Rheumatoid arthritis is a common disease, and it produces substantial morbidity as well as an increase in mortality.¹–⁴ Although the causes of rheumatoid arthritis are not fully understood, laboratory and clinical evidence suggests that proinflammatory ...

The causes of recurrent fetal loss include anatomical, genetic, and hormonal disorders. However, in approximately 60 percent of women the recurrent fetal loss is unexplained. Recurrent fetal loss is a well-known manifestation of several autoimmune ...

The presence of antiphospholipid antibodies in serum has been associated with the antiphospholipid-antibody syndrome, which is characterized by arterial and venous thrombosis or recurrent pregnancy loss attributed to placental thrombosis.¹–⁶ The ...

Esophageal cancer is a highly malignant disease. Data from French tumor registries indicate that five-year overall survival ranges from 2 percent to 8 percent for all stages.¹–³ The squamous-cell type predominates, but the incidence of adenocarcinoma of ...

Figure 1. A 50-year-old woman with metastatic breast cancer received seven courses of docetaxel at three-week intervals. After this treatment, the number and sizes of her lung metastases (the only known metastases) were unchanged. Total alopecia developed,...

Health maintenance organizations (HMOs) serving Medicare beneficiaries have been credited with reducing the length of stay and the number of bed-days associated with the traditional fee-for-service system,¹ and the assumption has been that HMOs could help ...

The difference in amino acid composition between beef and porcine insulins and human insulin was long thought to be responsible for the immunogenicity of these animal insulins in humans. As a result, much of the effort expended to meet the world's ...

Presentation of Case

A 58-year-old right-handed woman was admitted to the hospital because of multiple cranial neuropathies.

The patient had been well until two days earlier, when she began to have difficulty swallowing food while having dinner at home. ...

Medicare costs are a major concern of Congress these days, and it is easy to see why. This program accounts for about 20 percent of personal health care expenditures in the United States and 11 percent of the federal budget.¹,² Policy makers are worried ...

Only a few years ago, little was known about the role of cytokines in rheumatoid arthritis. The original view of the cytokine milieu in the inflamed joint as a melange of factors from various cells was clarified by two observations.¹ First, in ...

Two articles in this issue of the Journal ¹,² focus on autoantibodies as a cause of pregnancy loss. Rand and coworkers describe a mechanism by which antiphospholipid antibodies could cause placental thrombosis and infarction. They found that ...

To the Editor: Zhang et al. (Feb. 27 issue)¹ present data confirming the finding of the Study of Osteoporotic Fractures Research Group² that increased bone mass in postmenopausal women is associated with an increased risk of subsequent breast cancer. ...

To the Editor: Koh et al. (March 6 issue)¹ report that the administration of conjugated estrogen alone or with progestin reduced plasminogen-activator inhibitor type 1 (PAI-1) levels in postmenopausal women, and the authors speculate that this may ...

To the Editor: The occurrence of multiple organ-specific autoimmune disorders in the same patient has been well recognized.¹ Because of improved assays for adrenal autoantibodies, we recently instituted routine testing of patients with insulin-dependent ...

To the Editor: A familial form of primary pulmonary hypertension has been described and characterized.¹,² Its incidence in the general population ranges from 1 to 2 cases per million people, and it accounts for 6 percent of the 187 cases of primary ...

To the Editor: In their letter reporting the use of a continuous infusion of acyclovir to treat severe hemorrhagic varicella (March 6 issue),¹ Kakinuma and Itoh describe serologically confirmed infection with varicella-zoster virus in a patient with ...

To the Editor: The Image in Clinical Medicine titled ``Meningococcemia'' (March 6 issue)¹ was accompanied by a brief case history and showed the peripheral-blood smear of a 14-year-old boy with meningococcemia. The diagnosis of systemic lupus ...

To the Editor: Kessler et al. (Feb. 20 issue)¹ found that there was a higher probability of the use of psychiatric outpatient services in the United States than in Ontario among people with less severe mental illness. The authors conclude that any plans ...

Sudden death outside the hospital as a result of ventricular fibrillation, the subject of Life in the Balance, was irreversible until the 1950s. Until then, complete airway obstruction (a common byproduct of coma), apnea, and the absence of a pulse ...

Duchenne's muscular dystrophy is one of the most common and devastating inherited conditions, and the elucidation of its underlying cause is often cited as the first jewel in the crown of human molecular genetics. Today, studying DNA from patients to ...

Raymond Hurt has produced a remarkably thorough narrative history of thoracic surgery and the surgeons and physicians who made it into the special field that it is.

After due prefatory credits and a foreword by Denton Cooley, the story begins with Imhotep ...

Gastrointestinal cancers are extremely common worldwide, and for most of them, surgical excision remains the main potentially curative treatment. The emphasis of this book is thus on surgical therapy, although adjunctive radiotherapy, chemotherapy, and ...

The ability of consumers to complain effectively about services and products is a key ingredient of the market. In Exit, Voice, and Loyalty,¹ economist Albert O. Hirschman argues that the ability to take one's business elsewhere may not be enough to ...

Atrial Arrhythmias after Cardiothoracic Surgery Review Article, N Engl J Med 1997:336;1429-1434.. On page 1433, Figure 1 contains an error. The corrected figure appears below. We regret the error.