Metastatic renal-cell carcinoma has an extremely poor prognosis, with a median survival of less than one year.¹,² Systemic treatment with cytotoxic chemotherapy is usually ineffective.³ The introduction of interleukin-2 and interferon alfa for the ...

Concern that zidovudine may be associated with cardiac mitochondrial dysfunction has been aroused by several studies in animals and by limited clinical data. In studies in monkeys, zidovudine at 21 percent and 86 percent of the human daily dose was ...

The immunogenicity of oral poliovirus vaccine (OPV) is lower in infants in many developing countries than in infants in industrialized countries.¹–⁵ A review of studies in developing countries showed that the administration of three doses of OPV resulted ...

Thrombosis underlies most acute manifestations of coronary atherosclerotic disease, including myocardial infarction.¹ Plaque disruption, with resulting exposure of tissue factor to blood and binding of tissue factor to circulating coagulation factor VII,²,...

Figure 1. A three-year-old girl with a declining growth rate and recurrent iron-deficiency anemia presented with a five-day history of nonproductive cough, fever, and anorexia. In association with an upper respiratory tract infection two weeks earlier, ...

Deficiencies of HLA Molecules

A clinician's attention is normally drawn to a system only when it malfunctions. The HLA system is no exception in this regard, but in contrast to other systems, it also arouses interest when it functions well — too well, in ...

Ulcers result from breaks in the dermal barrier, with subsequent erosion of underlying subcutaneous tissue. In severe cases, the breach may extend to muscle and bone. Primary care providers are often the first to evaluate nonhealing pedal ulcers. Early ...

Presentation of Case

A 34-year-old man was admitted to the hospital because of ulcerative colitis with perirectal pain, swelling, and discharge.

The ulcerative colitis had initially been diagnosed 10 years earlier, in Puerto Rico. Thereafter, the patient ...

In this issue of the Journal, Childs and colleagues present preliminary evidence that in patients with metastatic renal-cell cancer, infusions of allogeneic hematopoietic stem cells after a preparative regimen that does not ablate the bone marrow (...

Mother-to-child transmission of the human immunodeficiency virus (HIV) causes a chronic and ultimately fatal pediatric infection that is now essentially preventable with antiretroviral prophylaxis. In more developed countries, prophylaxis has dramatically ...

It is the year 2000, the target date set by the World Health Organization (WHO) for the global eradication of poliomyelitis. In 1999, there were 7090 cases of polio, and in 1848 of these cases, the virus was isolated. During the first half of this year, ...

As we race toward the as yet unimagined scientific and medical triumphs of the 21st century, no one is more hopeful about the journey than I am. Nevertheless, moving ahead with cutting-edge research must not mean leaving behind well-established ...

To the Editor: The Acute Respiratory Distress Syndrome Network investigators (May 4 issue)¹ deserve commendation for their important study. Because of its importance and despite the clarity of the results, several points should be made.

First, this study ...

To the Editor: Kress et al. (May 18 issue)¹ report that daily interruption of sedative infusions in patients requiring mechanical ventilation resulted in a decreased duration of mechanical ventilation and a decreased length of stay in the intensive care ...

To the Editor: Alcohol withdrawal is a common problem among hospitalized patients and is frequently treated with intravenous diazepam. Propylene glycol is a solvent in which diazepam is often dissolved for intravenous infusion. We report a case of nearly ...

To the Editor: Hallstrom et al. (May 25 issue)¹ report that survival among patients with out-of-hospital cardiac arrest was similar whether untrained bystanders performed cardiopulmonary resuscitation (CPR) by chest compression alone or by chest ...

To the Editor: In the review article on hypernatremia by Adrogué and Madias (May 18 issue),¹ we wonder whether the patient described as having a pure water loss does not in fact have a sodium gain as well. Our reasoning is that if a 20 percent increase ...

To the Editor: Several studies have addressed interactions between pharmaceutical companies and physicians with respect to continuing medical education, the provision of gifts and promotional materials, and research, analyzing whether and how these ...

Joseph Needham (1900–1995) was the Sir William Dunn Reader in Biochemistry at Cambridge University for many years and author of two classic works that synthesized morphology, embryology, and biochemistry for the first time, Chemical Embryology (Cambridge: ...

Just when President Clinton has joined other world leaders to announce the completion of the first draft of the human genome, four philosophers have stepped forward to perform an “ethical autopsy” of eugenics, in which they explore the implications of ...

The subject of this book concerns everyone in one way or another. When nature calls regularly, one should be grateful. But when such calls are irregular and one suffers from headache, distention of the abdomen, disagreeable breath, and furred tongue, then ...

Causes and Outcomes of the Acute Chest Syndrome in Sickle Cell Disease Original Article, N Engl J Med 2000:342;1855-1865.. On page 1861, in Table 3, the first item in the title and under the heading “Risk Factor” should have been “hospital discharge,” not ...

Volume 342 Index (June 29, 2000). In the author index, on page 50, the author “Barbe, K.P.” should have read “Posfay Barbe, K.”