Atherosclerosis frequently develops in saphenous-vein coronary bypass grafts, leading to occlusion rates of 30 to 40 percent 10 to 12 years after surgery.¹,² This is especially common in patients with hyperlipidemia.³–⁶ The efficacy of lipid-lowering ...

Kaposi's sarcoma was originally described in the late 1800s as a rare neoplasm predominantly affecting elderly men of Jewish or Mediterranean descent. Currently, Kaposi's sarcoma is the most common cancer in patients with the acquired immunodeficiency ...

Cushing's disease results from excessive stimulation of the adrenal glands caused by the oversecretion of corticotropin by an adenoma, or, occasionally, hyperplasia of the corticotroph cells of the pituitary.¹,² It is the most frequent cause of ...

Transmission of hepatitis B virus (HBV) from infected surgeons to patients during procedures associated with a risk of exposure to the virus (sometimes referred to as exposure-prone procedures¹) has been documented repeatedly. Between 1984 and early 1993, ...

Figure 1. A continuous murmur heard on the 10th day of life in a 590-g infant delivered at 25 weeks' gestation led to the diagnosis of patent ductus arteriosus. The child had numerous medical problems, including hyaline membrane disease, renal dysfunction,...

Three centuries ago, the French philosopher René Descartes described the pineal gland as “the seat of the soul,” but it was not until the late 1950s that melatonin, the principal substance secreted by the pineal gland, was identified.¹ There is now ...

At least five different viruses cause hepatitis in humans. Two — hepatitis A virus (HAV) and hepatitis E virus (HEV) — are nonenveloped RNA viruses that are spread predominantly by fecal–oral transmission and cause acute self-limited disease.¹,² The ...

Presentation of Case

A 38-year-old schizophrenic man was admitted to the hospital because of digital clubbing and a cardiac murmur.

The patient had been well until about one year earlier, when he began to have swelling of the fingers and toes. Eleven ...

Coronary-artery bypass grafting (CABG) has been performed for more than 30 years. After the first bypass operation with a saphenous-vein graft, in 1964,¹ the technique was formally described in 1967²; one year later the use of a graft from the internal ...

Over the past two years, there has been great interest in a newly recognized herpesvirus, called both Kaposi's sarcoma–associated herpesvirus (KSHV) and human herpesvirus 8. A piece of the viral genome was initially found in Kaposi's sarcoma tissue by an ...

The proximate cause of the clinical manifestations of Cushing's syndrome — obesity, facial plethora, hirsutism, hypertension, muscle weakness, lethargy, and depression — is excess cortisol secretion. Few of these clinical manifestations are specific to ...

There is increased awareness of issues related to sex and sex roles in health care, including discrimination in the enrollment of subjects in research and in access to clinical care.¹ However, there is less awareness of how private health insurance,² ...

To the Editor: In their review of prosthetic heart valves, Vongpatanasin et al. (Aug. 8 issue)¹ propose guidelines for anticoagulant therapy after valve implantation without citing references to support them. The authors make the surprising ...

To the Editor: Enriquez-Sarano et al. (Aug. 1 issue)¹ observed no change in angiographic measures of coronary atherosclerosis in 601 patients with isolated nonischemic valvular regurgitation, both mitral (n = 385) and aortic (n = 216), between 1980 and ...

To the Editor: Recent regulatory changes have allowed a larger number of Medicare beneficiaries to receive more covered home health care visits, some over lengthy episodes of care. However, a focus on visits rather than patients or episodes of care ...

To the Editor: The article on economic reforms and child health in China by Shen and colleagues (Aug. 8 issue) ¹ was important not only for reporting an improvement in the growth of children during China's economic reforms, but also because of its ...

To the Editor: A 34-year-old man spent approximately 6 weeks at or above 5500 m climbing on Mt. Everest. He spent 4 weeks at 5500 m, 2 days at 6000 m, 10 days at 7000 m, and 3.5 days at or above 8000 m. The barometric pressure of 380 mm Hg at base camp (...

My first surprise on opening this slender book was that it was written by a single author, a sociologist. This fact aroused my interest as an academic neonatologist and my hope that the topic of pediatrics would be presented from a social perspective. (...

Every medical device has a history that is usually thought of as technological — the story of successive refinements in machines and tools. But instruments of diagnosis and healing also reflect an understanding of the pathophysiologic states they are ...

Litigation concerning mass toxic substances (i.e., substances affecting many thousands of people) has become a permanent feature of the medical landscape, in no small measure as a result of the rise and fall of Bendectin. Michael Green, a professor of law ...

As one who has watched human cytogenetics from its birth in 1956 to its present extraordinary capabilities and who counsels families with chromosomal problems without ever having learned how to prepare a karyotype, I found this book a godsend. Human ...