Stimulating fetal hemoglobin by increasing γ-globin synthesis in patients with sickle cell disease would, if the production of βS-globin decreased concomitantly, have a large “sparing” effect on the formation of intracellular hemoglobin S polymer¹–³ and ...

Sickle cell anemia and the β-thalassemia syndromes are prevalent disorders caused by mutations affecting the adult-globin (beta-globin) chain of hemoglobin A (the chains designated as α₂β₂)¹–⁵. Sickle cell anemia was the first disease to be characterized ...

Children and adults with brain tumors who are treated with cranial radiation may subsequently have deficits in neuroendocrine function¹–¹³. Although deficiency of growth hormone is common, hypothyroidism and gonadal disturbances are seldom reported and ...

Cholangitis related to the acquired immunodeficiency syndrome (AIDS) has been described increasingly since the first report of acalculous cholecystitis in such a patient¹–⁴. AIDS-related cholangitis is characterized by chronic abdominal pain, low-grade ...

Myocarditis occasionally masquerades as acute myocardial infarction because patients may present with severe chest pain, electrocardiographic changes, and elevated serum levels of creatine kinase. In patients with normal coronary arteries who presumably ...

Figure 1. Sickle Cell Anemia.

Scanning electron microscopy shows numerous sickled erythrocytes in a peripheral-blood specimen from a 21-year-old black woman with sickle cell anemia who was admitted to the hospital with acute chest and abdominal pain (...

The interleukin-1 family consists of three structurally related polypeptides. The first two are interleukin-1α and interleukin-1β, each of which has a broad spectrum of both beneficial and harmful biologic actions, and the third is interleukin-1-receptor ...

Serious birth defects, often genetically determined, complicate and threaten the lives of 3 percent of newborn infants¹. These disorders account for 20 percent of deaths during the newborn period and an even higher percentage of serious morbidity in ...

Presentation of Case

A 72-year-old woman was admitted to the hospital because of swelling and ecchymoses of both lower extremities and anemia.

The patient was in excellent health until five weeks earlier, when pain and swelling developed in the right leg. ...

Humans, other primates, and ruminants benefit from having a structurally and functionally distinct hemoglobin during fetal development. In human fetal hemoglobin (α₂(γ)₂), the (γ) subunit differs from the β subunit of adult hemoglobin A (α₂β₂) in 39 of ...

Deficiency of one or more anterior pituitary hormones may follow treatment with external radiation when the hypothalamic-pituitary axis falls within the fields of radiation. Hypopituitarism has been described in patients who received radiation therapy for ...

In an editorial four years ago I suggested that universal health insurance was an idea whose time had come¹. That prediction may have been a little premature -- but now, with the election of a president strongly committed to health care coverage for all, ...

To the Editor: The analysis of strategies to prevent Lyme disease by Magid et al. (Aug. 20 issue)¹ does not factor in certain practical outcomes that motivate the many physicians who are reluctant to offer empirical treatment for tick bites. The decision ...

To the Editor: Many readers may have missed one of the most interesting items in the September 3 issue of the Journal: the fine print on the back of an advertisement for the Lopid brand of gemfibrozil. Gemfibrozil reduced the incidence of coronary events ...

To the Editor: Cocconi et al. (Aug. 20 issue)¹ reported enhancement of survival in patients with metastatic malignant melanoma by some 20 weeks after treatment with dacarbazine and tamoxifen as compared with dacarbazine alone. In a cautious accompanying ...

To the Editor: The editorial by Cheson (Aug. 6 issue)¹ mentions the bcl-2 oncogene in follicular B-cell non-Hodgkin's lymphoma. The chromosomal location of this oncogene is incorrectly identified. This oncogene was cloned at the site of the t(14;18) (q32;...

To the Editor: Jordan et al. (Sept. 3 issue)¹ provided a list of normal reference laboratory values that was prefaced by the statement “Reprints are available at $2.50 each,” implying that these values are reference values for clinical laboratories. ...

To the Editor: Pressed by the increasing shortage of human organs, we are rapidly moving toward the use of xenografts from pigs or nonhuman primates. We must ask whether endogenous animal retroviruses pose any public health risk when transplanted into a ...

“Nobody ever died because he couldn't smell.” So said a grants administrator at the National Institutes of Health in trying to explain why so few research dollars address smell and taste. As compared with vision and hearing, these “chemical senses” have ...

This is a thoughtfully organized, comprehensive multiauthored textbook devoted to all aspects of central nervous system infections. It was the editors' intention that their book occupy a position between large general textbooks and single-subject ...

John M. Berecz, a clinical psychologist who himself has Tourette's syndrome, has written a book with the goal of “spacious theorizing” about Tourette's syndrome and obsessive-compulsive disorder. He believes both have been overinterpreted from a specious ...

The Medical Treatment of Epilepsy belongs in the libraries of neurologists, pediatricians, and other physicians who take care of patients with epilepsy. The editors have admirably fulfilled their stated goal of providing a comprehensive guide to the ...

The surgical treatment of patients with intractable epilepsy has gained remarkable popularity during the past decade, but there are few comprehensive textbooks dealing with the subject. In this book the editor's aim is to provide the reader with “a good ...

In the 10-year period from the elucidation of the clinical picture of the X-linked form of mental retardation associated with a fragile X chromosome to the publication of this book, it has become apparent that the fragile X syndrome is the most common ...

Managed competition has received widespread support from members of Congress, President-elect Bill Clinton, large insurance companies, and editorialists writing in influential publications¹–⁴. A central tenet of the managed-competition theory is that ...

Case Records of the Massachusetts General Hospital (Case 36-1992). On page 790, in Table 1, the serum uric acid concentration should have been 12.6 mg/100 ml (750 micromoles/liter), not 12.6 micrograms/100 ml (0.7 micromoles/liter) as printed.

Warfarin in the Prevention of Stroke Associated with Nonrheumatic Atrial Fibrillation. On page 1409, in Figure 1, the solid line should have referred to the patients in the warfarin group and the broken line to those in the placebo group. We regret the ...