Professor o fNeurology and Neurosurgery, Albert Einstein College o f Medicine/Montefiore LUCY STUART TOMPKINS, M.D.Medical Center, N e w York Associate Professor o fMedicine (Infectious Diseases andGeographic Medicine)CHRISTOPHER A. SLAPAK, M.D. and Microbiology and Immunology, Stanford University School o f Medicine; Director, Ctinical Mibrobiology Laboratory, Stanford University Medical Center,Assistant Professor of Medicine, Harvard Medical School andDana-Farber Cancer StanfordInstitute, Boston PHILLIP p. TOSKES, M.D.JAMES B. SNOW, JR., M.D. Professor o f Medicine and Chief, Division o f Gastroenterology, University o fDirector, National Institute o n Deafness and Other Communication Disorders, Florida, GainesvilleNational Institutes o fHealth, Bethesda GERARD TROMP, M.DARTHUR J. SOBER, M.D. Research Assistant Professor, Department o f Biochemistry andMolecular Biology,Associate Professor o fDenmatology, Harvard Medical School; Associate Chief Jefferson Medical College o fThomas Jefferson University, Philadelphiaof Dermatology, Massachusetts General Hospital, Boston E.R TRULOCK, M.D.FRANK E . SPEIZER, M.D. Associate Professor o f Medicine, Washington University School o f Medicine;Edwad H Kass Professor o f Medicine, Harvard Medical School; Co-Director, Barnes Hospital, St LouisChanning Laboratory, Brigham and Women's Hospital, Boston KENNETH L. TYLER, M.D.ANDREW SPIELMAN, SD Professor o fNeurology, Medicine, Microbiology, University o fColorado HealthProfessor o fTropical Public Health, Harvard Medical School o f Public Health, Sciences Center; Chief, Neurology Service, V A Medical Center, DenverBoston DAVID VALLE, M.D.WALTER E. STAMM, M.D. Professor o fPediatrics andMolecular Biology andGenetic, Johns Hopkins Uni-Professor o fMedicine, University o fWashington School o fMedicine; Head, In- versity School o f Medicine; Investigator, Howard Hughes Medical Institute,fectious Diseases, Harborview Medical Center, Seattle BaltimoreALLEN C. STEERE, M.D. MAURICE VICTOR, M.D.Professor o f Medicine and Chief, RheumatologyAmmunology, N e w England Professor o fMedicine (Neurology), Dartmouth Medical School, Hanover; Dis-Medical Center andTufts University School o fMedicine, Boston tinguished Physician o fthe Veterans Administration, White River JunctionROBERT S. STERN, M.D. JAMES E WALLACE, M.D.Professor, Department o fDermatology, Beth Israel Hospital, Boston Professor o f Medicine, University o f Washington School o f Medicine Associate Physician-in-chief, University o f Washington Medical CenterDENNIS L . STEVENS, M.D., Ph.D. SeattleProfessor o f Medicine, University o f Washington School o f Medicine, Seattle; RICHARD J. WALLACE, Jr., M.D.Chief, Infectious Diseases, V A Medical Center, Boise Chairman, Department o f Microbiology, University ofTexas hcuitn Lenie'GENE H. STOLLERMAN, M.D. TylerProfessor o f Medicine andPublic Health, Boston University; University Hos'pital, PETER D. WALZER, M.D.Boston Professor o fMedicine, University o fCincinnati College o fMedicine; Chief, InRICHARD M. STONE, M.D. fectious Diseases Section, V A Medical Center, CincinnatiAssistant Professor of Medicine, Harvard Medical School andDana-Farber Cancer LEONARD WARTOFSKY, M.D.Institute, Boston Professor o f Medicine and Physiology, Unifonned Services University o ftheSTEPHEN E. STRAUS, M.D. Health Sciences; Chairman, Department o f Medicine, Washington Hospital Center, Washington, D CChief, Laboratory o f Clinical Investigation, National Institute o fAllergy and In-fectious Diseases, National Institutes o fHealth, Bethesda CARL V. WASHINGTON, Jr. M.D.DAVID H.P. STREETEN, M.D. A s s i s t a n t P r o f e s s o r o f D e r m a t o l o g y , E m o r y U n i v e r s i t y S c h o o l «of M e d i c i n e , AtlantaProfessor o fMedicine and Head, Section o f Endocrinology, State University o fN e w York Health Science Center, SyracuseROBERT A. SWERLICK, M.D.Associate Professor, Department o f Dermatology, E m o r y University School o fMedicine, Atlanta

XX DAFTAR KONTRIBUTORSTEVEN E. WEINBERGER, M.D. SHELDON M. WOLFF, M.D.Associate Professor o f Medicine, Harvard Medical School; Associate Chairman Endicott Professor and Chairman, Department o f Medicine, Tufts Universityfor Education, Department o f Medicine, and Clinical Director, Pulmonary and School o fMedicine; Physician-in-Chief, N e wEngland Medical Center, BostonCritical Care Division, Beth Israel Hospital, Boston BEVERLY woo, M.D.LOUIS WEINSTEIN, M.D., Ph.D. Assistant Professor o f Medicine, Harvard Medical School; Physician, BrighamSenior Physician (Emeritus), Department o f Medicine, Brigham and Women's and Women's Hospital, BostonHospital, Boston ALASTAIR J. J, WOOD, M.B.Ch.B., FRCP (Edin)ROBERT A. WEINSTEIN, M.D., EA.C.P. Professor o f Medicine and Professor o f Pharmacology, Vanderbilt UniversityProfessor o fMedicine andProgram Director, Joint University o fIllinois/ Univer- School o f Medicine; Attending Physician, Vanderbilt Universily Hospital,sity o fChicago Infectious Disease Fellowship Training Program, Department o f NashvilleMedicine, Michael Reese Hospital and Medical Center, Chicago THEODORE E. WOODWARD, M.D., M.A.C.RPETER F. WELLER, M.D. Professor o fMedicine Emeritus, University o fMaryland School o fMedicine andAssociate Professor o f Medicine, Harvard Medical School; Division o f Infec- Hospital, Baltimoretious Disease, Department o f Medicine, Beth Israel Hospital, Boston ROBERT L. WORTMANN, M.D.MICHAEL R. WESSELS, M.D. Professor and Chairman, Department o fMedicine, East Carolina University SchoolAssociate Professor o fMedicine, Harvard Medical School; Associate Physician, of Medicine; Chief Medical Service, Pitt County M e m o r i a l Hospital, UniversityBeth Israel Hospital; Division o f Infectious Diseases, Channing Laboratory, Medical Center o fEastern Carolina-Pitt County, GreenvilleBrigham and Women's Hospital, Boston SHIRLEY H. WRAY, M.D., Ph.D., F.R.C.P.NICHOLAS J, WHITE, M.B., B.S., B.Sc, M.R.C.P. Associate Professor o f Neurology, Harvard Medical School; Director, Unit forWellcome Mahidol University, Oxford Tropical Medicine Research Programme, Neurovisual Disorders, Department o f Neurology, Massachusetts General Hos-Faculty o fTropical Medicine, Mahidol University, Bangkok pital, BostonRICHARD J. WHITLEY, M.D. PAUL W. WRIGHT, M.D.Loeb Eminent Scholar in Pediatrics and Professor o f Pediatrics, Medicine and Professor o f Family Practice, University ofTexas Health Center, TylerMicrobiology, University o fAlabama at Birmingham, Birmingham JOSHUA WYNNE, M.D.GRANT R. WILKINSON, Ph.D. Professor o f Internal Medicine and Chief, Division o f Cardiology, Wayne StateProfessor o f Pharmacology, Vanderbilt University School o fMedicine, Nashville University School o fMedicine; Chief, Section o fCardiology. Harper Hospital, DeUoitGORDON H. WILLIAMS, M.D. KIM B. YANCEY, M.D.Professor o fMedicine, Harvard Medical School; Chief, Endocrine-HypertensionDivision, Brigham and Women's Hospital, Boston Senior Investigator, Dermatology Branch, National Cancer Institute, National Institutes o f Health, BethesdaJEAN D. WILSON, M.D. JAMES B. YOUNG, M.D.Charies Cameron Sprague Distinguished Chair and Professor o f Internal Medi-cine; Chief, Division o fEndocrinology andMetabolism, The University ofTexas Professor o fMedicine, Northwestern University Medical School; Attending Phy-Southwestern Medical Center, Dallas sician, Northwestern Memorial Hospital, ChicagoBRUCE U. WINTROUB, M.D. DORI F. ZALEZNIK, M.D.Professor andChairman, Department o fDermatology, University o f California al Assistant Professor o f Medicine, Harvard Medical School; Hospital Epidemio-San Francisco; Associate Dean U C S P / M t . Zion Medical Center, San Francisco logist, Beth Israel Hospital, Boston

xxi KATA PENGANTARSejak edisi pertama P r i n s i p - P r i n s i p I l m u Penyakit D a l a m H a r r i s o n Ti»j»uan yang terutama berorientasi etiologi dalam Bab Enam,diterbitkan hampir 50 tahun yang lalu, setiap edisi berikutnya telah \"Penyakit Infeksi,\" telah direvisi secara luas dan diperbarui di bawahmenjadi andalan dasar klinis yang kokoh dan kemajuan ilmu pengawasan editor baru kami, Dennis L . Kasper. Di sini pembacapengetahuan untuk sementara. Pada H a r r i s o n edisi ke-I3 ini, para akan menemukan pendekatan terhadap diagnosis, pencegahan, daneditor telah merevisi teks secara luas untuk menunjukkan kemajuan terapi dari infeksi bakteri, virus, dan jamur yang terakhir. Bab-babyang penting dalam pengertian kami mengenai biologi dan baru meliputi \"Infeksi (Kecuali A I D S ) pada Pengguna Obat Suntik,\"patofisiologi penyakit dan dalam pada itu untuk membangun \"Infeksi pada Pejamu dengan Daya Tanggap Imun yang Lemah,\"hubungan yang tepat antara kemajuan yang luar biasa pada ilmu dan \"Infeksi Kulit, Otot, dan Jaringan Lunak.\" Terdapat juga revisipengetahuan dasar dengan kedokteran klinis, dan untuk menegaskan bab-bab utama yang meliputi interaksi pejamu-organisme, diagno-kemajuan ini sementara tetap mempertahankan kebenaran yang ada sis laboratorium penyakit infeksi, septikemia dan syok septik, infeksiyang, walaupun tidak baru, tetap berguna dan penting secara klinis. nosokomial, serta mekanisme molekuler dari patogenesis bakteri.Setiap bab dalam edisi ke-13 ini telah banyak sekali direvisi atau Terdapat sebuah bab yang penting dan terbaru mengenai retrovirusditulis kembali, dan telah ditambahkan bab-bab baru. Dalam kata manusia.pengantar ini, kami tidak dapat menggambarkan semua bagian yangtelah direvisi. Namun, kami ingin meminta perhatian pembaca pada Kami percaya bahwa bab mengenai penyakit H I V dan A I D S olehbeberapa bagian yang paling penting: Anthony S. Fauci dan H . Clifford Lane merupakan salah satu dari sebagian besar risalah yang komprehensif dan terbaru mengenai Bagian Satu, \"Pengantar Ilmu Kedokteran Klinis,\" terdiri dari A I D S . Hal ini meliputi bidang riwayat alamiah dan epidemiologibab-bab baru mengenai etis medis dan pengaruh faktor sosial terhadap mengenai risalah ilmiah tentang mekanisme imunopatogenik penyakitpenyakit, meliputi pengaruh usia, jenis kelamin, latar belakang HIV. D i samping itu, bab tersebut berisi suatu sistem organ melaluigenetik, geografi, dan asal etnik. Faktor-faktor ini sangat pendekatan sistem organ serta timbulnya infeksi dari komplikasimempengaruhi insidensi dan ekspresi klinis penyakit manusia. penyakit H I V yang utama.Contoh dari persoalan kesehatan perempuan pada Bab 5 meliputiskrining penyakit jantung iskemik dan pembahasan mengenai osteo- Inti dari H a r r i s o n , penyakit sistem organ, meliputi Bab Tujuhporosis dan penyakit yang diperantarai secara imunologis. Penyakit sampai Empatbelas, dan mencakup catatan ringkas mengenaimedis yang penting selama kehamilan terdapat pada Bab 6 yang baru. patofisiologi penyakit manusia yang utama, dengan perhatian padaBab 8 yang baru, \"Ilmu Kedokteran Geriatrik,\" menjelaskan manifestasi penyakit, prosedur diagnostik, diagnosis banding, danperubahan yang berhubungan dengan usia pada setiap sistem organ strategi terapi. Tinjauan penyakit sistem organ yang komprehensifdan akibat klinisnya. Terdapat juga pembahasan yang terperinci meliputi bab baru mengenai elektrokardiografi, dengan ilustrasi barumengenai penatalaksanaan keadaaan yang sering pada manusia lanjut yang unggul mengenai pengenalan elektrokardiografik dari infarkusia, yang meliputi gangguan intelektual, mobilitas, inkontinensia, miokard akut. Terdapat bab yang diperbarui mengenai fibrosis kistik,dan reaksi obat iatrogenik. Dua bab yang tepat pada waktunya pencangkokan paru, glomerulopati yang berhubungan dengan(9 dan 10) terfokus pada kesadaran akan biaya dan aspek kuantitatif penyakit multisistem, penyakit peptik-asam (dengan fokus khususdari obat. pada H . p y l o r i ) , hepatitis akut dan kronik, dan pencangkokan hati. Bagian Dua, \"Manifestasi Penyakit Jantung,\" tetap memper- Seksi mengenai hematologi dan onkologi meliputi bab-babtahankan aliran utama edisi ini, dan berfungsi sebagai pengantar tentang onkogen dan gen supresor tumor, gen supresor tumor, palingkedokteran klinis yang komprehensif. Gejala pasien yang utama sering hilang atau mengalami mutasi pada kanker manusia. Terdapatditinjau kembali melalui sistem organ dan berhubungan dengan bab baru yang penting mengenai terapi kanker, dengan menekankankeadaan penyakit yang spesifik—dasar diagnosis banding. Edisi pada imunoterapi dan peranan terapi gen yang potensial. Terdapatke-13 juga berisi bab mengenai nyeri kepala, nyeri punggung dan juga bab baru mengenai penyakit yang mempengaruhi sistemleher, demam, meliputi demam yang tidak diketahui sebabnya {fever endokrin multipel, porfiria, dan pirai ( g o u t ) . Bab mengenai diabeteso f u n k n o w n o r i g i n ) , dan gangguan penciuman, citarasa, dan meliputi pembahasan pengaruh kendali yang ketat mengenaipendengaran. Terdapat bab yang baru sama sekali dan bab yang ditulis komplikasi diabetes.kembali secara luas mengenai diare dan konstipasi, serta bab yangbenar-benar baru mengenai ikterus. Pada Bab Empatbelas, \"Penyakit Neurologis,\" terdapat bab baru mengenai pengaruh neurobiologi terhadap neurologi maupunBagian Tiga, \"Genetik dan Penyakit,\" telah diperbarui secara luas, psikiatri. Terdapat juga tabulasi yang terperinci mengenai penemuan genetik molekuler yang mutakhir dalam neurologi. Terdapat bab barumeliputi sebuah bab baru mengenai gen dan neoplasia. mengenai elektrofisiologi klinis, penyakit demielinasi mirip sklerosis multipel, meningitis bakteri dan abses otak, penyakit virus pada sistemBagian Empat, \"Farmakologi Klinis\" dan Bagian L i m a , \"Gizi saraf pusat, dan penyakit sistem saraf autonom. Untuk pertama kalinya terdapat bab mengenai sistem kelelahan kronik, suatu wujudKlinis,\" telah disusun kembali dan diperbarui. Bab mengenai yang telah menciptakan minat yang besar karena hubungannya dengan kedokteran psikosomatik.farmakologi klinis meliputi prinsip-prinsip terapi obat dan sebuah Akhimya, Bab Limabelas, \"Risiko Lingkungan dan Pekerjaan,\"bab baru mengenai reaksi buruk terhadap obat. Cakupan fisiologi telah diperluas dan disusun kembali.dan farmakologi yang terbaru dari sistem saraf autonom menyelidiki Pada H a r r i s o n edisi ke-12, editor memutuskan untuk mengenali data laboratorium dengan menggunakan unit Sistem Internasionalperan kuncinya pada banyak penyakit dan berbagai cara yang di [ I n t e r n a t i o n a l System (SI)] untuk nilai laboratorium klinis, ditambah dengan sistem konvensional nomenklatur laboratorium yangdalamnya obat berinteraksi dengan sistem ini. Termasuk juga di sini digunakan pada sebagian besar rumah sakit di Amerika Serikat. Kami merasa hal ini adalah penting, karena unit Sistem Internasional seringsebuah bab yang diperbarui mengenai protein G dan pengaturanperantara kedua (second messenger)Cakupan gizi dalam kedokteran klinis meliputi kebutuhan gizi,penilaian status gizi, gangguan makan yang penting seperti anoreksianervosa dan bulimia, serta obesitas. Pembahasan yang baru terdapatpada terapi diet, meliputi nutrisi enteral dan parenteral.

x x i i KATA PENGANTARdigunakan pada banyak negara lain selain Amerika Serikat. Pada Women's Hospital. Beliau juga adalah Professor o f M e d i c i n e padaedisi ke-12 dan pada edisi ke-13 ini, kami telah mendaftar unit H a r v a r d M e d i c a l School. Kami menyambut kedatangan. D r KasperSistem Internasional yang pertama dan unit konvensional dalam sebagai editor baru dan kolega yang istimewa.tanda kurung untuk semua ukuran kecuali tekanan darah, yanghanya diberikan dalam milimeter air raksa, dan untuk ukuran- Kami juga ingin untuk mengekspresikan penghargaan kepadaukuran dengan jumlah yang sama untuk kedua sistem tersebut. banyak rekan dan kolega, yang sebagai ahli dalam bidangnya, yangSebagai pembaca literatur medis mungkin sadar, dalam New membantu kami dengan kritik yang membangun dan saran yangE n g l a n d J o u r n a l of M e d i c i n e 1 9 9 2 , yang mengesahkan unit Sistem bermanfaat. Robert Alpern, Jon Astor, JudyAnn Bigby, TroyenInternasional sebelumnya, memutuskan untuk \"mundur\" ke Brennan, Neil A. Breslau, Bruce Bristian, Charles Carpenter, R i -penggunaan hanya unit konvensional. Namun, editor H a r r i s o n chard Davey, William Dec, William R Dillon, Robert Dluhy, Jef-telah menyimpulkan bahwa, paling sedikit untuk edisi ke-13, kami frey Drazen, Stuart J. Eisendrath, Judy Falloon, Christopher Fanta,sebaiknya terus menggunakan unit Sistem Internasional, dengan Robert A. Fishman, David W. Foster, Patricia Fraser, Jonas Galper,unit konvensional dalam tanda kurung. Pada sebagian besar Alan M . Gelb, Donald Goldmann, Stephen Goldring, Linniekeadaan, interkonversi antara Sistem Internasional dan unit Golightly, Christine Grady, James E . Griffin, Rachel Haft, Robertkonvensional adalah jelas. Namun, adalah penting sekali bahwa Handin, Seigo Izumo, Joseph H. Keffer, Arthur Kleinman, An-pembaca mengkonsultasikan laboratoriumnya sendiri untuk nilai thony Komaroff, H . Clifford Lane, Russell K . Laros, Jr., Richardnormal. Mungkin bahaya potensial terbesar yang melekat pada M. Locksley, Joseph Loscaizo, Carlos Luciano, James Maguire,keberadaan kedua sistem tersebut adalah interpretasi glukosa Robert Mayer, Walter O'Donnell, Tristram G . Parslow, Doloresplasma dan kadar kalsium plasma, tetapi perhatian sebaiknya M. Peterson, Lynn Peterson, Michael Polls, Kenneth Ryan, Frankdiamati dalam interpretasi semua nilai laboratorium. Sacks, Jay P. Sanford, Paul Sax, Michael Seiden, Egilius Spierings, Chirstopher Stowell, Daniel VIock, Robert Walker, StevenDalam tinjauan kebutuhan untuk meneruskan pendidikan bagi Weinberger, Michael Wessels, Alison Wichman dan Edward Yeh.izin praktik dan izin praktik ulang, dan juga perhatian terhadap Buku ini tidak dapat diedit tanpa bantuan pengabdian teman sekeija kami pada kantor editorial dari masing-masing editor Kamisertifikasi dan sertifikasi ulang, revisi S w a - P e n i l a i a n dan T i n j a u a n secara khusus berhutang budi kepada: Dorothy Binford, Marie Bullock, Martha Cassin, Hilda Gardner, Christy K. Gonzales,P r a - U j i akan diterbitkan bersama dengan edisi ini. Hal ini terdiri Brenda H. Hennis, Leslie LaPiana, Julie McCoy, Jaylyn Olivo, Lucy Renzi, Kathryn A. Saxon, dan Elin Woodger.dari beberapa ratus pertanyaan yang bcrdasarkan H a r r i s o n , bersamadengan jawaban dan penjelasan untuk jawaban. D i samping itu.Companion Handbook yang dipelopori sebagai suplemen untukH a r r i s o n edisi ke-11 yang diperbarui dan akan segera terbit. Akhimya, kami terus akan berhutang budi kepada dua anggotaSalah satu kekuatan H a r r i s o n adalah hubungan yang erat antara yang terkemuka dari organisasi McGraw-Hill: J . Dereck Jeffers,editor. Dalam konteks tersebut, kami gembira sekali untuk E d i t o r - i n - C h i e f , dan Stuart Boynton, Development Editor. Merekamenyambut editor baru yaitu D r Dennis L . Kasper, yang memiliki adalah tim yang efektif yang memberi semangat yang konstan dan saran yang bijaksana kepada editor, dan sangat membantu terbitnyakeahlian yang sangat mendalam pada semua aspek penyakit infeksi. edisi ini dengan hasil yang baik dan tepat waktu.Dr. Dennis L . Kasper dari Infectious Diseases D i v i s i o n pada BethI s r a e l H o s p i t a l di Boston dan menjabat sebagai Co-Director ofthe C h a n n i n g Laboratory, yang berhubungan dengan B r i g h a m and EDITOR