The high rate of multiple births resulting from in vitro fertilization is a major health issue.¹–³ The medical, social, and financial consequences are considerable, chiefly because of the excessive morbidity among the survivors of high-order multiple ...

In patients with end-stage renal disease, treatment of anemia with recombinant human erythropoietin (epoetin) has improved cardiovascular function and the quality of life.¹,² However, these benefits come at substantial economic cost, with 1994 Medicare ...

Advanced kidney failure usually leads to anemia, primarily as a result of deficient renal erythropoietin production. Most patients undergoing hemodialysis are treated with recombinant human erythropoietin (epoetin) to stimulate erythropoiesis and correct ...

Despite advances in the treatment of childhood acute lymphoblastic leukemia (ALL), the risk of relapse remains about 30 percent. Studies have shown that the presence or absence of residual disease, as assessed by the polymerase-chain-reaction (PCR) assay, ...

During childhood and young adulthood, the skeleton accrues virtually all the bone mineral it will ever have.¹ Since the aging process is associated with bone loss, the more bone mass one gains in the formative years, the less likely it is that increased ...

Figure 1. A 31-year-old woman was receiving gonadotropin stimulation as part of an in vitro fertilization protocol. By day 10 of her menstrual cycle a 5-cm ovarian cyst had developed. The cyst was aspirated transvaginally under sonographic guidance. ...

Acute lymphoblastic leukemia (ALL) is diagnosed in 3000 to 4000 persons in the United States each year; two thirds of them are children.¹,² The current rate of cure of nearly 80 percent in children attests to remarkable progress in the development of ...

Presentation of Case

A 10-year-old girl was admitted to the hospital because of urinary retention.

The patient had been in excellent health until two days earlier, when she experienced suprapubic “pressure” on voiding, with urinary frequency. The next day,...

In this issue of the Journal, Templeton and Morris describe the use of a large data base to define clinical factors that are predictive of pregnancy and of multiple gestation after in vitro fertilization.¹ They conclude that when more than two embryos are ...

Currently, there are approximately 200,000 patients with end-stage renal disease in the United States who require dialysis therapy to stay alive, and dialysis is initiated in nearly 70,000 new patients each year.¹ About 90 percent of patients undergoing ...

Measurement is the backbone of science, and the science of hematology is no exception. For many years, the number of normal or abnormal cells in the blood and bone marrow has been determined by counting cells visually or electronically and identifying ...

Each week about 50,000 people visit the Journal's site on the World Wide Web. We have now redesigned it so that there are two parts: a free, unrestricted area for all users, and an enlarged, subscriber-only site. The new site offers subscribers access to ...

To the Editor: In their report on the Pacemaker Selection in the Elderly (PASE) trial, Lamas et al. (April 16 issue)¹ compare single-chamber pacing (VVIR mode [ventricular pacing, ventricular sensing, inhibition response, rate-adaptive]) and dual-chamber ...

To the Editor: A 49-year-old woman admitted with typical Guillain–Barré syndrome was treated with intravenous immune globulin (Gamimune N 10%, Bayer, Elkhart, Ind.), at a dose of 45 g per day (0.4 g per kilogram of body weight) for five days.

The sodium ...

To the Editor: Bartter's-like syndromes are characterized by hypokalemia, hypochloremia, metabolic alkalosis, and normal blood pressure despite hyperreninemia and hyperaldosteronism.¹ We report on an infant with a Bartter's-like syndrome characterized by ...

To the Editor: The letter by Steinmuller (April 23 issue)¹ reports the problems, including hemolysis, that occurred when sterile water was used to dilute 25 percent albumin. The problems occur because although the albumin is concentrated about fivefold ...

To the Editor: Van der Horst et al. (April 9 issue)¹ report no additional benefit from early treatment of port-wine stains with the pulsed-dye laser, which is in contradistinction to our experience² and that of others. Several issues should be raised ...

To the Editor: In the discussion of Case 15-1998 (May 14 issue),¹ Canavan's disease is said to be characterized by “the absence of N-acetylaspartic acid activity on magnetic resonance spectroscopy.” In actuality, N-acetylaspartic acid is elevated in ...

To the Editor: I find it interesting that all of Manian's DEFs (deficiencies, errors, and frustrations) were due to problems with hospital staff and payers (April 19 issue)¹; none dealt with the multiple problems physicians create daily. I have compiled ...

To the Editor: Readers of the Journal should be aware that, in Massachusetts and perhaps other states, some physicians are providing diagnostic and treatment services over the Internet, without having seen or examined patients. This practice involves ...

In the early 1980s when I first tried to understand the neurochemistry of appetite control, I made a pilgrimage to New York to meet the Merlin of the field, whose wizardry had inspired my scientific desires. This person was Gerard Smith, the editor of ...

With the current plethora of comprehensive textbooks on liver disease, the question whether another book of this type is needed should be addressed. Gitlin's book, The Liver and Systemic Disease, is not an original concept, since there is already at least ...

The skin is the one organ of the body that is completely accessible to clinical examination without the aid of specialized equipment. In multiorgan diseases, the skin is often involved, and to the astute observer it can provide valuable clues to the ...

Platelet Satellitism Correspondence, N Engl J Med 1998:339;131-132.. On pages 131 and 132, in the letter by Peters et al., the term “polymorphonuclear neutrophils” should be replaced by the term “platelet–neutrophil complexes” in lines 16, 17, 19, 22, 29, ...