The incidence of high-order multiple gestation, defined as a pregnancy involving three or more fetuses, has been rapidly increasing, because of the growing use of infertility treatment, especially induction of ovulation with gonadotropins and in vitro ...

Coronary artery disease is the leading cause of death among women over 65 years of age in the United States.¹ In 1992 it accounted for more than 45 percent of all deaths in women, which is more than the proportion due to all forms of cancer combined.² ...

Despite dramatic declines, coronary heart disease remains the leading cause of death among men and women in the United States. Much effort has focused on the pharmacologic management of hypertension and blood lipid levels and on improved therapy for acute ...

Pemphigus foliaceus is an autoimmune disease characterized by superficial subcorneal blisters and autoantibodies that are specific for the extracellular region of the desmosomal glycoprotein, desmoglein 1 (Figure 1).¹,² The disease can be induced by the ...

Pemphigus foliaceus is an autoantibody-mediated blistering disease in which antibodies against desmoglein 1 cause loss of adhesion among keratinocytes in the superficial epidermis.¹ Desmogleins are transmembrane glycoproteins found in desmosomes, which ...

Figure 1. The urachus is an epithelial tube that connects the apex of the urinary bladder with the allantois in the fetus and is involved in forming the umbilical structures. The lumen of the urachus usually becomes obliterated during embryonic ...

The immune system is an organization of cells and molecules with specialized roles in defending against infection. There are two fundamentally different types of responses to invading microbes. Innate (natural) responses occur to the same extent however ...

Stage

Six days after he was found on the floor with altered consciousness, a 51-year-old man went to see his physician. The episode was associated with emesis and fecal incontinence. The patient reported feeling confused for approximately 30 minutes after ...

In 1969, when I was a second-year medical student, my Introduction to Clinical Medicine instructor introduced me to the Journal. He said that if I read the Journal every week, I would not miss out on any advances in medicine. I took his advice and have ...

The demand for high rates of pregnancy among women treated for infertility has encouraged a tacit acceptance of certain complications of the treatment. This is especially true when treatment results in multiple gestation, and indeed, twins are often ...

The primary causes of the most common autoimmune disorders have been elusive. Pemphigus foliaceus has attracted considerable attention, despite its low incidence, because the associated autoantibodies are directly pathogenic, their target protein is known,...

In this issue the Journal launches a new series of review articles, Advances in Immunology. The articles will appear monthly, usually in the first issue of the month (some articles will have two parts, which will be published in consecutive weeks). We ...

To the Editor: The Heart Outcomes Prevention Evaluation Study investigators (Jan. 20 issue)¹ found that the administration of ramipril to a population of high-risk patients significantly reduced the rates of myocardial infarction, stroke, and death from ...

To the Editor: The results of the analysis of Doppler ultrasonography for the diagnosis of fetal anemia caused by maternal red-cell alloimmunization reported by Mari and colleagues (Jan. 6 issue)¹ are promising, but a note of caution must be sounded. The ...

To the Editor: In the retrospective study by Maron et al. (Feb. 10 issue)¹ of patients with hypertrophic cardiomyopathy who received implantable cardioverter–defibrillators, the rate of appropriate discharge was quite high when the device was implanted ...

To the Editor: A 12-year-old girl presented to her primary care physician with a 6-cm circle of erythema with central clearing on the side of her neck. The patient lived in an area of Connecticut where Lyme disease is endemic. Her physician diagnosed ...

To the Editor: In 1997, Hershey et al. reported finding a mutation in the interleukin-4 receptor α allele in 13 of 20 patients with atopy, as compared with 5 of 30 control subjects.¹ This mutation (termed Q576R) increases the signaling function of the ...

To the Editor: The January 27 Case Record (Case 3-2000)¹ concerned a patient who had systemic amyloidosis, AL type, with restrictive cardiomyopathy and multiple organ involvement. I wish to draw attention to amyloidosis of the adrenal glands, which Dr. ...

To the Editor: Schmidt et al. (Feb. 10 issue)¹ credit foscarnet therapy with the favorable outcome in a patient infected with the human immunodeficiency virus (HIV) who had Epstein–Barr virus (EBV)–associated polyclonal B-cell lymphoproliferation. This ...

To the Editor: Kell, one of the major red-cell groups in humans, comprises 22 antigens. These antigens are encoded by alleles on chromosome 7, including sets of antithetical antigens such as Kell (K) and Cellano (k), which differ by a single amino acid.¹ ...

Tuberculosis-control workers in the United States may very well be stunned by Richard Coker's assessment of their efforts in From Chaos to Coercion: Detention and the Control of Tuberculosis. After all, the rates of tuberculosis in the United States and ...

The granulomatous disorders encompass a wide spectrum of common and rare afflictions that together impose a tremendous burden of disease. Common causes include infections such as tuberculosis and idiopathic disorders such as sarcoidosis and Crohn's ...

In this book, Nuland combines his long experience of research into early beliefs about the nature and function of major visceral organs (stomach, heart, spleen, liver, and uterus) with anecdotes about each of these organs drawn from his 35-year surgical ...

Case Records of the Massachusetts General Hospital (Case 12-2000) Case Records of the Massachusetts General Hospital, N Engl J Med 2000:342;1196-1204.. On page 1203, the sentence that begins on line 14 of the left-hand column should have read, “We usually ...

Treatment of Acromegaly Editorial, N Engl J Med 2000:342;1210-1211.. On page 1210, on lines 36 and 42–43 of the right-hand column, the term should have been “dopamine-agonist drugs,” not “dopamine-antagonist drugs,” as printed.