ROUTINE obstetrical care now includes screening for elevated levels of maternal serum alpha-fetoprotein between 15 and 18 weeks after the last menstrual period. If the levels are elevated in two samples, after adjustment for weight and race, and ...

THE concept of oncogenes has revolutionized our understanding of cancer, but there have been disappointingly few situations in which the detection of activated oncogenes has proved to be of clinical value. The difficulty in relating activation of ...

NEPHROPATHIC cystinosis is a lysosomal storage disease in which cystine accumulates intracellularly in many tissues, including the kidney. Renal failure generally occurs at approximately 10 years of age,^{1 2 3 4} although glomerular dysfunction can be ...

TUMOR-infiltrating lymphocytes (TIL) are lymphoid cells that infiltrate solid tumors and that can be grown by culturing single-cell suspensions from tumors in interleukin-2.^{1 , 2} We have previously reported that TIL obtained from some human melanomas have ...

HYPERLIPIDEMIA is a striking feature of the nephrotic syndrome. It is a matter of debate, however, whether this hyperlipidemia leads to an increased risk of coronary heart disease and, if so, whether hypolipidemic therapy is indicated.^{1 2 3} In addition, ...

IN Type I glycogen storage disease, glycogen accumulates in the liver, kidney, and intestine because of deficient glucose-6-phosphatase activity (Type Ia) or deficient glucose-6-phosphate translocase activity (Type Ib). Lack of activity of either enzyme ...

IT has been well established that the life expectancy of children and adults with severe mental retardation is reduced as compared with that of the general population.^{1 2 3 4} However, no studies have specifically addressed the life expectancy of ...

Presentation of Case

A 28-year-old woman was admitted to the hospital because of severe abdominal pain and vomiting.

The patient was well until 18 months earlier, when she experienced the first of four or five bouts of severe pain in the left lower ...

The application of gene-transfer technology to human gene therapy has been intensively investigated during the past six years. The first experiment in humans, representing an intermediate step toward this objective, was approved by the National Institutes ...

Although all agree that elevations in serum lipid levels are an integral part of the nephrotic syndrome, almost every other aspect of this secondary hyperlipidemia has been a source of controversy. The study reported by Joven et al. in this issue of the ...

I have attended a hospital clinic as a patient several times during the past few years. Most of my visits were scheduled, although a few were made on very short notice. Rarely have I waited for less than an hour past the time of my appointment, and ...

To the Editor: The Special Article by Stossel and Stossel (March 15 issue)* on declining American representation in leading clinical-research journals confirms my observations of the decline of original contributions in clinical research and development ...

To the Editor: Exposure to human immunodeficiency virus (HIV) or other infections by needle-stick injury occurs during phlebotomy or other procedures when contaminated needles or blades are picked up to be used again or to be discarded. Most packaged ...

To the Editor: In the April 5 issue of the Journal,¹ Dr. Melmed presented a concise review of the pathophysiology and treatment of acromegaly. We concede that the nature of such an article precludes in-depth discussion of specific treatment-related ...

To the Editor: In the April 5 issue, Merimee presents a comprehensive review of the pathogenetic mechanisms of diabetic retinopathy.¹ He states that the "leakage of protein into the deep and superficial layers of the retina is responsible for hard and ...

To the Editor: The optimal treatment for Q fever—induced endocarditis is controversial. The antibiotic used most commonly has been a tetracycline, given either alone or in combination with cotrimoxazole, lincomycin, or rifampin.¹ The new quinolone ...

To the Editor: We would like to report on a boy who had two acute episodes of aseptic meningitis during therapy with intravenous immune globulin.

A seven-year-old boy was referred to our department by his family doctor because of persistent idiopathic ...

To the Editor: As the Medical Task Force on Anencephaly has pointed out (March 8 issue),¹ the cause of human anencephaly is still not known, but studies in animals demonstrate that anencephaly results from failure of closure of the anterior neuropore. ...

To the Editor: Chemical injury of the oral mucosa is a well-known side effect of the injudicious use of aspirin as a local obtundent. Placement of an aspirin tablet in the mouth, adjacent to a painful tooth, produces a sloughing and separation of the ...

To the Editor: Spontaneous intracerebral hematomas have occurred after attacks of migraine,¹ drug abuse,² exposure to cold,³ severe dental pain,⁴ and surgery.⁵ We describe a patient in whom this occurred after break dancing.

A 27-year-old man attended a ...

Ethical aspects of the interaction between doctors and the pharmaceutical industry are often discussed in the Journal,^{1 2 3} and the suggestion was recently made that a commission be established to develop guidelines for ethical behavior.² Sweden has had a ...

In the past decade we have witnessed the emergence of magnetic resonance imaging (MRI) as a powerful imaging technique. To document that progress, the editors of this book have enlisted the collaboration of 68 experts in the field. The book consists of ...

The purpose of CT and MRI of the Thorax is to present a critical review and assessment of the present status and future prospects of CT and magnetic resonance imaging (MRI) of the chest. The book is not devoted to a complete discussion of CT or MRI of the ...

Somewhat unusually, the content of this book is in no way reflected by its title. MRI Atlas of the Brain contains no chapters or, indeed, even images devoted to discussions or demonstrations of normal intracranial anatomy. Instead, the work is a cross ...

Caffey's Pediatric X-Ray Diagnosis has gone through eight editions, the latest (Silverman FN, ed. Chicago: Year Book) in 1985. This new book, the "essentials" of Caffey, represents an attempt to produce a shorter, physically less cumbersome, and more ...

This book consists mainly of high-quality photographs of anatomical preparations, supplemented with illustrations and pertinent photographs of surface anatomy in living models. The dissections are superb, and many are augmented by coloring the vessels and ...

The Atlas of Human Anatomy by Dr. Frank Netter is a welcome collection of the author's superb anatomical paintings spanning his nearly 50-year career. The educational value of Netter's paintings is well known to anatomists and physicians who for years ...

VEIN GRAFT IN VASCULAR SURGERY

The 1st international symposium will take place in Bologna, Italy, Oct. 18 and 19.

Contact Prof. A. Stella, Cattedra di Chirurgia, Vascolare, Policlinico S. Orsola, Bologna, Italy; or call (39) 51 63–63–288.

PATHOLOGY UPDATE