Genetic, hormonal, and environmental factors each have a role in the etiology of breast cancer,¹–⁵ which is the most common malignant condition and the second most common cause of cancer-related death among American women.⁶ Inherited mutations in p53,⁷ ...

The BRCA1 gene has been identified at the chromosome 17q locus, which is linked to familial breast and ovarian cancer.¹,² BRCA1, a potential tumor-suppressor gene, encodes a predicted 200-kd protein whose function is unknown. Genetic susceptibility to ...

Passive smoking, which includes exposure to both sidestream smoke from burning cigarettes and exhaled mainstream smoke, has been associated with increased respiratory symptoms in children¹ and excess deaths from lung cancer in adults.² However, the ...

Guaiac tests for fecal occult blood detect the pseudoperoxidase activity of heme, either as intact hemoglobin or as free heme. Hemoccult II, a widely used guaiac test for fecal occult blood, has a low sensitivity for detecting colorectal neoplasms in ...

Figure 1. A 67-year-old woman had a 20-year history of Paget's disease of bone, resulting in conductive hearing loss, bone and joint pains, pathologic fractures, limb deformities, and difficulty walking. Treatment with calcitonin and etidronate had been ...

Figure 1. A 67-year-old man had Paget's disease involving the right tibia and the first lumbar vertebrae. The patient initially presented with bone pain and bowing of his right lower leg, but the vertebral lesion was not symptomatic. An x-ray film of the ...

Efforts to control health care costs have led to increasing pressures on academic health centers.^1-4 The mission of academic health centers includes teaching, research, and clinical care, and each of these activities has its own revenue streams: tuition ...

At a conservative estimate, 50 million people worldwide have epilepsy. The annual incidence ranges from 20 to 70 cases per 100,000¹ and the point prevalence is 0.4 to 0.8 percent.² The incidence rates are highest in childhood, plateau from the age of 15 ...

Presentation of Case

A 32-year-old woman was admitted to the hospital because of left subcostal pain, bouts of fever, and a mass in the left hepatic lobe.

The patient had been well until four years earlier, when she began to have progressive, constant ...

For decades, teaching has been the Cinderella of academic medicine. As a stepchild, it has garnered little respect in comparison with that accorded its sister tasks of research and patient care. In recent years, as full-time academic physicians have been ...

Breast cancer is the most common cancer among women in the Western world, with a cumulative lifetime risk of 1 in 8.¹ The two strongest risk factors are age and a family history of breast cancer. Five years ago, a region on chromosome 17 was shown by ...

Each year 60,000 people in the United States die of colorectal cancer. Current approaches to screening can reduce that number by perhaps one third. One clinical trial in the United States has demonstrated a reduction in mortality associated with yearly ...

To the Editor: In regard to your editorial (Sept. 21 issue)¹ on the National Center for Injury Prevention and Control (NCIPC), no one disputes the need to perform research with a valid purpose such as identifying ways of improving public health, but when ...

To the Editor: Pilote et al. (Aug. 31 issue)¹ give insight into differences in the use of angiography and revascularization after acute myocardial infarction according to geographic region. Although the availability of angiography appears to be an ...

To the Editor: Hirschtick et al. (Sept. 28 issue)¹ report an increased frequency of bacterial pneumonia among persons positive for the human immunodeficiency virus (HIV) as compared with seronegative controls, even among patients with CD4 counts of more ...

To the Editor: The detection of hepatitis C virus (HCV) infection by enzyme immunoassay and molecular biologic techniques still leaves unidentified other hepatitis viruses that may be responsible for acute and chronic hepatitis unrelated to infection ...

To the Editor: Annas (Aug. 24 issue),¹ in his well-thought-out article “Medicine, Death, and the Criminal Law,” shows that physicians who continue to hold to the tradition of putting the patient's interests first have little to fear from the criminal ...

To the Editor: Saint et al. (Sept. 28 issue)¹ describe a “home-court advantage” for Massachusetts General Hospital (MGH) physicians in their discussions of the clinicopathological conference (CPC) cases. Although this certainly may be true, I would like ...

Over 1 million people are given a diagnosis of cancer in the United States each year. Given the high cost of aggressive treatment of cancer and the increasing prevalence of managed-care and capitated insurance programs, oncologists are coming under ...

In The Molecular Basis of Cancer, the editors have undertaken the formidable task of presenting the state of the art of the rapidly changing field of molecular oncology. They have gathered an impressive array of well-known investigators and educators to ...

For many years the treatment of cancers of the gastrointestinal tract has remained static. The advances in the past decade have occurred for the most part not because of new drugs, new surgical techniques, or new forms of radiotherapy. Instead, response ...

This new atlas has been assembled by three highly regarded and widely experienced surgical oncologists. The book is devoted to “familiarizing residents, fellows and practitioners of general surgical oncology with state of the art surgical principles and ...

Natalie Robins tells the story of an 18-year-old woman who died 11 years ago while under the care of residents at New York Hospital and of her father's crusade to blame the medical-education system. Sidney Zion's efforts ultimately led to the New York ...

The rush to shrink the federal government and reduce its costs, propelled by the Republican-controlled Congress with the reluctant acquiescence of the Clinton administration, has begun to change the Public Health Service and other federal health agencies ...