SURGERY for Cushing's syndrome can cure hyper-cortisolism and preserve pituitary—adrenal function in most patients in whom a specific diagnosis is established. Current diagnostic tests, however, do not always distinguish clearly among the causes of the ...

CUTANEOUS and ocular infection with herpes simplex virus type 1 (HSV-1) was initially recognized as a health risk for wrestlers in the mid-1960s.^{1 2 3 4} Several clusters of primary cutaneous HSV-1 infection were recognized, and transmission was also ...

DURING pregnancy, most maternal fuels gain access to the developing conceptus in a concentration-dependent fashion.¹ Circulating maternal fuels may affect the quantitative and qualitative characteristics of the nutrient mixture in which organogenesis and ...

HYPERINFLATION of the lungs impairs the function of the diaphragm by placing it at mechanical disadvantage, shortening its operating length, and changing the mechanical linkage between its various parts. These factors decrease the tension that can be ...

ENVIRONMENTAL and occupational diseases encompass a wide range of human illness and are important causes of disability and death in modern American society.^{1 , 2} They include lung cancer and mesothelioma in persons exposed to asbestos, leukemia in persons ...

ALTHOUGH the causes of the common forms of idiopathic inflammatory bowel disease remain unclear, considerable progress has been made in the identification of important pathophysiologic mechanisms since these disorders were last reviewed in the Journal.¹ ...

The past 20 years have witnessed a remarkable increase in our knowledge of the cellular and molecular mechanisms that underlie the diverse actions of insulin, the central hormone of metabolic regulation. Interest in the molecular details of insulin action ...

Presentation of Case

A 46-year-old man was admitted to the hospital because of a cough, fever, and bilateral pulmonary nodular lesions.

The patient was a native of Puerto Rico and an executive in a construction company. He was in excellent health until ...

Endogenous Cushing's syndrome continues to tax the diagnostic skills of many physicians because it is an unusual disorder with which they have had little experience and because no single diagnostic test has proved to be completely reliable.

Cushing's ...

Since the advent of insulin in 1922, treatment programs designed to normalize the plasma glucose concentrations of pregnant women with diabetes have led to remarkable improvements in perinatal mortality.¹ These results stimulated the state of California ...

Chronic obstructive pulmonary disease (COPD) is characterized by increased resistance to airflow, air trapping, and hyperinflation of the lungs. The increased resistance to airflow increases the work and energy required for breathing. Hyperinflation puts ...

DEATHS

Ehrenberg — Ruth Ehrenberg, M.D., formerly of Chestnut Hill, died April 18 at the age of 91.

Dr. Ehrenberg received her degree from Friedrich-Wilhelms-Universitaet Medizinische Fakultaet in Berlin, Germany, in 1926. She was a member of the American ...

To the Editor: The article by Catalona et al. (April 25 issue)¹ discussed the role of prostate-specific antigen (PSA) in screening for prostate cancer. The search for a clinically practical screening test for this disease is clearly a worthy one.

The ...

To the Editor: The article by Brown et al. (May 2 issue)¹ nicely demonstrated the significant difference in the incidence of neonatal infection with herpes simplex virus (HSV) between infants born to women with recently acquired asymptomatic genital HSV ...

To the Editor: Kent (May 16 issue)¹ calls for increased attention to be focused on women who are at risk for human immunodeficiency virus (HIV) infection. We would like to point out that both the perception of risk of HIV infection and the ability to act ...

To the Editor: Boers et al. in 1985¹ and Clarke et al. in the April 25 issue² presented evidence that heterozygosity for homocystinuria due to cystathionine β-synthase deficiency predisposes patients to vascular disease. In both cases, the results were ...

To the Editor: The recent study of laparoscopic cholecystectomy (April 18 issue)* provides much-needed information on this new procedure. However, it is hard to judge the extent to which the favorable results of laparoscopic surgery reported in this ...

To the Editor: The age at which a person begins to smoke cigarettes has been found to be related to the total number of years of subsequent smoking^{1 2 3 4}; however, the possible association of this factor with other smoking-related variables has not been ...

To the Editor: Thrombolytic therapy for acute myocardial infarction can lead to major bleeding complications. Perhaps the most serious complication is intracranial hemorrhage, but intraparenchymal bleeding in other organs can occur and can be ...

To the Editor: Irrigation of the external ear canal to remove cerumen is a frequent medical practice. It is usually safe, but can result in damage to the external, middle, and even inner ear. Trauma to the delicate squamous epithelium lining the external ...

To the Editor: In the Special Report by Gasser et al. concerning the threat of infectious disease associated with Americans returning from the Persian Gulf (March 21 issue),¹ a number of febrile systemic illnesses were considered. Early in Operations ...

I have told her I will not do a pelvic so already we are on better terms. I've learned when best to say this so as to ease her fears.

But she worries that I will examine her breasts, perhaps take too much pleasure with her beauty, her softness. It's ...

(Editor's note: Though not well known to the younger generation, Edward Delos Churchill [1895–1972] was for more than 30 years the John Homans Professor of Surgery and Chief of the Surgical Services at Massachusetts General Hospital. He was a thoracic ...

It is unusual for the expressive power of the novelist and the intellectual reach of the scientist to come together in one person. Such a person is George Klein, a Swedish scientist, whose book of essays on science, scientists, and experiences in life ...

The author, a professor of English at the University of Miami, hypothesizes that at some time in the last decades of the 18th century and the first few decades of the 19th century a definable period of medical thought came into being. Its seminal ideas ...

What does an illness mean? To Herman Roth's physicians, his half-paralyzed face and an abnormal CT image of his brain meant an intracranial tumor, perhaps resectable, but otherwise enlarging and lethal.

To Herman Roth, his sagging face and loss of hearing,...

Slender, portable, with an attractive dark green cover, this book seems on first impression to promise a friendly and rather superficial summation of an old theme: the history of yellow fever. As soon as its pages are open, however, this initial ...

As a reviewer, I need to tell the readers of the Journal whether they should buy or read one or both of these books. As for Paying the Doctor, the question is relatively easy to answer. Twenty contributors have collaborated in producing a 15-chapter book ...

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EVOLUTION OF THE NEW ENGLAND JOURNAL OF MEDICINE

The "16th Annual Joseph ...

The Gulf crisis began when Iraq invaded Kuwait on August 2, 1990. Trade sanctions against Iraq were rapidly instituted. During the six-week war beginning on January 16, 1991, over 120,000 allied sorties were carried out. The massive bombing and ground war ...