Each year in the United States there are at least 250,000 new cases of appendicitis, requiring hospital admission for more than 1 million patient-days.¹ A similar number of patients with suspected appendicitis are hospitalized but are found to have other ...

Obesity before pregnancy is associated with an increased risk of fetal macrosomia and perinatal mortality.¹–³ The mother's being leaner than average (underweight), on the other hand, is associated with an increased risk of delivering an infant who is ...

Synovial sarcomas, which account for 5 to 10 percent of soft-tissue sarcomas, typically arise in the para-articular regions in adolescents and young adults. These tumors occur in two major forms, biphasic and monophasic.¹ Biphasic synovial sarcomas ...

Acute rejection is a strong risk factor for chronic rejection in recipients of renal grafts from cadaveric donors.¹ This fact has prompted the development of new immunosuppressive agents designed to reduce the incidence and severity of acute rejection.²–⁶ ...

High rates of successful pregnancy after in vitro fertilization depend on placing more than one embryo into the mother, a practice resulting in a 30-to-35-fold increase in dizygotic-twin deliveries.¹ Increased frequencies of twin-associated anomalies ...

Figure 1. A 29-year-old woman (gravida 1, para 0) underwent a routine ultrasound examination at 32 weeks of gestation. Her pregnancy had been uneventful. Ultrasonography revealed a male fetus. The genital study with conventional gray-scale sonography (...

Over 60 years ago, Selye¹ recognized the paradox that the physiologic systems activated by stress can not only protect and restore but also damage the body. What links these seemingly contradictory roles? How does stress influence the pathogenesis of ...

Presentation of Case

A 50-year-old right-handed woman was admitted to the hospital with worsening headache and a left abducent-nerve palsy.

The patient had been well until six weeks earlier, when she began to have diffuse headaches that fluctuated in ...

Despite the advances in surgery over the past century, the diagnosis of acute appendicitis continues to present clinicians with problems. As Rao et al. report in this issue of the Journal, as many as 47 percent of clinical diagnoses of acute appendicitis ...

Obesity is one of the most common nutritional problems complicating pregnancy in developed countries. Maternal obesity has been defined in various ways, including a body weight above 80 to 114 kg (175 to 250 lb), a weight 50 to 300 percent more than ideal ...

The study of chromosomal translocations in tumors has revealed much about the molecular biology of cancer.¹ The report by Kawai et al.² in this issue of the Journal highlights an important question: how useful to patient care are discoveries in the ...

The birth in 1978 of Louise Brown, the first child conceived by in vitro fertilization, may be considered a milestone in the alleviation of long-standing infertility for many couples, especially those with female-factor infertility. But it became clear ...

To the Editor: With respect to the report by Hammer et al. (Sept. 11 issue),¹ we are troubled by the randomization of patients with human immunodeficiency virus (HIV) infection and CD4 cell counts of 50 or fewer per cubic millimeter to a group without a ...

To the Editor: While we endorse many of Steinbrook's recommendations about battling human immunodeficiency virus (HIV) infection (Sept. 11 issue),¹ his call for a “national standard” for reporting such infection may hinder efforts to stop the spread of ...

To the Editor: Savage et al. (Sept. 11 issue)¹ present convincing data favoring stent placement over balloon angioplasty for obstructive coronary bypass grafts, but several caveats about important variables should be kept in mind. First, there were ...

To the Editor: The chronic phase of chronic myeloid leukemia was diagnosed in a 41-year-old man and treated with interferon alfa and hydroxyurea. After four months of treatment, there was a sudden onset of high fever, severe bone pain in multiple sites, ...

To the Editor: In their review of legionnaires' disease (Sept. 4 issue),¹ Stout and Yu list imipenem as efficacious, citing a review that I wrote. In my review I stated that there is evidence that this drug is not effective for the treatment of ...

To the Editor: Astier and Paraire (Sept. 25 issue)¹ describe the fatal intoxication of a man in the process of cleaning a degreasing tank with 1,1-dichloro-1-fluoroethane. The available information suggests that the man died of respiratory arrest. The ...

To the Editor: The article “Transfer of Symptomatic Peanut Allergy to the Recipient of a Combined Liver-and-Kidney Transplant,” by Legendre et al. (Sept. 18 issue),¹ raises interesting questions about the mechanisms of transfer, the pathophysiology of ...

Mental Ills and Bodily Cures is somewhat misleadingly titled: it is not a general history of the physical therapies, or bodily cures, that prevailed in psychiatry before the introduction of chlorpromazine, but rather an account of the use of these ...

Substance abuse among pregnant women and women with children is one of the most emotionally charged issues of our day. Many physicians who provide care to these women are ignorant of aspects of substance abuse outside their own narrow confines. Ways of ...

Psychopharmacology trials have gone through a big boom in the past 10 years. According to a recent list, there are 294 products that act on the central nervous system in the worldwide pharmaceutical pipeline, and approximately 40 percent of them are ...