Directional coronary atherectomy was developed by Simpson in 1984, and unlike balloon angioplasty, it allows the resection of coronary atherosclerotic plaque. From October 1986 through December 1989, 1020 procedures were performed at 14 investigational ...

In the past decade percutaneous transluminal coronary angioplasty has been applied to increasingly complex clinical and anatomical situations, with simultaneous improvement in success rates and reduction in complication rates¹. Despite intensive ...

Rates of breast cancer vary more than fivefold among countries,¹ suggesting that there are potentially modifiable environmental determinants². Dietary fat has been thought to increase the risk of breast cancer³; however, in prospective studies we and ...

The first description of a patient with myophosphorylase deficiency (McArdle's disease) was reported in 1951 by McArdle, who concluded that the disorder was “characterized by a gross failure of the breakdown of glycogen to lactic acid”¹. However, it was ...

Figure 1. Left Ventricular Aneurysm.

The images show the results of contrast left ventriculography in a 72-year-old woman who presented with progressive cardiac failure after myocardial infarction. Panel A is a right anterior oblique view showing the left ...

Each year approximately 2.5 million U.S. women are hospitalized for cardiovascular illness, which also claims the lives of 500,000 women annually; half these deaths are due to coronary heart disease¹. Despite the magnitude of this problem and its adverse ...

Few diagnoses in medicine engender as much pessimism as the diagnosis of metastatic cancer of an unknown primary site. Patients with this syndrome often have widespread metastatic disease, with involvement of multiple visceral sites such as the liver, ...

Presentation of Case

A 54-year-old man was admitted to the hospital because of a mass in the right thigh and a radiographic density in a lung.

The patient had been well until three months earlier, when he observed painless swelling of the right thigh, ...

In this issue of the Journal are three articles about the health of women. Nanette Wenger and her colleagues¹ review what is known about the differences in cardiovascular health between men and women: cardiovascular disease is the leading cause of death ...

Although balloon angioplasty has been an important advance in the treatment of coronary artery disease, this procedure is limited by a high rate of restenosis. In balloon angioplasty, coronary stenoses are dilated but atherosclerotic plaques are not ...

To the Editor: The review of indications for hysterectomy by Carlson et al. (March 25 issue)¹ provides valuable information that should reduce unnecessary hysterectomies. However, the sometimes adverse aftermath of hysterectomy was not sufficiently ...

To the Editor: In discussing screening and informed consent (Feb. 11 issue),¹ Dr. Lee failed to mention the development of more sensitive screening techniques capable of achieving reductions in mortality not seen in clinical trials of 10 to 30 years ago. ...

To the Editor: Regulation 46.208 of the National Institutes of Health's Office for Protection from Research Risks states that fetal research is permitted only if both the father and the mother have consented to it. Aside from cases of rape, exceptions to ...

To the Editor: Seibel and Kiessling (March 11 issue)¹ invoked equal worth of the sexes and the nationwide practice of paying sperm donors to justify their proposal to pay oocyte donors. The risks and benefits associated with paying donors are not ...

To the Editor: Reid et al. (Feb. 18 issue)¹ reported that calcium supplementation significantly slowed axial and appendicular bone loss in normal postmenopausal white women. However, the conclusions were generalized. Could the authors comment on the ...

To the Editor: With reference to the Clinical Problem-Solving case in the March 4 issue,¹ I was surprised that autoimmune hemolytic anemia and neutropenia were not considered in the differential diagnosis.

A pregnant woman taking 5 mg of oral prednisone ...

To the Editor: A 40-year-old cardiac-catheterization nurse reported that she had marked scleral edema and throat irritation after being exposed to latex. In order to work, she put vinyl liners inside latex gloves. When vinyl gloves were not available, ...

To the Editor: We are writing about two instances in which we believe that good labeling practices have not been followed for nonprescription medications.

In the first instance, Sandoz Corporation is marketing new preparations of Triaminic Syrup and ...

To the Editor: An assessment of whether a patient appears younger or older than the “stated age” has long been taught and recorded as a component of the physical examination. We sought to determine how accurate observers were in their judgment of ...

Searching the MEDLINE data base (by means of CD-ROM, on-line services, or a diskette service) is considered routine in most academically oriented clinical and research work. Whatever the search strategy, much garbage accumulates, and the results must be ...

Keeping current with new information and changing practices is a constant challenge in any subspecialty. Fortunately, UpToDate makes this task a lot easier in the field of nephrology.

Uptodate is a HyperCard application that covers all the major areas of ...

In recent years there has been a trickle of books and a number of general medical articles dealing with the medical problems encountered by humans during space flight. A recent example is Space Physiology and Medicine (edited by A.E. Nicogossian, C.L. ...

The practice of medical oncology and hematology has been irreversibly altered by the concept of high-dose chemotherapy with marrow rescue -- a euphemism for bone marrow transplantation. Transplantation now has an increasing role in the management of a ...

Airway management in the acute care setting is an important skill to have no matter what the cause of the actual or potential respiratory compromise. Intubation is an acquired skill, and there is clearly a need for a sound knowledge of the basics of ...

Approximately 7 million patients in the United States have been given a diagnosis of diabetes. An additional 6 million may have undiagnosed diabetes. These two groups represent 5 percent of the U.S. population. Since in one study 26 percent of the ...

Lichtenstein and Fauci have assembled a talented and authoritative group of contributors to address practical matters concerning the practice of allergy and immunology and rheumatology. The editors have recruited a number of authors from outside the ...

Dust to Dust is a remarkable Triple Crown achievement in medicine, photography, and writing. Dr. David Heiden, a San Francisco physician, has taken the weak pulse of African famine victims and amplified it through a stethoscope of light and tears. The ...

Although the inclusion of women and minorities in medical research is necessary for valid inferences about health and disease in these groups, both women and members of minority groups have been excluded from or underrepresented in many clinical trials. ...

The Food and Drug Administration (FDA) is taking two important steps to ensure that new drugs are properly evaluated in women. First, it is providing formal guidance to drug developers to emphasize its expectations that women will be appropriately ...