Vitamin A is essential for embryogenesis, growth, and epithelial differentiation. By the term “vitamin A,” we refer to retinoid compounds that have the biologic activity of retinol. Preformed vitamin A in the diet comes from animal sources, such as dairy ...

Guillain–Barré syndrome is the most common cause of acute neuromuscular paralysis,¹ yet its cause and pathogenesis are unknown. In approximately two thirds of patients, neuropathic symptoms follow an infection — often a mild, undiagnosed respiratory or ...

The resistance of tumors to multiple drugs is a major problem in cancer chemotherapy. P-glycoprotein, a transmembrane ATP-dependent efflux pump encoded by the mdr1 gene,¹ has a central role in multidrug resistance in vitro,² and its clinical relevance is ...

Insulin, the central hormone controlling the utilization of fuel, is initially synthesized in pancreatic beta cells as its relatively inactive precursor, proinsulin. A series of enzymes that process prohormones act on proinsulin to produce mature insulin ...

Figure 1. Photographs of a four-year-old boy show the typical features of Kawasaki's disease. These features include bilateral nonexudative conjunctivitis (Panel A); dry, fissured, erythematous lips and a “strawberry” tongue (Panels A and B); erythematous ...

Stroke is the third leading cause of death in the United States, after coronary heart disease and cancer. There are approximately 500,000 cases of stroke each year; of these, 150,000 are fatal.¹ Many survivors are left with mental and physical impairment ...

After lung cancer, prostate cancer is the leading cause of deaths from cancer among men in the United States. It will claim 40,000 lives in 1995.¹ Studies in the early 1990s demonstrated that levels of prostate-specific antigen (PSA), a serine protease, ...

Presentation of Case

A 61-year-old man was admitted to the hospital because of increasing weakness in all his extremities.

The patient had been in good health until five years earlier, when weakness developed in the distal portion of the left leg, with ...

Vitamins are essential to good health, yet the consumption of excessive amounts of some vitamins, particularly A and D, can lead to toxicity. In this issue of the Journal, Rothman et al.¹ add to a body of evidence suggesting that the consumption of too ...

Guillain–Barré syndrome¹,² is a leading cause of acute paralysis. It occurs worldwide, in patients of all ages and both sexes. The weakness develops in a matter of days, sometimes with frightening rapidity and severity. Thirty percent of patients require ...

Resistance to a broad array of cytotoxic drugs — multidrug resistance — is thought to be a major reason chemotherapy fails to cure most cancers. Multidrug resistance has been studied intensively since the human MDR1 gene was identified almost 10 years ...

In various ways computers can help people become more active participants in their own health care and that of family members, as emphasized earlier by Kassirer.¹ Computers can help people acquire medical information, interact with care givers, connect ...

To the Editor: In a large cohort study, Sánchez-Guerrero et al. (June 22 issue)¹ found no association between silicone breast implants and connective-tissue diseases, defined according to a variety of standardized criteria, or signs and symptoms of these ...

To the Editor: The Clinical Problem-Solving article entitled “Diverted by the Chief Complaint” (July 6 issue)¹ deserves the name “Diverted by Our Major Mistake.”

It is amazing that a pathology report of a liver biopsy and not the distended jugular veins ...

To the Editor: In their update on gastric carcinoma (July 6 issue),¹ Drs. Fuchs and Mayer correctly point out the limitations inherent in determining the clinical stage of gastric carcinoma by means of abdominal computed tomographic (CT) scanning. As ...

To the Editor: In their otherwise comprehensive review of the mechanisms of renal osteodystrophy, Hruska and Teitelbaum (July 20 issue)¹ do not mention the role of acidosis. The high-phosphate diet of the average adult American generates approximately ...

To the Editor: Calcium-channel blockers are associated with rashes, including light-induced and lichenoid eruptions. An association with lupus erythematosus has been reported, although the patient and the nature of the lesion were not described.¹

In ...

To the Editor: Iodine deficiency persists in the former Federal Republic of Germany, including West Berlin, where the use of iodized salt is voluntary. In contrast, iodine supplementation of all household salt and of pig and cattle food was mandated in ...

As the editors point out in their preface, the prevalence of chronic obstructive pulmonary disease among adults is similar to that of asthma — and the associated mortality rate is some 25 times higher — yet it is accorded much less attention by funding ...

The respiratory tract is the organ most at the mercy of environmental factors because of its requirement for a continuous sampling of air, a need that increases many fold with exercise and work. The skin can be covered and washed, and we have some control ...

In a figurative as well as a literal sense, transplantation of the heart is an idea that has long kindled the imagination of Eastern and Western societies alike. Lieh Tzu, the ancient Chinese historian, reported that approximately 100 years after Ezekiel ...

This book contains 22 chapters written or coauthored by 25 workers in the field of vascular disease. It covers the classic aspects of disease in a comprehensive, if somewhat uneven fashion. Modern approaches to cellular and molecular disease are touched ...

Polycystic Ovary Syndrome Review Article, N Engl J Med 1995:333;853-861.. On page 854, the parenthetical phrase starting in the fourth line of the legend to Figure 1 should have read, “>9 ml in volume,” not “>9 cm in maximal diameter,” as printed. We ...