Adjuvant combination chemotherapy, tamoxifen, or both improve survival when given to women with stage I and II invasive primary breast cancer,¹ but overall mortality rates for the disease have remained stable²,³. Slight improvements in five-year survival ...

Most patients with ulcerative colitis are nonsmokers, and patients with a history of smoking usually acquire their disease within a few years after they have stopped smoking¹–⁴. Among patients who continue to smoke, symptoms may improve, suggesting that ...

There is evidence from analyses of large cohorts of patients that HLA compatibility between the donor and recipient affects the outcome of cadaveric kidney transplantation¹–³. The influence of the HLA system in heart transplantation, however, remains ...

Chronic myeloid leukemia (CML) was treated for many years with radiation and with chemotherapy, mainly busulfan and hydroxyurea. Since that treatment neither prevented progression of the disease from a chronic to a blastic phase nor substantially ...

Figure 1. Gingival Hypertrophy in Myelomonocytic Leukemia.

A 36-year-old woman with chronic myelomonocytic leukemia had marked gingival hypertrophy, thought to be due to infiltration of the gingiva by leukemic cells. The patient presented with a white-...

Bone marrow transplantation is the intravenous infusion of hematopoietic progenitor cells to reestablish marrow function in a patient with damaged or defective bone marrow (Figure 1). Although some have traced the origin of this procedure to the end of ...

Hematopoietic growth factors promote both growth and differentiation of blood cells¹,². These factors activate specific hematopoietic growth factor receptors that are expressed on the surface of blood progenitor cells of the bone marrow. The past decade ...

Presentation of Case

A 72-year-old man was admitted to the hospital because of chronic cutaneous ulcers and the recent onset of progressive renal failure.

The patient had been in good health until five years earlier, when congestive failure developed. ...

As the search for the cause of inflammatory bowel disease continues,¹ the association between cigarette smoking and a more favorable clinical course in ulcerative colitis remains the sole epidemiologic feature that distinguishes it from Crohn's disease². ...

The time constraints of cardiac transplantation -- namely, the need to implant the donor organ within four hours of its removal -- have prevented cardiac surgeons from considering prospective HLA matching of the donor and recipient, even if they thought ...

Organ transplantation has been targeted for elimination or reduction in many proposed schemes of health care reform¹–³. Although recent figures suggest a dramatic increase in cost effectiveness,⁴ transplantation is expensive and its exclusion is defended ...

To the Editor: We enjoyed Mills's recent Sounding Board article (Oct. 14 issue)¹ deploring the torture of data and would like to add a few points. Multiple-hypothesis testing (data torturing) by a desperate or inexperienced investigator is analogous to ...

To the Editor: Hull and colleagues (Nov. 4 issue)¹ compared postoperative warfarin therapy with a once-daily postoperative regimen of the low-molecular-weight heparin Logiparin for the prevention of postoperative venous thrombosis in patients undergoing ...

To the Editor: Perhaps the most important finding in the study by Heijboer and coworkers comparing real-time compression ultrasonography with impedance plethysmography (Nov. 4 issue)¹ is that the overwhelming majority of patients who present with ...

To the Editor: Harris and Hollstein (Oct. 28 issue)¹ reviewed the clinical implications of the p53 tumor-suppressor gene. Of particular interest to clinicians is the prognostic importance of p53 mutations. The authors mentioned that there is now more and ...

To the Editor: In a recent article Hamosh and Corey of the Cystic Fibrosis Genotype-Phenotype Consortium (Oct. 28 issue)¹ reported on correlations between the genotypes and phenotypes of patients with cystic fibrosis. The mean age of the patients with ...

To the Editor: The conclusions drawn by Kaufman et al. (Nov. 4 issue)¹ in their article on selective bladder preservation by combination treatment of invasive bladder cancer do not seem to be compatible with their results. They state “Of the 53 patients ...

To the Editor: We report two cases of uveitis associated with rifabutin therapy. A 52-year-old woman with pulmonary Mycobacterium avium complex infection who was negative for the human immunodeficiency virus was referred to our clinic in October 1992 ...

To the Editor: Cytomegalovirus retinitis is a leading cause of morbidity in patients with AIDS. Although it is optimally treated systemically with either ganciclovir or foscarnet, intraocular therapy is becoming increasingly popular. We report here the ...

To the Editor: A 71-year-old man was recently referred to our echocardiography laboratory for a stress test with dobutamine. Initially, he appeared to be a calm, soft-spoken man. His resting heart rate was 81 beats per minute. During the first dose of ...

The number of vertebrate animals used in research rose sharply in the United States after World War II, with the establishment of the National Institutes of Health. In 1983 it was estimated that between 17 million and 20 million vertebrate animals were ...

A series of recent books and journal articles have argued that community must be considered in deciding questions ranging from individual clinical cases of futile treatment to the allocation of resources and health care reform. Freedom and Community ...

The history of coal mining is rife with greed, inhumanity, and incredible danger. Sweatshops, exploitation of child labor, absentee ownership of highly profitable industries, and destruction of native culture were all phenomena of the Industrial ...

Public opinion, systematically sampled in polls, mattered a great deal to makers of health policy in Britain in the 1940s and in the United States in the 1960s, according to Lawrence R. Jacobs. “Political struggles,” caused mainly by doctors, he writes, “...

The practice of “patient-centered” or “biopsychosocial” care, long championed by Ian McWhinney and George Engel, rests on two basic principles. First, medical care must be firmly grounded in the patient's subjective experience of illness; to deal only ...