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February 13, 1992  Vol. 326 No. 7

Original Articles
425-430

NUMEROUS studies have documented that in the performance of cardiac angiography, fewer hemodynamic and electrophysiologic changes result from the use of a nonionic, low-osmolality contrast agent than from the use of a high-osmolality contrast agent.1 2 3 ...

431-436

CONVENTIONAL contrast agents used for intravascular imaging are solutions of sodium or meglumine salts. When they are injected into the intravascular space, two osmotically active particles are administered for every three iodine atoms. Thus, when sodium ...

437-443

PLACEBO-controlled trials have demonstrated that zidovudine reduces morbidity and mortality when administered to patients with human immunodeficiency virus (HIV) infection late in the course of their infection,1 and that this drug also reduces morbidity ...

444-449

IN 1986 we reported two cases of a rapidly progressive familial disease characterized clinically by untreatable insomnia, dysautonomia, and motor signs and pathologically by selective atrophy of the anterior ventral and mediodorsal thalamic nuclei1 (the ...

450-454
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OVER the past two decades, the rate of delivery by cesarean section in the United States has risen from 5 percent to 25 percent.1 , 2 The more frequent use of cesarean section has increased costs and maternal morbidity without decreasing the rate of ...

466-471

MüLLERIAN inhibiting substance is a glycoprotein hormone produced by fetal Sertoli cells that causes regression of the müllerian ducts in males during sexual differentiation.1 2 3 Serum concentrations of this hormone remain high in boys for several years, ...

Review Article
455-465

    EVERY year, 112,000 Americans die of gastrointestinal cancer, and carcinoma of the pancreas accounts for 22 percent of these deaths.1 It is a disease with an extremely poor prognosis: fewer than 20 percent of affected patients survive the first year, and ...

    Case Records of the Massachusetts General Hospital
    472-481

    Presentation of Case

    A 57-year-old man was admitted to the hospital because of hypotension and tightness in the chest.

    There was a 20-year history of episodic headache, flushing, lacrimation, and hypotension, with syncope on several occasions. Fifteen ...

    Editorials
    482-484

    THE articles by Barrett et al.1 and Steinberg et al.2 in this issue of the Journal address the important problem of deciding how to choose between low-osmolality and high-osmolality intravascular radiographic contrast agents. Should low-osmolality agents ...

    484-486

    ALTHOUGH the past five years have brought advances in treatment, the article by Hamilton and associates in this issue of the Journal demonstrates that the human immunodeficiency virus (HIV) as a viral infection and the acquired immunodeficiency syndrome (...

    486-487

      1 FIRST heard of scrapie, the prototype spongiform encephalopathy also known as prion disease, at a conference at Wye College in England in 1962. J.T. Stamp, of the Moredun Institute of Edinburgh, presented data on the serial transmission and replication ...

      Sounding Board
      487-488

      A title like that tells where you are going — a relationship as old as Adam and Eve. What gives away the meaning? It's the word heart, that all-purpose metaphor for love and emotion.

      Hearts have astonishing lives of their own. Hearts are faint and hearts ...

      Correspondence
      488-489

      To the Editor: It has been brought to our attention that certain data were omitted from our article "Rice-Based Oral Electrolyte Solutions for the Management of Infantile Diarrhea," in the February 21, 1991, issue.*

      On page 519, we mentioned that ...

      489-490

      To the Editor: Guerrant and Bobak (Aug. 1 issue)1 point out that the cost of routine stool cultures is very high and suggest a selective approach to help improve the cost effectiveness of cultures. A major reason for the high cost of stool cultures that ...

      490-492

      To the Editor: Although the status of plasma high-density lipoprotein (HDL) levels as a marker of protection against cardiovascular disease is well established, the value of more detailed analyses of this class of lipoproteins is less certain. Stampfer ...

      492-493
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      To the Editor: With regard to the excellent paper by Hagar and Rahimtoola on Chagas' heart disease in the United States (Sept. 12 issue),1 we think that some additional points should be addressed. Atypical chest pain — i.e., substernal chest pain not ...

      493-494

      To the Editor: Geisler et al. (June 27 issue)1 attribute efficacy to GM-1 (Sygen), the Fidia Pharmaceutical Corporation's bovine-brain extract containing gangliosides, in restoring motor function after spinal-cord injury, but the study fails to show any ...

      494

      To the Editor: As compared with common incandescent lamps, halogen lamps have the advantage of emitting brilliant white light. This advantage is associated with a higher emission of ultraviolet rays, however. The fact that halogen lamps are more widely ...

      494-495

      To the Editor: In his editorial in the September 12 issue,1 Holtzman comments on the report by Hammond and his colleagues in the same issue2 on the efficacy of screening for cystic fibrosis by measuring so-called immunoreactive trypsinogen. He questions ...

      495

      To the Editor: The letter by Dr. Quill (Sept. 19 issue)1 responding to the article on health care proxies and living wills by Professor Annas (April 25 issue)2 describes New York's health care proxy law inaccurately in one crucial respect. Contrary to ...

      496
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      Natural causes? Sometimes you never know. Demented Blagen, in a closed garage with the motor running, also had a circumflex occlusion.

      Or the woman calmly dead between her sheets. Overdose? Perhaps, but sometimes it's possible to give up breathing during ...

      Book Reviews
      496
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      "Infection is every doctor's business," says Francis O'Grady in the foreword to this book, which, he believes, is "appropriately placed in size between the intimidatingly expansive and the cryptically synoptic." The work of two experts from the United ...

      496-497

      The field of medical virology continues to develop rapidly. New agents and their associated clinical syndromes are being recognized, and the new fields of specific antiviral chemotherapy and genetically engineered immunogens are rapidly expanding, ...

      497

      Clinical virology may be defined as the study of the cause, diagnosis, treatment, and prevention of human viral infections. The first edition of this textbook, published in 1987, was written to provide an authoritative review of the current state of ...

      497-498
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      Diarrhea, we are told in this book, makes a strong epidemiologic claim to our attention. The supporting data appear in the introductions to numerous chapters, where statements such as these are made: "each year, more than five million of the world's ...

      498

      The field of immunology has grown tremendously over the past decade. Certainly many of the advances in a variety of medical specialties have relied on our better understanding of the workings of the immune system. Advances have been made not only in basic ...

      498-499

      This textbook covers a broad spectrum of lung diseases, including asthma, vasculitis, hypersensitivity disorders due to drugs and inhaled organic dusts, and complications of transplantation. The themes unifying these diverse topics are the cellular and ...

      Notices
      499-500

      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.

      IODINE DEFICIENCY IN EUROPE

      The 1st international workshop, subtitled "A ...