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May 23, 1991  Vol. 324 No. 21

Original Articles
1445-1450

ALTHOUGH an experienced physician may be able to foretell the likely outcome of trying to wean a patient from mechanical ventilation, it is desirable to have predictive indexes that can be easily measured and widely applied. The purposes of such indexes ...

1451-1456

THE B-cell lymphoproliferative syndrome is an infrequent complication of marrow or organ transplantation. Epstein–Barr virus (EBV) has been found to induce such uncontrolled proliferation of B cells in patients who are immunodeficient.1 2 3 4 The clinical ...

1457-1463

THE association between chronic hepatitis B virus (HBV) infection, characterized by persistent hepatitis B surface antigenemia, and renal disease was first reported in 1971.1 Since then various morphologic patterns of HBV-related renal disease, including ...

1464-1470

GAUCHER'S disease is the most prevalent lysosomal storage disorder. It is caused by an insufficiency of glucocerebrosidase (glucosylceramidase) activity1 , 2 with secondary accumulation of glucocerebroside within the lysosomes of macrophages. The storage ...

1483-1488
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THE clinical manifestations of the growth hormone insensitivity syndrome (Laron dwarfism) result from the inability of growth hormone to exert its biologic actions.1 , 2 Affected children have the severe growth retardation and other physical ...

Review Articles
1471-1476

THE study of brain tumors is especially rewarding today: molecular biology has provided new insights into pathogenesis, neurosurgical technology has increased the capacity for tumor removal, and promising new nonsurgical therapies are being developed. ...

1477-1482

DESPITE recent advances in prevention and treatment,1 trauma remains the leading cause of death among North American children over the age of one year.2 Blunt head injuries from motor vehicle collisions cause most of the deaths and injuries,2 3 4 but ...

Case Records of the Massachusetts General Hospital
1489-1495

Presentation of Case

A 13-year-old boy was admitted to the hospital because of chronic otitis media, episodic dizziness, fluctuating left-sided hearing loss, and a destructive process in the left mastoid bone.

There was a long history of otitis media. The ...

Editorials
1496-1498

For a small but important fraction of patients receiving mechanical ventilation, protracted dependence on a ventilator entails serious hazard, disability, and cost. Most such patients have a major catabolic illness, severe underlying lung disease, or ...

1498-1500

Ten years ago five homosexual men in Los Angeles were reported to have acquired a mysterious and profound immune deficiency associated with pneumocystis pneumonia and other opportunistic infections. The report on these men, published in the Morbidity and ...

Sounding Board
1500-1504

In the early and mid-1980s, when democratic nations were forced to confront the public health challenge posed by the epidemic of the acquired immunodeficiency syndrome (AIDS), it was necessary to face a set of fundamental questions: Did the history of ...

1504-1509

One of the most important challenges of the human immunodeficiency virus (HIV) epidemic is the potential for transmission of the virus in the health care setting, either from the patient to the health care provider or from the health care provider to the ...

Massachusetts Medical Society
1509

DEATHS

Beaman — George Burnham Beaman, Jr., M.D., of New London, N.H., died recently at the age of 85.

Dr. Beaman received his degree from Harvard Medical School in 1934. He was a member of the American Psychiatric Association. Dr. Berman was a 50-year ...

Correspondence
1509-1511

To the Editor: Hansotia and Broste (Jan. 3 issue)* provide interesting data on the risk of automobile accidents in subjects with epilepsy or diabetes mellitus. On the basis of their results, they state that they "do not think it wise to restrict further ...

1511-1513

To the Editor: After reading the report by Relman et al. on the identification of the agent of bacillary angiomatosis (Dec. 6 issue), I wondered whether Kaposi's sarcoma, another disorder of the immunosuppressed, characterized by a "proliferation of ...

1513-1514

To the Editor: Perkocha and his colleagues (Dec. 6 issue) 1 reported on the identical appearance of the bacilli in the peliotic liver lesions of eight patients infected with the human immunodeficiency virus (HIV) and in the skin lesions of bacillary ...

1514

To the Editor: When the manuscripts of the articles by Relman et al.,1 Perkocha et al.,2 and Slater et al.3 (Dec. 6 issue) were submitted to the Journal, each group of authors was unaware of the others' findings. However, since that time we have ...

1514-1515

To the Editor: Bousquet et al. (Oct. 11 issue)1 and others2 2 3 4 5 report that there is a general association between numbers of eosinophils and the severity of asthma. Unfortunately, the controls for their bronchial-biopsy data1 may not have been ...

1515

To the Editor: In their letter (Dec. 27 issue) Drs. Spurlock and Dailey presented an interesting case of asthma, but they did not comment on preservatives and dye additives in toothpastes. Tartrazine, a yellow azo dye, is well known to cause ...

1515-1516

To the Editor: The study by Schwartz et al. of recombinant factor VIII concentrate for the treatment of hemophilia (Dec. 27 issue)1 raises two questions in regard to long-term therapy with this new product. First, factor VIII inhibitors developed in 5 of ...

1516-1517

To the Editor: Vascular endothelial damage plays an important part in the pathophysiology of disseminated intravascular coagulation.1 , 2 It may mediate a variety of triggering events to initiate intravascular coagulation and platelet aggregation, which ...

1517

To the Editor: Nephrotoxicity is a serious side effect of cyclosporine therapy1 that appears to be caused by arteriolar vasoconstriction due to local release of thromboxane A2.2 , 3 Calcium-channel blockers have the capacity to interfere with renal ...

1517-1518

To the Editor: We wish to share our recent observation of two potentially useful clinical signs. While dining in the hospital cafeteria, we were seated across the table from three senior faculty members at Dalhousie University. During the meal someone's ...

Book Reviews
1518

Approximately 20 years ago I took part in the deliberations of a panel of the President's Science Advisory Committee considering the regulation of foods, drugs, pesticides, and other substances to protect health. After substantial study of the use of ...

1518-1519

The everyday use of medical imaging such as computed tomography (CT), magnetic resonance imaging (MRI), and sonography requires that medical students, technicians working in these fields, and physicians have a basic understanding of sectional gross ...

1519

Nuclear magnetic resonance was discovered in 1946 and has been exploited as a sensitive analytical technique by chemists and physicists during the intervening decades. In the past 10 years, nuclear magnetic resonance imaging has become an important ...

1519-1520

Here is an excellent addition to the introductory material available on general radiology. The book's main objective is to serve as a complete introductory textbook for radiology trainees and a radiology reference for trainees or practitioners in medicine ...

1520

Here is an excellent summary textbook. In the preface, the author states that his intention is to provide coverage of the entire field of neuroimaging (including computed tomography, magnetic resonance imaging, and angiography) in a single book. This is a ...

1520

The relatively recent and rapid development of interventional and vascular radiology as a specialty in the field of radiology and medical imaging has been both a gratifying accomplishment and a continuing challenge. One challenge for interventional ...

Books Received
1520-1522

The receipt of these 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.

Addresses of most overseas publishers are ...

Notices
1522-1524

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.

OCCUPATIONAL AND ENVIRONMENTAL MEDICINE

The conference will be held in ...

Correction
1524
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Pulmonary Aspergillosis in the Acquired Immunodeficiency Syndrome (March 7, 1991; 324:654–62). On page 656, in Table 1, under the last heading "Mode of Diagnosis/Confirmation," the entry "autopsy" for Patient 3 should have been flagged with a double ...