L. Mazzaferri, MD, FACP xiii Acknowledgement The editors are grateful to Jeff Smith and Jenny Riegler for their unflagging professionalism and patience. xiv Contents Case 1 Mitral Regurgitation - Chronic Versus Acute: Implications for Timing of Surgery ¿ . ¿ ¿ ¿ . . ¿ . . . . . ¿ . . . . . . . . . . . 1 Harisios Boudoulas, MD Charles F. Wooley, MD Advances and diagnostic imaging in a surgical technique have changed the approach to mitral valve regurgitation. This chapter provides an expert's perspective. Case 2 Cystic Fibrosis in Adults .. ¿ ¿¿¿¿¿¿¿¿¿¿¿¿ 36 Andrew Libertin, MD John S. Heintz, MD As children with cystic fibrosis grow into adulthood, the internist assumes a greater role in their care. Case 3 Thrombotic Thrombocytopenic Purpura . . . . . . . . . . 51 . . . Donald E. Thornton, MD Earl N. Metz, MD, FACP Patients with ITP continue to present difficulties in diagnosis and management. Two experts discuss the current approach to ITP.