PROSTHETIC breast augmentation and reconstruction have been practiced for several decades and have been considered to be safe and accepted surgical procedures. Smooth-walled silicone implants (filled with silicone gel or saline) have been the most common ...

RENAL damage is an important potential side effect of cyclosporine therapy and has been a reason for caution when one is considering its use in the treatment of patients with autoimmune diseases. Primarily described in patients who have undergone renal ...

DESPITE optimal medical management with digitalis, diuretic agents, and vasodilator agents, exertional dyspnea remains a disabling symptom in patients with severe chronic left ventricular failure. Although dyspnea is the consequence of the impairment of ...

GLYCOGEN storage disease Type Ib is a rare hereditary metabolic disorder characterized by growth failure, hepatomegaly, hypoglycemia, lactic acidosis, and neutrophil deficiency.^{1 , 2} Except for the neutrophil abnormalities, which are unexplained, all ...

The top panel is an oblique sagittal magnetic resonance image (MRI) aligned to give a long-axis view of the thoracic aorta in a 55-year-old patient with Marian's syndrome and aortic dissection. The intimal flap begins in the ascending aorta (solid black ...

Epilepsy

Clinical Manifestations

The term "epilepsy" refers to conditions that are characterized by recurrent epileptic seizures. Seizures consist of paroxysmal spells of transitory alteration in consciousness or in other cerebral cortical functions and ...

THE total number of patients who present at emergency departments because of drug overdose is difficult to ascertain, but in many facilities it is inordinately high. In one urban hospital, for example, overdoses and other drug-related emergencies are ...

Presentation of Case

A 33-year-old woman with hepatic and respiratory failure was admitted to the hospital for consideration of liver and lung transplantation.

The patient was well until seven years earlier, when right-upper-quadrant pain with enlargement ...

THE potential for immunosuppressive agents to control the poorly understood pathophysiologic consequences of autoimmunity has intrigued clinical immunologists for decades. Unfortunately, the toxicity of these agents has often outweighed their clinical ...

IN this issue of the Journal, Dr. David A. Kessler, the commissioner of the Food and Drug Administration, presents his rationale for removing silicone-gel breast implants from the market.¹ Each year about 150,000 women receive these implants — 80 percent ...

THE fate of the silicone-gel breast implant may have been foretold in 1988 when a member of the Food and Drug Administration's advisory panel on general and plastic surgical devices suggested that because the benefits of breast implants were unclear, ...

To the Editor: Stout and colleagues (Jan. 16 issue)¹ provide evidence that potable water was a potential environmental source in 8 of 20 cases of sporadic community-acquired legionnaires' disease. Their inability to identify a source of exposure in 60 ...

To the Editor: The study (Jan. 23 issue)¹ of the comparative efficacy of foscarnet and ganciclovir for the treatment of cytomegalovirus (CMV) retinitis in patients with the acquired immunodeficiency syndrome (AIDS) provides important information. On ...

To the Editor: From recent reports it appears that the detection of human immunodeficiency virus (HIV) infection in neonates (babies ≤1 month old) is possible,^{1 2 3 4 5 6 7 8} although not as reliable as in older babies, children, and adults.^{1 , 3 , 7 , 8} ...

To the Editor: The study by Long et al. (Dec. 12 issue)¹ demonstrating significantly improved short-term survival (28 days) after two doses of artificial surfactant is consistent with recent data.² However, the absence of a significant difference in ...

To the Editor: The remarkable report by Gordeuk et al. (Jan. 9 issue)¹ is not the first crack in the monolithic facade of hereditary hemochromatosis. Hemochromatosis is known to be a group of diseases, and it is important to perceive the common ...

To the Editor: In response to the review article on recent advances in dermatology by Phillips and Dover (Jan. 16 issue),¹ we would like to correct some stated information. The authors describe podofilox as recently approved by the Food and Drug ...

How do you review a 2193-page masterpiece? A marathon cover-to-cover reading would have been impractical and, given the book's enormous scope, inefficient for gaining personally useful information. I therefore placed this pair of volumes on an outside ...

Braunwald's Heart Disease is now in its fourth edition. Its production was a task requiring enormous time and effort with superb results. This edition has undergone considerable revision, with 15 additional or substituted chapters, although it contains 26 ...

The type and extent of knowledge in cardiovascular medicine have changed rapidly over the past decade. The explosive growth in this field is based on two factors: the expansion of clinical cardiology, brought about by the development of new diagnostic and ...

It often seemed to me, as a medical student in the early 1960s, that the accurate diagnosis of coronary artery disease was more of theoretical than of practical importance, simply because the therapeutic options were so limited. The same might have been ...

"Accumulate cases and analyze them carefully. In this way you may discover a new hypothesis." This recommendation by the author of Basic and Advanced Visual Cardiology summarizes the case-report philosophy of medical education. This book is a ...

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.

DARIER'S DISEASE PATIENTS NEEDED

A national study, funded by the National ...

On April 16, 1992, the Food and Drug Administration announced that breast implants filled with silicone gel would be available only through controlled clinical studies and that women who need such implants for breast reconstruction would be assured of ...

Repeated, unsuccessful efforts throughout this century to create a national scheme of health insurance have left a clear message: most Americans prefer private insurance to plans mandated or operated by the government to finance their medical care. This ...