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March 7, 1991  Vol. 324 No. 10

Original Articles
641-648

IT has been suggested that selected platelet-derived substances, such as serotonin (5-hydroxytryptamine) and thromboxane A2, may play an important part in the pathophysiology of certain acute coronary artery disease syndromes.1 , 2 Specifically, increased ...

648-654

CORONARY atherosclerosis is common, but its ischemic manifestations are unpredictable and are not linearly related to the severity of disease. The factors responsible for the transition from stable to unstable ischemic syndromes remain elusive,1 but ...

654-662

REMARKABLY, aspergillosis is unusual in patients with the acquired immunodeficiency syndrome (AIDS). Only 3 cases were included among the first 1762 cases of AIDS in the United States reported to the Centers for Disease Control.1 Of 1067 patients with ...

662-666

WHEN meningomyelocele is detected in a fetus, prenatal counseling and management may be problematic. Termination of the pregnancy may be chosen by the mother in many cases, whereas in others termination may not be possible because of personal or religious ...

674-677

SHORTLY after Robert and Guibaud reported in 19821 an association between the use of valproic acid during pregnancy by women with seizure disorders and the occurrence of spina bifida in their offspring, carbamazepine was also implicated, on the basis of ...

Review Article
667-674

DURING the 1980s the number of allogeneic bone marrow transplantations performed worldwide increased exponentially. In 1990 more than 4000 allogeneic transplantations were estimated to have been completed. This dramatic increase has been stimulated by the ...

Case Records of the Massachusetts General Hospital
677-687

Presentation of Case

A 30-year-old man was admitted to the hospital because of headaches, visual blurring, sexual dysfunction, polydipsia, and polyphagia.

The patient was well until six months earlier, when he began to experience increased thirst, ...

Editorials
688-690

Over the past 10 to 15 years, we have gained considerable insight into the pathophysiology of acute ischemic heart disease, and as a result our therapeutic approach has changed substantially. In the 1960s and early 1970s, Prinzmetal's variant angina, an ...

690-691

About 10 of every 10,000 American babies are born with anencephaly or meningomyelocele (spina bifida), the disorders known collectively as neural-tube defects. The incidence of anencephaly has declined from 8 per 10,000 live births in 1970 to about 3 to 4 ...

Sounding Board
691-694

Diane was feeling tired and had a rash. A common scenario, though there was something subliminally worrisome that prompted me to check her blood count. Her hematocrit was 22, and the white-cell count was 4.3 with some metamyelocytes and unusual white ...

Correspondence
694-696

To the Editor: The October 4 editorial by Keusch1 rightly stresses the importance of the recent study by Rahmathullah et al. in India2 and of other research suggesting that increased intake of vitamin A may reduce mortality among children in certain ...

696-697

To the Editor: Leoung et al. (Sept. 20 issue)1 reported that administering 300 mg of aerosolized pentamidine every four weeks was more effective in preventing Pneumocystis carinii pneumonia (PCP) than administering 30 mg every two weeks. We wonder ...

697-698

To the Editor: The results of Joven et al. (Aug. 30 issue)1 support the hypothesis that overproduction of lipoproteins containing apoprotein B is the principal cause of hyperlipidemia in patients with the nephrotic syndrome. Although the authors measured ...

698-699

To the Editor: Since the beginning of competitive athletics, people have sought methods to enhance their performance. "Blood doping," the use of red-cell transfusions to increase the oxygen-carrying capacity of the blood, has been used by some athletes ...

699

To the Editor: In the Current Concepts article "Sleep Disorders and Aging" (Aug. 23 issue),1 I was concerned about the reference to clonazepam as a "benzodiazepine with a short half-life." The mean half-life of clonazepam is 23±5 hours, as compared with ...

699

To the Editor: We report the results of our use of the polymerase chain reaction to identify Toxoplasma gondii in the aqueous humor of patients with presumed ocular toxoplasmosis. Currently, the diagnosis of ocular toxoplasmosis is based clinically on ...

700

To the Editor: In their study of the medical appropriateness of coronary angiograms in a cohort of Medicare patients, Brook et al. (Oct. 25 issue)* required that, to be considered appropriate, the procedure had to have been performed for an indication ...

700-701

To the Editor: In the letter to the Editor by Cunningham and Leveno (Aug. 9 issue),* I am bothered by the graphs, which are large and impressive but inappropriate and inaccurate with respect to the data they are intended to illustrate.

First, the graphs ...

701-702

To the Editor: On the basis of two recently published cooperative group studies,1 , 2 levamisole was approved for use in humans in the United States in 1990. It was first synthesized in 1966 by Janssen Pharmaceutica of Belgium.3 It is an anthelmintic ...

702

To the Editor: I wish to report the serendipitous discovery of a symptomatic treatment for low back pain that, until now, has been underutilized. Six months ago I evaluated a 48-year-old retired airline pilot with a two-month history of frequent severe ...

Book Reviews
702

The first edition of Anatomy as a Basis for Clinical Medicine was published in 1985 in an attempt to break into the market as a gross-anatomy textbook for first-year medical students. The author has recently revised the book, and now offers a second ...

702-703

This second edition of Atlas of Human Cross-Sectional Anatomy again contains excellent line drawings of sectional anatomy. These black-and-white drawings are particularly clear, with easy-to-read, uncluttered labeling. Transverse sections of the head, ...

703

Doppler ultrasonography, which delineates blood flow and vascular motion, is so commonly used clinically that few would challenge its favorable impact on clinical care. In its most recent manifestation, the technique has moved beyond audible and charted ...

703

The imaging aspects of cardiac diagnosis have evolved remarkably in the past decade, particularly in regard to patients with congenital heart disease. Cardiac angiography, once the principal imaging procedure before surgery, has now been replaced in a ...

703-704

The intended audience of the first of these books, edited by Kucharczyk, comprises practicing radiologists and physicians working in other specialties related to neurologic diagnosis. The book's format is didactic: the chapters are organized according to ...

704-705

This is a unique book, with an emphasis on the clinical approach to the patient and a focus on problem solving and answers to clinical questions. The author's perspective reflects the fact that he is British and works in a multidisciplinary atmosphere ...

Notices
705-707

Notices submitted for publication should contain a mailing address and phone number of a contact person or department. We regret we are unable to publish all Notices received.

EMORY UNIVERSITY SCHOOL OF MEDICINE

The following conferences will be held in ...

Correction
707
  • Free Full Text

Prevalence and Predictors of Rhabdomyolysis in Patients with Hypokalemia (November 22, 1990; 323:1488). In the first paragraph of the letter, the 17th line, the text should have read, "more than 2.66 μkat per liter in women and more than 3.33 μkat per ...

Information for Authors
708

These guidelines are in accordance with the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals." (The complete document appears in the February 9, 1991, issue of the British Medical Journal and the February 7, 1991, issue of the New ...

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