Interferon alfa is effective in reducing serum alanine aminotransferase concentrations during treatment and, to a lesser extent, during the year after treatment in patients with chronic hepatitis C virus (HCV) infection.¹ Liver-biopsy findings may be more ...

Serologic testing for antibodies to hepatitis C virus (HCV) has shown that over 90 percent of cases of post-transfusion non-A, non-B hepatitis in the United States are caused by HCV. Acute HCV infection is usually not detected clinically. Less than one ...

Paraneoplastic syndromes are most often associated with small-cell lung carcinoma, a relatively common neuroendocrine neoplasm. The autoimmune neurologic syndromes may reflect host immune responses against neuron-like components of the tumor cells¹ (...

Congenital bilateral absence of the vas deferens (CBAVD) accounts for at least 6 percent of cases of obstructive azoospermia and is responsible for 1 to 2 percent of cases of infertility in men.¹ CBAVD is also present in about 95 percent of male patients ...

Figure 1. Tension pneumopericardium, a rare complication of pyogenic lung abscess, occurred in a 27-year-old white man with the acquired immunodeficiency syndrome. Cultures of specimens obtained through a bronchoscopic sheath catheter had yielded ...

In 1788 Cawley reported on a “free living young man” who had died of emaciation and diabetes and whose postmortem examination revealed multiple pancreatic calculi.¹ In the two centuries since that early description of chronic pancreatitis, literally ...

Epidemiologic, clinical, genetic, experimental, and pathological studies have clearly established the primary role of lipoproteins in atherogenesis.¹,² Lowering plasma cholesterol concentrations reduces the availability of atherogenic lipoproteins and ...

Most of the mutations responsible for genetic disease are remarkably subtle, considering the dramatic effects they may have on the phenotype. A change in just one of many thousand bases in a gene can be sufficient to disrupt and thus alter or eliminate ...

Stage

A 74-year-old woman was referred to a hematologist for a transfusion-dependent anemia that had been present for seven months. The anemia was initially recognized after a fall that caused fractures of several ribs and a lumbar vertebra. Prednisone (...

The Clinical Problem-Solving exercise in this issue of the Journal, entitled “Costly Errors,”¹ contains many valuable lessons about the diagnosis and treatment of autoimmune hemolytic anemia — lessons learned from a regrettable and flawed approach to a ...

An estimated 3.5 million people in the United States have chronic hepatitis C. Each year, 8000 to 10,000 chronically infected patients die of liver-related complications, and 1000 undergo liver transplantation¹ (and Alter M: personal communication). ...

A critical component of the development of drugs targeted at treating complex disorders is a reliable animal model that can predict efficacy in clinical trials. Until now, attempts to devise treatments for Alzheimer's disease have been hindered by the ...

To the Editor: The case–control study by Perneger et al. (Dec. 22 issue)¹ on the association of end-stage renal disease (ESRD) with analgesic drugs reaches inappropriate conclusions that are based on flawed methods. Fundamental to the validity of case–...

To the Editor: The report by Woods et al. (Dec. 22 issue)¹ on spreading oligemia as demonstrated by positron-emission tomography (PET) during a spontaneous episode of migraine confirms previous observations made on the basis of conventional studies of ...

To the Editor: The review of gastrointestinal polyposis and nonpolyposis syndromes by Rustgi (Dec. 22 issue)¹ inappropriately distinguishes the hereditary flat adenoma syndrome from attenuated adenomatous polyposis coli (and in doing so perpetuates the ...

To the Editor: Castleberry and coworkers (Dec. 22 issue)¹ report that isotretinoin (13-cis-retinoic acid) may induce long-term responses in some patients with juvenile chronic myelogenous leukemia. In this study of 10 children, isotretinoin induced ...

To the Editor: Immunohistochemical techniques are commonly used to detect antigens of therapeutic or prognostic importance in patients with cancer. Some technical problems in their use are well recognized, such as antigen masking by fixatives.¹ We ...

In the doctors' coatroom, maybe 10 years ago, I heard a colleague say that he had had enough — now he was doing it only for the money. For money alone? Could you make enough, I wondered, not to live in resentment against the fatigue, the perpetual ...

Theological Voices in Medical Ethics, a stimulating collection of essays compiled by the Park Ridge Center for the Study of Health, Faith, and Ethics, asks that explicit reference to religious faith play a greater part in the contemporary bioethical ...

The Nuremburg Trial and the annunciation of the Nuremburg Code in 1947 were watershed events in the history of the ethics of human experimentation. Although some of the judges who issued the judgment at Nuremburg were Americans, the period from the 1940s ...

Clearing the Fields: Solutions to the Global Land Mines Crisis is a comprehensive and authoritative book that presents the proceedings of a symposium held in New York on April 29, 1994, and cosponsored by the Council on Foreign Relations and the Center ...

Case Records of the Massachusetts General Hospital (Case 5-1995) Case Records of the Massachusetts General Hospital, N Engl J Med 1995:332;452-459.. On page 453, in line 9 of the left-hand column, the titers of antinuclear antibodies on day 36 should have ...

Cushing's Syndrome Review Article, N Engl J Med 1995:332;791-803.. On page 792, in Figure 1, at the bottom of the panel on Cushing's disease, the thick purple lines (denoting hypersecretion) for cortisol and corticotropin should have been dotted purple ...