The optimal substitute for a diseased aortic valve in children and young adults has not been identified. Although several mechanical valves have satisfactory hemodynamic characteristics, all necessitate lifelong treatment of the patient with ...

Idiopathic nephrotic syndrome is clinically characterized by heavy proteinuria and can result in corticosteroid resistance with focal and segmental glomerulosclerosis and in end-stage renal failure¹,². In 15 to 55 percent of patients there is a recurrence ...

Diabetic nephropathy is the most common cause of end-stage renal failure in the Western world¹. Among patients with insulin-dependent diabetes, those with proteinuria are at greatest risk for early death²,³. The cumulative incidence of nephropathy among ...

Arterial gas embolism can occur after traumatic chest injury, during medical or surgical procedures, or as a result of distention and barotraumatic rupture of alveoli due to trapped gases in otherwise healthy divers¹. In patients undergoing surgery, gas ...

Studies of the common cold have relied on diagnosis by the patients themselves¹–³ or diagnosis by an investigator using individual symptoms reported by the patients⁴–⁶. These methods have limited usefulness for determining which anatomical areas of the ...

Figure 1. Multiple Jejunoileal Diverticula.

An 82-year-old man with a one-year history of diarrhea, steatorrhea (20 g of fat per day), and massive weight loss (20 kg) was suspected of having pancreatic carcinoma. The results of gastroduodenoscopy and an ...

With health care at the top of the nation's agenda, increasing numbers of physicians are contributing to the American Medical Political Action Committee (AMPAC), the political wing of the American Medical Association (AMA). The largest political action ...

The dramatic hemorrhages, the effect of the disease on history through its presence in Queen Victoria's descendants, and the devastating role of therapeutic concentrates in the transmission of the acquired immunodeficiency syndrome (AIDS) have made ...

Stage

A 44-year-old Israeli-born farmer who lived in the Jordan Valley was admitted to the hospital for evaluation with a two-week history of fever, jaundice, and malaise. His family history was unremarkable, and he had no history of liver disease. He had ...

Presentation of Case

A 27-year-old woman was admitted to the hospital because of secondary infertility and a bladder mass.

The patient was a native of Zimbabwe. She resided in an urban area and frequently visited relatives in the countryside, where she ...

With the development of surgical techniques to replace diseased aortic valves by Bahnson et al.¹ and independently by Hufnagel and Conrad,² a quest began for the ideal, permanent substitute for the aortic valve. Various mechanical valves have been ...

In this issue of the Journal, Dantal et al. report the remarkable observation that the removal of serum proteins by adsorption to protein A Sepharose led to remission of proteinuria in patients with recurrences of the nephrotic syndrome after ...

To the Editor: In their report on risk factors for the sudden infant death syndrome (SIDS) (Aug. 5 issue)¹, Ponsonby et al. made one important omission. They failed to mention whether the criteria for SIDS were met. These include investigation at the ...

To the Editor: In the report by Feldman et al. (July 15 issue)¹ we are concerned about the lack of agreement between the results of the two doses used in the trial. When the study was designed, it seemed plausible that the 120-mg dose would be more ...

To the Editor: Cervello and colleagues (July 15 issue)¹ reported a case of hypokalemic myopathy associated with Giardia lamblia infection. To determine the frequency of hypokalemia and rhabdomyolysis in patients with severe giardiasis, we analyzed ...

To the Editor: Case 27-1993 (July 8 issue)¹ was interesting and informative. However, I would have to disagree with the anatomical diagnosis of cerebral vasculitis. The description of the microscopical examination and the lesions shown in Figures 2 and 3 ...

To the Editor: The mechanisms responsible for hypertrophy of the juxtaglomerular apparatus are not understood. We present histologic evidence to suggest that transforming growth factor β3 (TGF-β3), a multifunctional cytokine, may be regulated with renin ...

To the Editor: The “Three-Dimensional CT Diagnosis of Maxillofacial Trauma” (Images in Clinical Medicine, July 8 issue)¹ contains remarkable pictures. At first I thought they were a Steven Spielberg creation. They surely represent the technological ...

To the Editor: Large errors in the stated vitamin K content of milks and formulas seem worth correcting (Sept. 23 issue)¹. Human milk averages about 3 μg per liter,²,³ not 20 ng per liter. Cow's milk is only two- or threefold higher⁴ (not 15 to 17 mg per ...

To the Editor: I was dismayed by the minimal discussion of potential side effects of therapy in the recent review article on endometriosis by Olive and Schwartz (June 17 issue)¹. Although short-term use of gonadotropin-releasing hormone (GnRH) agonists ...

To the Editor: The National Institutes of Health recently launched the Women's Health Initiative (WHI). Although one of us sits on the WHI Advisory Board, we are commenting not in that capacity, but rather as epidemiologists concerned about the ...

Although the vast majority of scientists believe that the human immunodeficiency virus (HIV) is the cause of AIDS, a minority believe, equally strongly, that the cause of AIDS is more complex and as yet only partially understood. Thus far, this ...

This book, the work of a committee of the National Research Council of the National Academy of Sciences, is a preliminary report on the social consequences of the AIDS epidemic in this country. The panel is properly modest about its efforts: “No attempt ...

In the brave new world of the immunocompromised host, we are faced with infections by ever more exotic organisms, as well as novel patterns of disease caused by agents we thought we understood. Moreover, drug-resistant strains of conventional organisms ...

Future medical historians examining tuberculosis in the 20th century will describe a bimodal incidence in many of the industrialized nations. After a long period of steady decline, in the final 15 years of the century the pathogen confounded all ...

In 1988, the Centers for Disease Control described chronic fatigue syndrome and proposed a research case definition for it. This move classified an interrelated but heterogeneous array of debilitating symptoms under a new name. There has now been ...

This book, whose editor has developed one of the best-known laboratories of autonomic function in the world, provides a complete overview of disorders of the autonomic nervous system. It covers the anatomy and physiology of the autonomic nervous system, ...

In the absence of federal action, many states, squeezed by recession¹ and spiraling health care costs, have approved or are moving toward the enactment of legislation that would reform the way health care is paid for and provided within their borders. The ...