BREAST cancer will develop in approximately one woman in nine,¹ and such patients are at very high risk for second cancers in the other breast.² The relatively good survival after treatment for breast cancer (over 70 percent at five years) provides ample ...

APPROXIMATELY 40 percent of adult Americans have heartburn, the cardinal symptom of gastroesophageal reflux disease, at least once each month.¹ Among patients who seek medical attention for symptoms of reflux esophagitis, 10 to 20 percent have serious ...

CRYPTOCOCCAL disease is a common opportunistic infection in patients in the United States who have the human immunodeficiency virus (HIV), occurring in 5 to 10 percent of those with the acquired immunodeficiency syndrome (AIDS).¹ Early in the AIDS ...

PRADER—WILLI syndrome represents the most common form of genetic obesity and is associated with mental retardation, short stature, sexual infantilism, and hypotonia^{1 2 3 4 5 6} (Table 1). In about 60 percent of affected persons a microscopically visible ...

CYSTIC fibrosis is a lethal recessive genetic disorder caused by mutations of the cystic fibrosis transmembrane conductance regulator, a gene comprising 27 exons and 250 kilobases that resides on chromosome 7.^{1 2 3 4 5} The most important clinical ...

Percutaneous Mitral Balloon Valvotomy by Means of the Double-Balloon Technique.

The inflation of 18-mm (above) and 20-mm (below) dilating balloons can be seen in a stenotic mitral valve. Note the "waist" produced by the stenotic valve (arrows) before full ...

BLOOD clotting is a host defense mechanism that, in parallel with the inflammatory and repair responses, helps protect the integrity of the vascular system after tissue injury. This system is normally quiescent but becomes active within seconds after ...

Presentation of Case

A 64-year-old woman was admitted to the hospital because of slowly progressive paraparesis and pain in the buttocks.

The patient was in a stable state of health until 10 months earlier, when she began to experience a "heavy" feeling ...

Gastroesophageal reflux is one of the most prevalent clinical conditions affecting the gastrointestinal tract. Its spectrum ranges from the postprandial heartburn experienced at times by most adults to severe, complicated disease characterized by ...

What do rare conditions such as the Prader—Willi and Angelman syndromes have to do with the real world of the busy practitioner? They seem esoteric and exotic, and yet these rare syndromes are windows into the world of a newly recognized phenomenon of ...

Visual images are a rich source of the information we use in clinical medicine, yet we expend little effort to enhance our perception and recognition of these images. A new feature introduced in this issue of the Journal, Images in Clinical Medicine, will ...

The current practice of requiring the informed consent of research subjects is relatively new. The emphasis on a person's right to accept or refuse participation in biomedical research stems directly from the atrocities committed by Nazi "scientists" — an ...

To the Editor: Carette et al. recently reported their study of the use of injections of corticosteroids into facet joints for the treatment of chronic low back pain (Oct. 3 issue).¹ Although the authors should be commended for undertaking this type of ...

To the Editor: We think there are several points in Dr. McCarthy's¹ article on sucralfate (Oct. 3 issue)¹ that require clarification. As McCarthy notes, Lam et al. reported that cigarette smoking adversely affects the therapeutic efficacy of H₂-...

To the Editor: Burger and coworkers (Sept. 19 issue)¹ conclude that in giant-cell arteritis episodes of amaurosis fugax are due to vasospasm involving the retinal arteries and that "vasospasm apparently can be initiated by a vasospastic substance that is ...

To the Editor: Increasing numbers of HIV-infected patients requiring maintenance treatment with zidovudine are entering programs of long-term dialysis. Zidovudine is normally cleared rapidly by the kidney, with 90 percent of a given dose recoverable in ...

To the Editor: Cyclosporine is an indispensable drug for organ transplantation,¹ the rationale for its use being its immunosuppressive effect. We recently reported that cyclosporine also favorably alters energy metabolism under conditions otherwise ...

To the Editor: Clozapine (Clozaril) is an antipsychotic agent with a risk of agranulocytosis of 1 to 2 percent. Its manufacturer requires that the white-cell count and differential count be determined before treatment with clozapine is begun, and that ...

Several themes run through this important, unusual, and difficult book. Every biomedical scientist and clinician knows that Élie Metchnikoff was the propounder of the theory that phagocytosis is an important part of the defense system of chordates. Most, ...

Despite the recent decline in the popularity of psychoanalysis, omnivorous interest in Freud's life and the history of the analytic movement continues to increase. Scholarly books exploring ever more specialized and arcane areas of analytic history seem ...

What happens when a literary scholar takes a close look at the clinical interview and the fundamental nature of the patient—doctor relationship? Kathryn Hunter's intriguing study of how physicians interpret and retell patients' stories of illness sheds ...

Owsei Temkin's books have demonstrated how the rational healer gained an almost godlike status in Western culture. The Falling Sickness: A History of Epilepsy from the Greeks to the Beginning of Modern Neurology (2nd ed. Baltimore: Johns Hopkins ...

The most vociferous criticism of the American tort system for resolving claims of medical malpractice has come from the medical profession. In this book, Professor Weiler of Harvard Law School rejects many premises of physicians about the tort system, ...

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NATIONAL KIDNEY FOUNDATION

The "1st Annual Spring Clinical Meeting and Trade ...

Diagnosis of Cytomegalovirus Pancreatitis in AIDS by Endoscopic Retrograde Cholangiopancreatography (January 16, 1992;326:204). The name of the first author was listed incorrectly. The author's correct name is John P. Cella, M.D. We regret the error.