Bone metastases occur in most women with advanced breast cancer. The destruction of bone in these lesions results from osteoclast-induced bone resorption that may be stimulated by osteoclast-activating factors released by tumor cells.¹,² Cytotoxic ...

Cigarette smoking promotes atherosclerosis and is associated with an increased risk of sudden death, myocardial infarction, angina, peripheral vascular disease, and stroke.¹ In patients with cardiac disease who stop smoking, there is a rapid decline in ...

Hemochromatosis is transmitted as an autosomal recessive trait.¹,² The responsible gene is tightly linked to the HLA class I region on chromosome 6, and a candidate locus has recently been identified.³–⁵ The clinical phenotype of skin pigmentation and ...

Severe combined immunodeficiency is a congenital syndrome due to various genetic abnormalities that cause susceptibility to infection, failure to thrive, lymphoid hypoplasia, very low levels of T lymphocytes, and hypogammaglobulinemia.¹,² Untreated, the ...

Bone marrow transplantation to treat autosomal recessive severe combined immunodeficiency was undertaken in a one-month-old girl. The donor was the patient's HLA-mismatched six-year-old sister, who had previously received a marrow transplant from her ...

Figure 1. A 62-year-old woman who was euthyroid while taking levothyroxine for radioactive iodine–induced hypothyroidism was noted to have trophic changes in her fingernails. The physical examination was otherwise normal. During a search for subclinical ...

Venous thromboembolism, which includes deep-vein thrombosis (usually involving leg veins) and pulmonary embolism, is a common cause of death. Treatment of affected patients reduces the incidence of fatal pulmonary embolism, but therapy should be based on ...

Presentation of Case

An 18-year-old right-handed man was admitted to the hospital because of severe, persistent headache and the development of ataxia and slurred speech.

The patient had been in good health until one week earlier, when he awoke with ...

Bisphosphonates are drugs that inhibit bone turnover by decreasing the resorption of bone. They do this both directly, by inhibiting the recruitment and function of osteoclasts (the bone-resorbing cells), and indirectly, by stimulating osteoblasts (the ...

Hemochromatosis, first described more than 100 years ago, is a common inherited disorder of iron metabolism in people of European descent.¹ Nonetheless, it has been much underdiagnosed and misdiagnosed, in part because of an earlier belief that it was a ...

The transplantation of allogeneic hematopoietic stem cells is being used to treat thousands of adults and children with life-threatening hematologic diseases. In the absence of a suitable HLA-identical sibling donor, possible alternatives are mismatched ...

To the Editor: In her editorial on the article by Hansson and associates (July 25 issue),¹,² Dr. Parsonnet suggests that the age at which Helicobacter pylori infection is acquired is the predictive factor for the different diseases induced by this ...

To the Editor: I enjoyed seeing the excellent photomicrograph of Helicobacter pylori provided by Genta and Graham in Images in Clinical Medicine (July 25 issue).¹ They describe a 35-year-old man with a duodenal ulcer who received triple therapy with ...

To the Editor: Attal et al. (July 11 issue)¹ state that their trial “demonstrates that high-dose therapy improves both event-free and overall survival” in patients with multiple myeloma, but that conclusion is not supported by their data. Although the ...

To the Editor: The report by Walters et al. on successful eradication of sickle cell disease through bone marrow transplantation (Aug. 8 issue)¹ raises some ethical issues. Although this multicenter study was conducted under the supervision of a Data ...

To the Editor: In their otherwise excellent review (July 11 issue),¹ Toglia and Weg fail to mention an emerging type of venous thrombosis during pregnancy. We recently admitted a multiparous 37-year-old woman who was six weeks pregnant after induced ...

To the Editor: A first-catch urine sample from women may be an appropriate specimen for diagnosing chlamydial and gonococcal infection by DNA-amplification procedures.¹,² This noninvasive means of obtaining a diagnostic specimen may provide a way to ...

To the Editor: From the report by Semenza et al.¹ and the accompanying editorial by Kellermann and Todd² on the risks associated with heat waves (July 11 issue), it seems that the vocabulary of risk factors has shifted over the past 15 years. When a ...

A number of comprehensive general textbooks of nuclear medicine have been published in the past few years. At least one and possibly two are slated for revision in the near future. The addition of the two textbooks reviewed here does not make the ...

The last time I devoted my summer holiday reading to a single book was when War and Peace was assigned in high school. In addition to bulk, the similarities between the Final Report of the Advisory Committee on Human Radiation Experiments and Tolstoy's ...

This two-volume textbook of human physiology is indeed comprehensive. The editors and the 102 other contributors have produced an excellent treatise that integrates a vast amount of molecular, cellular, and systemic physiologic information. The editors do ...

Motor Vehicle Collision Injuries is an ambitious book with multiple objectives aimed at multiple audiences with various levels of background knowledge. The challenge of explaining cephalgia and sciatica to nonmedical readers while stimulating the interest ...