The antiprogestin mifepristone (RU 486) causes abortion by competitively blocking progesterone receptors.¹–³ For maximal effectiveness, a prostaglandin should be given 48 hours after mifepristone.¹,³,⁴ The rates of termination of pregnancies 49 days old ...

Hypertrophic cardiomyopathy, a disorder occurring in approximately 1 of every 500 people, causes a broad spectrum of pathological findings and clinical manifestations.¹,² Early observations²,³ emphasized the morphologic features of this disease (e.g., ...

Hermansky–Pudlak syndrome, an autosomal recessive disorder, consists of oculocutaneous albinism, a storage-pool deficiency, and lysosomal accumulation of ceroid lipofuscin.¹–³ The albinism causes congenital nystagmus, a visual acuity approximating 20/200,^...

Renal-cell carcinoma is the 10th most common cancer in Western countries, with about 30,600 new cases diagnosed and 12,000 deaths from the disease in the United States during 1996.¹ Surgical resection of localized disease is the only curative treatment. ...

Metastatic renal-cell carcinoma is refractory to chemotherapy, and median survival is usually less than a year.¹–⁴ Performance status, number of metastatic sites, time from diagnosis of the primary tumor to the discovery of metastases, and weight loss are ...

Figure 1. A 59-year-old man with hypertension presented with a three-month history of fatigue and progressive shortness of breath. Physical examination revealed mild jaundice, tachypnea, tachycardia, bibasilar rales, and mild hepatomegaly. Laboratory ...

Figure 1. Progressive painless swelling of the right leg developed in an 81-year-old woman. Duplex scanning of the legs showed no evidence of venous thrombosis. Ventilation–perfusion scanning of the lungs suggested a high probability of pulmonary embolus, ...

Inhibitors of human immunodeficiency virus (HIV)–encoded protease, combined with nucleoside analogues with antiretroviral activity, cause profound and sustained suppression of viral replication, reduce morbidity, and prolong life in patients with HIV ...

Presentation of Case

A 49-year-old woman was admitted to the hospital because of interstitial lung disease.

She had a 13-year history of biopsy-confirmed primary biliary cirrhosis, with a positive test for antimitochondrial antibodies. She was treated ...

Remodeling of the left ventricle by the process of hypertrophy is usually a response to increased afterload. This adaptive reaction maintains cardiac output. The most common pattern of hypertrophy is concentric remodeling due to systemic hypertension, in ...

Renal-cell carcinoma constitutes about 2 percent of all cancers, and its incidence is steadily rising. The sporadic form of the disease usually presents in the fifth, sixth, or seventh decade of life, often with locally advanced tumors that are diagnosed ...

The combination of escalating health costs per retiree and the pending retirement of the baby-boom generation makes the preservation of Medicare benefits for our children as well as our parents problematic at best and impossible under current policy. A ...

To the Editor: In his review of hepatitis B virus (HBV) infection, Lee (Dec. 12 issue)¹ stated that “HBV DNA can no longer be detected by any means” in patients who become negative for hepatitis B surface antigen (HBsAg) and in whom antibodies to HBsAg ...

To the Editor: The article by Delmas et al. (Dec. 4 issue)¹ suggests that raloxifene has many of the beneficial effects of estrogen in postmenopausal women, but it contained little information on adverse events. At a public Food and Drug Administration ...

To the Editor: Hamm and colleagues present impressive results concerning the operating characteristics of troponin T and troponin I in the triage of patients with acute chest pain (Dec. 4 issue).¹ I am concerned that their conclusion that “negative test ...

To the Editor: It has been previously reported that valvular heart disease may be associated with the use of anorectic drugs.¹ We report a case of restrictive cardiomyopathy due to endocardial fibrosis after short-term use of fenfluramine–phentermine.

A ...

To the Editor: The thyroid and lungs develop as outgrowths of the ventral foregut. Differentiation and early function of both organs appear to be related through the common expression of the thyroid transcription factor-1 (TTF-1) gene on chromosome ...

To the Editor: We were surprised by the description of a patient's demise at the end of the presentation of Case 32-1997 (Oct. 16 issue),¹ which concluded: “The patient was declared brain-dead. She died after life-support measures were terminated.”

Since ...

To the Editor: At last, a physician willing to suggest that the American medical profession is a spineless, avaricious, and directionless cartel unworthy of being called caring (Nov. 27 issue).¹ The fact that this sentiment had to be couched in irony of ...

One consequence of the recent focus on women's health in the United States has been the widening of the definition of health to include social interactions, domestic issues, mental health, and reproductive function. Traditionally, women's-health research ...

“It's better to give than to receive” is a common expression among some resource-starved academicians who look enviously upon colleagues who have joined the ranks of foundations and governmental granting agencies. This refreshingly self-critical and ...

Family medicine is the broadest of the generalist disciplines. Physicians who practice this specialty need access to up-to-date information on a broad range of disorders. They practice in a setting that emphasizes health promotion and preventive care ...

Utility of the Apolipoprotein E Genotype in the Diagnosis of Alzheimer's Disease Original Article, N Engl J Med 1998:338;506-511.. On page 508, in Table 3, the column headings for columns 3 and 4 (“Only Clinical Criteria for AD” and “Only Pathological ...

During the Cold War, physicians and others described the potential medical consequences of thermonuclear war and concluded that health care personnel and facilities would be unable to provide effective care to the vast number of victims of a nuclear ...