At present, the role of surgery in the treatment of patients with non-small-cell lung cancer, stage IIIA (locally invasive primary tumors or tumors associated with involvement of the ipsilateral mediastinal lymph nodes [N2]), is controversial¹,². An ...

Radon-222 in dwellings is the dominant source of exposure to ionizing radiation in most countries¹. Nationwide measurement programs suggest that the average radon concentration in Sweden is about 2.7 pCi per liter (100 Bq per cubic meter), a level that ...

After experimental studies,¹,² intrahepatic portosystemic shunts were established in patients by balloon dilation of tissue between portal and hepatic veins³,⁴. The results were disappointing, because most patients soon died with recurrent bleeding. ...

Simian immunodeficiency viruses (SIVs) are primate lentiviruses that are morphologically similar and biologically related to human immunodeficiency viruses (HIVs)¹–⁴. SIVs naturally infect some nonhuman primate species, such as African green monkeys and ...

In 1963 Liddle et al.¹ described a disorder that simulated primary aldosteronism, characterized by severe hypertension and hypokalemia but with negligible secretion of aldosterone. They theorized that this was “a disorder in which the renal tubules ...

Figure 1. Transjugular Intrahepatic Portosystemic Shunt.

This hepatic Doppler sonogram in a 55-year-old man with alcoholic cirrhosis and portal hypertension shows the successful placement of a transjugular intrahepatic portosystemic shunt. The procedure ...

Colorectal carcinoma is the second leading cause of death from cancer in the United States,¹ and almost 50 percent of patients with colorectal cancer die of the disease. Since the prognosis is related to the depth of invasion of the cancer, and since ...

More than 100,000 Americans under the age of 18 years are estimated to have some degree of neurologic disability attributed to cerebral palsy¹. Approximately 25 percent of the people with cerebral palsy identified by registries in France and the United ...

Presentation of Case

An 11-year-old boy was admitted to the hospital because of recurrent abdominal pain.

The child was born of a full-term normal pregnancy and delivery, weighing 3.5 kg. His early growth and development were normal. He was well until one ...

When the call went out recently for an increase in the number of primary care providers, nurse practitioners were prominent among the many professional groups that stepped forward. Now approximately 50,000 strong, they claim that their skills suit them ...

Adjuvant chemotherapy given after elimination of all macroscopic disease by surgery is now standard therapy for patients with selected solid tumors, such as node-positive colon cancer and breast cancer. Durable local control is usually achieved with ...

In most patients with cirrhosis of the liver, esophagogastric varices, a potentially life-threatening complication of portal hypertension, eventually develop. Twenty-five to 35 percent of these patients bleed from varices, usually within the first year ...

The simian immunodeficiency viruses (SIVs) were initially identified on the basis of antibody cross-reactivity with human immunodeficiency virus type 1 (HIV-1)¹. Serum samples from macaque monkeys from Asia with AIDS-like diseases were found to have ...

Health care reform has engendered many debates. One that has captured the attention of physicians, nurses, and policy makers is the relation, and perhaps the competition, between physicians and advanced-practice nurses. Advanced-practice nurses are ...

To the Editor: I am amazed at the conclusions drawn in the Special Article on preventive care for women (Aug. 12 issue)¹ -- namely, that “women are more likely to undergo screening with Pap smears and mammograms if they see female rather than male ...

To the Editor: The article by Becker et al. (Aug. 26 issue)¹ on racial differences in rates of cardiac arrest and subsequent survival calls attention to a problem that has been ignored for years. There are indeed several lines of evidence for a genetic ...

To the Editor: Dr. Simon's review of hyperthermia (Aug. 12 issue)¹ states that “the majority of anesthetic agents can trigger malignant hyperthermia. . . . ” The syndrome is triggered only by halogenated volatile anesthetics and succinylcholine. It is ...

To the Editor: In February 1993 a six-year-old boy weighing 22 kg fell into a river in an alpine region near Innsbruck, Austria (air temperature, -4 °C; water temperature, 2.5 °C). He drifted away immediately and was not pulled out of the water until 65 ...

To the Editor: The study by Wilimas et al. (Aug. 12 issue)¹ was well designed and addressed an important clinical problem. I cannot, however, agree with the authors' conclusion that intravenous ceftriaxone has been proved to be an appropriate treatment ...

To the Editor: Guidelines recently published by the American Cancer Society¹ recommend that men over the age of 50 have an annual digital rectal examination and a prostate-specific-antigen assay. These recommendations are problematic. Other expert panels ...

To the Editor: The potential value of the expression of bcl-2 protein as a diagnostic tumor marker and prognostic indicator in non-small-cell lung carcinoma, as described by Pezzella et al. (Sept. 2 issue),¹ may be severely limited. The fact that bcl-2 ...

To the Editor: The excellent review article on acute monoarthritis by Baker and Schumacher (Sept. 30 issue)¹ contains an erroneous statement. In discussing how to differentiate acute arthritis of the elbow from acute olecranon bursitis by physical ...

To the Editor: A change in the financing of our health care system is clearly needed -- and imminent. When I was in practice I was astounded by the amount of paperwork the private sector generated in paying for health care and dismayed by the amount of ...

Barbara Tuchman records that during the Black Death epidemic in the early 14th century, “doctors were admired, lawyers universally hated and mistrusted”¹. The great plagues and wars of the Middle Ages produced a “cult of death,” including a vast popular ...

Murder, Magic, and Medicine explores the links between the folk use of plant products and their modern applications in medicine; to a much lesser extent, it addresses products of nonvegetable origin. One chapter is devoted to each of the three uses ...

Textbooks of psychopharmacology age quickly -- a tribute to the vibrancy of the field. The best of them offer more than a summary of current knowledge; they demonstrate how to reduce a mass of data to usable generalizations without losing the details that ...

Lane and Healey, orthopedists from the Hospital for Special Surgery with world-renowned expertise in orthopedic oncology and the treatment of metabolic bone diseases, have recruited a group of orthopedists, primarily from Cornell University Medical ...

The editor's intent is to provide an “intelligible, informative and, above all, practical” guide to the care of patients with endocrine or endocrine-related disorders. The book has two strong points: first, it very quickly focuses on the information ...

Medical and surgical therapies are increasingly subject to formal risk-benefit analysis; surgical complications remain substantial causes of morbidity that often weigh heavily in discussions of the relative merits of medical and surgical alternatives. ...

Irritable Bowel Syndrome Review Article, N Engl J Med 1993:329;1940-1945.. On page 1943, in Table 4, the “Suggested Initial Dose” for amitryptiline should have been 10-25 mg at bedtime and that for desipramine should have been 50 mg at bedtime. We regret ...