Key Revision Changes

New chapter-opening vignettes

Chapter 2 Chemical Basis of Life

Patients with hereditary pancreatitis have a biochemical problem that causes whole-body pain as the pancreas digests itself.

Chapter 3 Cells

People who can,t get AIDS because the absence of a cell-surface co-receptor prevents HIV binding.

Chapter 4 Cellular Metabolism

A 17-year-old boy dies because a toxin from food poisoning interferes with aerobic respiration and his mitochondria cannot produce ATP.

Chapter 5 Tissues

A death row inmate donates his body to science, and it ends up on the Internet as digital images to complement the vast printed medical literature.

Chapter 6 Skin and the Integumentary System

A woman loses her skin (toxic epidermal necrolysis) from a reaction to antibiotic treatment.

Chapter 7 Skeletal System

Pioneering skull base surgery. This vignette describes a new approach to remove a previously inaccessible tumor.

Chapter 8 Joints of the Skeletal System

Signs of gout in dinosaurs include erosion patterns of bone at a joint, as revealed by X-rays of fossilized remains.

Chapter 9 Muscular System

The girl who couldn,t smile had Moebius syndrome and was aided by surgery that transplanted nerve and muscle tissue from her legs to her face.

Chapter 12 Somatic and Special Senses

A chemist in the late 1700s, curious about his own colorblindness, had his physician dissect his eyes after he died. The physician did not have the technology to determine subtle changes. Almost 200 years later, thanks to proper storage and advance technology, we continue to learn about colorblindness.

Chapter 14 Blood

A New Natural Resource describes the increased use of stem cells in cord blood because they are less likely to cause a reaction in the recipient.

Chapter 16 Lymphatic System and Immunity

The Gift of Life describes how a father successfully donated a portion of his liver to his daughter.

Chapter 19 Respiratory System

A case of carbon monoxide poisoning may be difficult to diagnose because symptoms are attributable to other causes.

Chapter 20 Urinary System

In a few cases, toxin from E. coli food poisoning affects not only the digestive tract but also the kidneys.

Chapter 23 Human Growth and Development

The World,s Oldest Human explains how good genes and a good outlook on life contributed to the longevity of a French woman (122 years). The vignette also explains how most succumb to heart disease, cancer, etc. in their fifties to eighties~so if one survives those possibilities, that person is likely to live quite long.

New tables

Table 11.6 Unusual and severe sleep disorders are described.

Table 14.11 The table on clotting factors includes a more detailed list of clotting factors that allows for a more in-depth look at blood clotting without losing sight of the main issue.

Table 16.4 This table describes cytokine functions in the immune response.

Table 16.9 As the use of transplants increases, students need to understand the different types (autograft, isograft, allograft, xenograft) of transplants.

Table 23.6 This table compares the leading causes of death worldwide in 1900, 1986, and 1993 (numbers from the Centers for Disease Control).

New Clinical Applications

3.1 Faulty Ion Channels Cause Disease

Diseases resulting from faulty ion channels, plus drugs that work by acting on ion channels are described.

3.4 Cloning

Recent progress in cloning, highlighting some issues and potential benefits.

6.3 Acne

Acne is a topic to which most students personally relate. To dispel myths and
misunderstandings, the physiological cause of acne is described with discussion of
recommended treatments.

10.1 Migraine

Migraine, causes and treatments are discussed in detail.

11.4 Parkinson,s Disease

Though Parkinson,s disease affects many and its cause is unknown, there is hope in new drug treatments along with controversial surgery treatment.

13.5 Misrepresenting Melatonin

Melatonin has been advertised to be effective in treating insomnia, jet lag, depression, etc., but this clinical application explains that there is still a lot that is unknown about this chemical.

15.5 Space Medicine

This clinical application on space medicine details the problems of the effects of microgravity on the cardiovascular circulation and presents solutions to the problems of maintaining good flow.

19.2 Lung Irritants

Asbestos and beryllium, both lung irritants, cause extrinsic allergic alveolitis.

23.4 Joined for Life

A sensitive description of conjoined twins relates to tissue development in utero.

Content changes

Chapter 3 Cells

Clarification of terminology for facilitated diffusion, channels and carriers.

Chapter 4 Cellular Metabolism

Completely reworked section on oxidation/reduction, hydrogen/electron carriers, and
oxidative phosphorylation. Upgraded figures for glycolysis, citric acid cycle, and electron transport; also more on the effects of ultraviolet light on DNA. Enhanced presentation of the role of transfer RNA in protein synthesis.

Chapter 10 Nervous System I: Basic Structure and Function

Improved diagrams and discussion of resting potential and threshold, including new discussion of gated channels; clearer discussion of recycling of membrane in section on neurotransmitter release.

Chapter 15 Cardiovascular System

The information on electrocardiograms, including the physiological significance of the EKG pattern, has been brought into the flow of the text as opposed to being relegated to a boxed aside.

Chapter 16 Lymphatic System and Immunity

The order and flow of the immune response has been reworked.

Chapter 21 Water, Electrolyte, and Acid-Base Balance

Clearer discussion of acids, bases, and buffers.

Updates

Joined for Life A sensitive description of conjoined twins relates to tissue development in utero.

Chapter 3 Cells

There has been an introduction and added discussion of transcytosis, which combines endocytosis and exocytosis. In particular, the text discusses transcytosis as it relates to infection with HIV.

Clinical Application 3.2 The Blood-Brain Barrier

Alterations in the blood-brain barrier may be a factor in Gulf-war Syndrome.

Clinical Application 3.3 Disease at the Organelle Level

Mitochondrial diseases have been added to the discussion.

Chapter 10 Nervous System I: Basic Structure and Function

Vignette adds a look at pupil dilation as a possible marker for Alzheimer,s disease.

Clinical Application 10.6 Drug Addiction

Adds down-regulation of receptors and nicotine to the discussion of addiction.

Clinical Application 11.2 Spinal Cord Injuries

The discussion of spinal cord injuries has been updated to include details of Christopher Reeve,s spinal cord injury.

Clinical Application 14.5 Replacing Blood

The use of PEG (polyethylene glycol) to "coat" the red blood cells (cover the surface antigens that cause a transfusion reaction) to allow for universal use of the blood~no need for typing.

Chapter 16 Lymphatic System and Immunity

The AIDS coverage has been updated with more current information.

Chapter 17 Digestive System

The vignette has been updated to include the use of a breath test for H. pylori as opposed to the more traumatic stomach biopsy.

Clinical Application 17.3 Hepatitis

Updated information on the different types of viruses that cause hepatitis and the various ways the different viruses
are contracted.

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