Concurrent infection with Treponema pallidum and the human immunodeficiency virus (HIV) is a growing public health problem because the incidence of both syphilis and the acquired immunodeficiency syndrome (AIDS) is increasing¹. Infection with HIV may ...

Until recently, atherosclerotic disease of the aortic arch was not regarded as a source of cerebral emboli¹. We have reported on the basis of autopsy studies that the presence of ulcerated plaques in the aorta is an independent risk factor for ischemic ...

Intraocular neovascularization occurs in numerous ischemic retinal disorders, including diabetic retinopathy, ischemic retinal-vein occlusion, and retinopathy of prematurity¹,². This proliferation often results in vitreous hemorrhage, retinal detachment, ...

Space-occupying lesions in the brain of patients infected with the human immunodeficiency virus (HIV) are commonly due to Toxoplasma gondii infection or lymphoma¹. Multiple other infectious agents, including nocardia species and Mycobacterium tuberculosis,...

Figure 1. Primary Syphilis.

Panel A shows a primary chancre of syphilis, which began as a papule, eroded and developed into a painless ulcer (arrows) with raised, firm, indurated borders and a clean smooth base. Histologically, it is characterized by ...

Despite extensive efforts to improve the technical aspects of mammography, the extent of radiologists' variability in interpretation has seldom been examined. In a study of xeromammograms, the level of agreement on the diagnosis of benign abnormalities ...

Tumors of the central nervous system constitute the largest group of solid neoplasms in children and are second only to leukemia in their overall frequency during childhood. Each year, brain tumors develop in approximately 1500 to 2000 children in the ...

Modern concepts of neoplasia rely on the evidence that a tumor arises from the clonal progeny of a single transformed cell. This ancestral cell of the neoplasm has multiple sites of acquired, and sometimes inherited, DNA damage that all its progeny share. ...

Stage

A 77-year-old man with mitral-valve prolapse said he had had insomnia and shortness of breath for five days. A murmur of mitral regurgitation had first been noted nine years earlier.

Response

The patient's mitral regurgitation could have progressed, ...

At the beginning of this century, while he was developing schedules for the treatment of syphilis with arsphenamine, Ehrlich discovered that inadequate therapy for early syphilis was followed within 6 to 12 months by the appearance of neurologic disease ...

The three disease processes responsible for most ischemic strokes are large-vessel atherothrombotic disease (accounting for about 14 percent of ischemic strokes), small-vessel atherothrombotic or lipohyalinotic disease (i.e., lacunar stroke, accounting ...

The blood vessels of the human retina do not normally grow after birth. All postnatal neovascularization in this tissue is therefore pathologic, arising as a complication of diseases such as diabetes, sickle cell disease, and retinal-vein occlusion. The ...

It should come as no surprise that there is a range of skills and expertise among physicians involved in similar activities. This is true in every endeavor, and it is true for radiologists who interpret mammograms. The findings reported in this issue of ...

In an era in which the importance of a scientific advance often appears to be measured by the amount of media coverage it generates, the level of reporting of the recent identification of BRCA1, a susceptibility gene for breast cancer on chromosome 17 and ...

To the Editor: Jensen et al. (July 14 issue)¹ found that 64 percent of a group of 98 people without back pain had lumbar-spine disk abnormalities (bulges, protrusions, or extrusions). This result may be a substantial overestimate. How did the authors ...

To the Editor: In the article by Gullo et al. (July 14 issue)¹ the authors conclude, “Diabetes in patients with pancreatic cancer is frequently of recent onset and is presumably caused by the tumor. Diabetes is not a risk factor for pancreatic cancer.” ...

To the Editor: In regard to the letters to the editor (July 21 issue)¹ about the excellent article by Cleeland et al. (March 3 issue),² we were surprised, as neurosurgeons treating chronic pain and pain from cancer, at the lack of attention to the ...

To the Editor: Doxorubicin is a widely used and effective antineoplastic agent. However, doxorubicin therapy is limited by dose-dependent cardiotoxicity that may lead to congestive heart failure.¹ To optimize doxorubicin therapy, it is important to ...

To the Editor: Cooper et al. (July 21 issue)¹ described neurocardiogenic syncope in a mother and daughter. The authors stated that they were “not aware of a familial clustering of this disorder.” In fact, there have been several previous reports ...

To the Editor: I would like to correct several technical errors in the report by Mac Kenzie et al. (July 21 issue)¹ and offer findings by the Milwaukee Water Works (MWW) relevant to preventing outbreaks of cryptosporidiosis.

The report by Mac Kenzie et ...

To the Editor: Benowitz and Henningfield (July 14 issue)¹ have calculated a recommended threshold level of nicotine in cigarettes below which they believe nicotine dependence is less likely to occur. I have questions about the assumptions behind and the ...

To the Editor: A 10-year-old boy was hospitalized for high-grade fever and treated with intravenous ceftriaxone (50 mg per kilogram of body weight per day). After two days cholelithiasis was diagnosed by ultrasound examination. On the same day the ...

In the July 2, 1970, issue of the Journal, Philip Tumulty asked, “What is a clinician and what does he do?” The same question could be asked today about ethics consultants: What is an ethics consultant and what does he or she do? La Puma and Schiedermayer ...

Forced into Treatment eloquently examines the interface between patients' rights and their need for treatment. We are invited to see that the element of coercion does not preclude a successful outcome; it may in fact be integral to success in certain ...

Prostate cancer is now the most common type of cancer among American men. Over the past few years, new forms of technology such as prostate-specific-antigen (PSA) testing and transrectal ultrasonography have permitted the early detection of prostate ...

The detection and treatment of breast cancer have spawned much controversy, as evidenced by dissimilarities in practices among countries and over time. This book consists of 49 short chapters, almost essays, on selected topics by 61 contributors from ...

Acute respiratory problems are among the most common of all diseases seen by physicians. Most of these illnesses are caused by infectious organisms. They can lead to substantial disability, serious morbidity, and even death. Medical knowledge of ...

Every user of MEDLINE has encountered the difficulty of storing and managing a large number of retrieved references. A bibliography-management software package makes it possible to create and maintain a personal bibliographic data base and to generate ...

Pheochromocytomas, Multiple Endocrine Neoplasia Type 2, and von Hippel-Lindau Disease Original Article, N Engl J Med 1993:329;1531-1538.. On page 1534, in line 26 of the right-hand column, the phrase, “at the time of diagnosis were significantly younger,” ...

Access to Specialty Care Editorial, N Engl J Med 1994:331;1151-1153.. On page 1152, beginning with the sentence that starts in line 6 of the right-hand column, the rest of the paragraph should have read, “Practices that deter referrals and inhibit access ...