The prevalence of adenomatous polyps of the colon and rectum in the United States and other Western countries is high, as is the incidence of colorectal cancer¹,². Many people with polyps have been identified in recent years as a result of screening with ...

Familial adenomatous polyposis is a dominantly inherited syndrome characterized by the progressive development of hundreds of adenomatous colorectal polyps, some of which inevitably progress to cancer. Although the clinical manifestations of this syndrome ...

The most common form of non-insulin-dependent diabetes mellitus (NIDDM) is characterized by obesity, insulin resistance, insulin secretory dysfunction, and overproduction of glucose in the liver. The relative roles of these metabolic abnormalities in the ...

Polymyositis, dermatomyositis, and inclusion-body myositis are distinct groups of inflammatory myopathies, each with characteristic immune-mediated mechanisms¹–⁶. In polymyositis and inclusion-body myositis, sensitized CD8+ cytotoxic T cells recognize ...

Figure 1. Mycosis Fungoides.

Mycosis fungoides is an epidermotropic variant of cutaneous T-cell lymphoma. The most notable histologic features in the plaque stage include a broad, band-like, cellular lymphoid infiltrate involving the densely fibrotic ...

The discovery that mammalian cells generate nitric oxide, a gas previously considered to be merely an atmospheric pollutant, is providing important information about many biologic processes. Nitric oxide is synthesized from the amino acid L-arginine by a ...

Numbness, painful tingling, or weakness may be the result of the entrapment of a peripheral nerve. These problems are encountered by medical providers of all types, and although common, they often lead to diagnostic and management difficulties. This ...

Presentation of Case

A 17-year-old girl was admitted to the hospital because of massive hemoptysis and renal failure.

The patient had been well until about three days earlier, when she began to have symptoms of an upper respiratory tract infection, with ...

The syndrome of familial adenomatous polyposis is characterized by the emergence of multiple (>100) colonic polyps early in life and by inevitable progression to colonic carcinoma. The gene responsible for this syndrome, the adenomatous polyposis coli (...

The most common therapeutic intervention in medicine is the writing of a prescription¹. The proliferation of therapeutic alternatives and the growing recognition of the clinical and economic consequences of suboptimal pharmacotherapy²–⁴ have stimulated a ...

To the Editor: As practicing pediatricians in a medium-sized urban setting, we were disturbed to read the article by Rosman et al. (July 8 issue)¹ on the use of diazepam to prevent febrile convulsions. We physicians need to do more talking and less ...

To the Editor: Drs. Pancake and Zucker-Franklin (Aug. 19 issue)¹ report that about two thirds of the patients with mycosis fungoides in their study appeared to be infected with human T-cell lymphotropic retrovirus type I or type II (HTLV-I or HTLV-II), ...

To the Editor: Conventional methods of detecting Mycobacterium tuberculosis in clinical samples, such as microscopy or culture, are either low in sensitivity and specificity or time-consuming. The use of the polymerase chain reaction (PCR) has been ...

To the Editor: Edwards and Kushner (June 3 issue)¹ advocate universal screening for presymptomatic hemochromatosis. Such screening would probably identify 10 times the number of people with this condition now identified. This recommendation is based on ...

To the Editor: In evaluating the effect of topical tretinoin (retinoic acid) cream on the skin, Griffiths et al. (Aug. 19 issue)¹ conclude that tretinoin causes an 80 percent increase in extracellular type I collagen formation in the papillary dermis. ...

To the Editor: In a study of New Jersey State Cancer Registry records (July 29 issue),¹ Ayanian et al. found that rates of survival from breast cancer among patients with local and regional disease were lower for uninsured patients and patients with ...

To the Editor: The Image in Clinical Medicine “Colocolic Fistula” (June 17 issue)¹ is a splendid radiographic demonstration of a typical complication of Crohn's disease. For a clinician, however, this nice image also raises an important question: Why ...

To the Editor: Dr. Kreisberg's cogent assessment and coherent comments on clinical problem-solving (Aug. 5 issue)¹ emphasize the need for a probing history taking in every patient. The first reported instance of leptospirosis in Connecticut was ...

Daniel Callahan is well known for his support of age-based rationing of health care resources, a position that has sparked public and professional debate on how best to spend limited health care dollars. In this new book, he cuts through the policy ...

Ronald Dworkin is one of the country's leading constitutional scholars, and in Life's Dominion he presents his argument about how the U.S. Constitution should be interpreted when a state seeks to restrict abortion. Dworkin focuses on what he sees as the ...

A leading Broadway composer, 88 years old, is undergoing renal hemodialysis while preparing for the upcoming opening of his new show, The New York Times recently reported. I suspect that most of us would see such aggressive medical treatment as ...

The literature of medical autonomy deals with crises and conflicts of short-term care, but in long-term care most of the struggles concern mundane, routine experiences. The standards of autonomy in short-term care are rarely challenged in long-term care, ...

The current interest in palliative care was conceived, born, and nourished because of the health care system's ineffectiveness in delivering appropriate, compassionate treatment to the dying. Medicine became expert at curative intervention but impotent in ...