MIFEPRISTONE (RU 486) is a 19-norsteroid that has antiprogesterone activity by virtue of its ability to inhibit progesterone binding competitively at the receptor level.¹ It was first used to terminate pregnancies in humans in 1982.² Since then, several ...

MONOCLONAL antibodies directed against myelin antigens are frequently detected in patients with polyneuropathy associated with IgM monoclonal gammopathy.^{1 , 2} Some patients with demyelinating neuropathy and IgM monoclonal gammopathy have a monoclonal (M) ...

CLASSIC immunologic techniques have thus far failed to establish the identity of the beta-cell surface proteins that serve as the antigens for the islet-cell autoantibodies found in the serum of patients with insulin-dependent diabetes mellitus (IDDM). It ...

THE question of whether women who delay childbearing are at an increased risk of having an adverse outcome of pregnancy is of importance because of the growing proportion of first births to older women. Between 1970 and 1986 the rate of first births in ...

DIFFERENTIATION of hematopoietic progenitor cells into lineages is accompanied by the activation of genes that regulate the expression of surface antigens specific to each cell line and each stage of differentiation. These antigens, known as surface ...

THE condition of anencephaly has attracted considerable recent attention in medical, legal, ethical, religious, and lay discussions. The primary reason for these discussions and for the preparation of this document has been the interest in transplanting ...

Neurologic Disorders

The tendency of certain workplace toxins, including organic solvents such as n-hexane, metals such as lead and arsenic, and certain organophosphate compounds, to cause profound and occasionally irreversible damage to the axons of ...

Presentation of Case

A 15-year-old girl was admitted to the hospital because of pain in the right wrist and multiple radiolucent bony defects.

The patient was in apparent good health except for scoliosis, for which she was seen in periodic orthopedic ...

In the evolution of eutherian mammals (species that gestate their young in utero), the stimulatory effect on the uterus of progesterone, a steroid hormone present in all vertebrates, was a critical adaptation. Half a century ago, the distinguished French ...

Four decades have passed since Waters and Wager¹ coined the term "elderly primigravida" to describe a woman who is 35 years of age or older and pregnant for the first time. Surely this definition has been no wellspring of joy for the increasing numbers of ...

The entire hematopoietic system in all its complexity arises from a small number of stem cells that not only differentiate but also replenish the bone marrow by a process of self-renewal. These stem cells supply the marrow with committed progenitor cells ...

To the Editor: I would like to register my disagreement with Dr. Brett's contention (Sept. 7 issue)¹ that the results of the Helsinki² trial imply no benefit in 986 of 1000 men with hypercholesterolemia treated with gemfibrozil. In both this trial and ...

To the Editor: Matthews et al. (Sept. 7 issue)* state that women who became menopausal but did not receive hormone-replacement therapy and women who did receive such therapy had significantly higher concentrations of serum total cholesterol at the end of ...

To the Editor: In his review Dr. Wrenn (Sept. 7 issue)¹ largely equates the problem of fecal impaction with that of simple constipation and makes a number of statements consistent with this view that I would question. Regarding patient assessment, Wrenn ...

To the Editor: The two articles^{1 , 2} and the editorial³ (Sept. 21 issue) on the risks of extended-wear contact lenses reveal the serious deleterious effects of extended wear and poor hygiene in the cleaning of soft lenses. However, there are two points ...

To the Editor: Moraes et al. (May 18 issue)¹ report that 32 of 62 patients with progressive external ophthalmoplegia (including 15 of 18 patients with Kearns—Sayre syndrome) had demonstrable deletions of mitochondrial DNA and that the family histories of ...

To the Editor: In their review of cryptococcal infections in the acquired immunodeficiency syndrome (AIDS), Chuck and Sande (Sept. 21 issue)¹ describe in detail the presenting signs and symptoms of cryptococcal meningitis. Although 66 percent of those ...

To the Editor: Asymptomatic, nonpalpable, purpuric macules 1 to 2 cm wide developed on the legs of a 60-year-old man and subsequently spread to his back, buttocks, and arms. He had been taking verapamil and digoxin for atrial fibrillation for five years. ...

To the Editor: At 7 p.m., a middle-aged, obese man with a history of intermittent dysphagia was seen at the emergency room of the Minneapolis Veterans Affairs Medical Center. He reported complete inability to eat or drink for approximately 12 hours. ...

To the Editor: The article by Welch and Larson (Sept. 21 issue)* on the cost effectiveness of bone marrow transplantation in leukemia is a useful analysis of the present situation. In discussing the implications for the future, however, the authors ...

To the Editor: My partner and I recently received our medical school alumni magazines. The one from Johns Hopkins noted that of 127 graduates in the class of 1989, only 1 was entering family practice. The one from Tufts noted with pride that 476 alumni ...

A fish hook lodges in my throat.

Spittle, kindergarten paste, thickens everything — even vision.

Mouth pocked with sores and blisters, swollen ulcerated tongue.

Topside sandpapered with number 7 coarsest grade.

Taste buds, saliva glands, seared.

Cool ...

This textbook of neurology has become one of the two major American works in the field. The preface states that the target audience is primarily neurology residents and medical students, but its appeal is much wider, and it will interest virtually all ...

This textbook is one of the standard clinical references in neurology. It enjoys an excellent reputation that is richly deserved. I first became familiar with the third edition of this textbook as a medical student. The earlier editions were written ...

Genetic heterogeneity is one of the stumbling blocks in the path to understanding Alzheimer's disease. The 23 essays that make up this book are a monument to heterogeneity. The articles vary wildly from topics in molecular genetics to legal issues of ...

Parkinson's disease and related disorders are commonly seen in neurologic practice and may have a prevalence rate of 1 percent among those over the age of 55. The introduction of levodopa for the treatment of Parkinson's disease in the 1960s was a major ...

For years, physicians interested in epilepsy have had few comprehensive works on this multifaceted subject. Many disciplines are joined in the study and treatment of epilepsy. Dr. Engel has now provided us with an authoritative, up-to-date textbook.

This ...

Trauma is the leading cause of death in persons under 45 years of age. Approximately 75 percent of these deaths are due to head injuries, making this a major public health concern. While substantial efforts have been directed at studying severe head ...

SCIENCE JOURNALISM CENTER

The "Gatekeepers Workshop" will be held in Columbia, Mo., March 29–31. Contact SJC, Univ. of Missouri-Columbia, P.O. Box 838, Columbia, MO 65205; or call (314) 882–2914.

UNIVERSITY OF KANSAS MEDICAL CENTER

The following courses ...

Book Review of Neurologic Disorders of Ambulatory Patients: Diagnosis and management (January 25, 1990; 322:277). The name of the book's author was given incorrectly. The correct name is John H. Wagner, Jr. We regret the error.

The Institute of Medicine of the National Academy of Sciences has just released a report on quality assurance for the Medicare program.¹ The legislation authorizing the study called for an ambitious and far-reaching strategic plan for assessing and ...