Congestive heart failure is a relatively common clinical problem¹ that is associated with the progressive impairment of left ventricular function and a poor long-term prognosis². Angiotensin-converting-enzyme inhibitors have been shown to improve survival ...

Human herpesvirus 6 (HHV-6) infects over 90 percent of the U.S. population early in life, causing fever or rash in some children¹–⁵. In normal adults, DNA of HHV-6 is commonly found in peripheral-blood mononuclear cells and saliva, suggesting that the ...

The introduction of the dibenzodiazepine antipsychotic agent clozapine (8-chloro-11[4-methyl-1-piperazinyl]-5H-dibenzo-[b,e][1,4] diazepine) was an important development in the pharmacotherapy of schizophrenia. Preclinical¹–⁵ and clinical⁶–⁹ ...

Human herpesvirus 6 (HHV-6) was first isolated from patients with the acquired immunodeficiency syndrome or lymphoproliferative diseases and was named human B-lymphotropic virus¹. However, later studies revealed that the virus is T-lymphotropic in vitro² ...

Low-grade B-cell lymphomas of mucosa-associated lymphoid tissue (MALT) that occur in the stomach, small intestine, salivary gland, lung, and thyroid are indolent neoplasms characterized by a prolonged clinical course and persistent disease at the site of ...

Figure 1. Secondary Syphilis.

The hands of a 41-year-old woman with secondary syphilis show a symmetric, dusky red, and polymorphic papulosquamous rash, also present on her soles.

Discoveries in cancer research are rarely so exceptional that they both cause immediate changes in the treatment of patients and dramatically advance our understanding of the mechanisms underlying the disease. However, observations of the striking ...

The prevalence of iron-deficiency anemia among infants and children in the United States is now relatively low, but iron deficiency remains the leading cause of anemia. Iron deficiency persists despite increased understanding of methods for its prevention,...

Presentation of Case

A 63-year-old man was admitted to the hospital because of fever, chills, and fatigue.

The patient had been in stable health until 17 days earlier, when he experienced the onset of dull occipital headache, myalgias, and night sweats. ...

The belief that a depression of cardiac contractility is the fundamental defect in patients with chronic heart failure has led to the development during the past 20 years of nearly 100 new drugs with positive inotropic activity. Although all these agents ...

Human herpesvirus 6 (HHV-6) was discovered in 1986 by Salahuddin and coworkers¹ and was initially called human B-lymphotropic virus. The virus was later shown to have a marked tropism for CD4-positive T cells and was renamed HHV-6. HHV-6 is genetically ...

Clozapine appears to induce two clinically distinct types of neutropenia; these are the basis for the study by Alvir et al., reported in this issue of the Journal¹. One is a mild-to-moderate neutropenia (absolute neutrophil count, 500 to 1500 per cubic ...

To the Editor: Rossaint et al. (Feb. 11 issue)¹ discussed the potential benefits of inhaled nitric oxide in the adult respiratory distress syndrome (ARDS). Their hypothesis is that inhalation of nitric oxide causes selective vasodilation of the pulmonary ...

To the Editor: Dr. Cohen (Feb. 25 issue)¹ briefly describes endoscopic laser third ventriculostomy for the relief of hydrocephalus due to stenosis of the aqueduct of Sylvius. I wonder whether this is the safest way to treat the condition. ...

To the Editor: I agree with the conclusions of Randhawa et al. (Dec. 10 issue)¹ that liver-biopsy specimens showing evidence of the expression of the EBER-1 gene may be useful for predicting the development of post-transplantation lymphoproliferative ...

To the Editor: In his review of gynecomastia (Feb. 18 issue),¹ Dr. Braunstein includes a long and detailed list of agents that have the potential to induce the condition. Human growth hormone was not listed. Although not widely known, it has been ...

To the Editor: Gambian trypanosomiasis is rarely reported to result from a needle stick in the laboratory. We report such a case. On March 5, 1992, a 50-year-old laboratory technician accidentally stuck her left hand with a needle containing Trypanosoma ...

To the Editor: Giardiasis is the leading cause of waterborne outbreaks of diarrhea in the United States,¹ yet its role as a potential cause of malabsorption in elderly patients may be underestimated². We report a case of severe hypokalemic myopathy ...

To the Editor: Oral rehydration solutions have been recommended for the treatment and prevention of dehydration due to diarrhea in the United States¹,² and worldwide³. Although several of these solutions are commercially available in the United States, ...

To the Editor: Dr. Grumet (Feb. 11 issue)¹ reviews the problem of noise in hospitals and offers several valuable suggestions. To ameliorate the problem, I believe physicians as a group must assume their share of responsibility, particularly for the noise ...

To the Editor: Dr. Kassirer (March 4 issue)¹ suggests that the need for primary care internists could be satisfied if the edentulous Federated Council for Internal Medicine (FCIM) would take a strong, enforceable stand. Historically, the FCIM was ...

To the Editor: A 51-year-old woman was admitted to our hospital in severe respiratory distress due to the acute onset of pulmonary edema and bronchospasm. She was comatose and required emergency intubation. Arterial-blood gas measurement before ...

It is not often that a medical textbook survives through multiple editions over a period of more than 130 years, but Gray's Anatomy has managed to do just that. When it was first published in 1858, it was considered a superb textbook. Gray's intention was ...

This book is a compendium of “how to do it” chapters, each describing the operative details of a classic neurosurgical procedure as performed by a recognized authority in the field. For each chapter, Dr. Wilson selected a senior author whose name is ...

Emerging Strategies in Neuroprotection has as its goal the summarizing of the new field of neuroprotection after neural injury. It comprises 17 chapters written by 42 authors and contains approximately 1450 references, many from 1991. The editors have ...

The border zone between the brain and the body -- known as the skull base -- has long been an area of doom. Patients who had tumors in this area and surgeons who ventured into this area faced poor prognoses and poor outcomes. But recent advances in ...

The authors of this textbook, representing almost exclusively the staff of the Massachusetts Eye and Ear Infirmary, have produced a reference work on otology based on the experience of that institution. This approach has several benefits for the reader ...

Complications in Head and Neck Surgery is a multiauthored book on the prevention, recognition, and treatment of complications seen in the practice of head-and-neck surgery. The content of this book follows the outline of Complications of Head and Neck ...

This comprehensive book addresses the management of many of the difficult abdominal and thoracic reoperative problems encountered by the general surgeon. The authors have collected contributions from 58 surgeons at major academic medical centers, many of ...

David Beck and Steven Wexner have succeeded in producing an up-to-date textbook to replace the now out-of-print Essentials of Anorectal Surgery, edited by Goldberg, Gordon, and Nivatvongs (Philadelphia: J.B. Lippincott, 1980). Although there are many ...

Case Records of the Massachusetts General Hospital (Case 50-1992). On page 1805, the reference citation in the last line of the left-hand column should have been to Robertson LE, Huh Y, Hirsch-Ginsberg C, et al. Clinical, immunophenotypic, and molecular ...