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- Volume 43, 1992
Annual Review of Medicine - Volume 43, 1992
Volume 43, 1992
- Review Articles
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Lung Transplantation
Vol. 43 (1992), pp. 1–8More LessLung transplantation has become a therapeutic option for appropriately selected patients with end-stage lung disease. Recipient selection guidelines are summarized, and the timing of transplantation is discussed. Functional results and survival statistics are reviewed.
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Antithrombins: Their Potential as Antithrombotic Agents
Vol. 43 (1992), pp. 9–16More LessThe inhibition of thrombin is the key to the prevention and treatment of thrombotic disorders. Although heparin is an extremely effective anticoagulant, it has certain limitations that are not shared by newer thrombin inhibitors. As a result, these novel inhibitors may have advantages over heparin in certain clinical settings.
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Suicide: Risk Factors and Prevention in Medical Practice
Vol. 43 (1992), pp. 37–46More LessSuicide is a preventable cause of death that increasingly affects younger age groups. We review the epidemiology of suicide in the general population, in psychiatric patients, and in medical/surgical patients. The essential role of the primary care physician in preventing suicide is examined.
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The Molecular Biology of G6PD Variants and Other Red Cell Enzyme Defects
Vol. 43 (1992), pp. 47–59More LessModern techniques of molecular biology have made it possible to identify mutations in a number of different hereditary red cell enzyme defects. Most of the studies have been performed in glucose-6-phosphate dehydrogenase deficiency, where a large number of point mutations have been identified. The same mutations are encountered repeatedly, even in patients with defects that were thought, on the basis of biochemical properties of the residual enzyme, to be distinct. A beginning has been made in identifying mutations in a few other red cell enzyme defects.
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The Molecular Basis of Colon Cancer
Vol. 43 (1992), pp. 61–68More LessThere are approximately 160,000 new cases of colon cancer every year in the United States. Colon carcinoma results from the aggregate effects of multiple genetic alterations. Some genetic alterations may be inherited, while others reflect somatic mutations. The latter may themselves be the indirect result of environmental factors such as diet. It is the total accumulation of these genetic changes, combining the activation of oncogenes with the inactivation of tumor suppressor genes, that is responsible for determining the biologic properties of colon cancer.
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A Putative Role of Hypercholesterolemia in Progressive Glomerular Injury
Vol. 43 (1992), pp. 83–92More LessRecently, much experimental evidence has accumulated contending that hypercholesterolemia is an aggravating factor in the progression of initial glomerular injury to glomerulosclerosis. Many of the features of progressive glomerular disease share biological properties with those of atherosclerosis, and data suggesting a noxious role for oxidized low-density lipoprotein in the glomerulosclerosis process are emerging. This review discusses these issues and examines the pathobiology of cholesterol-induced glomerular injury.
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Detection of Microbial Nucleic Acids for Diagnostic Purposes
Vol. 43 (1992), pp. 147–155More LessThe last decade has seen an explosion of interest in the use of molecular genetic techniques to diagnose infectious diseases. Specific molecular probes have been developed for nearly all of the significant, known microbial pathogens. The evolution of incrementally more powerful technologies, particularly gene amplification, has made it possible to detect pathogens with exquisite sensitivity, as well as specificity, based on their nucleic acids. As increasingly rapid and automated methods have become incorporated into successive generations of probe tests, these diagnostics have gained increasing acceptance for routine clinical use.
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Biological Regulation of Factor VIII Activity
Vol. 43 (1992), pp. 325–339More LessFactor VIII, the plasma protein deficient in hemophilia A, is a crucial cofactor for regulation of hemostasis. Our understanding of factor VIII increased tremendously once it became possible to isolate homogeneous preparations of this protein from plasma. In addition, the isolation of the factor VIII gene has provided new means of exploring the structure and function of factor VIII. This increasing knowledge also sheds light on the genetic alterations resulting in hemophilia as well as in thrombophilia. This chapter summarizes our current understanding of the regulation of factor VIII function and raises questions to be answered in the years to come.
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Pulmonary Complications of Transplantation
Vol. 43 (1992), pp. 425–435More LessImproved immunosuppressive regimens, advances in surgical proficiency and techniques, and improved supportive medical care have translated into dramatic increases in graft survival in organ transplantation and in patient outcome in bone marrow transplantation. Though effective immunosuppression has also led to an increase in infectious complications, several recent advances, including the development of effective surveillance protocols and antiviral therapy and the use of prophylactic antibiotics, appear to have made a significant positive impact on the management of infections and survival of transplant recipients. In addition, a clearer understanding of noninfectious pulmonary complications, such as bronchiolitis obliterans, and continued improvement in techniques for evaluating a host of posttransplant pulmonary disorders will likely further enhance posttransplant therapy and survival.
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Acute Progressive Epstein-Barr Virus Infections
Vol. 43 (1992), pp. 437–449More LessA few Epstein-Barrvirus (EBV) infections result in progressive, potentially fatal disease. Nearly all of these progressive EBV infections occur in individuals known or suspected to be immunodeficient. Diagnosis and treatment are difficult.
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The Resurgence of Measles in the United States, 1989-1990
Vol. 43 (1992), pp. 451–463More LessAfter almost a decade of relatively few reported cases, a major resurgence of measles occurred in the United States in 1989-1990. The increase primarily involved unvaccinated racial and ethnic minority children less than five years of age residing in inner-city areas. Outbreaks of measles among vaccinated school-aged children continued to occur but had less impact than outbreaks among preschool-aged children. Efforts to prevent measles must be aimed at improving age-specific measles vaccination coverage among preschool-aged children, and implementation of a two-dose measles strategy among school-aged children.
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Quinolone Antimicrobial Agents
Vol. 43 (1992), pp. 465–486More LessThis chapter reviews the chemistry, microbiology, pharmacology, and clinical use of the fluoroquinolone antimicrobial agents. The molecular and clinical problems of bacterial resistance are reviewed. The clinical areas in which fluoroquinolones have been investigated are detailed, with particular attention to areas of appropriate and inappropriate use.
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The Ophthalmopathy of Graves' Disease
Vol. 43 (1992), pp. 487–495More LessOphthalmopathy is an integral component of Graves’ disease. It usually appears at the same time as hyperthyroidism, and is characterized by proptosis (exophthalmos), periorbital and conjunctival edema, eye muscle dysfunction, and on occasion corneal ulceration or optic neuropathy. Graves’ ophthalmopathy, like Graves’ hyperthyroidism, is an autoimmune disease, but the mechanisms that initiate and maintain it are not known. Most patients can be treated conservatively, but a few require antiinflammatory or surgical therapy to relieve symptomsa nd preserve vision.
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Therapeutic Approaches to Hemoglobin Switching in Treatment of Hemoglobinopathies
Vol. 43 (1992), pp. 497–521More LessThe past decade has witnessed profound increases in knowledge of the structure, function, and developmental regulation of the human globin genes. This information has deepened our understanding of the molecular and cellular mechanisms underlying inherited disorders affecting hemoglobin, and it has provided a new perspective for attaining meaningful increases in fetal hemoglobin synthesis in the management of sickle cell anemia and beta thalassemia. Efforts to provide therapy for these disorders are based on three factors: an understanding of their pathophysiology; the potential for fetal hemoglobitno alter its manifestation; and the concept that developmental changes in globin gene expression might be reversed by manipulating cellular and molecular regulatory mechanisms. In this review we discuss these topics and examine critically recent efforts to apply various pharmacological agents to in vitro, animal, and human models with the goal of increasing HbF synthesis. Several agents have demonstrated activity in patients with hemoglobin disorders. One such agent, hydroxyurea, has been shown to be potentially efficacious in phase II clinical trials in patients with sickle cell anemia and awaits testing in a placebo-controlled phase III study.
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Kidney Preservation Ex Vivo for Transplantation
Vol. 43 (1992), pp. 523–551More LessIschemic injury to the renal allograft, prior to implantation, is an important cause of delayed graft function. With improved understanding of the pathophysiological mechanisms involved, strategies have been devised to minimize ischemic injury during preservation ex vivo. It is clear that reducing the warm ischemic time, flushing the kidney with hypothermic solution containing cell-impermeant compounds, and maintaining the organ at low temperature ex vivo have increased the duration that the kidney can be preserved. The effectiveness of a number of other components of preservation solutions, as well as the relative merits of continuous perfusion of the organ ex vivo, is more controversial. In this chapter, we review the mechanistic features of ischemic acute renal failure and discuss various preservation strategies and their success in the context of these basic principles of ischemic pathophysiology.
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Previous Volumes
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Volume 75 (2024)
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Volume 74 (2023)
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Volume 73 (2022)
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Volume 72 (2021)
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Volume 71 (2020)
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Volume 70 (2019)
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Volume 69 (2018)
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Volume 68 (2017)
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Volume 67 (2016)
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Volume 66 (2015)
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Volume 65 (2014)
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Volume 64 (2013)
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Volume 63 (2012)
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Volume 62 (2011)
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Volume 61 (2010)
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Volume 60 (2009)
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Volume 59 (2008)
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Volume 58 (2007)
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Volume 57 (2006)
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Volume 56 (2005)
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Volume 55 (2004)
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Volume 54 (2003)
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Volume 53 (2002)
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Volume 52 (2001)
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Volume 51 (2000)
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Volume 50 (1999)
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Volume 49 (1998)
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Volume 48 (1997)
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Volume 47 (1996)
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Volume 46 (1995)
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Volume 45 (1994)
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Volume 44 (1993)
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Volume 43 (1992)
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Volume 42 (1991)
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Volume 41 (1990)
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Volume 40 (1989)
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Volume 39 (1988)
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Volume 38 (1987)
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Volume 37 (1986)
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Volume 36 (1985)
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Volume 35 (1984)
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Volume 34 (1983)
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Volume 33 (1982)
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Volume 32 (1981)
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Volume 31 (1980)
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Volume 30 (1979)
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Volume 29 (1978)
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Volume 28 (1977)
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Volume 27 (1976)
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Volume 26 (1975)
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Volume 25 (1974)
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Volume 24 (1973)
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Volume 23 (1972)
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Volume 22 (1971)
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Volume 21 (1970)
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Volume 20 (1969)
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Volume 19 (1968)
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Volume 18 (1967)
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Volume 17 (1966)
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Volume 16 (1965)
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Volume 15 (1964)
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Volume 14 (1963)
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Volume 13 (1962)
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Volume 12 (1961)
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Volume 11 (1960)
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Volume 10 (1959)
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Volume 9 (1958)
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Volume 8 (1957)
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Volume 7 (1956)
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Volume 6 (1955)
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Volume 5 (1954)
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Volume 4 (1953)
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Volume 3 (1952)
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Volume 2 (1951)
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Volume 1 (1950)
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Volume 0 (1932)