THERE is substantial geographic variation in the medical and surgical management of disease in the United States.^{1 2 3 4 5 6 7 8} To date, however, specific variations in cancer treatment have not been comprehensively examined.

Clinical trials published ...

SURGICAL treatment for local and regional breast cancer has changed considerably during the past decade. Until the early 1980s, the standard treatment was mastectomy. Then reports of several trials were published, showing that breast-conserving surgery ...

FAMILIAL hypertrophic cardiomyopathy is one of the most common forms of heritable cardiac disease and an important cause of sudden death in adolescents and young adults.^{1 2 3} Clinical studies have identified both morphologic and functional abnormalities ...

IN some patients Hodgkin's disease or non-Hodgkin's lymphoma is associated with a second lymphoproliferative disease, either benign or malignant. One such benign lymphoproliferative disease is lymphomatoid papulosis, a recurrent, multifocal cutaneous ...

THE Guillain—Barré syndrome, a subacute inflammatory demyelinating polyneuropathy, leads to severe quadriparesis and requires artificial ventilation in about 20 percent of patients. Although functional recovery is the rule, 15 percent of patients have ...

WITH the virtual elimination of poliomyelitis, Guillain—Barré syndrome has become the most common cause of acute generalized paralysis, with an annual incidence of 0.75 to 2 cases per 100,000 population. Several clinical variants of this demyelinating ...

Presentation of Case

An 80-year-old man was admitted to the hospital because of repeated bouts of hematochezia during several hours before entry.

The patient was in stable health until two or three days earlier, when he experienced crampy pain in both ...

During the past two decades there have been enormous changes in the care of women with primary breast cancer. We have learned that breast cancer is usually microscopically disseminated at the time the diagnosis is first made and that the degree of ...

Although sporadic descriptions of hypertrophic cardiomyopathy were published as early as 1869 in France¹ and 1907 in Germany,² it was not until the mid-20th century that a comprehensive picture of this disorder began to take shape.^{3 4 5} In the ensuing ...

Approximately half a million cases of sepsis occur each year in the United States, and the estimated mortality is 35 percent (175,000 deaths annually). Half are caused by gram-negative rods, and half of these are associated with a positive blood culture. ...

Several monoclonal antibodies directed against bacterial lipopolysaccharide (endotoxin) are being developed for the adjunctive treatment of gram-negative sepsis. Two of these, E5 (XOMA, Berkeley, Calif.)¹ and HA-1A (Centocor, Malvern, Pa.),² have been ...

To the Editor: Efforts to "prove" that the Washington, D.C., handgun ban (with a grandfather clause) — sometimes misleadingly referred to as a registration or licensing system — has been effective in reducing homicide have always had to disguise the fact ...

To the Editor: In 1987,¹ the Journal published a detailed study by Pollack et al. of 2394 admissions to nine North American pediatric intensive care units. The paper concluded that differences in mortality rates among the units studied were explained by ...

To the Editor: In the very challenging study by Chan et al. (Dec. 5 issue)¹ on the predictive value of P-glycoprotein expression in the management of neuroblastoma, the authors point out that an increase in such expression was associated with predictors ...

To the Editor: In the report by Gribben et al. (Nov. 28 issue),¹ the polymerase chain reaction (PCR) was used to detect the presence of residual bcl-2—positive cells in bone marrow purged ex vivo with monoclonal antibody and complement. The study ...

To the Editor: The combination of levamisole (Ergamisole) and fluorouracil is beneficial in the adjuvant treatment of stage C colorectal carcinoma^{1 , 2} and has been well tolerated, the main toxicity being nausea or diarrhea. We report a case of the ...

To the Editor: In this issue of the Journal Warren et al.¹ assess the evidence supporting the efficacy of HA-1A. Their synthesis of these data is largely subjective and differs substantially from the conclusions of the Food and Drug Administration ...

To review this encyclopedic work required a strategy consistent with the way a textbook is usually used. I chose to read each chapter relating to the principal diagnoses of all patients admitted to my general medical service at a busy county hospital ...

The first edition of this book was published in 1985, and it quickly became a standard textbook for medical students and house officers. For many physicians, it was their introduction to the principles of test evaluation and critical reading of the ...

Two pathologists, a radiologist, and a chest physician have collaborated to produce a book on a heterogeneous group of pulmonary diseases. According to the preface, what the diseases have in common is the fact that "they frequently come to biopsy for ...

This comprehensive work unites the separate contributions of 68 authors and 4 editors and, at $100 and 784 pages, will be bought more as a work of reference than to be read from cover to cover. As the editors point out, immunosuppression has become a ...

The first question to be asked is whether a new book on the esophagus is needed. The answer is yes. There is a paucity of textbooks that are comprehensive, and none of them are recent in this changing field. Although there are excellent monographs on ...

The goal of the third edition of this book is to provide "concise, up-to-date, and practical information and advice concerning common problems in the general field of nephrology and hypertension." True to this objective, chapters representing the clinical ...

Brain Endocrinology is a successful attempt by Marcella Motta, its editor, to organize a textbook that comes very close to giving a "comprehensive view of modern... neuroendocrinology." The book contains 17 chapters, mostly written by people who have ...

I usually have mixed emotions on first viewing an atlas. There is something almost magical in the ability of color photographs to capture a brief moment in the life of a disease for later study by both the student and the sophisticate, but the lack of an ...

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. The Journal does not publish unsolicited ...

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.

AMERICAN COLLEGE OF CARDIOLOGY

The following courses will be offered: "Clinical ...

Mortality in Patients with the Acquired Immunodeficiency Syndrome Treated with Either Foscarnet or Ganciclovir for Cytomegalovirus Retinitis (January 23, 1992;326:213–20). S.A. Teich, of the Mount Sinai School of Medicine in New York, was inadvertently ...

Petrosal Sinus Sampling with and without Corticotropin-Releasing Hormone for the Differential Diagnosis of Cushing's Syndrome (September 26, 1991; 325:897–905). On page 901, in Figure 2, Panels A and B, the "0" on the abscissas should have been "2." We ...