The search for occult metastatic cells in patients with small, curatively resected tumors is of considerable importance, because early dissemination of tumor cells is one of the leading causes of relapse at distant sites¹,² and of death from cancer.³ ...

Preterm birth is a common cause of neonatal morbidity and mortality. An extensive body of evidence indicates that infection is associated with preterm delivery and with low birth weight of the infant.¹ Chorioamnionitis is strongly correlated with preterm ...

Orthostatic intolerance is a syndrome characterized by adrenergic symptoms that occur when an upright posture is assumed: the heart rate increases by at least 30 beats per minute, without orthostatic hypotension.¹ Most patients with orthostatic ...

Figure 1. A 70-year-old man presented with a five-day history of worsening headaches associated with vomiting and confusion on the day of admission. He was being treated with warfarin for transient ischemic attacks and left ventricular dysfunction. There ...

Although euthanasia and physician-assisted suicide are illegal in most countries, they are performed in several parts of the world.¹–⁹ Oregon has made physician-assisted suicide legal under specified conditions.¹⁰ In the Netherlands, a physician who ...

The Oregon Death with Dignity Act, enacted on October 27, 1997, legalized physician-assisted suicide in the state of Oregon.¹ This law allows the physician who has primary responsibility for managing a patient's terminal illness to prescribe a dose of ...

Each year in the United States, breast cancer is diagnosed in more than 170,000 women.¹ Despite this substantial burden of disease, however, assessment of breast-cancer risk has received very little attention outside the oncology clinic.²,³ In primary ...

Presentation of Case

A 20-year-old man was admitted to the hospital because of back pain and hemoptysis.

The patient had been in excellent health until about two and a half months earlier, when pleuritic, right-sided posterior chest pain developed. About ...

Each year more than 180,000 women in the United States receive a diagnosis of breast cancer, and over 40,000 of them ultimately die of their disease. Larger primary tumors and tumor cells in axillary nodes are strong predictors of metastatic disease and ...

Preterm birth is the greatest cause of perinatal mortality and morbidity in the developed world. The cause of spontaneous preterm birth is multifactorial, but infection has been implicated in up to 40 percent of cases.¹ Historically, the approach for ...

Many readers of the Journal who closely follow the national debate over euthanasia and assisted suicide may find themselves wondering why there has been so little discussion of the actual clinical outcomes of attempts to help patients end lives of ...

We noted in the November 18 issue¹ that Dr. Vera Price, the author of a Drug Therapy article published in the September 23 issue,² had received major research support through her university from companies that manufactured drugs discussed in her article ...

To the Editor: In their review article, Sakane et al. (Oct. 21 issue)¹ asserted that the more severe clinical features of Behçet's disease, such as ocular and central nervous system involvement, are commonly associated with the presence of the HLA-B51 ...

To the Editor: Talley et al. (Oct. 7 issue)¹ report the absence of a symptomatic benefit of treating Helicobacter pylori infection in patients with nonulcer dyspepsia. The study was conducted in the United States. Previous double-blind, randomized ...

To the Editor: Knight et al. (Oct. 21 issue)¹ describe electrocardiographic artifacts that mimic ventricular tachycardia and the consequences of this phenomenon on patient care. At our institution as well, too many artifacts are misread as ventricular ...

To the Editor: In their study of lamivudine as initial treatment for chronic hepatitis B, Dienstag and colleagues (Oct. 21 issue)¹ state that 34 (52 percent) of 66 patients with compensated liver disease who were positive for serum hepatitis B e antigen ...

To the Editor: An intramural coronary artery is defined as an arterial segment of variable length that, instead of lying subepicardially, courses deep in the myocardium and is covered by myocardial fibers (a “myocardial bridge”).¹ On an angiogram, it may ...

The history of the biomedical revolution is somewhat vague, even to most scientists participating in it. Although the names Watson and Crick are well known, little has been written about the rich history of molecular biology that preceded the discovery of ...

As oncology changes from a largely empirical endeavor to a science in which diagnosis and therapy are guided and, indeed, defined by the genetic alterations in a patient's tumor, books such as this one will become increasingly important. The ultimate ...

In this era of modern cancer medicine, there are now 8 million to 10 million survivors of cancer in the United States, a number that increases each year. Although many survivors are “cured” of their cancer, they remain at risk for second neoplasms. The ...

As Pui comments in the preface, the need for this book is based on the relative paucity of books in which all aspects of childhood leukemias are collated, despite the rapid expansion of scientific and clinical knowledge of these diseases. The book is ...

In 1997, Oregon passed the Death with Dignity Act, which legalized physician-assisted suicide.¹ With legalization came concern that physician-assisted suicide might be forced on poor, uneducated, or uninsured patients or that it might be ...