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Handbook of Liver Disease
Gastroenterology/Hepatology No Responses » Sep 232010

Here’s instant access to the symptoms, signs, differential diagnosis, and treatment for the full range of liver disorders. Written by an international ‘who’s who’ of hepatology-and now in full color-this new 2nd Edition provides readers with top-notch, authoritative guidance they can count on! * Discusses the hottest topics in the field, such as non-alcoholic steatohepatitis (NASH) and the latest information on liver transplantation. * Includes expanded coverage of chronic hepatitis C, most notably the use of combination therapy with peginterferon and ribavirin and improvements in the management of the side effects of antiviral therapy. * Offers the most recent therapeutic options for the management of chronic hepatitis B and advances in the understanding of the molecular biology of this virus. * Updates the approach to the diagnosis of many liver diseases due to newer tests based on molecular techniques and advances in imaging. * Features over 340 full-color illustrations. * Uses a redesigned templated, outline format that makes reference a snap. * Presents a concise, in-depth clinical summary-in an outline format-of the current practice of hepatology for each major disease entity. * Provides a liberal use of tables, algorithms, and figures, rendering complex concepts understandable.

* Includes alert symbols that highlight information that’s critical to patient safety DOWNLOAD IT FREE HERE Handbook of Liver (…) See larger image Handbook of Liver Disease (Paperback) By (author) Lawrence S.0/10 (1 vote cast) VN:F [1. Friedman MD.9.3_1094] please wait.* Includes key point boxes at the beginning of each chapter.50 In Stock VN:F [1.3_1094] Rating: +1 (from 1 vote) ... providing at-a-glance access to vital information.9.95 USD $89. Keeffe MD List Price: New From: Used from: $99.95 In Stock $42. Rating: 10. Emmet B.

including coronary artery disease.• Posted by admin at 7:01 pm Tagged with: GASTROENTEROLOGY/HEPATOLOGY Oxford American Handbook of Cardiology . and students. arrhythmias. cardiovascular disease remains the leading cause of death in the United States. valvular and congenital heart disease. are covered comprehensively yet concisely DOWNLOAD IT FREE HERE Oxford American Handbook (…) . The reader will find here all the essential practice guidelines and management strategies as well as a unique chapter on preventive cardiology and a useful summary of recent major clinical trials in cardiology. cardiomyopathies. as well as an excellent reference guide for general practitioners. and heart failure. The vast number of patients with cardiovascular disease coupled with ongoing clinical advances makes the Oxford American Handbook of Cardiology a must-buy for residents. fellows.Sept 2010 Edition Cardiovascular No Responses » Sep 232010 Despite major advances in prevention and treatment. Common cardiac conditions.

9. Rating: 10..0/10 (1 vote cast) VN:F [1.9.95 USD $40. Critical Care No Responses » Sep 232010 .92 In Stock VN:F [1.3_1094] Rating: +1 (from 1 vote) • Posted by admin at 6:53 pm Tagged with: Cardiovascular The Intensive Care Manual Anaesthesiology.See larger image Oxford American Handbook of Cardiology (Oxford American Handbooks in Medicine) (Paperback) List Price: New From: $49..3_1094] please wait.

and mechanical ventilation Intravascular access and hemodynamic monitoring Shock Renal failure Infectious diseases Nutritional Cardiac arrhythmias and acute myocardial infarction Endocrine disease and hematologic disorders Gastrointestinal problems Coma Sedation and airway management DOWNLOAD IT FREE HERE The Intensive Care (…) . this original sourcebook helps ICU staff solve problems of critically ill patients quickly and effectively. treatments. and needed lab standards and algorithms.With up-to-date guidance that is easy to find and practical. Filled with convenient summary approaches. oxygen delivery. diagnostics. The Intensive Care Manual simplifies finding ICU answers on: Respiratory failure.

50 In Stock $0. Papadakos List Price: $48.81 In Stock VN:F [1.3_1094] please wait.0/10 (2 votes cast) VN:F [1.3_1094] Rating: +1 (from 1 vote) • Posted by admin at 6:45 pm Tagged with: Anaesthesiology.Last » Search for More Books partner-pub-5604 ISO-8859-1 Search .9.9....95 USD New From: Used from: $7.. Apostolakas. Rating: 10.See larger image The Intensive Care Manual (Paperback) By (author) Michael J. Peter J. Critical Care Page 1 of 47612345»102030.

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(Christof Daetwyler) Awards: "Headache interactive" received the prestigeous European Academic Software Award 2000 (EASA2000) in Rotterdam and the highest honor "summa cum laude" at the MediKinale International in Munich in 2000. HEADACHE (SOURCE : http://webcampus. for Educational Media at the Institute for Medical Education at the University of Berne. Dedication: I dedicate this work to my parents. Copyright 2005 .MY FRIENDS • • Best E-Books The Health Info Suffusion WordPress theme by Sayontan Sinha © 2010 MEDICAL BOOKS FREE 2. The original (German) version of "Headache Interactive" was develped at the Dept.interactive: This program might be used for educational purposes free of charge and with no royalties inflicted.drexelmed. produced and implemented by: .2009 by Christof Daetwyler and Marco Mumenthaler.edu/interactive/headache/) About headache. The English version was done by the authors in their spare time without any monetary support. who always supported me. Credits: The English abbreviated version was developed. Switzerland with funding provided by Astra-Zeneca AG and GlaxoSmithKline AG.

Switzerland Scientific Illustrator The model used for hedache.an online tool for teaching/learning medical communicatioon skills which was developed at the Drexel University College of Medicine for the AACH (American Academy on Communication in Healthcare). for Neurology at the University of Berne Hospital Content Development and Physician on Camera Mo Levin. NH Editor of the American Versio Willi R.Christof Daetwyler.interactive is based on doc.com . MD Dept. Hess. MD Drexel University College of Medicine Educational Design and Project Management. for Educational Media at the Institute for Medical Education at the University of Berne.A. Production and Implementation Marco Mumenthaler. MD Former Director of the Dept. Dept. for Neurology at Dartmouth Hitchcock Medical Center in Lebanon. M. .

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usp%3D0&amp.ng/params.2" src="http://as.• • • • • • • • • • • • • • • • • • • • • • • • • Dermatology Emergency Medicine Endocrinology Gastroenterology Genomic Medicine Hematology Infectious Diseases Nephrology Clinical Procedures General Surgery Neurosurgery Ophthalmology Orthopedic Surgery • • • • • • Physical Medicine and Rehabilitation Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Otolaryngology and Facial Plastic Surgery Plastic Surgery Thoracic Surgery Transplantation Trauma Urology Vascular Surgery Cardiac Disease & Critical Care Medicine Developmental & Behavioral General Medicine Genetics & Metabolic Disease Surgery <script type="text/javascript" language="JavaScript1.transactionid %3D9508475344&amp.kw%3D0&amp.occ %3D0&amp.richmedia%3Dyes&amp.ct%3D0&amp.pf%3D0&amp.artid .com/js.inst%3D0&amp.medscape.pos%3D101&amp.tid%3D0&amp.

Testicle Cancer.%3D0&amp. Penis. Adrenals.scg%3D0&amp. and Sexual Disorders Fistulas Hydronephrosis and Ureter Disorders Incontinence Infections and Related Inflammatory Conditions Interstitial Cystitis Male Infertility Neurogenic Bladder and Overactive Bladder Stones Strictures Surgery Trauma .ssp %3D15&amp.cg%3D0&amp.env%3D0&amp.affiliate %3D2&amp.site%3D1&amp. Kidney.spon%3D0&amp. and Urethra Cancer.tile%3D3091257783"></script> Urology Sections • • • • • • • • • • • • • • • • • • • • • • • Benign Prostatic Hypertrophy Cancer. Premature Ejaculation. Bladder.pclass%3Dhp&amp. Prostate Cancer.st%3D0&amp. and Ureter Cancer. Wilms Tumor and Neuroblastoma Common Problems of the Penis Common Problems of the Testicle Common Problems of the Urethra Congenital Urologic Conditions Dermatological Disorders Erectile Dysfunction.pub%3D0&amp.leaf%3D0&amp.

Penis. and Urethra • Bladder Cancer • Carcinoma In Situ of the Urinary Bladder • • • • • • Cystectomy. Adrenals. Staging. Prostate • Controversies in Prostate Cancer • Precancerous Lesions of the Prostate • Prostate Cancer . Kidney. Pathology. Partial* Cystectomy. Bladder. Radical<*/li> Extragonadal Germ Cell Tumors* Penile Cancer Surveillance for Recurrent Bladder Cancer Urethral Cancer Cancer. Diagnosis. Benign • • • • Simple Prostatectomy* Transurethral Microwave Thermotherapy of the Prostate (TUMT) Transurethral Needle Ablation of the Prostate (TUNA) * Transurethral Resection of the Prostate * Cancer.Biology. and Ureter • Urothelial Tumors of the Renal Pelvis and Ureters Cancer. and Natural History .• Urologic Imaging Urology Articles Sort: Alphabetically | by Section Benign Prostatic Hypertrophy • Interstitial Laser Coagulation of the Prostate * • Prostate Hyperplasia.

Brachytherapy (Radioactive Seed Implantation Therapy) Prostate Cancer .Management of Localized Disease Prostate Cancer .External Beam Radiotherapy Prostate Cancer .Metastatic and Advanced Disease Prostate Cancer .Radical Retropubic Prostatectomy Prostate-Specific Antigen Cancer. Partial* Orchiectomy. Testicle • Leydig Cell Tumors • Nonseminomatous Testicular Tumors • • • • • Orchiectomy.Radical Perineal Prostatectomy Prostate Cancer .Nutrition Prostate Cancer . Radical* Testicular Cancer* Testicular Choriocarcinoma Testicular Seminoma Cancer.Neoadjuvant Androgen Deprivation Therapy Prostate Cancer . Wilms Tumor and Neuroblastoma • Neuroblastoma • Wilms Tumor Common Problems of the Penis • Balanitis* • Balanitis Circumscripta Plasmacellularis* • • • Balanitis Xerotica Obliterans* Balanoposthitis* Dorsal Slit of the Foreskin* .Cryotherapy Prostate Cancer .• • • • • • • • • • Prostate Cancer .

Adult Circumcision. and Buried Penis Priapism Common Problems of the Testicle • Cryptorchidism • Epididymitis • • • • • • Hydrocele Manual Detorsion of the Testes* Spermatocele Testicular Torsion Torsion of the Appendices and Epididymis* Varicocele Common Problems of the Urethra • Urethral Caruncle • Urethral Diverticula • • • • Urethral Prolapse Urethral Syndrome Urethral Warts Urethritis Congenital Urologic Conditions • Cystic Diseases of the Kidney • Horseshoe Kidney • Prune Belly Syndrome .• • • • • Paraphimosis Pearly Penile Papules* Peyronie Disease Phimosis.

Nonmalignant Erectile Dysfunction.Dermatological Disorders • Dermatologic Diseases of the Male Genitalia. and Sexual Disorders • Erectile Dysfunction • Hematospermia • • Penile Prosthesis Implantation Premature Ejaculation Fistulas • Enterovesical Fistula • Renoalimentary Fistula • • Vesicovaginal and Ureterovaginal Fistula Vesicovaginal Fistula* Hydronephrosis and Ureter Disorders • Hydronephrosis and Hydroureter • Megaureter and Other Congenital Ureteral Anomalies • • • • • • Obstructed Megaureter Retroperitoneal Fibrosis Ureterocele Ureteropelvic Junction Obstruction Urinary Tract Obstruction Vesicoureteral Reflux Incontinence • Artificial Urinary Sphincter • Injectable Bulking Agents for Incontinence • • Pubovaginal Sling* Urinary Incontinence. Premature Ejaculation. Malignant • Dermatologic Diseases of the Male Genitalia. Medical and Surgical Aspects * .

Noninfectious Hydrocele. Filarial Lymphogranuloma Venereum (LGV)* Nonbacterial Prostatitis Orchitis* Papillary Necrosis Papillomavirus* Pediatrics. Tuberculous Pyonephrosis Radiation Cystitis Renal Corticomedullary Abscess Syphilis* Trigonitis . Bacterial Prostatitis. Surgical Therapies Infections and Related Inflammatory Conditions • Acute Bacterial Prostatitis and Prostatic Abscess • Chronic Bacterial Prostatitis • • • • • • • • • • • • • • • • • • • • • • Chronic Pelvic Pain Syndrome and Prostatodynia Cystitis. Nonsurgical Therapies Urinary Incontinence. Urinary Tract Infections and Pyelonephritis * Perinephric Abscess Prostatitis.• • Urinary Incontinence. Nonbacterial Emphysematous Pyelonephritis Epididymal Tuberculosis Fournier Gangrene Gonococcal Infections* Hemorrhagic Cystitis.

• • • • • • • Tuberculosis of the Genitourinary System Ureaplasma Infection* Uric Acid Nephropathy* Urinary Tract Infection. and Impact • • Overactive Bladder in Children Overactive Bladder .Treatment Other • • • • • • • Alport Syndrome* Azotemia* Bartholin Gland Diseases* Enterocele and Massive Vaginal Eversion* Granular Cell Tumors* Pericarditis. Male • Sertoli-Cell-Only Syndrome • Vasovasostomy and Vasoepididymostomy* Neurogenic Bladder and Overactive Bladder • Neurogenic Bladder • Overactive Bladder . Males* Urinary Tract Infections in Pregnancy Xanthogranulomatous Pyelonephritis Interstitial Cystitis • Interstitial Cystitis Male Infertility • Infertility. Females* Urinary Tract Infection.Etiology. Diagnosis. Uremic* Proteinuria* .

Testicle & Epididymis* . Chronic* Relaxed Vaginal Outlet* Uremia* Uremic Encephalopathy* Uterine Prolapse* Stones • Bladder Stones • Cystinuria • • • • • • • • • • • • • Extracorporeal Shockwave Lithotripsy* Hypercalciuria Hyperoxaluria Hyperuricosuria and Gouty Diathesis Hypocitraturia Intracorporeal Lithotripsy Nephrocalcinosis* Nephrolithiasis Nephrolithiasis. Acute Renal Colic Percutaneous Endourology Pregnancy and Urolithiasis Pyelolithotomy* Struvite and Staghorn Calculi Strictures • Ureteral Stricture • Urethral Strictures Surgery • Adrenal Surgery* • Anesthesia.• • • • • Pyelonephritis.

• • • • • • • • • • • • • • • • • • • • • • • • • • • Augmentation Cystoplasty* Laparoscopic and Robotic Radical Prostatectomy * Laparoscopic Pelvic Lymph Node Dissection * Lasers in Urology Lymph Node Dissection. Pelvic* Lymph Node Dissection. No Scalpel* Zipper Injuries* . Dorsal Penile* Nerve Block. Neonatal * Paraphimosis Reduction* Penile Injection & Aspiration* Pyeloplasty* Robotic and Laparoscopic Renal Surgery * Suprapubic Catheterization* Techniques of Local Anesthesia for Prostate Procedures and Biopsies * Transperitoneal Laparoscopic Radical Nephrectomy * Transureteroureterostomy* Ureterocalicostomy* Ureterolithotomy* Ureteroscopy* Urethral Catheterization. Retroperitoneal* Nephrectomy. Radical* Nephroptosis Nephrostomy* Nerve Block. Men* Urinary Diversions and Neobladders* Vasectomy. Partial* Nephrectomy. Dorsal Penile.

CLOSE [X] • • • • • • • • SPECIALTY SITES Allergy and Immunology Cardiology Clinical Procedures Critical Care Dermatology Emergency Medicine Endocrinology • • • • • • • • • Obstetrics/Gynecology Oncology Ophthalmology Orthopedic Surgery Otolaryngology & Facial Plastic Surgery Pathology Pediatrics: Cardiac Disease & • Physical Medicine & Rehabilitation Plastic Surgery Psychiatry Pulmonology Radiology Rheumatology Sports Medicine • • • • • • . and Nuclear Medicine *This article has been cross posted from another specialty to this index page because of its relevance. MRI... Obstructive Uropathy * • Transrectal Ultrasonography (TRUS) of the Prostate * • Urologic Imaging Without X-rays .Trauma • Bladder Trauma • Penile Fracture and Trauma • • • • • • Renal Trauma Scrotal Trauma Testicular Trauma Ureteral Injury During Gynecologic Surgery Ureteral Trauma Urethral Trauma Urologic Imaging • Bedside Ultrasonography.Ultrasound. Articles in.

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A Functional Approach: Companion to Histology and Neuroanatomy: Second Edition . HYSTOLOGY ATLAS (SOURCE : http://www.sh tml) Home | Search | About Us | FAQ | Reviews | Contact Us Atlas of Microscopic Anatomy .anatomyatlases.4.org/MicroscopicAnatomy/MicroscopicAnatomy.

14) Section 2. M.84 to 6. Epithelial Tissue (Plates 2.1 to 1.27 to 3.83) Section 6.62) Section 5.D. Ph.51) Section 4.. Afifi.57 to 4. Blood (Plates 4. Cells (Plates 1. Professor of Anatomy The University of Iowa Peer Review Status: Externally Peer Reviewed First Published: 1999 Last Revised: 1999 Table of Contents Preface Preface to the First Edition Introduction Section 1. Heidger. Muscular Tissue (Plates 5. and Anatomy Department of Anatomy Paul M.132) .15 to 2.D. PhD Professor of Anatomy Department of Anatomy Adel K.63 to 5. Jr. Bergman. Connective Tissue (Plates 3.26) Section 3. Nervous Tissue (Plates 6. Professor of Pediatrics. Neurology.Editors: Ronald A.

175) Section 10.364) Appendices Appendix I: How to Study a Microscope Slide Appendix II: The Preparation of Cells and Tissue for Microscopic Study Appendix III: Methods of Fixation and Study Appendix IV: Comments on Color Groups. Endocrine Glands (Plates 15.297 to 16.245 to 13. Stains.161) Section 9.296) Section 16.176 to 10.221 to 11.Section 7. Urinary System (Plates 12. Special Senses (Plates 16.262 to 14.162 to 9. Lymphatic System (Plates 9. Female Reproductive System (Plates 13.316 to 17. Cardiovascular System (Plates 8.315) Section 17. Respiratory System (Plates 11.230) Section 12.279 to 15. Male Reproductive System (Plates 14. Integument (Plates 7. Central Nervous System (Plates 17.220) Section 11. Digestive System (Plates 10.278) Section 15.147) Section 8.133 to 7.148 to 8. and the Staining Mechanism Appendix V: Nervous System Glossary of Terms .261) Section 14.244) Section 13.231 to 12.

Bergman. D'Alessandro.D. Advertising is not accepted. Reviews and Comments Home | Search | About Us | FAQ | Reviews | Contact Us Anatomy Atlases is curated by Ronald A. the Anatomy Atlases logo.References This Site's Awards. "Anatomy Atlases". D'Alessandro. D'Alessandro.org/ This site complies with the HONcode standard for trustworthy health information: verify here. M. or given to any third party be they reliable or not. Please send us comments by filling out our Comment Form. Anatomy Atlases is funded in whole by Michael P.D. The information contained in Anatomy Atlases is not a substitute for the medical care and advice of your physician. leased. All rights reserved. and "A digital library of anatomy information" are all Trademarks of Michael P. M. URL: http://www. M. Ph.anatomyatlases. All contents copyright © 1995-2010 the Author(s) and Michael P. .D. Your personal information remains confidential and is not sold. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.D.

nlm.nih. 6th Edition" . Cancer medicine (source: http://www.5.gov/bookshelf/br.fcgi? book=cmed) Search for Within This book All books PubMed NCBI » Bookshelf » Holland-Frei Cancer Medicine » See "Cancer Medicine.ncbi.

Illinois 5Derald H Ruttenberg Cancer Center. MD. Jr. Kornelia Polyak. University of Chicago Hospital. Chicago Tumor Institute. Chicago. MD. surgical oncologists.1 Donald W Kufe. pathology. Houston. MD. ISBN: 1-55009-113-1 Cancer Medicine is the best known and respected work in the field of oncology and was the first comprehensive textbook devoted to reporting and assessing the rapid and continuous development in the diagnosis and treatment of cancer. Todd R Golub. radiation oncology. MD. radiation oncologists. 5th edition Edited by Robert C Bast. Houston. PhD     Overview: Gene Structure General Techniques Gene Analysis: DNA Gene Expression: MRNA Transcript Analysis . PhD. Harvard Medical School Boston. Texas 2Dana-Farber Cancer Institute. and Charles D Stiles. MD.Holland-Frei Cancer Medicine. Table of Contents • • • • Editors Contributors Preface Section 1 Cancer Biology o Chapter 1 Molecular Biology Barrett J Rollins. Cancer Medicine e. surgical oncology. imaging interventional radiology. endoscopy. Cancer Medicine is widely recognized as a leading reference resource for medical oncologists. MD Anderson Cancer Center. University of Texas.5 continues this high standard while providing updated information in all areas of oncology .3 Ralph R Weichselbaum. Texas 4Department of Radiation and Cellular Oncology.including molecular biology.2 Raphael E Pollock. University of Chicago. ScD (hc).4 James F Holland. and others who treat cancer patients. 2000. New York. MD2 1University of Texas. MD Anderson Cancer Center. and medical oncology. internists. New York Hamilton (ON): BC Decker. MD. MD. Massachusetts 3Department of Surgical Oncology. Mount Sinai School of Medicine.5 and Emil Frei. MD. III.

and Carlo M Croce. and Arthur B Pardee. David W Goodrich. Alec Kimmelman. MD. MD.   o Gene Expression: Protein Analysis Miscellany References Chapter 2 Cell Proliferation. MD. MD      Discovery and Identification of Oncogenes Mechanisms of Oncogene Activation Oncogenes in the Initiation and Progression of Neoplasia Summary and Conclusions References o Chapter 5 Tumor Suppressor Gene Defects in Human Cancer Eric R Fearon. MD   Genetic Basis for Tumor Development Somatic Cell Genetic Studies of Tumorigenesis . MD. MD. MD and Bert Vogelstein. MD         Background Growth Factor Receptors with Tyrosine Kinase Activity Classification of Growth Factors and Their Receptors Abnormalities Associated with Growth Factors in Cancer Cells Aberrations Affecting GrowthFactor Receptors in Tumor Cells Signaling Pathways of Tyrosine Kinase Receptors Implications for Cancer Therapy References o Chapter 4 Oncogenes Marco A Pierotti. MD. and Stuart A Aaronson. MD     Proliferation Differentiation Apoptosis References o Chapter 3 Growth Factor Signal Transduction in Cancer Paolo Fedi. and Apoptosis Michael Andreeff. Gabriella Sozzi. Steven A Schichman. Differentiation.

MD    Tumor–Host and Tumor–Stromal Interactions Adhesion Proteolysis . and Janet D Rowley. MD. Olatoyosi M Sobulo. Retinoblastoma—A Paradigm for Tumor Suppressor Gene Function The p53 Gene The INK4a Locus and the p16INK4a and p19ARF Genes The APC Gene The BRCA1 and BRCA2 Genes The WT1 Gene The NF1 and NF2 Genes The VHL Gene DNA Repair Pathway Genes Candidate Tumor Suppressor Genes Summary References            o Chapter 6 Recurring Chromosome Rearrangements in Human Cancer Olufunmilayo I Olopade. MD     Historical Perspectives What Makes a Cancer Cell a Cancer Cell? Acknowledgments References o Chapter 8 Invasion and Metastases Lance A Liotta. MD and Elise C Kohn. MD     Myeloproliferative Disorders Malignant Lymphoproliferative Diseases Acknowledgment References o Chapter 7 Biochemistry of Cancer Raymond W Ruddon. MD.

MD  Dependence of Tumors on Angiogenesis: The Beginning of the Field of Angiogenesis Research Summary and Future Directions References   • Section 2 Tumor Immunology o Chapter 10 Tumor Immunology Jeffrey Schlom. Tom Smyrk.    Tumor Cell Migration Angiogenesis Genetic Regulation of Invasion and Metastasis Novel Technologies for Identification of Metastasis and InvasionPromoting Genes and Gene Products Metastasis as a Therapeutic Target Summary References    o Chapter 9 Tumor Angiogenesis Judah Folkman. Barbara Weber. MD  Genetic Basis of Cancer Syndromes . PhD and Scott I Abrams. MD. MD. and Henry T Lynch. MD. PhD           Targets for Immunotherapy Issues Problem Areas in Immunotherapy Cancer Vaccines Antibody Therapy Adoptive Transfer Cytokines Conclusion Acknowledgments References • Section 3 Cancer Etiology o Chapter 11 Genetic Predisposition to Cancer Marcia S Brose.

MD. Leslie Bernstein. Risk Assessment. MD          Multi-stage Carcinogenesis Gene–Environment Interactions and Interindividual Variation Carcinogen Metabolism DNA Damage and Repair Biologic Response to Tumor Promoters Oncogenes and Tumor-Suppressor Genes Clonal Evolution Chemical and Viral Interactions Implications for Molecular Epidemiology.     o Cancer-Associated Genodermatoses Other Cancers with Familial Clusterings Application Conclusions/Future Directions References Chapter 12 Chemical Carcinogenesis Ainsley Weston. PhD. and Cancer Prevention References  o Chapter 13 Hormones and the Etiology of Cancer Brian E Henderson. PhD and Curtis C Harris. MD           Breast Cancer Endometrial Cancer Ovarian Cancer Prostate Cancer Adolescent and Young Adult Genital Cancer Cervical Cancer Thyroid Cancer Osteosarcoma Conclusion References . and Ronald K Ross.

o Chapter 14 Ionizing Radiation John B Little. MD. PhD           Historical Perspective Epidemiology Genetic Factors in Skin Carcinogenesis Xeroderma Pigmentosum Cockayne Syndrome Trichothiodystrophy Basal Cell Nevus Syndrome and Basal Cell Cancers Familial melanoma Carcinogenesis References o Chapter 16 Physical Carcinogens Cesare Maltoni. MD      Known Physical Carcinogens Mechanisms of Carcinogenesis Electromagnetic Fields Conclusions References . MD          Development of Radiation Injury Principal Cellular and Tissue Effects of Radiation Neoplastic Transformation in Vitro by Radiation Stages in Neoplastic Transformation Molecular Mechanisms Experimental Radiation-Induced Carcinogenesis Human Epidemiologic Studies Risk Assessment References o Chapter 15 Ultraviolet Radiation Carcinogenesis James E Cleaver. MD. and James F Holland. Franco Minardi. PhD and David L Mitchell.

and George Acs.o Chapter 17 Trauma and Inflammation John F Gaeta. MD . MD    Mechanisms Of Possible Traumatic Causation Interactions of Trauma and Tissue Repair References o Chapter 18 Tumor Viruses Howard A Fine. MD       Properties of Herpesviruses Oncogenic Features of Herpesviruses Epstein-Barr Virus: An Oncogenic Human Herpesvirus Human Herpesvirus 8 and Malignancies Oncogenic Potential of Other Human Herpesviruses References o Chapter 20 Papillomaviruses and Cervical Neoplasia Catherine M McLachlin. MD and Christopher P Crum. MD. Mechanisms. Swan N Thung. MD. MD and Joseph G Sodroski. and Pathobiology of Genital HPV Infection HPV and Human Genital Neoplasia References   o Chapter 21 Hepatitis Viruses Max W Sung. MD  Definitions. MD          Classification Structure Life Cycle Mechanisms of Oncogenesis Immunodeficiency Endogenous Retroviruses Retroviral Vectors Conclusion References o Chapter 19 Herpesviruses Jeffrey I Cohen.

PhD          Surveillance of Cancer in the Population Temporal Trends in Cancer Occurrence in the United States Survival of Patients with Cancer Types of Observational Epidemiologic Studies Descriptive Studies Analytic Epidemiology Measures of Association Case-Control Studies What Constitutes “Proof” in Epidemiologic Studies? . HGV.      Hepatitis A Virus Hepatitis B Virus Hepatitis C Virus Hepatitis D Virus Hepatitis E Virus Hepatitis of Unknown Etiology: the Role of the HFV. MD and Phyllis A Wingo. and TTV Clinical Significance of Viral Hepatitis to Hepatocellular Carcinoma References   o Chapter 22 Parasites Piero Mustacchi. MD        Schistosomiasis and Cancer of the Bladder Schistosomiasis and Cancer of Other Sites East Asian Distomiasis Malaria American Burkitt’s Lymphoma Cancer in Animals References • Section 4 Cancer Epidemiology o Chapter 23 Cancer Epidemiology Michael J Thun.

Margie Clapper. Robert A Schnoll. Elizabeth C Miller.   • IARC Classification of Carcinogens Summary References Section 5 Theory and Practice of Clinical Trials o Chapter 24 Theory and Practice of Clinical Trials Marvin Zelen. PhD          Physiochemical Composition of Tobacco Smoke Carcinogenic and Genotoxic Effects of Tobacco Constituents Genetic Variation in Cancer Susceptibility Strategies for Cessation Smokeless Tobacco Tobacco Addiction Prevention of Tobacco Use Summary References o Chapter 26 Nutrition in the Etiology and Prevention of Cancer Steven K Clinton. MS. PhD. MD. and Cancer Studies . PhD         Types of Clinical Trials Planning Clinical Trials Reporting of Clinical Trials Statistical Models Meta-Analysis Falsification of Data References Additional Reading • Section 6 Cancer Prevention o Chapter 25 Prevention of Tobacco-Related Cancers Paul F Engstrom. MD  Methodologic Issues in Diet. Nutrition. PhD. Tracy Orleans. and Edward L Giovannucci. and C. MD.

and Curtis J Mettlin. PhD   Key Criteria in the Decision to Screen Methodologic Issues in the Evaluation of Early-Detection Programs Breast Cancer Colorectal Cancer Lung Cancer Prostate Cancer Testicular Cancer Cervical Cancer Endometrial Cancer Ovarian Cancer Melanoma and Nonmelanoma Skin Cancer Oral Cancer The Cancer-Related Checkup Conclusion References              • Section 8 Principles of Cancer Pathology .   o Nutrition and the Etiology of Common Cancers Summary of Research Efforts Focusing on Specific Nutrients References Chapter 27 Chemoprevention of Cancer Michael B Sporn. MD. MD     Agents for Chemoprevention and Their Mechanism of Action Chemoprevention Trials Chemoprevention and Overall cancer Incidence References • Section 7 Cancer Screening and Early Detection o Chapter 28 Cancer Screening and Early Detection Harmon J Eyre. Robert A Smith. PhD. MD and Scott M Lippman.

MD   Solid Tumor Structure and Tumor Stroma Generation Role of the Surgical Pathologist in the Diagnosis and Management of the Cancer Patient Role of the Cytopathologist Role of the Immunohistochemist Role of the Electron Microscopist Role of the Clinical Pathologist Role of the Autopsy Pathologist Summary and Conclusions References        • Section 9 Principles of Imaging o o o Chapter 30 Principles of Imaging Richard J Steckel. MD. MD.and MRI-Guided Aspiration Cytology References o Chapter 30C Imaging Neoplasms of the Thorax Poonam V Batra. MD and Richard J Steckel. Robert Kagan. MD Chapter 30B Imaging Neoplasms of the Head and Neck and Central Nervous System Robert B Lufkin. MD    Magnetic Resonance Imaging CT. and Harold F Dvorak. Helen H Wang. Ann M Dvorak.  MD. MD  Diagnosis .o Chapter 29 Principles of Cancer Pathology James L Connolly. MD and William M Thompson. Stuart J Schnitt. MD. MD Chapter 30A Imaging Cancer of Unknown Primary Site A. MD      Lung Cancer Mediastinal Masses Pleural Cancers Conclusion References o Chapter 30D Imaging Neoplasms of the Abdomen and Pelvis Robert A Halvorsen Jr.

MD Chapter 30F Imaging the Breast Lawrence W Bassett. MD           Types of Mammography Examinations Standardized Mammography Reporting The Normal Mammogram The Abnormal Mammogram Mammography of the Postsurgical Breast Mammography for Staging Ultrasonography Imaging-Guided Needle Biopsy of the Breast Other Breast Imaging Modalities References o Chapter 30G Ultrasound in Cancer Medicine Edward G Grant.          o o Staging Post-treatment Surveillance Gastrointestinal Tract: Hollow Organs Liver Metastases Biliary Obstruction and Lesions of the Pancreas Kidney Tumors of the Female Reproductive Tract Prostate Conclusion References Chapter 30E Cross-Sectional Imaging of Musculoskeletal Neoplasms Leanne L Seeger. MD      Central Nervous System Ultrasonography Head and Neck Ultrasonography Thoracic Ultrasonography Breast Ultrasonography Abdominal Ultrasonography .

MD and Donald L Morton. MD    Historical Considerations The Contemporary Role of Surgical Oncology Combined Modality Therapy . MD. MD. MD Chapter 31 Interventional Radiology for the Cancer Patient Marshall Hicks. MD     Gamma Camera Methods Including SPECT Positron Emission Tomography Conclusion References o o Chapter 30I Perspectives in Imaging Richard J Steckel. MD      Intra-arterial Therapy Biopsy Intratumoral Gene Therapy Mechanical Devices References • Section 10 Principles of Surgical Oncology o Chapter 32 Principles of Surgical Oncology Raphael E Pollock. Chusilp Charnsangavej. and Michael Wallace.         o Intraoperative Ultrasonography Retroperitoneal Ultrasonography Pelvic and Endovaginal Ultrasonography Prostatic and Transrectal Ultrasonography Testicular Ultrasonography Venous Ultrasonography Subcutaneous Ultrasonography Summary References Chapter 30H Radionuclide Imaging in Cancer Medicine Randall A Hawkins.

MD. George M Hahn. MD       Indications for Central Venous Access in Oncology Techniques for Placement of Central Venous Access Catheters Complications of Long-term Central Venous Access Prevention of Complications Treatment of Complications Results of Long-term Central Venous Catheters in Cancer Patients Conclusion References   • Section 11 Principles of Radiation Oncology o Chapter 34 Physical and Biologic Basis of Radiation Oncology Arno J Mundt.    o Cancer Management Surgical Therapy Surgical Oncology in the Future References Chapter 33 Vascular Access in Cancer Patients Michail Shafir. and Ralph R Weichselbaum. and Robert W Carlson. PhD. MD      Historical Perspective Biologic Rationale Physics and Physiology of Heating Clinical Experience References . PhD. MD      Physical Basis of Radiation Therapy Treatment Planning and Delivery Biologic Basis of Radiation Therapy Future Directions References o Chapter 35 Principles of Hyperthermia Daniel S Kapp. PhD. John C Roeske.

and Medical Art Chemotherapy Trials Adjuvant and Neoadjuvant Chemotherapy Surrogate End Points Palliative Therapy Laws of Therapeutics Truth Telling Resuscitation Burnout . Donald W Kufe. MD. MD. Emil Frei III. PhD. Anne C E Moor. MD              The Medical Oncologist’s Role Clinical Responsibilities Cancer Prevention Clinical Research Fundamental Science. MD            History Overview Light Absorption and PDT-Relevant Photochemistry Photosensitizers Photosensitizer Transport and Distribution Biologic Mechanisms of PDT Photodynamic Therapy and Oxygen Photodynamic Therapy with Molecular Delivery Systems Perspectives Acknowledgments References • Section 12 Principles of Medical Oncology o Chapter 37 Principles of Medical Oncology James F Holland. PhD.o Chapter 36 Photodynamic Therapy of Cancer Tayyaba Hasan. MD. and Robert C Bast Jr. Clinical Science. and Bernard Ortel.

MD    General Mechanisms of Drug Resistance Resistance to Multiple Drugs Resistance Factors Unique to Tumor Cells In Vivo: Host-TumorDrug Interactions Approaches to Overcoming Resistance to Specific Groups of Drugs Conclusion and Future Directions References    o Chapter 40 Principles of Dose. and Larry Norton. Antonella Surbone. MD  Pharmacokinetic Rationale for Regional Chemotherapy . MD and Karen H Antman.   • Nomenclature: Systeme Internationale (SI) Units Summary References Section 13 Principles of Chemotherapy o Chapter 38 Cytokinetics Teresa Ann Gilewski. MD      Dose Schedule of Drug Administration Combination Chemotherapy Holotherapy References o Chapter 41 Regional Chemotherapy Maurie Markman. Schedule. and Combination Chemotherapy Emil Frei III. Chau Dang. MD. MD. MD. MD      Cell Proliferation Growth Curve Analysis Conclusion Acknowledgment References o Chapter 39 Drug Resistance and Its Clinical Circumvention Charles S Morrow. MD and Kenneth H Cowan.

MD    In Vitro Techniques Summary References o Chapter 44 Pharmacology Mark J Ratain. MD and Gregory A Curt. MD and Charles K Grieshaber. MD     General Mechanisms of Drug Action Principles of Pharmacokinetics Principles of Pharmacodynamics References o Chapter 45 Toxicology by Organ System Michael R Grever. R Hanauske. PhD    Basic Principles of Preclinical Toxicology Evaluation of Toxicity in Humans Effect of Variation in Drug Metabolism on Toxicity . Mathematical Model (Describing Regional Anticancer Drug Delivery) Theoretical Concerns Practical Issues Clinical Examples Conclusion References      o Chapter 42 Animal Models in Developmental Therapeutics Samir N Khleif. MD and William Plunkett. MD        The Role of Animal Models Animal Tumor Models Limitations of Animal Models Animal Models in Cancer Drug Development Other Animal Models Conclusion References o Chapter 43 In Vitro and In Vivo Predictive Tests A.

and Joseph R Bertino. MD. Robert E Handschumacher. Michael Colvin. MD. and Yung-Chi Cheng. MD and William N Hait. Complexity of Assessing Treatment-Related toxicity in Context of Human Disease Toxicity Associated with Chemotherapy by Organ System Conclusion References    • Section 14 Chemotherapeutic Agents o Chapter 46 Folate Antagonists Barton A Kamen. MD            Historical overview Mechanism of Actions Biological Chemistry Pharmacokinetics of MTX Inadvertent Drug Interactions Clinical Application: Dosage Schedules Current Uses for MTX in the Treatment of Neoplastic Disease Adverse Effects Resistance to Antifolates Strategies to overcome resistance to MTX References o Chapter 47 Pyrimidine and Purine Antimetabolites Giuseppe Pizzorno. MD    Pyrimidine Analogues Purine Analogues References o Chapter 48 Alkylating Agents and Platinum Antitumor Compounds D. MD   Alkylating Agents References o Chapter 49 Anthracyclines and DNA Intercalators/Epipodophyllotoxins/DNA Topoisomerases Eric H Rubin. MD. Peter D Cole. MD . MD.

       o Topoisomerase Biology How Drugs Poison Topoisomerases Cellular Response to Topoisomerase-Mediated DNA Damage Mechanisms of Resistance to Topoisomerase Targeting Intercalating Topoisomerase-Targeting Drugs Nonintercalating Topoisomerase-Targeting Drugs References Chapter 50 Microtubule-Targeting Anticancer Drugs Derived from Plants and Microbes: Vinca Alkaloids. PhD       Receptor Proteins in Steroid Hormone Action Measurement of Estrogen and Progestin Receptors Receptors and Response to Endocrine Therapy Receptors and Prognosis for Cancer Recurrence Summary References o Chapter 53 Hypothalamic and Other Peptide Hormones Andrew V Schally. PhD. and Epothilones William T Beck. PhD and Ana Maria Comaru-Schally. Chemistry. MD . PhD      Vinca Alkaloids Taxanes: Paclitaxel (Taxol) and Docetaxel (Taxotere) Epothilones Summary References o Chapter 51 Asparaginase JoAnne Kurtzberg. and In Vitro Activity Conclusions References • Section 15 Principles of Endocrine Therapy o Chapter 52 Steroid Hormone Binding and Hormone Receptors Eugene R DeSombre. PhD and Elwood V Jensen. Taxanes. Carol E Cass. MD    Mechanism of Action. and Peter J Houghton. PhD.

         o Analogues of Peptide Hormones Agonists of LHRH LHRH Antagonists Mode of Action of LHRH Analogues Somatostatin Analogues Antagonists of Bombesin and Gastrin-Releasing Peptide Antagonists of Growth Hormone–Releasing Hormone Treatment of Various Tumors with Peptide Analogues References Chapter 54 Corticosteroids Lorraine I McKay. PhD         Hormones of the Adrenal Cortex Control of Corticosteroid Secretion Pharmacokinetics of Corticosteroids Steroid Synthesis Inhibitors Pharmaceutical Derivatives Physiologic and Pharmacologic Effects of Corticosteroids Corticosteroids in the Treatment of Neoplasms References o Chapter 55 Estrogens and Antiestrogens V. Craig Jordan. MD    Biology of Aromatase Historical Development of Aromatase Inhibitors Development of Improved Aromatase Inhibitors . PhD     Tamoxifen New Agents Conclusion References o Chapter 56 Clinical Use of Aromatase Inhibitors in Breast Carcinoma Harold A Harvey. PhD and John A Cidlowski.

MD and John T Isaacs. MD     Tumor Production of Protein Hormones or Their Precursors Metabolism of Steroids Tumor Production of Enzymes or Fetal Proteins Tumor Production of Cytokines . PhD       Cellular Organization of the Normal Prostate Definition of Androgen Responsiveness on a Cellular Basis Mechanism of Androgen Action Overview of Regulation of Systemic Androgen Levels Pharmacological Approaches to Lower Circulating Androgen Androgen Deprivation Strategies for the Treatment of Recurrent and Metastatic Prostate Cancer Intermittent Androgen Suppression Conclusion References    o Chapter 59 Paraneoplastic Syndromes William D Odell. MD and Kenneth S McCarty Sr. PhD   Pharmacology Clinical Observations on Progestin Receptor and Target Tissue Responses to Progestins Conclusion References   o Chapter 58 Androgen Deprivation Strategies in the Treatment of Advanced Prostate Cancer Samuel R Denmeade.   Classification Selection of Patients for Aromatase Inhibition Therapy Future Perspectives in the Clinical Development of Aromatase Inhibitors Summary References   o Chapter 57 Progestins Kenneth S McCarty Jr.

MD    Contact Allergens Bacillus Calmette-Guérin Chemically Defined Components of Mycobacterial Immunostimulants CORYNEBACTERIUM PARVUM (PROPIONIBACTERIUM ACNES) Other Bacterial Vaccines Levamisole Conclusion References      o Chapter 61 Active Specific Immunotherapy with Vaccines Mepur H Ravindranath.            • Tumor Stimulation of Antibody Production Miscellaneous Syndromes Endocrine Syndromes Caused by Cancer Paraneoplastic Syndromes of the Nervous System Dermatologic Syndromes of Cancer Glomerulonephritis Hematologic Syndromes Other Syndromes Fever and Cancer Tumor Production of Other Proteins Conclusion References Section 16 Principles of Biotherapeutics o Chapter 60 Immunostimulants Robert C Bast Jr. MD and Donald L Morton. PhD and Donald L Morton. MD     Tumor-Host Interaction Whole Cells as Cancer Vaccines Clinical Trials of Tumor Vaccines Current Status of Vaccine Therapy for Human Cancers .

PhD      Molecules: Their Induction. MD    Hematopoiesis and the Role of Growth Factors Erythropoietin Granulocyte Macrophage Colony-Stimulating Factor . MD and Bryan R G Williams. and Gene Regulation Angiogenesis Inhibition Antitumor Effects in Humans Perspective References o Chapter 63 Cytokines: Biology and Applications in Cancer Medicine Elizabeth A Grimm.   o Future Directions Conclusions References Chapter 62 Interferons Ernest C Borden. Receptors. PhD              Interleukin-2 Interleukin-12 Tumor Necrosis Factor-α Interleukin-1 Interleukin-6 Interleukin-4 Colony-Stimulating Factors Interleukin-10 Interleukin-13 Interleukin-15 Conclusion Acknowledgements References o Chapter 64 Hematopoietic Growth Factors Razelle Kurzrock.

                           Granulocyte Colony-Stimulating Factor Macrophage Colony-Stimulating Factor Stem Cell Factor Thrombopoietin Interleukin-1 Interleukin-2 Interleukin-3 Interleukin-4 and Interleukin-13 Interleukin-5 Interleukin 6 Interleukin-7 Interleukin-8 Interleukin-9 Interleukin-10 Interleukin-11 Interleukin-12 Interleukin-15 Interleukin-16 Interleukin-17 Interleukin-18 Other Hematopoietic Growth Factors Use of Hematopoietic Growth Factors after Chemotherapy Hematopoietic Growth Factors in the Transplantation setting Thrombopoietic Agents in the Clinic: an Overview Hematopoietic Growth Factors in Bone Marrow Failure States Future Perspectives References .


Chapter 65 Monoclonal Serotherapy Robert C Bast Jr, MD, Michael R Zalutsky, PhD, Robert J Kreitman, MD, Edward A Sausville, MD, and Arthur E Frankel, MD
      

Therapy with Unmodified Monoclonal Antibodies Elimination of Malignant Cells from Bone Marrow Ex Vivo Therapy with Drug–Monoclonal Antibody Conjugates Radiolabeled Monoclonal Antibodies Targeted Toxins Conclusions References

Section 17 Principles of Gene Therapy

Chapter 66 Cancer Gene Therapy Donald W Kufe, MD, Sunil Advani, MD, and Ralph Weichselbaum, MD
     

Gene Delivery Systems Retroviruses Therapeutic Genes Selective Gene Expression Viral Oncolysis References

Section 18 Principles of Bone Marrow Transplantation

Chapter 67 Autologous Bone Marrow and Stem Cell Transplantation William P Peters, MD, Caroline Hamm, MD, and Roy D Baynes, MD

Rationale and Requirements for Autologous Hematopoietic Stem Cell Transplantation Principles Dose intensity Combination Chemotherapy Volume of Disease Procedure Specific Diseases

     

     o

Non–Hodgkin’s Lymphoma Immune Function Following Transplantation Organ Toxicity Future Directions References

Chapter 68 Transplantation of Allogeneic Hematopoietic Cells for the Treatment of Malignancies Richard J O’Reilly, MD, Esperanza B Papadopoulos, MD, and Trudy N Small, MD

Biology of Allogeneic Marrow Transplants Applied to the Treatment of Hematological Neoplasia Late Complications of Marrow Transplantations HLA-Matched Marrow Transplants for Leukemia Marrow Transplantation for Acute Myelogenous Leukemia Marrow Transplantation for Acute Lymphoblastic Leukemia Marrow Transplantation for Chronic Myelogenous Leukemia Marrow Transplantations for Myelodysplastic Syndromes Marrow Transplantation for Lymphoma Marrow Transplantation for Multiple Myeloma Nonmyeloablative Regimens Used with Peripheral Blood Stem Cells Marrow Transplantation for Patients Lacking an HLA-Identical Sibling Donor T Cell–Depleted HLA-Nonidentical Related and HLA-Compatible Unrelated Marrow Grafts References

        

 •

Section 19 Principles of Psycho-Oncology

Chapter 69 Principles of Psycho-Oncology Jimmie C Holland, MD and Jane Gooen-Piels, PhD
  

Historical Perspective Hearing the Diagnosis Factors in Adaptation to Cancer

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Psychosocial Problems Guidelines for Recognition of Psychosocial Distress Psychiatric Disorders Psychiatric and Psychosocial Interventions Blurring of Conventional Psychosocial and Behavioral Interventions with Alternative/ Complementary Therapies Quality-of-Life Assessment Family Issues Grief in Surviving Family Members Summary References

     •

Section 20 Principles of Oncology Nursing

Chapter 70 Principles of Oncology Nursing Mary Johnson, RN and Connie Henke Yarbro, RN
      

Oncology Nursing as a Specialty Role of the Oncology Nurse Nursing Care Related to Specific Cancer Therapies Supportive Care Survivorship Summary References

Section 21 Principles of Cancer Rehabilitation Medicine

Chapter 71 Principles of Cancer Rehabilitation Medicine Kristjan T Ragnarsson, MD and David C Thomas, MD
     

Application of Rehabilitation Concepts The Cancer Rehabilitation and Adaptation Team Functional Assessment The Rehabilitation Process Cancer of the Brain Cancer of the Spine

Robert C Bast Jr. MD and Kathleen M Foley. MD. MD               The Primary Physician The Radiologist The Pathologist The Surgical Oncologist The Anesthesiologist The Medical Oncologist The Radiation Oncologist The Gynecologic Oncologist The Pediatric Oncologist The Psycho-oncologist The Rehabilitation Specialist The Nurse Oncologist The Oncology Pharmacist Other Support Personnel o Chapter 73 Palliative Care Alan C Carver. and Physician . MD. MD. MD. and Ralph R Weichselbaum. Donald W Kufe. MD   The Role of the Oncologist Suffering in the Patient. Family.        • Cancer of the Head and Neck Cancer of the Lung Cancer of the Breast Cancer of the Gastrointestinal Tract Cancer of the Genitourinary System Cancer of the Limbs Conclusion References Section 22 Principles of Multidisciplinary Management o Chapter 72 Principles of Multidisciplinary Management James F Holland. MD. Raphael E Pollock. Emil Frei III.

RN. and Terry Lierman    Legislative History of the National Cancer Institute Federal Budget Process Public Policy Factors Affecting Medical Research . MD        Informed Consent Human Subjects Research Terminating Medical Care Assisted Suicide and Euthanasia Financial Incentives Ethical Issues in Human Cancer Genetics References o Chapter 75 Legal Aspects of Cancer Joseph M Taraska. MD and Steven Joffe. Marguerite Donoghue Baxter. PA        Elements of Liability Preventing Legal Complications Consent For Whose Acts Must the Physician Respond? The Physician as an Expert Witness Managed Care Withdrawing Life Support/Physician-Assisted Suicide and Euthanasia References  o Chapter 76 The Government and Cancer Medicine John E Ultmann. MD.   Guidelines in the Care of the Dying Patient A Legal Mandate for Palliative Care Conclusion: The Need for Education and Training in End-of-Life Care References  • Section 23 Principles of Societal Oncology o Chapter 74 Ethical Aspects of Caring for Patients with Cancer Ezekiel J Emanuel.

MD           Effects of Managed Care on Providers Effects of Managed Care on Insurers Effects of Managed Care on Employers Effects of Managed Care on Government Programs Effects of Managed Care on Patients and Patient Care Implications for Cancer Care Demands of Patients Facing Terminal Illnesses Current Strategies for the Delivery of Cancer Care Future Directions in Health-Care Reform References o Chapter 78 Outcomes Assessment Jane C Weeks. Public Policy Factors Affecting Costs of Treating and Preventing Cancer Tobacco And Research THE MARCH: Coming Together to Conquer Cancer National Dialogue on Cancer Analysis A Call to Action Epilogue References        o Chapter 77 Clinical Oncology in a Changing Healthcare Environment Martin N Raber. MD        Historic Perspective Outcome Measures Study Designs Outcomes Studies in Oncology Outcomes Management Summary References . MD and Joseph S Bailes.

o Chapter 79 Questionable Cancer Therapies Barrie R Cassileth. PhD            The Evolution of Questionable Cancer Therapies Terminology and Definitions Impact on the Health Care System CAM Use and Users Mainstream Acceptance of CAM CAM Costs and Insurance Coverage CAM Therapies and Practitioners CAM Practitioners and Practices CAM Research Issues References Recommended Books • Section 24 Neoplasms of the Central Nervous System o Chapter 80 Neoplasms of the Central Nervous System Michael D Prados. MD               Epidemiology and Risk Factors Molecular Genetics Familial Syndromes Pathology Grading Systems Clinical Presentation Diagnostic Neuroimaging Surgical Diagnosis and Resection Cortical Mapping and Interactive Image-Guided Resections Postoperative Imaging Clinical Trials Glioblastoma Multiforme and Anaplastic Astrocytoma Anaplastic Oligodendroglioma Low-Grade Gliomas Ependymoma .

MD and Charles B Wilson. MD   Diagnostic Evaluation of the Solitary Thyroid Nodule Differentiated Thyroid Carcinoma . MD.         • Brainstem Glioma Spinal Cord Tumors Medulloblastoma and Primitive Neuroectodermal Tumors Other Primary Tumors of the Central Nervous System Disease Metastatic to the Central Nervous System Spinal Metastases Neoplastic Meningitis Future Directions References Section 25 Neoplasms of the Eye o Chapter 81 Neoplasms of the Eye David H Abramson. Ira J Dunkel. MD. MD and Ann M Gillenwater. MD       Prolactinomas Growth Hormone-Secreting Pituitary Adenomas Mixed Adenomas Adrenocorticotropic Hormone-Secreting Adenomas Endocrine-Inactive Pituitary Neoplasms References o Chapter 83 Neoplasms of the Thyroid Steven I Sherman. and Beryl McCormick. MD     Ophthalmic Oncology in Children Adult Ocular Tumors Ophthalmic complications of radiation and chemotherapy References • Section 26 Neoplasms of the Endocrine Glands o Chapter 82 Pituitary Neoplasms Aviva Abosch.

Aaron I Vinik. MD. MD. MD. MD. MD. MD. Pheochromocytomas. and Waun Ki Hong. MD. MD          Pathogenesis Diagnosis Differential Diagnosis Imaging Characterization of Adrenal Masses Staging Pathologic Diagnosis Management of Adrenal Cortical Carcinoma Long-Term Treatment Outcome The Use of Inhibitors of Adrenal Function in Patients with Functioning Adrenal Cortical Carcinoma Future Prospects References   o Chapter 85 Neoplasms of the Neuroendocrine System and Neoplasms of the Gastroenteropancreatic Endocrine System Larry K Kvols. and Multiple Endocrine Neoplasia Syndromes References   • Section 27 Neoplasms of the Head and Neck o Chapter 86 Head and Neck Cancer Gary L Clayman. Scott M Lippman. Phillippe Chaninian. Stephen B Baylin. and Norman W Thompson. MD. MD  Neuroendocrine Neoplasms of the Gastroenteropancreatic System Parathyroid Carcinomas. MD    Etiology and Epidemiology Biology Chemoprevention Approaches . Roger R Perry. George E Laramore. Li-teh Wu.  MD.   o Medullary Thyroid Cancer Anaplastic Thyroid Carcinoma References Chapter 84 Neoplasms of the Adrenal Cortex David E Schteingart.

and Histologic Features References • Section 28 Neoplasms of the Thorax o Chapter 88 Cancer of the Lung Ara A Vaporciyan. Jonathan C Nesbitt. MD                 Historical Note Smoking and Lung Cancer Environmental Causes of Lung Cancer Familial Predisposition to Lung Cancer Molecular Pathogenesis Cancer Screening and Early Detection Age and Lung Cancer Pathology of Lung Cancer Natural History Diagnosis and Staging Performance Status General Guidelines for Management Results Therapy for NSCLC Radiotherapy Special Considerations .      o Anatomy Pathology Diagnosis Treatment Chemotherapy Approaches in HNSCC References Chapter 87 Odontogenic Tumors George Thomas Gallagher. MD. DMD and Gerald Shklar. Radiographic. and Jack A Roth. MD. MD. MD. Ritsuko Komaki. MD. DDS   Clinical. Jin Soo Lee. Craig Stevens.

    o Chemotherapy for NSCLC Management of SCLC Conclusion and Future Prospects References Chapter 89 Malignant Mesothelioma A. MD              Historical Perspective Incidence and Epidemiology Etiology Other Etiologic Factors Pathology Clinical Features Prognostic Factors Other Types of Malignant Mesotheliomas Benign Mesotheliomas Differential Diagnosis Treatment Prospectus and Prevention References o Chapter 90 Thymomas and Thymic A. MD and Harvey I Pass. MD          Epidemiology and Etiology Anatomic Pathogenesis Clinical Features Associated Paraneoplastic Syndromes Diagnosis Differential Diagnosis Staging Therapy References . Philippe Chahinian. Philippe Chahinian.

MD    Cardiac Tumors Tumors of the Great Vessels References o Chapter 92 Primary Germ Cell Tumors of the Thorax John D Hainsworth. MD        Molecular and Genetic Basis for Pulmonary Metastases Diagnosis and Imaging Nonsurgical Treatment of Pulmonary Metastases Surgical Treatment of Pulmonary Metastases Pediatric Tumors Summary References • Section 29 Neoplasms of the Alimentary Canal o Chapter 94 Neoplasms of the Esophagus Mark K Ferguson. MD. MD     Benign Teratomas of the Mediastinum Malignant Germ Cell Tumors Poorly Differentiated Carcinoma of the Mediastinum References o Chapter 93 Metastatic Tumors in the Thorax Donald L Morton. Philippe Chahinian. MD and F. and Valentin Fuster. MD and Perry Shen. MD        Anatomy and Histology Etiology Epidemiology Presentation Diagnosis Staging Evaluation Therapy .o Chapter 91 Tumors of the Heart and Great Vessels A. David E Gutstein. Anthony Greco. MD.

and Alison A Evans. and Paul Mansfield. MD. MD. MD             History Demographics Etiology Clinical Manifestations Laboratory Tests Surgery for Gastric Cancer Treatment of Gastric Cancer Adjuvant Biologic Response Modifier Therapy of Gastric Cancer Regional Chemotherapy Radiation for Gastric Cancer Perspectives References o Chapter 96 Primary Neoplasms of the Liver Paul F Engstrom. Elin Sigurdson. John C Morris. MD.  o Palliative Therapy of Esophageal Obstruction References Chapter 95 Neoplasms of the Stomach Howard W Bruckner. PhD            Epidemiology Risk Factors Molecular Pathogenesis Prevention Clinical Presentation Pathologic Diagnosis Staging and Prognosis Imaging Modalities Management Other Primary Hepatic Neoplasms References . MD.

MD and Robert A Wolff. MD              Imaging Techniques Liver Resection Adjuvant Chemotherapy Systemic Chemotherapy Hepatic Arterial Chemotherapy Cryosurgery Radiofrequency Ablation Embolization Chemoembolization Radiation Therapy Percutaneous Ethanol Injection Summary References o Chapter 98 The Gallbladder Steven A Curley.o Chapter 97 Treatment of Liver Metastases Nancy E Kemeny. MD        Causative Factors Clinical Presentation Pathology Diagnostic Studies Treatment of Intrahepatic Cholangiocarcinoma Hilar Bile Duct Cholangiocarcinoma References o Chapter 100 Neoplasms of the Ampulla of Vater Douglas B Evans. MD  Diagnostic Evaluation . MD   Gallbladder Carcinoma References o Chapter 99 Diagnosis and Management of Biliary Tract Cancer Steven A Curley. MD and Yuman Fong.

James L Abbruzzese. and Douglas B Evans. Potentially Resectable Disease Treatment of Locally Advanced Disease Treatment of Metastatic Disease References o Chapter 102 Neoplasms of the Small Intestine. MD       Pathology Staging Epidemiology of Colorectal Cancer Tumor Markers Screening Clinical Approach . MD     Tumors of the Small Intestine Tumors of the Appendix Neoplasms of the Peritoneum References o Chapter 103 Adenocarcinoma of the Colon and Rectum Howard W Bruckner. Vermiform Appendix. MD. MD. MD. and Marnin Merrick. and Peritoneum Erik Barquist. MD           Epidemiology Pathology Molecular Biology of Pancreatic Cancer Symptom Patterns Diagnostic Imaging Biliary Drainage Treatment of Localized. MD and Michael Zinner.    o Treatment Associated Syndromes Conclusions References Chapter 101 Neoplasms of the Exocrine Pancreas Robert A Wolff. MD. John Pitrelli.

MD. MD. MD          Pathogenesis Incidence Etiology Molecular Biology Clinical Features Radiographic Evaluation Staging and Grading Surgical Treatment Adjuvant Therapy . Philip W Kantoff. MD.      o Principles of Colorectal Surgery Radiation Therapy Summary Summary References Additional Reading Chapter 104 Neoplasms of the Anus Brenda Shank. MD. Warren E Enker. and Charles L Shapiro. MD          Gross and Microscopic Anatomy Epidemiology Etiology Pathology Diagnosis Staging Treatment Melanoma References • Section 30 Neoplasms of the Genitourinary Tract o Chapter 105 Renal Cell Carcinoma Jerome P Richie. and Marshall S Flam.

Anthony L Zietman. MD.       o Treatment of Metastatic Disease Future Directions in Therapy Surgical Considerations for Metastatic Disease Sarcomas of Renal Origin Wilms’ Tumor (Nephroblastoma) Renal Oncocytoma References Chapter 106 Neoplasms of the Renal Pelvis and Ureter Jerome P Richie. MD           Epidemiology Biology Pathology Signs and Symptoms Diagnostic Evaluation Staging Superficial Bladder Carcinoma Muscle-Invasive Bladder Cancer Chemotherapy for Metastatic Disease References . MD and Philip W Kantoff. MD. and Kenneth Wishnow. MD        Molecular Changes Histopathology Diagnosis Staging Treatment Secondary Tumors of the Ureter References o Chapter 107 Bladder Cancer Philip W Kantoff.

MD. Puras.o Chapter 108 Neoplasms of the Prostate William K OH. MD. MD. Jerome P Richie. MD. A Marcial-Vega. MD. and V. Anthony V D’Amico. MD                Introduction Epidemiology and Risk Factors Biology of Prostate Cancer Screening for Prostate Cancer Diagnosis and Staging of Prostate Cancer Prognostic Factors in Localized Prostate Cancer Management of Localized Prostate Cancer Radical Prostatectomy Radiation Therapy Comparison of Treatment Options Management of Locally Advanced Prostate Cancer Management of Disseminated Cancer Hormone Refractory Prostate Cancer New Approaches to Prostate Cancer Therapy References o Chapter 109 Neoplasms of the Penis Victor A Marcial. A. MD           Epidemiology Etiology Anatomic Pathogenesis Intraepithelial Epidermoid Carcinoma Invasive Epidermoid Carcinoma Radiotherapy Chemotherapy Prognosis Prevention Conclusions . MD. and Philip W Kantoff. Mark Hurwitz.

MD. MD and Guillermo Tortolero-Luna. Bruce J Roth. MD. o References Chapter 110 Neoplasms of the Testis Craig R Nichols. Robert Timmerman. MD. Richard S Foster. MD    The Vulva Carcinoma of the Vagina References o Chapter 112 Neoplasms of the Cervix J. MD. Taylor Wharton. and Lawrence H Einhorn. MD                 Epidemiology Pathology Clinical Presentation Staging Therapy Treatment Versus Cancer Stage Therapy for Disseminated Disease Treatment of Good-Risk Disseminated Germ Cell Tumors Treatment of Patients with “Poor-Risk” Disseminated Disease High-Dose Chemotherapy Treatment of Multiply Recurrent Germ Cell Cancer Special Situations Long-Term Toxicity of Chemotherapy Long-Term Toxicity of Radiation Therapy Extragonadal Germ Cell Tumors References • Section 31 Neoplasms of the Female Reproductive Organs o Chapter 111 Neoplasms of the Vulva and Vagina Jacob Rotmensch. MD and Arthur L Herbst. MD   Epidemiology Diagnosis and Treatment .

MD           Incidence and Epidemiology Clinical Presentation Preoperative Diagnosis Clinicopathologic Classification and Staging Patterns of Spread Prognostic Factors Treatment Prognosis Other Malignant Fallopian Tube Neoplasms References o Chapter 115 Ovarian Cancer Jonathan S Berek. and George S Hagopian. Gillian M Thomas. and George S Hagopian. MD. MD. MD. MD. MD           Risk Factors Pathology Diagnosis Staging Prognostic Factors Oncogene activation and Loss of Tumor Suppressor Function Treatment of Primary Disease Treatment of Recurrent Disease Future References o Chapter 114 Neoplasms of the Fallopian Tube Carmel J Cohen. MD  Epithelial Ovarian Cancer . Gillian M Thomas. MD. and Robert F Ozols. Gillian M Thomas. MD.   o Current Practice Future Opportunities References Chapter 113 Endometrial Cancer Carmel J Cohen.

MD. MD. MD        Clinical Profile Diagnosis Sarcoma-Like Variants Patterns of Spread Prognostic Factors and Prognosis Nonuterine Gynecologic Sarcomas Surgical Treatment .      o Epithelial Ovarian Cancer Nonepithelial Ovarian Cancer Sex Cord-Stromal Tumors Uncommon Ovarian Tumors Metastatic Tumors References Chapter 116 Gestational Trophoblastic Disease Ross S Berkowitz. and George S Hagopian. MD and Donald P Goldstein. MD             Historical Perspective Epidemiology Histopathologic Classification of GTD Molecular Pathogenesis Natural History Diagnosis Staging Therapy Results of Therapy Subsequent Pregnancies Second Cancers References o Chapter 117 Gynecologic Sarcomas Carmel J Cohen. Gillian M Thomas.

and William D Bloomer. MD. Bernard Fisher. Gabriel N Hortobagyi. MD.      • Postsurgical Therapy for Gynecologic Sarcomas Hormone Therapy Radiation Therapy for Leiomyosarcoma Radiation Therapy for Malignant Mixed Müllerian Tumors Chemotherapy References Section 32 Neoplasms of the Breast o Chapter 118 Neoplasms of the Breast Richard G Margolese. MD               Pathology Relation of Tumor Characteristics to Outcome Epidemiology Risk Factors Breast Cancer Biology Natural History and Prognostic Markers Diagnosis and Screening Psychosocial Aspects of Breast Cancer Surgical Biology Systemic Adjuvant Therapy Issues for Further Study Regarding Therapy Management of Metastatic Breast Cancer New Drugs Prevention of Invasive Breast Cancer in Women with Intraductal Carcinoma in Situ (DCIS) Prevention of Invasive Breast Cancer in Women at Increased Risk Perspectives References    • Section 33 Neoplasms of the Skin . MD.

MD. MD  Classification of Benign and Malignant Bone Tumors . John M Kirkwood. Charles A Forscher.o Chapter 119 Neoplasms of the Skin Thomas B Fitzpatrick. MD          The Ozone Layer Ultraviolet Radiation in the Carcinogenesis of Skin Cancers Tumors Arising from the Epidermis Tumors Arising from Mucosa Tumors Arising from Dermal Connective Tissues Tumors Arising from Appendages Metastatic Carcinoma Lymphomas and Leukemias References • Section 34 Malignant Melanoma o Chapter 120 Malignant Melanoma Donald L Morton. and Robert C Wollman. MD. MD. MD             History of Melanoma Epidemiology and Etiology Precursor Lesions Clinical Characteristics Prognostic Features of Clinically Localized Disease Prognostic Features of Regional Lymph Node Metastases Prognostic Features of Distant Metastases Management of Primary Melanoma Management of Regional Lymph Nodes Management of Distant Metastases Future Horizons References • Section 35 Neoplasms of the Bone and Soft Tissue o Chapter 121 Bone Tumors Gerald Rosen. Richard Essner. and Michael T Selch. Henry J Mankin. MD. MD. MD.

       o

Staging of Bone Tumors Bone-Producing Tumors Fibrous Lesions of Bone Cartilage Tumors of Bone Bone Tumors of Vascular or Uncertain Histogenesis Malignant Vascular Lesions of Bone References

Chapter 122 Sarcomas of Nonosseous Tissues Peter W T Pisters, MD, Brian O’Sullivan, MD, and George D Demetri, MD
         

Etiology and Screening Clinical Presentation, Classification, and Diagnosis Staging and Prognostic Factors Treatment of Localized Primary Soft-Tissue Sarcoma Treatment of Locally Advanced Disease Treatment of Metastatic Soft-Tissue Sarcoma Specific Clinical Situations Special Issues in Soft-Tissue Sarcoma Management Summary References

Section 36 Neoplasms of the Hematopoitic System

Chapter 123 Myelodysplastic Syndrome Lewis R Silverman, MD
       

History Classification Etiology Pathobiology Clinical and Laboratory Features Pathogenesis and Relation to Leukemic Transformation Treatment Clinical Management

  o

Future Directions References

Chapter 124 Acute Myeloid Leukemia in Adults Charles A Schiffer, MD and Richard M Stone, MD
       

Pathogenesis and Etiology Morphologic Classification and Clinical and Laboratory Correlates Presenting Signs and Symptoms Therapy New Approaches Complications Summary References


Chapter 125 Chronic Myeloid Leukemia Richard T Silver, MD
             

Incidence and Epidemiology Etilogy Clinical and Hematologic Characteristics Terminal Chronic Myeloid Leukemia Pathophysiology Cytogenetics Fluorescence In Situ Hybridization (FISH) Test Molecular Biology of CML Treatment Treatment of Blast Crisis Bone Marrow Transplantation Cytogenetic and Molecular Follow-Up Future Directions References


Chapter 126 Acute Lymphocytic Leukemia in Adults Charles A Schiffer, MD and Richard A Larson, MD

    o

“Biologic” Differences Between Adult and Childhood ALL Therapy Future Prospects References

Chapter 127 Chronic Lymphocytic Leukemia Kanti R Rai, MD and Michael J Keating, MD
       

Historical Perspective Incidence and Epidemiology Immunobiology and Immunophenotype of CLL Cells Clinical Consequences of Defective B- and T-Cell Functions Natural History and Terminal Events Clinical Staging and Other Prognostic Features Conclusion References


Chapter 128 Hairy-Cell Leukemia Harvey M Golomb, MD and James Vardiman, MD
      

Epidemiology and Etiology Diagnosis: Morphologic and Immunophenotypic Features Clinical Manifestations Differential Diagnosis Treatment Future Prospects References


Chapter 129 Hodgkin’s Disease Peter Mauch, MD and James O Armitage, MD
    

History Epidemiology and Etiology Pathology Treatment of Stage I-II Hodgkin’s Disease Treatment of Advanced Hodgkin’s Disease

and Natural History Differential Diagnosis and Sites of Disease at Presentation Staging and Disease Detection Disease Parameters Which Influence Prognosis and Assessment of Disease Response Therapeutic Approaches According to Real References   o Chapter 131 Mycosis Fungoides and the Sézary Syndrome Youn H Kim. MD and Lee M Nadler. MD      Epidemiology and Etiology Pathology. Immunobiology. MD and Richard T Hoppe. MD        Epidemiology and Etiology Pathology/Pathogenesis Natural History Diagnosis Staging and Prognosis Therapy References o Chapter 132 Plasma Cell Tumors Kenneth C Anderson.  o Summary References Chapter 130 Non–Hodgkin’s Lymphomas Arnold S Freedman. MD and Steven H Bernstein. MD    Mast Cell Biology Mast Cell Leukemia and Other Mast Cell Neoplasms References . MD    Multiple Myeloma Other Plasma Cell Dyscrasias References o Chapter 133 Mast Cell Leukemia and Other Mast Cell Neoplasms Richard M Stone.

MD       Epidemiology Kaposi’s Sarcoma Non–Hodgkin’s Lymphoma (NHL) Hodgkin’s Disease Squamous Cell Neoplasia References • Section 38 Neoplasms of Unknown Primary Site o Chapter 136 Neoplasms of Unknown Primary Site John D Hainsworth. MD      Pathophysiology Clinical Features Laboratory Findings and Differential Diagnosis Natural History and Therapy References • Section 37 Neoplasms in AIDS o Chapter 135 Neoplasms in Acquired Immunodeficiency Syndrome David T Scadden. Epidemiology Leslie L Robison. MD and F. Anthony Greco. MD Chapter 137B Incidence. PhD . Origins. MD        Poorly Differentiated Neoplasms Adenocarcinoma of Unknown Primary Site Squamous Carcinoma of Unknown Primary Site Poorly Differentiated Carcinoma of Unknown Primary Site Neuroendocrine Carcinoma of Unknown Primary Site Summary References • Section 39 Neoplasms in Children o o Chapter 137A Principles and Practice of Pediatric Oncology Michael A Weiner.o Chapter 134 Polycythemia Vera and Essential Thrombocythemia Scott Murphy.

MD             Central Nervous System Vision Hearing Teeth and Salivary Glands Heart Lungs Kidneys Bladder Liver Intestine Musculoskeletal System Endocrine System .         o Acute Leukemia Central Nervous System Tumors Lymphomas Neuroblastoma Retinoblastoma Wilms’ Tumor Bone Tumors Rhabdomyosarcoma References Chapter 137C Principles of Pediatric Radiation Oncology John C Breneman. MD and Ashwatha Narayana. MD     Psychosocial Issues Technical Considerations Biologic Issues References o Chapter 137D Late Effects of Treatment of Cancer in Children and Adolescents Daniel M Green.

Michael E Trigg. MD.  o Second Malignant Tumors References Chapter 138A Childhood Acute Lymphoblastic Leukemia Paul S Gaynon. MD       Heterogeneity Response and Outcome Advances in Primary Therapy Treatment After Relapse Conclusion References o Chapter 138B Pediatric Acute Myeloid Leukemia Richard Aplenc. MD. and Michael A Weiner. MD          Epidemiology Etiology Classification and Diagnosis Presentation Therapy Prognosis Supportive Care Conclusion References o Chapter 138C Hodgkin’s Disease in Children and Adolescents Allen Chauvenet. MD and Beverly Lange. MD. MD       Clinical Presentation and Staging Biology Treatment Late Effects of Childhood Hodgkin’s Disease Conclusion References . Cindy L Schwartz. MD. and Fatih M Uckun.

PhD.o Chapter 138D Non-Hodgkin’s Lymphoma in Children Mitchell S Cairo. MD      Pathologic Characteristics Clinical Presentation and Diagnosis Treatment Perspectives References o Chapter 139B Renal Tumors of Childhood Paul E Grundy. MD     Introduction/Epidemiology Clinical Presentation/Staging Summary/Future Consideration References o Chapter 138E Langerhans’ Cell Histiocytosis Kara M Kelly. MD   The Histiocytic Disorders References o Chapter 139A Hepatic Tumors Marcio Henrique Malogolowkin. MD . MD. and Patrick R M Thomas. Michael L Ritchey. MD. MD and Sherrie Perkins. MB           Epidemiology Molecular Biology and Genetics Pathology Clinical Presentation Preoperative Evaluation Staging Therapy Prognostic Factors Acknowledgment References o Chapter 139C Germ Cell Tumors Barbara Cushing. Norman E Breslow. MD and Neyssa Marina. Daniel M Green. MD.

MD     Rhabdomyosarcoma Nonrhabdomyosarcoma Soft Tissue Sarcomas Conclusion References • Section 40 Complications of Cancer and its treatment o Chapter 140 Management of Cancer Pain Alan C Carver. MD and Darrell J Yamashiro.     o Pathology Molecular Biology and Genetics Clinical Presentation Treatment and Outcome References Chapter 139D Neuroblastoma Katherine K Matthay. MD        Scope of the Problem Barriers to Cancer Pain Management Mechanisms of Cancer Pain Neurophysiology of Pain Types of Pain Common Pain Syndromes in Patients with Cancer Strategy for Assessment and Treatment . MD and Lee J Helman. MD and Kathleen M Foley. MD        Epidemiology Molecular Pathogenesis Prognostic Markers Diagnosis and Staging Treatment Conclusions and Future Plans References o Chapter 139E Soft Tissue Sarcomas of Childhood Leonard H Wexler.

MD         Physiology and Pharmacology in Controlling Emesis Emetic Problems Control of Emesis and Patient Characteristics Treatment of Acute Chemotherapy-Induced Emesis Controlling Emesis in Special Situations Pharmacoeconomics. MD        Introduction and Historical Perspective Incidence Etiology Manifestations of Cachexia Treatment of Cachexia Epilogue References o Chapter 142 Antiemetic Therapy Richard J Gralla. MD and Jerome B Posner. MD    Metastases Nonmetastatic Complications References . Quality of Life.      o Pharmacologic Approaches Psychological and Behavioral Approaches Anesthetic Approaches Neurosurgical Approaches Sedation in the Imminently Dying References Chapter 141 Anorexia and Cachexia Takao Ohnuma. and Antiemetics Conclusion References o Chapter 143 Neurologic Complications Lisa M DeAngelis.

MD      Skeletal Metastases Steroid-Induced Skeletal Complications Methotrexate-Induced Osteopathy Skeletal Complications Secondary to Radiation Therapy References o Chapter 146 Hematologic Complications and Blood Bank Support Kenneth C Anderson. MD and Madeleine Duvic.o Chapter 144 Dermatologic Complications of Cancer Chemotherapy Narin Apisarnthanarax. MD                Alopecia Stomatitis Nail Reactions Extravasation Reactions Hyperpigmentation Radiation-Associated Reactions Photosensitivity Reactions Inflammation of Keratoses Hypersensitivity Reactions Acral Erythema Neutrophilic Eccrine Hidradenitis Eccrine Squamous Syringometaplasia Cutaneous Eruption of Lymphocyte Recovery Cytokine and Miscellaneous Reactions References o Chapter 145 Skeletal Complications Samuel Kenan. MD     Normal Hematopoiesis Hematopoiesis Causes of Pancytopenia Abnormalities of Red Cells and Red Cell Support . MD and Gabriel N Hortobagyi.

MD      Evaluation of the Cardiovascular System in the Cancer Patient Metastatic Involvement of Cardiac Structures Cardiac Effects of Mediator Release from Tumors Cardiac Dysrhythmia in the Cancer Patient Cardiac Complications of Cancer Treatment . MD and Robert S Benjamin. MD     Complications Resulting from Primary Cancer Progression Hemorrhagic Cystitis Radiation Nephritis Diagnosis. and Prevention of Nephrotoxicity of Cancer Therapeutic Agents Monitoring for Drug-Induced Nephrotoxicity References   o Chapter 149 Cardiac Complications Michael S Ewer.         o Abnormalities of White Cells and White Cell Support Abnormalities of Platelets and Platelet Support Other Therapeutic Modalities Effects of Transfusion on the Immune System Transfusion-Associated Graft-Versus-Host Disease Transfusion-Related Infectious Diseases Future Directions in Blood Component Therapy Conclusion References Chapter 147 Coagulopathic Complications of Cancer Sabine Eichinger. Treatment. MD    Cancer-Related Coagulopathic Complications Treatment-Related Coagulopathic Complications References o Chapter 148 Urologic Complications Christopher J Logothetis. MD and Jose E Sarriera. MD and Kenneth A Bauer.

  o Acknowledgments References Chapter 150 Respiratory Complications Roy B Jones. MD               Esophageal Carcinoma Esophagitis Upper Gastrointestinal Bleeding Pseudomembranous Colitis Typhlitis Chemotherapy-Related Ileus Acute Colonic Pseudo-Obstruction Diarrhea Hepatic Complications of Bone Marrow Transplantation Infectious Hepatitis Acute Pancreatitis Radiation Coloproctitis and Proctitis Anorectal Complications References . MD     Alterations in Hepatic Metabolism of Drugs Liver Toxicity and Hematopoietic Stem Cell Transplantation Hepatotoxicity by Anticancer Therapy References o Chapter 152 Gastrointestinal Complications Frank A Sinicrope. MD and Bernard Levin. PhD     Pulmonary Evaluation Specific Complications Conclusion and Perspective References o Chapter 151 Liver Function and Hepatotoxicity in Cancer Laurie D DeLeve.

MD           Hypothalamic-Pituitary Dysfunction Thyroid Disorders Diabetes Mellitus Metabolic Bone Diseases Adrenal Diseases Disorders of Growth Hormone Secretion and Growth Disorders of Electrolyte/Mineral Metabolism Disorders of Lipid Metabolism Sexual Dysfunction References . DMD     Pretreatment Assessment Oral Complications of RadioTherapy Oral Complications of Cancer Chemotherapy Oral Complications Associated with Bone Marrow Transplantation References  o Chapter 154 Gonadal Complications Catherine E Klein. MD          The Hypothalamic-Pituitary-Gonadal Axis Historical Background Preclinical Studies Effects of Chemotherapy on Gonadal Function Effects of Radiation Therapy on Gonadal Function Protective Measures Outcome of Pregnancy Psychosocial Issues References o Chapter 155 Endocrine Complications S.o Chapter 153 Oral Complications Stephen T Sonis. MD and Robert F Gagel. Jim Yeung.

MD  Sudden Death . and Anna T Meadows. MD and Gerald P Bodey. MD        Incidence of Secondary Cancer Clinical Characteristics Shared Environmental Risk Factors Genetic Risk Factors Therapy-Related Secondary Cancers Conclusion References • Section 41 Infections in Patients with Cancer o Chapter 157 Infections in Patients with Cancer Kenneth V I Rolston. MD              Factors Responsible for increased Susceptibility to Infections Bacterial Infections Fungal Infections Viral Infections Protozoal Infections Other Parasitic Infections Abdominal Infection Perianal Infections Skin Infections Therapy of Infections in Neutropenic Patients Infection Prevention Perspectives References • Section 42 Oncologic Emergencies o Chapter 158 Oncologic Emergencies John C Morris. MD. and Management Susan R Rheingold. MD and James F Holland. Alfred I Neugut. MD. Risk Factors.o Chapter 156 Secondary Cancers: Incidence.

MD. MBA. Atlanta. MD            Healthcare Policy and Information Technology Medical and Oncologic Informatics Information Overload Overview of Computers Personal Digital Assistant Internet Information Management Major Medical Databases of Interest to the Oncologist Clinical and Research Uses of Computers in Medical Oncology Oncology office and Hospital Information Systems References Expand All Collapse All An approved publication of the American Cancer Society Associate Editor: Ted S Gansler. American Cancer Society.          • Malignant Pericardial Tamponade Pulmonary Embolism Syncope in the Cancer Patient Superior Vena Cava Syndrome Bleeding in the Cancer Patient Chemotherapy Extravasation Respiratory Emergencies Tumor Lysis Syndrome Cytokine Release Syndrome References Section 43 Oncology and the Information Revolution o Chapter 159 Oncology and the Information Revolution Edward P Ambinder. Georgia .

which includes recommended doses. warnings. the reader is urged to check the product information sheet included in the package of each drug. This is particular important with new or infrequently used drugs. × Close (source: http://webcampus.2009 by Christof Daetwyler and Marco Mumenthaler. Headache online 7. Copyright 2005 . is in accord with the accepted standard and practice at the time of publication. The original (German) version of "Headache Interactive" was develped at the Dept. including choice of drugs and drug dosages. Switzerland with funding provided by Astra-Zeneca AG and GlaxoSmithKline AG. .edu/interactive/headache/) About headache. The English version was done by the authors in their spare time without any monetary support. for Educational Media at the Institute for Medical Education at the University of Berne.Notice: The authors and publisher have made every effort to ensure that the patient care recommended herein.drexelmed. However. and contraindications. Copyright © 2000. BC Decker Inc Bookshelf ǀ NCBI ǀ NLM ǀ NIH Help ǀ Contact Help Desk ǀ Copyright and Disclaimer 6.interactive: This program might be used for educational purposes free of charge and with no royalties inflicted. since research and regulation constantly change clinical standards.

Hess. for Neurology at Dartmouth Hitchcock Medical Center in Lebanon. Switzerland Scientific Illustrator The model used for hedache. Production and Implementation Marco Mumenthaler.Dedication: I dedicate this work to my parents. Credits: The English abbreviated version was developed. NH Editor of the American Version Willi R. MD Drexel University College of Medicine Educational Design and Project Management. MD Dept. M.com .an online tool for teaching/learning medical communicatioon skills which was developed at the Drexel University College of Medicine for the AACH (American Academy on Communication in Healthcare). MD Former Director of the Dept. Dept. who always supported me. for Educational Media at the Institute for Medical Education at the University of Berne. for Neurology at the University of Berne Hospital Content Development and Physician on Camera Mo Levin.A. (Christof Daetwyler) Awards: "Headache interactive" received the prestigeous European Academic Software Award 2000 (EASA2000) in Rotterdam and the highest honor "summa cum laude" at the MediKinale International in Munich in 2000. produced and implemented by: Christof Daetwyler.interactive is based on doc. .

csbsju.7. Biochemistry online (source: http://employees.edu/hjakubowski/classes/ch331/bcintro/d efault.html) .

Dynamics of Membrane Lipids • SUPPLEMENT: MOLECULAR MECHANICS AND DYNAMIC . Lipid Structure B.Biochemistry Online can also be found in the following dig libraries! Click on the logos. Biochemistry Online: An Approach Based on Chemical Logic Dr. Preface • • • • • WHY CHEMICAL LOGIC? UPDATES INTRODUCTION TO BIOCHEMISTRY BIOCHEMISTRY/MOLECULAR BIOLOGY DICTIONARIES REVIEW: THE CELL PERMISSIONS Pre-Class Questions Moodle Quiz • Molecular Modeling Chapter 1: LIPID STRUCTURE A. Henry Jakubowski Last Update: It has also been listed in: May 30. 20 visitors since 8/6/06 Table of Contents Check-in Place your cursor over the icons on the left for a description to appear here. Lipids in Water : Structure C.

Mathcad Spreadsheet D. The Structure and Property of Amino Acids B. C. Thermodynamics and IMF's in Protein Stability G. Glycoproteins: Biosynthesis and Function Chapter 4: DNA. Understanding Protein Conformation D. Composition.Not Just Junk Protein Structure: Literature Learning Module Chapter 3: CARBOHYDRATES A. Laboratory Determination of ∆Go for Protein Folding/Un F. GENOMICS. Monosaccharides and Disssacharides B. Complex Oligosaccharides C. The Structure of DNA B. Predicting Protein Properties Using Computational Biolo Bioinformatics .In Vivo and In Vitro Lit. Why do Single Chain Amphiphiles form Micelles not Bil and Double Chain Amphiphiles from Bilayers and not M Java Applet F. Sequence and Conformational Analyis of Proteins. The Language of DNA . Lipids in Water: Thermodynamics E. Lipids as Biological Signals Lipid Structure: Literature Learning Module Chapter 2: PROTEIN STRUCTURE A. Protein Aggregates . Learning Module E.Proteomics H. Jeopardy | (scrambled list of all Jeopardy answers for w you supply the correct question) D.• REVIEW THERMODYNAMICS XCel. Proteins Folding . AND PROTEOMICS A. The Central Dogma of Biology C.

Genomes and Other Omes (not Gnomes) Chapter 5: BINDING A. A Model Binding System: Myoglobin. Cofactors and Electron Pushing: Sources and Sinks D. More Complicated Enzymes Transport and Kinetics: Literature Learning Module Chapter 7: CATALYSIS REVIEW: ORGANIC CHEMISTRY A. and Oxidases . Kd Error Analysis C.Dehydrogenases. Models of Enzyme Inhibition D. Reversible Binding II: Experimental Binding Curves. The Chemistry of Dioxygen B. Reversible Binding I: Equations and Curves B.D. Binding and the Control of Gene Transcription: E. Enzyme catalyzed reactions in organic solvents E. Ribozymes and the RNA World Catalysis: Literature Learning Module Chapter 8: OXIDATION/PHOSPHORYLATION A. Mon Dioxygenases. Biological Oxidation Reactions . New Methods in Drug Development Binding: Literature Learning Module Chapter 6: TRANSPORT AND KINETICS A. Mechanisms of enzyme-catalyzed reactions C. and Dioxygen D. Hemoglobin. Methods of catalysis B. Passive and Facilitated Diffusion B. Steady State and Rapid Equilibrium Kinetics C.

et 5th Edition Free Web Version. Cox/Nelson • • • • • • • Biochemistry by Matthews. Martindale's Biochemistry Biophysical Resources Medical Biochemistry . Apoptosis .C. Energy Transduction: Uses of ATP B. 5th Edition. Garret and Grisham • Lehninger's rinciples of Biochemistry . Signal Transduction at Cell Membranes: Protein Kinases/Phosphatases D. Signal Transduction: Neurochemistry C. Tymoczko and Stry Searchable Biochemistry/Molecular Biology Books from NCBI Useful Reference: Molecular Cell Biology by Lodish. van Holde. by Berg. 2nd Edition.4th ed. Memory and Learning in Apylsis Capstone: The Origin of Life Appendices • List of Figures • List of Tables • • • 3/12/10 List of Moodle Quizzes Chime and Jmol Files Experimental Techniques Additional Web Links • Biochemistry. ATP and Oxidative Phosphorylation Reactions D.Programmed Cell Death and Signal Transd E. and Ahern Biochemistry. Photosynthesis: The Light Reaction Oxidation/Phosphorylation: Literature Learning Module Chapter 9: SIGNAL TRANSDUCTION A.

van and Ahern EverythingBio Resource A link to all Biochemistry books from the Journal of Che Education • • Archived Clustr Map from 1/15/09 Archived Clustr Map from 1/15/10 Search BC Online . Searchable Biochemistry concepts from Mathews.• • • • • Common mistakes found in Biochemistry textbooks! Physical Chem/Life Sciences: Atkins et al.


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The Merck Manual of Diagnosis and Therapy

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Introduction· Clinical Uses of Genetics· Ethical Controversies· Factors Affecting Gene Expression· Genetic Diagnostic Technologies· Mitochon Topics DNA Abnormalities· Multifactorial (Complex) Inheritance· Single-Gene Defects· Unusual Aspects of Inheritance

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the genetic information in a person's mother and father is recombined through crossing over (exchange b homologous chromosomes). many X chromosome genes in not paired. Each gen a specific DNA sequence. Having a pair of identical alleles for a particular gene is homozygo . the autosom usually homologous (identical in size. A karyotype is the full set of chromosomes in a person's cells. the small. Each gene has a location (locus). Twenty-two of the pairs. as well as a few other genes. which reduces the number of ch to 23—half the number in somatic cells. Germ cells (egg and sperm) undergo meiosis.000 genes. is a segment of DNA containing all the info necessary to synthesize a polypeptide (protein). determines a person's sex. and position and number of gene pair. Women have chromosomes (which are homologous) in somatic cell nuclei. somatic (non-germ) cell nuclei. Structure Humans have about 20. Each pair consists of one from the mother and one from the father. Genes are contained in chromosomes in the and mitochondria. Because the X c has many more genes than the Y chromosome. In meiosis. which is typically the same on each of the two homologous chromosomes. men have one X chromosome (which are heterologous). 2 alleles may have slightly different or the same DN sequences. the basic unit of heredity. The genes that occupy the same locus on each chromosome of inherited from the mother and one from the father) are called alleles. the sex chromosomes (X and Y). with certain exc RBCs). When an egg is fertilized by a sperm at conceptio normal number of 46 chromosomes is reconstituted. shape. The X chromosome carries genes resp many hereditary traits. In humans. normally have 46 chromosomes in 23 pairs. differently shaped Y chromosome carries ge initiate male sex differentiation. Protein synthesis determines m body's structure and function. Genes are arranged linearly along the DNA of chromosomes.Patterns Construction of a family pedigree The Merck Manual Minute Print This Topic Back to Top Email This Topic A gene.

expression is sex-limited or subject to chromosomal inactivation or genomic i Factors that affect gene expression without changing the genome are epigenet Knowledge of the biochemical mechanisms that mediate gene expression is gr rapidly. Gene Function Genes consist of DNA. the numb possible triplets is 43 (64). environmental factors. the degree of tissue differentia (determined by tissue type and age). DNA is a double helix in which nucleotides (bases) are adenine (A) is paired with thymine (T) and guanine (G) is paired with cytosin is transcribed during protein synthesis. it determines which proteins are code production. how the genes are a expressed. Because there are only 20 amino acids. Transcription is also controlled b RNA. As a chain of amino acids is assembled. also called alternative Because introns are spliced out. Some triplets code for the same amino acids as other triplets. The length of the gene depends on the length of the pr which the gene codes. unknown factors. Specif acids are coded by specific triplets. Introns contain other information that affects control and speed of pro production. One mechanism is variability in intron splicing. there are ex combinations. and physiolo of a person—ie. Y triplets may code for things such as instructions to start or stop protein synthe what order to combine and assemble amino acids.whereas having a pair of nonidentical alleles is heterozygosity. biochemical. but the se transcribed from introns are later spliced out. Phenotype refers to the entire physical. wh synthesis occurs. ie. the exons may also be spliced out. When DNA replicates itself during cel one strand of DNA is used as a template against which messenger RNA (mRN RNA has the same base pairs as DNA. Transfer RNA (tRNA) brings each amino acid back to the ri where it is added to the growing polypeptide chain in a sequence determined b mRNA. Phenotype is dete the types and amounts of proteins actually synthesized. Exons code for amino acid components of protein. how the cell (and thus the body) functions. except that uracil (U) replaces thymine mRNA travel from the nucleus to the cytoplasm and then to the ribosome. it folds upon itself to create a dimensional structure under the influence of nearby chaperone molecules. Genotype refers to genetic composition. The code in DNA is written in triplets of the four possible nucleotides. which is synthesized from the DNA strand that is not transcribed into m chromosomes also consist of histones and other proteins that affect gene expre (which proteins and how many proteins are synthesized from a given gene). the penetrance and expressivity of the gene (see General Principles Genetics: Factors Affecting Gene Expression). Genes consist of exons and introns. Gene expression depends on factors such as whether a trait is domi recessive. and then th . Exons and introns together are transcribed onto mRNA. Because there are 4 nucleotides.

. but different. 1: General Principles of Medical Genetics: Symbols for c a family pedigree. proteins.be assembled in many combinations. deafness. uses conventional symbols to represent family members and pertinent health i about them (see Fig. resulting in many different mRNAs capa coding for similar. 1 Symbols for constructing a family pedigree. The number of proteins that can be by humans is > 100. It is also commonly used in genetic counseling. Some sin defects cause abnormalities in multiple tissues. ).000 even though the human genome has only about 20. blue-colored scle dysplastic teeth. Histone modifications su methylation can increase or decrease proteins synthesized from a particular ge acetylation is associated with decreased gene expression. hypermobile joints. Fo osteogenesis imperfecta (a connective tissue disorder that often results from a in a single collagen gene) may cause fragile bones. DNA methylation tends to silen Histones resemble spools around which DNA winds. Construction of a family pedigree: The family pedigree (family tree) can be us diagram inheritance patterns. Some familial disorders with identical phenotypes have patterns of inheritance.00 Other mechanisms mediating gene expression include DNA methylation and h reactions such as methylation and acetylation. Expression of a trait may involve one gene or many genes. an effect called pleiotropy. Traits and Inheritance Patterns A trait may be as simple as the color of the eyes or as complex as susceptibilit diabetes. Fig. The strand of DNA transcribed to form mRNA may also be used as a template for synthesis of RN controls transcription of the opposite strand. and heart valve abnormalities (see also B Connective Tissue Disorders in Children: Osteogenesis Imperfecta).

. starting with the older generation at the top with the most recent at the bottom (see Fig. symbols for each generation in the family are placed in a row numbered with Roman numerals. people are numbered right with Arabic numerals. Fig. Within each generation. and Fig. ). also assigned an identifying number. 5: General Principles of Medical Gen linked recessive inheritance. each member of the pedigree can be identified by 2 numbers (eg. 2: General Principles of Medical G Autosomal dominant inheritance. 3: General Principles of Medical Ge Autosomal recessive inheritance. Fig. Last full review/revision May 2007 by Judith Content last modifi Back to Top Next: Clinical Uses of Geneti . . Siblings are usually listed by age. . with the oldest Thus. 4: General Principles of Medical Ge linked dominant inheritance. 4). II.In the pedigree.

Kidney transplantation (source : http://emedicine.Audio Figures Photographs Sidebars Tables Videos 10.medscape.com/article/1012654-overview) .

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• • • • • • • • • • • • • • • Neurosurgery Ophthalmology Orthopedic Surgery Otolaryngology and Facial Plastic Surgery Plastic Surgery Thoracic Surgery Transplantation Trauma Urology Vascular Surgery Cardiac Disease & Critical Care Medicine Developmental & Behavioral General Medicine Genetics & Metabolic Disease Surgery <script language="JavaScript1. MD.pub=170&amp.st=0&amp.transactionID=684 97225&amp.medscape.occ=0&amp.affiliate=2&amp.cg=ckb&amp.ssp=9&amp.env= 0&amp.2" type="text/javascript" charset="ISO-8859-1" src="http://as.richmedia=yes&amp. Foster G McGaw Hospital and Loyola University of Chicago .site=1&amp.com/js. Section of Pediatric Urology.tile=47088952&amp.tid=&amp.pf=0&amp.usp=0&amp.ct=0&a mp.artid=10042842&amp.ng/Params.pubs=170&amp. Departments of Urology and Pediatrics. Professor of Urology & Pediatrics.pos=101"></script > eMedicine Specialties > Pediatrics: Surgery > Transplantation Kidney Transplantation Author: David Hatch. Chief.

because of advances in surgical techniques and suppression of the immune system. [ CLOSE WINDOW ] . Department of Pediatrics. this condition was essentially untreatable. Director. However. Management of end-stage renal disease in US children aged 0-19 years by age group.000 children develops end-stage renal disease (ESRD) each year. Loyola University Medical Center Contributor Information and Disclosures Updated: Mar 24. Professor. 2009 • • • • • • • • • Print This Email This Overview Workup Treatment Follow-up Multimedia References Keywords Introduction Approximately 1 in 65. the mortality rate of children with chronic renal failure has dramatically declined.Coauthor(s): Rekha Agrawal. MD. Kidney transplantation has become the primary method of treating ESRD in the pediatric population. Division of Pediatric Nephrology. 2008. Before the 1950s. Data from US Renal Data Systems.

1 That same year. Hope for treating renal failure grew with the development of surgical techniques that allowed the anastomosis of blood vessels in the early 20th century. work that eventually won him a Nobel Prize. Jaboulay. visit eMedicine's Kidneys and Urinary System Center. Carrel reported an improved method of suturing vessels together. ESRD from any cause was uniformly lethal.Management of end-stage renal disease in US children aged 0-19 years by age group. For excellent patient education resources. The . performed the first human kidney transplant.2 In 1906. History of the Procedure Until the 1950s. 2008. Following anastomosis of the artery and vein. Also. This kidney made urine for only a short time. see eMedicine's patient education article Kidney Transplant.3 In 1909. a xenograft between a pig and human. Ullman demonstrated the successful autotransplant of a canine kidney to the dog's neck. the kidney made urine. in whose laboratory Carrel had worked. Ernst Unger transplanted an ape's kidney to a young girl with renal failure. In 1902. Data from US Renal Data Systems.

Within several years. . researchers revived interest in renal transplantation. Concurrently.8 Human use of azathioprine followed. Calne found that a derivative of 6-mercaptopurine (azathioprine) increased the success of experimental kidney transplantation in dogs. The success of kidney transplantation increased significantly when Goodwin and Starzl added prednisolone to azathioprine. thus skirting the problems of immune compatibility. in some cases. In 1954. This increased the number of individuals who were candidates for kidney transplantation. meaning that individuals were provided renal transplantation or dialysis regardless of their health insurance coverage or their ability to pay. and long-term graft survival from nonidentical donor kidneys became a possibility. ruptured. transplant centers began performing nonidentical living donor kidney transplantation.5 This reaction increased in severity and rapidity when the recipient received a previous transplant from the same donor.11 A negative crossmatch (no reaction against donor lymphocytes when incubated with recipient serum) indicated that no antibody was present in the recipient. dialysis became available as a pretransplant therapy for patients with ESRD and as a life-preserving measure for recipients of transplants whose kidneys failed. In 1968.9. directed against the donor's organ. became ischemic. a kidney transplant was performed between identical twins. This provided a legal framework for families to donate the organs of deceased loved ones for use in transplantation. However. Within hours or days. and. The number of kidney transplants dramatically increased because of the combination of this legislation and the contemporary advances in immunosuppression. ceased urine production. in 1973 the Medicare program in the United States was expanded to provide insurance coverage for patients with ESRD. transplanted kidneys became swollen. the Harvard Committee on Irreversible Coma described the features of brain death and made the important observation that patients who had lost basic brainstem function were dead despite the persistence of a heartbeat sustained by artificial ventilator support. In a series of experiments.4 Other early attempts at the transplantation of kidneys were unsuccessful.10 Encouraged by this success. Simultaneously. Researchers began to look for ways to prevent this response. Armed with new information about the immune response to allografting.6 Several transplants between twins followed.12 In 1970. Terasaki reported a marked decrease in early allograft failure from hyperacute rejection when a crossmatch between donor lymphocytes and recipient serum was performed. the possibility of kidney transplantation for patients with renal failure who did not have a twin donor remained unrealized. was used in an attempt to prevent the immune reaction to allografting. Ionizing radiation.failure of this attempt convinced Unger that a nonsurgical barrier to transplantation existed. Medawar and colleagues demonstrated that skin grafts from nonidentical rabbits were rejected and sloughed by a reaction involving leukocyte invasion of the graft. Kansas became the first state to enact legislation defining brain death. known to suppress bone marrow production of leukocytes.7 In the early 1960s. such statutes were widely established.

[ CLOSE WINDOW ] . Data from North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) Annual Report. a 1-year allograft survival rate of 75% was typical for kidneys donated by living relatives. a rate of 50% was typical for organs from cadavers.From a relatively rare procedure performed in research centers. Calne reported improvement in allograft survival with the use of a new immunosuppressive agent. New protocols incorporating cyclosporine and other drugs have increased the specificity of immunosuppression and decreased the prevalence of infection complications in transplant recipients. Frequency Approximately 1200 children (aged 0-19 y) in the United States develop ESRD each year.13 Improvement in graft survival followed the routine use of human leukocyte antigen (HLA) tissue matching14 and the use of antilymphocyte antibodies as a temporary adjunct to immunosuppression regimens. Etiology of end-stage renal disease in children aged 0-18 years by age group. cyclosporine. Etiology The most common cause of renal failure in children (<19 y) is glomerulonephritis (see image below).16 This represents approximately 16 cases per 1 million children. In 1978. 2007. During the 1970s. kidney transplantation became available in most major cities.15 Widespread use of cyclosporine led to a dramatic improvement in allograft survival.

Other etiologies are demonstrated in all children in the first image below and by age group in the second image below.Etiology of end-stage renal disease in children aged 0-18 years by age group. [ CLOSE WINDOW ] . 2007. Data from Annual Report North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS). 2007. Etiology of end-stage renal disease in North American children. Data from North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) Annual Report.

2007. Data from Annual Report North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS).Etiology of end-stage renal disease in North American children. .

In the late 1990s. Treatment options include hemodialysis.Etiology of end-stage renal disease in children aged 0-18 years by age group. [ CLOSE WINDOW ] Etiology of end-stage renal disease in children aged 0-18 years by age group. peritoneal dialysis. and renal transplantation. Although kidney transplantation is considered to be the management option of choice in children with ESRD. 2007. Data from North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) Annual Report. about two thirds of children with ESRD received a kidney transplant. a shortage of available organs has led to a decline in the proportion of patients who receive a kidney transplant (see below). Data from North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) Annual Report. 2007. .

2008. [ CLOSE WINDOW ] Management of end-stage renal disease in US children aged 0-19 years by age group. Data from US Renal Data Systems. Pathophysiology . Data from US Renal Data Systems. 2008.Management of end-stage renal disease in US children aged 0-19 years by age group.

These antigens (ie. Macrophages or dendritic cells process these foreign antigens and present them to T-helper lymphocytes.Despite numerous attempts and prolific experimentation. Interleukin (IL)–2 stimulates production of cytotoxic T lymphocytes. Early experimenters understood the outcome of the unmodified response to allografting (ie. through a series of elegant animal experiments. HLAs) widely vary between individuals and are coded by genes located on the short arm of chromosome 6. Modulation of that response became the goal of transplant investigators in the subsequent decades. Thus activated. . Medawar reasoned that exposure to foreign tissue resulted in an activation of the immune system and that it induced specific memory that allowed rapid reaction to subsequent exposure to similar grafts. the T-helper lymphocytes produce lymphokines that stimulate maturation of other reactive cells. Medawar demonstrated that skin grafts between nonidentical rabbits were ultimately sloughed. IL-4 induces transformation of B lymphocytes into plasma cells that produce antibody directed specifically against foreign HLAs. In addition. The description that follows is a simplified schema intended primarily to assist in the reader's understanding of currently used immunosuppressive agents. kidney transplantation between nonidentical twins was not successful until the 1960s. Following allografting. a rapid or gradual decrease in urine output and ultimate demise of the transplanted kidney) but not its mechanism. Although understanding of the immune response to allografts has dramatically increased over the 50 years since Medawar's experiments. Histocompatibility antigens are glycoproteins found on the cell membrane of all nucleated cells.5 He found that this reaction occurred much more rapidly in animals that had previously been grafted from the same donor and that the process involved a leukocytic infiltration in the allograft. the recipient is exposed to foreign HLAs from the graft. In the 1940s. it remains incomplete. T-helper lymphocytes can be stimulated directly by the secretion of IL-1 from macrophages (see below).

copyright 2001. Foreign antigens are processed by macrophages or dendritic cells (antigen-presenting cell) and then presented to T-helper lymphocytes. Thus activated.Simplified diagram of the immune response to nonidentical major histocompatability complex (MHC) antigens. Hatch. [ CLOSE WINDOW ] . used with permission. antibody-producing B lymphocytes. Release of interleukin-1 from macrophages activates T-helper lymphocytes. Diagram provided by David A. MD. these T-helper lymphocytes produce cytokines (interleukin-2) that stimulate production of cytotoxic T lymphocytes. and natural killer cells.


This response occurs more commonly. Foreign antigens are processed by macrophages or dendritic cells (antigen-presenting cell) and then presented to T-helper lymphocytes. these T-helper lymphocytes produce cytokines (interleukin-2) that stimulate production of cytotoxic T lymphocytes. or a combination of both processes. specifically directed against the mismatched tissue. and natural killer cells. MD. This response can vary in severity from mild allograft dysfunction to a dramatic rise in serum creatinine with loss of urine output. resulting in rejection. rupture. and loss of the allograft within minutes or hours. Relevant Anatomy See Pathophysiology. Once stimulated. This is called hyperacute rejection. Currently used pretransplant cross-matching techniques (between recipient serum and donor lymphocytes) have dramatically reduced the occurrence of this type of rejection. causing acute rejection. and natural killer cells attack target cells. a low-grade indolent immune reaction. Most centers consider transplantation in a child who has been disease free for 2 years following treatment of cancer. but not exclusively. . chronic rejection may be a longterm consequence of acute rejection. Transplantation is also contraindicated in any child or family with a history or high likelihood of noncompliance with a prescribed medication regimen. the immune response results in a rapid or gradual attack on the vascular endothelium of the allograft. antibody-producing B lymphocytes. If an individual is exposed to an organ expressing antigens against which the recipient already has developed antibodies. typified by a gradual obliteration of the lumen of small arteries in the graft caused by endothelial thickening. and it can cause swelling. called chronic rejection. Some recipients of transplants experience a gradual reduction in allograft function. Hatch. copyright 2001. Thus activated. Release of interleukin-1 from macrophages activates T-helper lymphocytes. Stimulated cytotoxic T lymphocytes. used with permission.Simplified diagram of the immune response to nonidentical major histocompatability complex (MHC) antigens. Diagram provided by David A. Children with renal failure from focal segmental glomerulosclerosis. the rejection occurs rapidly. Contraindications Obtain a thorough history from all potential pediatric recipients of kidney transplants. Therefore. in recipients who have experienced an acute rejection. Children with acute or chronic active infection and those with malignancy are not generally candidates for kidney transplantation. Active systemic lupus erythematosus and Goodpasture disease are also contraindications to transplantation because these processes can damage an allograft.

carefully evaluate all alternatives for treatment of end-stage renal disease (ESRD). Jaboulay M. More on Kidney Transplantation Overview: Kidney Transplantation Workup: Kidney Transplantation Treatment: Kidney Transplantation Follow-up: Kidney Transplantation Multimedia: Kidney Transplantation References Next Page » • Print This • Email This [ CLOSE WINDOW ] References 1. Ullman E. and Henoch-Schönlein purpura are at increased risk of recurrence following transplantation. Therefore. 1906. Hemodialysis is difficult in very small children. In such persons. transplantation may be the best option. Generally. In: Berlin Dlin Wochenschr.98:859. CAPD may not be possible because of peritoneal scarring. Bull Lyon Med. 3. The success rate of renal transplantation in very young children. Carrel A. 4. Counsel families accordingly. Vol 14. 1909:1057. continuous ambulatory peritoneal dialysis (CAPD) is the preferred method of treatment of children younger than 1 year. it can have a significant impact on organ survival and function. Lyon Med. 2.membranoproliferative glomerulonephritis. Nierentransplantation. Although this increased risk does not necessarily contraindicate transplantation. hemolytic-uremic syndrome. Unger E. La technique operatoire des anastomoses vasculaires et la transplantation des visceres. In: Wien Klin Wochenschr. especially those younger than 1 year. . Experimentelle nierentransplantation. 1902.107:575. Vol 1. 1902:281. systemic lupus erythematosus. Greffe de reins au pli du coude par soudure arte. is significantly less than that in older children. However.

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Acyclovir prophylaxis of varicella in children with renal disease receiving steroids. Transplantation. American Society of Transplant Surgeons. focal segmental glomerulosclerosis. et al. renal failure [ CLOSE WINDOW ] Contributor Information and Disclosures Author David Hatch. treatment. Br J Urol. Belitsky P. kidney donation. Whitaker RH. kidney transplant. Director. [ CLOSE WINDOW ] Further Reading [ CLOSE WINDOW ] Keywords kidney transplantation. [Medline]. Department of Pediatrics. Professor. [Medline]. membranoproliferative glomerulonephritis. American College of Surgeons.14(4):3058. HLAs. Coauthor(s) Rekha Agrawal. Departments of Urology and Pediatrics. Professor of Urology & Pediatrics. kidney rejection. Goodpasture syndrome. systemic lupus erythematosus. glomerulonephritis. Lande MB. Henoch-Schönlein purpura. hemolytic-uremic syndrome. histocompatibility antigens. Barry JM. nephrectomy. renal transplantation. Methods of assessing obstruction in dilated ureters. MD is a member of the following medical societies: American Academy of Pediatrics. Goldstein SL.55. hemodialysis. Hatch DA. et al. 57. Section of Pediatric Urology. renal transplant. Chief. Oct 1993. Fate of renal allografts transplanted in patients with urinary diversion. CAPD. 56.45(1):15-22. transplant. Pediatr Nephrol. kidney failure. end-stage renal disease. MD. MD. continuous ambulatory peritoneal dialysis.56(4):838-42. Feb 1973. and American Urological Association Disclosure: Nothing to disclose. ESRD. dialysis. Loyola University Medical Center . Somers MJ. Foster G McGaw Hospital and Loyola University of Chicago David Hatch. Division of Pediatric Nephrology. Goodpasture disease. [Medline]. Apr 2000.

Cardinal Glennon Children's Medical Center Casimir F Firlit. Managing Editor Brian F Gilchrist. Thomas E Starzl Transplantation Institute. The Floating Hospital for Children at Tufts-New England Medical Center. Up To Date contracted Author.Rekha Agrawal. Medscape contracted Video Blogger . MD. University of Nebraska Medical Center College of Pharmacy. American College of Surgeons. Tufts University School of Medicine Brian F Gilchrist. Inc Consulting fee Review panel membership. Cardinal Glennon Children's Medical Center. Department of Surgery. American Pediatric Surgical Association. Central Surgical Association. Department of Urology. and Islet Transplantation. and Society of University Surgeons Disclosure: Astellas Honoraria Speaking and teaching. Professor of Surgery. MD. MD is a member of the following medical societies: American Society of Pediatric Nephrology and International Society of Nephrology Disclosure: Nothing to disclose. Pancreas. American Urological Association. Surgical Director. MD is a member of the following medical societies: American College of Surgeons. eMedicine Disclosure: Nothing to disclose. Pharmacy Editor Mary L Windle. American Society of Transplant Surgeons. Association for Academic Surgery. and Illinois State Medical Society Disclosure: Nothing to disclose. PhD. Surgeon-in-Chief of Pediatric Surgery. University of Pittsburgh Medical Center Ron Shapiro. and Society for Surgery of the Alimentary Tract Disclosure: Nothing to disclose. Kidney. Robert J Corry Chair in Transplantation Surgery. PhD is a member of the following medical societies: American Academy of Pediatrics. MD is a member of the following medical societies: American College of Surgeons. Medical Editor Casimir F Firlit. Director. MD. Wyeth Honoraria Speaking and teaching. Pediatric Urology Specialists. PC. Stem Cells. Brystol Meyer Squibb StemCell Data Monitoring Committee Consulting fee Review panel membership. Associate Professor. MD. American Society of Transplant Surgeons. Adjunct Associate Professor. American Medical Association. Pharmacy Editor. PharmD. CME Editor Ron Shapiro. Attending Urologist.

American College of Surgeons. Professor of Surgery. National Kidney Foundation. Surgical Complications (Radiology) Renal Transplantation (Medical) (Transplantation) Pancreas Transplantation (Transplantation) Transplants. American Society of Transplantation. Department of Surgery. Association for Academic Surgery. and Southeastern Surgical Congress Disclosure: Nothing to disclose.Chief Editor Stuart M Greenstein. Medical Society of New Jersey. International College of Surgeons. Division of Transplantation. Renal (Emergency Medicine) Patient Education • Chronic Kidney Failure Symptoms • Chronic Kidney Failure Treatment • • Acute Kidney Failure Overview Chronic Kidney Failure Overview . MD is a member of the following medical societies: American Association for the Advancement of Science. Montefiore Medical Center Stuart M Greenstein. Consulting Surgeon. American Society of Transplant Surgeons. New York Academy of Sciences. • Search for CME/CE on This Topic » RELATED EMEDICINE ARTICLES • • • • Kidney Transplantation. MD. Albert Einstein College of Medicine.

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