ULTRASONIC examination has become a well-established diagnostic tool in many abdominal diseases. In recent years, the degree of resolution attainable with ultrasonic equipment has been considerably improved, making more accurate ultrasonic diagnosis ...

THE pathogenesis of pulmonary hypertension is incompletely understood. The histologic features of the small pulmonary arteries of patients with this disease suggest that the coagulation system on the endothelial surface may be activated as either a ...

PRIMARY pulmonary hypertension is an uncommon disease that is progressive and incurable.^{1 , 2} The recent National Institutes of Health (NIH) Registry on Primary Pulmonary Hypertension documented a median survival of 2.8 years after the diagnosis.³ In the ...

PEAK bone mass is a major determinant of bone mass later in life,¹ and an increase in peak bone mass should decrease the risk of osteoporotic fractures. Genetic factors play a major part in the determination of peak bone mass,² accounting for up to 80 ...

NOSOCOMIAL infections represent major sources of morbidity and mortality for patients in the intensive care unit (ICU).^{1 2 3 4 5} Important risk factors for such infections include life-threatening medical or surgical conditions, the immunocompromised ...

THE original descriptions of thyrotoxicosis by Parry and by Graves mention cardiovascular manifestations, and today we recognize that many patients with thyrotoxicosis have symptoms and signs reflecting the effects of excess thyroid hormone on the ...

Therapeutic Applications

Acute Neutropenia after Myelotoxic Anticancer Therapy

The administration of a colony-stimulating factor after standard-dose chemotherapy may be either prophylactic (i.e., given to prevent infectious complications) or therapeutic (...

Presentation of Case

First admission. A 45-year-old man was admitted to the hospital because of increasing confusion and a lymphocytic pleocytosis.

The patient was well until approximately 3 1/2 months earlier, in late February, when he traveled to Texas ...

Pulmonary hypertension, defined as a mean pulmonary-artery pressure above 20 mm Hg or a pulmonary-artery systolic pressure above 30 mm Hg, can arise in a variety of cardiopulmonary conditions that increase pulmonary blood flow, pulmonary vascular ...

Calcium is the most common mineral in the human body, where it is present in almost the same relative abundance as in the earth's crust. There are six stable isotopes of calcium; calcium-40 is the most common (97 percent), and calcium-46 the least ...

Experts in infection control coax, cajole, threaten, and plead, but still their colleagues neglect to wash their hands. Consider, for example, the report by Doebbeling et al. in this issue of the Journal. ¹ Presumably, everyone in the intensive care units ...

Several highly publicized episodes illustrate our continuing faith as a society in a flawed diagnostic test. In May, Roger Coleman, a convicted murderer who vociferously maintained his innocence, was executed in Virginia after failing a polygraph test ...

To the Editor: The thrust of the study by Anand and Hickey (Jan. 2 issue)* is that the use of deep levels of anesthesia and postoperative analgesia is safer and results in improved outcome in critically ill infants more often than the use of lighter ...

To the Editor: I am in complete agreement with Dr. Wald's review of sinusitis in children (Jan. 30 issue),* but would like to offer some additional insights into the management of sinusitis.

In many children, outflow from the sinuses is impeded by ...

To the Editor: The study by Amarenco et al. (Jan. 23 issue)¹ provides useful information about the prevalence of plaques in the aortic arch in patients with stroke. However, the authors' hypothesis that ulcerated plaques were responsible for many of the ...

To the Editor: In the February 12, 1976, issue of the Journal, Strober et al.¹ described a 15-year-old boy with chronic diarrhea and recurrent intestinal candidiasis who was thought to have a deficiency of secretory component. This epithelial-cell ...

To the Editor: The laparoscopic approach to cholecystectomy is becoming a simple and safe way to perform this procedure. Since this technique is rather new, it may result in unforeseen complications. We encountered a woman in whom an abscess developed ...

To the Editor: We are concerned about the article on syncytial giant-cell hepatitis by Phillips et al. (Feb. 14, 1991, issue).¹ There is a discrepancy between the size of the particles as stated in the legend to Figure 3B and the authors' previous ...

To the Editor: The article by Dr. Kessler (Dec. 5 issue)* makes a cogent argument about the need for health educators to teach patients and clients about their medications, and he correctly points out that written material, reinforced by counseling, is ...

To the Editor: In regard to the article by Warner et al. on cigarette advertising and magazine coverage of the hazards of smoking (Jan. 30 issue),* I have long been troubled by cigarette advertisements, particularly those aimed at young people, ...

To the Editor: The development of local anesthetics for the temporary relief of pain from mucositis associated with radiation and chemotherapy has been beneficial to many patients. We report the case of a patient in whom profound methemoglobinemia ...

Only 30 years ago the fetus was an anonymous stowaway. Knowledge about the physiology of the birth process was meager, and neonatal resuscitation had just been introduced. Since then, we have acquired an amazing amount of new information about the fetus ...

The understanding of perinatal and neonatal metabolism has rapidly expanded as a consequence of the technological breakthroughs that have characterized these areas of medicine over the past 25 years. Dr. Cowett has assembled an impressive group of ...

This book covers the subjects promised in the title. It includes the formation of blood in the fetus and the normal hematologic picture in the newborn, including the premature infant. The diagnosis and management of anemia, hemolytic disease, and ...

Almost 1 in every 100 babies is born with a congenital cardiac defect, the single most common congenital abnormality. Of these, approximately one fourth, or 2 to 2.5 per 1000 live-born infants, have a lesion severe enough to require cardiac ...

This book is based on the proceedings of the August 1989 Aspen Seminar on pediatric gastroenterology and nutrition, the fourth in a series sponsored by the Institute for Pediatric Medical Education that deals with various pediatric disorders.

This book ...

A holistic approach to orthopedic conditions in childhood is emphasized in this compact 350-page book aimed at orthopedics residents. Drs. Williams and Cole bring their vast clinical experience to bear, providing a comfortable overview of pediatric ...

Biomedical Science

Articular Cartilage and Osteoarthritis. Edited by Klaus E. Kuettner, Rudolf Schleyerbach, Jacques G. Peyron, and Vincent C. Hascall. 757 pp., illustrated. New York, Raven Press, 1992. $89.

Basic Anatomy of the Head and Neck. By Martha ...

OHIO STATE UNIVERSITY

The following courses will be offered in Columbus: "Internal Medicine Board Review" (Aug. 15–21); "Challenges and Controversies in Cancer Research" (Sept. 9–12); "The New Hypertensive Regimes" (Sept. 25 and 26); "Dermatopathology" (...

Subcutaneous Low-Molecular-Weight Heparin Compared with Continuous Intravenous Heparin in the Treatment of Proximal-Vein Thrombosis (April 9, 1992;326:975–82). On page 977, in the right-hand column, under the heading "Recurrent Venous Thromboembolism," ...

Acquired Syphilis in Adults (April 16, 1992;326:1060–9). On page 1060, in the right-hand column, the last sentence of the first full paragraph should have read, "Similarly, the number of syphilis-related deaths declined from 10.7 per 100,000 in 1940 to ...

Extreme Elevations of Serum Lactic Dehydrogenase Differentiating Pulmonary Toxoplasmosis from Pneumocystis Pneumonia (April 30, 1992;326:1226). In the first paragraph of the right-hand column, the last sentence should have read, "Six patients were tested ...