Alkylating agents are highly reactive molecules that cause cell death by binding to DNA.¹,² The most frequent site of alkylation in DNA is the O⁶ position of guanine. Alkylation here forms cross-links between adjacent strands of DNA,¹ which explains how ...

Physical activity clearly benefits cardiovascular health.¹–³ In prospective epidemiologic studies, both vigorous physical activity and moderate activity are consistently associated with a reduced risk of coronary heart disease.⁴–⁷ However, it is also ...

Congenital adrenal hyperplasia is characterized clinically by prenatal virilization and genital ambiguity in newborn girls, postnatal virilization in both boys and girls, and adrenal insufficiency with or without salt wasting.¹–³ Biochemically, the ...

Among men who have sex with men, Kaposi's sarcoma is the most common cancer associated with infection with the human immunodeficiency virus (HIV).¹,² Epidemiologic evidence and molecular evidence increasingly suggest that human herpesvirus 8 (HHV-8) is ...

Infection with human herpesvirus 8 (HHV-8) has been implicated in the development of Kaposi's sarcoma, primary effusion lymphoma, and multicentric Castleman's disease of the plasma-cell type.¹–⁴ These conditions have been described most frequently in ...

Figure 1. A 45-year-old woman with end-stage renal disease was seen for acute bacterial endocarditis. Echocardiographic study revealed marked mitral regurgitation with a large vegetation on the atrial side of the anterior leaflet of the mitral valve. At ...

Figure 1. A 78-year-old woman presented with marked dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Eight years earlier, she had received a bioprosthetic mitral valve because of mixed mitral-valve disease. Physical examination showed an elevation in ...

Myocarditis is defined clinically as inflammation of the heart muscle. First introduced into the medical literature at the beginning of the 19th century, the term “myocarditis” was initially used to describe diseases of the heart muscle not associated ...

Presentation of Case

A 71-year-old woman was admitted to the hospital because of a pituitary mass.

During the five years before admission, the patient had been tired and anorectic, her joints had ached, and her neck and shoulders had become stiff. A ...

Traditionally, cancer treatments have been selected on the basis of tumor type, pathological features, clinical stage, the patient's age and performance status, and other nonmolecular considerations. We have generally accepted with a certain fatalism that ...

Sudden death from cardiac causes often occurs during or just after physical exertion.¹–⁶ In some cases, such deaths occur during organized youth sports,⁶ a circumstance in which the victims are regarded as the epitome of health and fitness and their ...

The concept of emerging “new” pathogens is somewhat misnamed, since these pathogens are usually old infections that have newly adapted to social and technological changes. Such is the case for Kaposi's sarcoma–associated herpesvirus, also referred to as ...

To the Editor: In a brief letter, it is impossible to refute all of Dr. Angell's misleading charges in her editorial on the pharmaceutical industry (June 22 issue).¹ To answer her question about accountability, the industry is accountable to physicians ...

To the Editor: The article by Connolly et al. (May 11 issue)¹ on physiologic pacing as compared with ventricular pacing was published prematurely, since the period of follow-up (range, two to five years) was simply too short for the true advantages of ...

To the Editor: In the United States and the United Kingdom, about 57,000 patients are given a diagnosis of bladder cancer each year. Invasive bladder cancer usually arises from a precursor lesion of either flat carcinoma in situ or noninvasive papillary ...

To the Editor: Two recent publications based on post hoc analyses of data from the North American Symptomatic Carotid Endarterectomy Trial (NASCET) make a similar, albeit important, point: patients with carotid-artery stenosis should be carefully and ...

To the Editor: Hoeper et al. (June 22 issue)¹ reported improved hemodynamics in a group of 24 patients with primary pulmonary hypertension who were treated with aerosolized iloprost for at least one year. In contrast, we studied 18 such patients who were ...

To the Editor: Noninfectious adverse events from blood transfusion are relatively common. They range from febrile, nonhemolytic reactions and mild allergic reactions to serious hemolytic and anaphylactic reactions.¹ Hypotensive reactions to transfusion ...

Russia has undergone a series of enormous social experiments in the past two decades. In 1985, Mikhail Gorbachev introduced the concepts of glasnost and perestroika to the Soviet Union, a monolithic state that was under rigid central control and ...

Let's dispense with the suspense. This is a short, readable, thought-provoking book that discusses in nontechnical terms the future of humankind in the age of genetic engineering and should be read by anyone who wishes to participate in a public discourse ...

In simpler times, this short, well-written book would have warranted praise for its lucid discussion of the relation between science and art in clinical medicine. The central thesis is that physicians use both scientific evidence and clinical judgment in ...

Severe Ocular Irritation and Corneal Deposits Associated with Capecitabine Use Correspondence, N Engl J Med 2000:343;740-741.. On page 741, the first author's name should have been “Bandana Waikhom,” not “Bandana Walkhom,” as printed. We regret the error.