Although asthma may originate soon after birth,¹ the natural history of the disease is poorly understood. Many infants have episodes of wheezing associated with viral respiratory illnesses.² Neither the pathogenesis of these episodes nor their relation to ...

About 70 percent of patients with gastric ulcers are infected with Helicobacter pylori. ¹,² The use of nonsteroidal antiinflammatory drugs does not increase susceptibility to infection with H. pylori.³,⁴ Most gastric ulcers that are not related to ...

Depletion of CD4+ T lymphocytes is an important clinical problem in bone marrow transplantation¹–³ and human immunodeficiency virus (HIV) infection.⁴ Yet the mechanisms by which CD4+ T lymphocytes regenerate are poorly understood. In 1961 Miller ...

Congenital hyperthyroidism is rare. Most cases occur in infants born of mothers with a history of Graves' disease.¹ The disorder is usually transient in such infants, because it is caused by transplacental passage of maternal thyrotropin-receptor–...

Hormone-resistance syndromes can be broadly defined as conditions resulting from reduced or absent end-organ responsiveness to biologically active hormones. They are caused by defects in hormone receptors or post-receptor defects.¹–³ Mutations in the ...

Figure 1. Serial electrocardiograms (lead V₄) were obtained in a 67-year-old man taking digoxin for paroxysmal supraventricular tachycardia. An electrocardiogram obtained on June 28, 1983, showed no abnormalities. About six weeks later on August 15, while ...

Supraventricular tachycardia is any tachyarrhythmia that requires atrial or atrioventricular junctional tissue for its initiation and maintenance. Decades ago the term “paroxysmal atrial tachycardia” was coined to describe supraventricular tachycardia ...

Presentation of Case

A 71-year-old man was admitted to the hospital because of masses in the pancreas, presacral region, and left kidney, with left hydronephrosis.

The patient had a 2-year history of “tuberculous pleurisy” 47 years earlier in Europe, ...

Asthma might seem to be a single, easily recognizable disorder. At the margins, perhaps, chronic obstructive pulmonary disease and the gray zone of very mild disease can create diagnostic difficulty, but the central ground is no longer problematic. Or so ...

In the 1960s, the central role of the thymus in the production of T lymphocytes was demonstrated by Miller's classic experiments, in which neonatal thymectomy produced cellular immunodeficiency.¹ In the succeeding 30 years, research into both congenital ...

This issue of the Journal contains two reports that describe patients with thyroid dysfunction caused by mutations of the thyrotropin-receptor gene. Kopp et al. describe a child in whom a gain-of-function mutation led to continuous (constitutive) ...

The award of the 1994 Nobel Prize in Physiology or Medicine to Alfred G. Gilman and Martin Rodbell for the discovery of G (guanine nucleotide–binding) proteins and their role in cellular signal transduction has focused attention on the manifold functions ...

To the Editor: We agree with Dr. Toubia (Sept. 15 issue)¹ that female circumcision can cause lasting complications. The issue, however, is very complex. This traditional practice is as diverse as the people who practice it. The author states that there ...

To the Editor: In Dr. Pope's thoughtful review of acid-reflux disorders (Sept. 8 issue),¹ endoscopy is considered to be indicated only in a patient who continues to have symptoms after antireflux treatment. Assuming that the purpose of endoscopy is to ...

To the Editor: Frisch et al. (Aug. 4 issue)¹ examined the association between benign anal lesions and the risk of anal cancer. To evaluate this association further in different racial groups, we used a data base generated from computerized discharge ...

To the Editor: The reporting by Torres et al. on surveillance scanning of children with medulloblastoma (March 31 issue)¹ represents the opinion of a minority of clinical investigators caring for children with this type of tumor. As the leaders of the ...

To the Editor: Some patients with cancer have a paraneoplastic syndrome of opsoclonus-myoclonus (``dancing eyes-dancing feet''), which may be caused by antibodies directed against antigens shared by tumor and cerebellar cells.¹,² We describe a patient ...

To the Editor: There have been sporadic reports of the use of mixtures of helium and oxygen (heliox) as therapy in obstructive lung disease.¹–³ We describe a patient with respiratory failure for whom the use of heliox averted the need for intubation.

A ...

To the Editor: In his letter (Sept. 15 issue),¹ Huston described bilateral rupture of the Achilles tendon in a patient treated with enoxacin and prednisone. Although no cases of tendon rupture were reported to the Food and Drug Administration (FDA) ...

To the Editor: Dr. Brennan's tale of drug companies and public-relations firms that ``buy'' editorials (Sept. 8 issue)¹ struck home with me.

As the editor of American Family Physician, a medical journal that publishes primarily clinical review articles, ...

David Hilfiker's book is an important one for doctors (and students) who need to appreciate the breathtaking scope and impact of poverty and disenfranchisement in our nation. Well written though it is, it is not an easy book to read, because the people, ...

It is typical of the casual attitude of this book toward financial matters that nowhere on its cover or inside is there any indication of how much the book costs. Because the book's publication was funded by the Henry J. Kaiser Family Foundation, Merrill ...

This ambitious work helps explain why the American public should have expected the passage of health care reform legislation by the 103rd Congress and the Clinton administration. The book assesses health care politics in the United States, political ...

In the preface to Almost a Revolution, Dr. Appelbaum defines wisdom as an amalgam of many desirable traits, including understanding, but a special kind of understanding -- ``an understanding that allows one to apply one's understanding to effecting ...

Breast Implants and Connective-Tissue Diseases Correspondence, N Engl J Med 1994:331;1231-1235.. In the letter by Gabriel et al., which begins on page 1233, reference 2 on page 1234 should have read as follows:

2. Dugowson CE, Koepsell TD, Voigt LF, Bley ...

Acetaminophen Poisoning and Liver Function Correspondence, N Engl J Med 1994:331;1310-1312.. On page 1311, in the last paragraph of the letter by Whitcomb, the overdose level of acetaminophen should have been given as >4 g per day, not >4 g per deciliter ...