Hepatocellular carcinoma is the most common primary cancer of the liver. The disease has a dismal five-year survival rate of less than 5 percent.¹,² Hepatocellular carcinoma is an infrequent cancer in developed countries.² However, its incidence has ...

Bleeding peptic ulcer is a life-threatening emergency with a mortality rate of around 10 percent.¹,² Endoscopic therapy is the first treatment to control hemorrhage, and it improves the outcome for patients.³,⁴ In 15 to 20 percent of patients, bleeding ...

Drug-induced psychosis in patients with Parkinson's disease is a difficult problem to manage.¹,² It is the single most important factor leading to the placement of such patients in nursing homes,³ and it causes more stress for care givers than does motor ...

Invasive fungal infections are an important cause of morbidity and mortality in patients with neutropenia who are receiving chemotherapy for cancer.¹–³ Early diagnosis of these infections is difficult, and persistent fever may be the only sign. A delay in ...

Figure 1. While still a teenager, Chevalier Jackson (1865–1958) concocted a tool that enabled him to recover an expensive drill bit lost underground during oil-well drilling on his father's Pennsylvania farm. In 1890, four years out of medical school, he ...

Immigration to the United States has reached a historic high, with nearly 1 million citizens naturalized in 1996.¹ Approximately 600,000 came from countries where intestinal parasites are endemic. Health policy with respect to managing parasitic disease ...

Attention-deficit–hyperactivity disorder (ADHD) is a common but controversial syndrome characterized by developmentally inappropriate hyperactivity, impulsivity, and inattention.¹ The disorder, which continues throughout life,²–⁷ usually begins in ...

Presentation of Case

A 50-year-old woman was admitted to the hospital because of diarrhea that had developed during radiation treatment.

The patient had been well until 15 years earlier, when a stage 1A, Clark level II malignant melanoma (Figure 1), 0.45 ...

Primary hepatocellular carcinoma, one of the most common tumors in the world today, is occurring with increasing frequency in the United States, as shown in the study by El-Serag and Mason in this issue of the Journal. ¹ The most likely reason for this ...

The number of patients hospitalized for upper gastrointestinal bleeding from ulcers has decreased substantially in recent years. The decrease reflects a variety of factors: the widespread use of histamine H₂–receptor blockers and proton-pump inhibitors, ...

Managing psychosis is one of the most difficult challenges in the care of patients with Parkinson's disease. This complication occurs in 10 to 15 percent of such patients and consists of visual hallucinations, the belief that one is being persecuted, ...

Posting an audio recording of an oral presentation at a medical meeting on the Internet, with selected slides from the presentation, will not be considered prior publication. This will allow students and physicians who are unable to attend the meeting to ...

Consider this paradox: if a physician reads a case report about a novel method of ventilation for critically ill patients and wants to try it in the next several patients with respiratory failure he or she treats, the physician may do so provided the ...

To the Editor: Sasazuki et al. (Oct. 22 issue)¹ report increased survival at one year among patients who underwent transplantation of hematopoietic stem cells from unrelated donors that was associated with matching of HLA-A alleles. They do not report ...

To the Editor: An underlying hypothesis in the study by Eisenberger et al. (Oct. 8 issue)¹ is that bilateral orchiectomy is equivalent to treatment with a gonadotropin-releasing hormone agonist (e.g., leuprolide or goserelin) in the management of ...

To the Editor: The article by Daviglus et al. (Oct. 15 issue)¹ on the relation between the presence of risk factors for cardiovascular disease at 40 to 64 years of age and later Medicare expenditures has important implications for public health and ...

To the Editor: Creatine is being widely used as a possible performance-enhancing substance. Its safety, however, is being debated in both the scientific community¹–³ and in the popular press. We report on a patient who had transient renal insufficiency ...

To the Editor: A recently developed technique, spiral computed tomographic (CT) scanning, may be particularly useful in the identification of liver masses. Data indicate that hepatocellular carcinomas and other liver masses with a predominantly arterial ...

To the Editor: In the article by Ganzini et al. (Oct. 1 issue),¹ the 56 percent of people with amyotrophic lateral sclerosis (ALS) who said they would consider asking for physician-assisted suicide is not so different from the 48 percent of the general ...

To the Editor: Perceptions of research productivity vary widely. Although American and British researchers are acknowledged to be highly prolific in international biomedical and clinical research, the scientific output of researchers in smaller countries ...

Self-mutilation, most commonly by cutting or burning, frequently begins in adolescence and may continue for a lifetime if the behavior is left untreated. It can cause permanent scarring, blood loss, infection (including human immunodeficiency virus ...

Alexander Pope said, “The proper study of mankind is man.” Surely, studying the development of the human brain, mind, and personality — and their disorders — is one of the great scientific tasks of the coming century. In past generations, humans studied ...

The promise of clinical privacy that is part of the Hippocratic Oath contains an escape clause. “All that may come to my knowledge in the exercise of my profession . . . which ought not to be spread abroad,” takers of the oath affirm, “I will keep secret ...

The process of making medical decisions in the United States today is, in theory, a neat and well-defined affair. Authority and responsibility are shared, as mentally and emotionally capable adults choose voluntarily and intelligently from among various ...

High-Level Chloramphenicol Resistance in Neisseria meningitidis Original Article, N Engl J Med 1998:339;868-874.. On page 870, in the second paragraph in the right-hand column, the sentence that begins on line 11 should have read, “Two primers (primer A, ...

Case Records of the Massachusetts General Hospital (Case 3-1999) Case Records of the Massachusetts General Hospital, N Engl J Med 1999:340;300-307.. On page 301, in Table 2, the value for “Sodium (mmol/liter)” should have read “136,” not “13.6,” as ...