The absence of plasma citrulline in two patients with Reye's syndrome¹ first suggested that a decreased liver activity of either carbamyl phosphate synthetase or ornithine transcarbamylase or both might explain the hyperammonemia seen in the early phase ...

IN the blood of children with "encephalopathy and fatty degeneration of the viscera" (Reye's syndrome¹) the concentration of ammonia may be increased,² and that of citrulline reduced.³ Since ammonium is a substrate of carbamyl phosphate synthetase and ...

Digitalis toxicity is a diagnostic problem because in some patients signs or symptoms suggesting digitalis intoxication are in fact attributable to other causes. A conceptual approach to the problem is to classify any patient taking digitalis according to ...

The identification of appropriate explicit criteria continues to be a major concern in evaluating the quality of medical care. Payne has cautioned that explicit process criteria are not immutable or absolute values but "are a composite of education, ...

Chemotherapy

In view of the unsatisfactory results with operation and radiotherapy in disseminated disease, chemotherapy has been widely employed. The proper evaluation of drug therapy has been hindered by its indiscriminate use after the demonstration, ...

Ordinarily, the characteristics of biologic species are gradually changed by the slow process of evolution. During this process, the genetic integrity of evolving species is preserved by natural barriers that prevent the merging of hereditary ...

Presentation of Case

A 39-year-old man was admitted to the hospital because of congestive heart failure.

He was known to have a heart murmur since his high-school days but had always been well and vigorous, engaging in calisthenics and jogging. Six months ...

IN 1963 R.D.K. Reye and his colleagues described a constellation of clinical signs and symptoms in children consisting of encephalopathy with fatty infiltration of the viscera. Since that time this syndrome characterized by a prodromal viral or viral-like ...

Throughout most of its history, the practice of medicine has been conducted without concern for the levels of drugs in body fluids and tissues. In part this state of affairs was occasioned by methodologic deficiencies, but even after the advent of ...

About a year ago, Dr. Lamar Soutter, the first dean and chancellor of the University of Massachusetts Medical School, was obliged to resign because of ill health. For over 11 years he had resolutely planned for and developed a school that would be ...

No extract is available for articles shorter than 400 words.

To the Editor: We are sorry that Dr. Crosby (N Engl J Med 294: 333–334, 1976) has had a rude awakening from his dream of a perfect test for disorders of iron metabolism. It is doubtful whether any of the workers with experience of serum ferritin ...

To the Editor: Firkin¹ and more recently Duffy et al. (N Engl J Med 294:167–168, 1976) reported raised concentrations of serum and urine lysozyme (LZM) respectively, in patients with histiocytic medullary reticulosis (HMR).

We measured, over a six-month ...

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

To the Editor: In a case record of a woman with a pelvic mass, the discusser, Dr. Francis M. Ingersoll, queried the consulting radiologist about the possibility of distinguishing primary and secondary ovarian neoplasms with ultrasound. He was answered ...

To the Editor: The measurement of the pressure generated by the respiratory muscles at functional residual capacity against an occluded airway has recently been described by Milic-Emili et al. (N Engl J Med 293:1029, 1975) as a simple means of evaluating ...

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

To the Editor: We were disappointed to see that one of the verbs in our letter entitled "Impartial, Signed Reviews" (N Engl J Med 294:564, 1976) had been incorrectly changed and no longer agrees in number with its subject. Since the writings of teachers ...

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

Makino is one of the masters of cytogenetics, and this book is a masterpiece. Human cytogenetics is commonly dated to 1956, when the normal chromosome number was identified as 46. Makino sees human cytogenetics as a branch of cytogenetics, born in the ...

SYMPOSIUM ON FOLLOW-UP OF HIGH-RISK NEWBORNS

The Neonatology Service of the Medical Center of Western Massachusetts will present a symposium entitled "Follow-up of High-Risk Newborns," to be held at the Sheraton Inn, Springfield West, West Springfield, on ...