In 1975 we presented our first report on the efficacy of cyclophosphamide, methotrexate, and fluorouracil (CMF) as adjuvant treatment for node-positive breast cancer.¹ A subsequent report in the Journal, ² along with the results of the National Surgical ...

Conservative therapy in the management of early-stage carcinoma of the breast, once controversial, is now an established alternative to mastectomy. Several randomized studies in Europe and North America that address various aspects of conservative ...

A point mutation in which adenine is substituted for guanine at nucleotide 1691 in the gene coding for coagulation factor V has recently been reported to be associated with resistance to degradation by activated protein C.¹–⁴ In selected referral patients ...

In patients with thalassemia major, a regular program of transfusion sustains growth and development during childhood, but without concomitant chelation therapy, iron within the transfused red cells accumulates inexorably.¹ Excess iron damages the liver, ...

Figure 1. Magnetic resonance imaging and angiography of the brain revealed a left parietal arteriovenous malformation measuring 2.5 cm in diameter in a 32-year-old woman who presented with severe headache. Panel A, a coronal T₁-weighted magnetic resonance ...

Primary sclerosing cholangitis, a chronic cholestatic liver disease of unknown cause, is characterized by ongoing inflammation, destruction, and fibrosis of intrahepatic and extrahepatic bile ducts.¹–⁴ Over time, bile ducts become irregularly narrowed and ...

Approximately one third of adults and half of children with the acquired immunodeficiency syndrome (AIDS) eventually have neurologic complications, which are directly attributable to infection of the brain by the human immunodeficiency virus type 1 (HIV-1)...

In 1866, Gregor Mendel, a high-school science teacher in what is now Brno, Czech Republic, described plant-breeding experiments that he had done in the garden of the monastery of St. Thomas. The paper appeared in the transactions of the Brünn Natural ...

Stage

A 34-year-old homosexual man, who had been infected with the human immunodeficiency virus (HIV) since 1986 but without a defining illness of the acquired immunodeficiency syndrome (AIDS), presented with a two-week history of pruritus, jaundice, and ...

It has been almost exactly 100 years since William Halsted published his seminal report on the use of radical mastectomy “for the cure of cancer of the breast,”¹ and it is fitting that this issue of the Journal includes the long-term results of two ...

Iron is essential for all organisms from bacteria to humans; but like excessive amounts of alcohol, which is so pleasant in moderation, a surfeit of iron is fatal. The lethal effects of iron overload can be immediate, as in an accidental or deliberate ...

Numerous genetic accidents, including the activation of proto-oncogenes and the loss of tumor-suppressor genes, can result in the stimulation of cell division. However, mammalian cells have evolved an intricate set of checks and balances against ...

To the Editor: Esrig and colleagues (Nov. 10 issue)¹ demonstrate that the immunohistochemical detection of p53 protein in bladder-tumor cells predicts the progression of disease independently of the tumor stage and histologic grade and correlates with an ...

To the Editor: In their excellent review of cutaneous reactions to drugs (Nov. 10 issue), Roujeau and Stern¹ include vasculitis associated with lymphomas in the differential diagnosis of drug-induced vasculitis. Cutaneous vasculitis has also been ...

To the Editor: In his review of fluoxetine (Nov. 17 issue),¹ Dr. Gram failed to mention two studies of inpatients with major depression who had improvement with fluoxetine comparable to that with desipramine² or imipramine³ and that an analysis of ...

To the Editor: We found the study by Hakim et al. (Nov. 17 issue)¹ comparing biocompatible and bioincompatible dialysis membranes for the treatment of acute renal failure interesting but flawed in several respects. The improvement in survival in the ...

To the Editor: Extracorporeal photochemotherapy, or photopheresis, is a technique for modulating cell-mediated immunity that was first described as a successful treatment for cutaneous T-cell lymphoma.¹ In 1992, Costanzo-Nordin et al. reported the ...

To the Editor: Faith T. Fitzgerald, M.D., reviewed (Nov. 3 issue)¹ Michael Lerner's book, Choices in Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer.² On page 69 of that book, under the subheading “Establish a Working ...

To the Editor: We summarize the costs per test incurred by the U.S. Army since the establishment of programs to test for the human immunodeficiency virus (HIV) in 1985. These costs are now less than $2.50 per serum specimen, as compared with typical ...

To the Editor: With respect to Angell and Kassirer's editorial (July 21 issue)¹ concerning the public's confusion about the results of clinical trials, I think the public and the media would be better able to assess research results if medical ...

In 1969 our laboratories described a quantitative method for evaluating academic careers that was based on a concept called parse analysis.¹ With the help of two postdoctoral fellows whose names were negligently omitted from the original report*, we ...

Since the 1992 presidential election, family values have been a hot political topic, and properly so. Families matter. Unfortunately, much of the public discussion has been characterized by a distressing ignorance about, and a remarkable indifference to, ...

My son, five years old at the time, and I had just finished dinner with a friend and her young son. As we headed to our cars, my friend's son darted across a crowded parking lot. His mother chased him, grabbed him, and spanked him several times on the ...

The first volume of what is essentially a two-volume set, the clinical guide, is a traditional textbook; its companion is a compendium of photographs. The clinical guide attempts to cover the whole range of issues associated with child abuse. Most of the ...

The Republican party's commitment to shrink the size of government, erase its budget deficit, and employ market forces to allocate medical resources will substantially shape this year's debate on the future federal role in health care. The Clinton ...