THE terminal phase of blood coagulation begins with the activation of fibrinogen by thrombin, and under physiologic conditions, it ends with the formation of highly polymerized, cross-linked fibrin. Thrombin converts fibrinogen to fibrin monomer through ...

IN 1959, Prinzmetal et al.¹ described a group of patients with chest pain at rest associated with transient ST-segment elevation and termed this syndrome "variant" angina pectoris. They hypothesized that this syndrome was due to coronary arterial spasm, ...

GYRATE atrophy of the choroid and retina is an autosomal-recessive tapetoretinal disease characterized by night blindness, patchy atrophic areas in the mid-periphery of the fundi, constriction of visual fields, myopia, and posterior cataracts.¹ The ...

SINCE the reports of DeGowin¹ and Richardson² and their colleagues, androgens have come into widespread use for the treatment of anemia in patients receiving maintenance hemodialysis. Although there have been many studies, most were uncontrolled. Various ...

THE demonstration that a number of peptides are localized in the brain has resulted in major new developments in neuroendocrinology and the neurosciences. The surprise and disbelief occasioned by early reports of hypothalamic releasing hormones located in ...

PERIVENTRICULAR-intraventricular hemorrhage is by far the most important variety of neonatal intracranial hemorrhage because it is both a common and a serious lesion. The other major types of hemorrhage — subdural hemorrhage, primary subarachnoid ...

MALABSORPTION of the carbohydrate lactose is a common cause of flatulence, abdominal discomfort, and diarrhea in otherwise healthy persons. The possibility that such symptoms could result from malabsorption of the other major dietary carbohydrates (...

Presentation of Case

A 69-year-old woman was admitted to the hospital because of pain in the right upper quadrant.

A cholecystectomy had been performed 30 years earlier. She was well until eight months before admission, when she experienced right-upper-...

The containment of health-care costs persists as a policy imperative, but the center of gravity appears to be shifting away from regulatory procedures, such as health-care planning and rate setting, toward the theme of competition among alternative ...

Amid a flurry of controversy, the trustees of the Massachusetts General Hospital have disallowed heart transplantation by the cardiac surgical service.¹ Meanwhile, the Mayo Clinic is establishing a new heart-transplantation program.² Moribund in the 1970s,...

The issue of "physicians of the future" is best addressed in terms of the larger, less parochial issue of "What is the best combination of systems, tools, and people for solving any health-care problem in the context of the individual patient's life?" To ...

No extract is available for articles shorter than 400 words.

To the Editor: We have recently encountered previously unreported complications of the use of water mattresses on hospital beds. Water mattresses are being used with increasing frequency in our hospital in an effort to prevent the development of ...

To the Editor: A 32-year-old man was admitted to the hospital with signs and symptoms of an acute Central-nervous-system (CNS) infection. He had no history of recent genital infection, but two months earlier he had been treated with prostatic massage for ...

To the Editor: In December 1979, marine biologists at the New England Aquarium in Boston observed a sudden increase in the number of stranded and dead harbor seals (Phoca vitulina) on Cape Cod. Over the next nine months, approximately 500 seals were ...

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

To the Editor: Spiegel et al. report in the December 18 issue¹ that intraoperative measurements of urinary cyclic AMP during surgery for primary hyperparathyroidism are useful in determining how much parathyroid tissue needs to be removed, and they ...

To the Editor: There is a common assumption that since Africans often have volvulus and since they eat high-fiber diets, the latter are therefore the cause of the former. Sigmoid volvulus is indeed exceedingly common in some African tribes. However, it ...

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

To the Editor: Running has become one of the most popular forms of exercise, and much is known about its effects on cardiopulmonary function. However, as a runner and a gastroenterologist, I am disappointed to find that so little is known about the ...

To the Editor: As a result of the nation's energy crisis, wood-burning stoves are rapidly becoming common household fixtures and are consequently a new source of burn injuries, especially among children.

During October and November 1980, Shriners Burns ...

No extract is available for articles shorter than 400 words.

To the Editor: The recent focus on technology assessment, ¹ and the growth of bureaucratic offices to perform this function^{2 , 3} have stimulated me to report my experiences in the early days of what is now known as technology assessment. The need for ...

No extract is available for articles shorter than 400 words.

To the Editor: The true and proper goal of education is to bring people to themselves. By this standard, medical education is a conspicuous failure. In medical school, information is packaged and delivered in great quantities. No time is allowed for ...

No extract is available for articles shorter than 400 words.

To the Editor: In his thoughtful essay on arrogance, Dr. Ingelfinger confronts the tension between autonomy and expertise that exists in the physicianpatient relation. His description of the patient who personally shoulders all the burdens of medical ...

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

"One day after her mastectomy, her surgeon walked into her room and with a big smile announced that he had some very good news for her: a close examination of the removed breast revealed that she did not have cancer after all. Five days later she left the ...

It is a pleasure to see two fine surgical textbooks such as these reappear in new editions. Both are written mainly for medical students, and we must judge them primarily on how well they can be used by students. However, we must also ask who else will ...

"Advances in the management of gunshot missile wounds have come largely during wartime and tend to be forgotten during peacetime." "As in the years following other wars, the hard-won lessons of military surgery are already fading from memory, and surgical ...

No extract is available for articles shorter than 400 words.

No extract is available for articles shorter than 400 words.

The receipt of the following books is acknowledged, and this listing must be regarded as sufficient return for the courtesy of the sender. Books that appear to be of particular interest will be reviewed as space permits.

The Journal solicits reviews of ...

DERMATOPATHOLOGY

A course entitled "Gross and Microscopic Pathology of the Skin" will be held at Resorts International Hotel Casino in Atlantic City, June 15–19.

Contact the Dermatopathology Fdn., P.O. Box 377, Canton, MA 02021.

FORENSIC MEDICINE

The ...