Except for certain types of familial cancer, such as adenomatous polyposis coli, the contribution of hereditary factors to the development of cancer is thought to be relatively minor.¹–³ This premise, however, applies mainly to dominant genes, which have ...

The normal ocular surface is covered by corneal, limbal, and conjunctival epithelial cells that, together with a stable preocular tear film, maintain its integrity. Severe damage to the limbal epithelial cells from chemical or thermal burns, the Stevens–...

Because unrecognized injury to the cervical spine can produce catastrophic neurologic disability, clinicians liberally order radiographs of the cervical spine, and as a result the majority of the radiographs are normal.¹–⁸ Eliminating even a small ...

The question of which patients with head trauma should undergo scanning has remained controversial since the introduction of computed tomography (CT) in the early 1970s. Initially, CT was a scarce resource reserved for severely injured patients. As CT ...

Figure 1. A 64-year-old man was evaluated for progressively worsening edema of the legs. He had jugular venous distention, an enlarged liver, pitting edema, no history of tuberculosis, and a negative skin test for tuberculosis. An electrocardiogram showed ...

Figure 1. Progressive cardiac failure developed during a viral illness in a 76-year-old woman. Examination revealed marked jugular-vein distention with Kussmaul's sign, edema of the legs, and a pericardial knock. A chest film showed mild cardiac ...

Lymphocytes and Lymphoid Tissue

The complexity of the cellular interactions that occur during acquired immune responses requires specialized microenvironments in which the relevant cells can collaborate efficiently. Because only a few lymphocytes are ...

Breast-feeding is the best method of feeding neonates and young infants.¹ Its popularity has increased in recent years,² although in 1995 only about 60 percent of new mothers in the United States were breast-feeding their infants at the time of hospital ...

Presentation of Case

A 13-year-old boy was admitted to the hospital three years and eight months before the diagnostic procedure because of abdominal pain.

Periumbilical pain had begun the day before the initial admission, after the patient had eaten ...

The relative roles of genetic constitution and environmental exposure in the causation of cancer have been debated for decades.¹ Geographic differences, trends over time in the risk of cancer, and detailed studies of migrant populations overwhelmingly ...

The promise of bioengineered replacements for diseased or damaged tissues has become a reality, notably for skin and cartilage. The article by Tsai et al. in this issue of the Journal ¹ demonstrates the promise of a nascent form of technology that may ...

Emergency physicians have traditionally relied heavily on diagnostic imaging in the evaluation of patients with head or neck trauma. This conservative approach is intended to reduce the risk of missing intracranial lesions or cervical-spine fractures to ...

On both sides of the Atlantic, revolutionary claims have been made about the ultimate impact of genetics on clinical medicine. John Bell at Oxford has asserted that “within the next decade genetic testing will be used widely for predictive testing in ...

To the Editor: In the February 24th issue, 19 cases were identified in which authors of Drug Therapy articles were in violation of the Journal 's conflict-of-interest policy for review articles and editorials.¹ According to this policy, “authors of such ...

To the Editor: Hambrecht and colleagues (Feb. 17 issue)¹ report that exercise training improves endothelial function in the coronary circulation. In their discussion of the potential mechanisms involved, the authors correctly point out that the ...

To the Editor: We have three comments about the interesting report by Lee et al. (March 2 issue)¹ on the expression of hypoxia-inducible factor 1 (HIF-1) and vascular endothelial growth factor (VEGF) in acute myocardial ischemia and infarction.

First, ...

To the Editor: Coronary cameral fistulas are communications between the coronary arterial circulation and the chambers or great vessels of the heart. The majority of these fistulas are congenital in origin. However, acquired coronary cameral fistulas are ...

To the Editor: The February 24 issue of the Journal includes three reports and an editorial on physician-assisted suicide.¹–⁴ Ganzini et al.¹ and Sullivan et al.² describe the experience with physician-assisted suicide in Oregon in 1998 and 1999; neither ...

To the Editor: We have encountered several patients who were found to have hyperkalemia only when serum potassium concentrations were measured at a certain community hospital. At that hospital, blood samples were collected from patients into gel-...

When I received this 882-page textbook, I was intrigued by the subtitle: “A Companion to Sleisenger and Fordtran's Gastrointestinal and Liver Disease.” Should we consider this book, with its six renowned section editors, a partner of the established ...

Hepatology is one of the areas of clinical medicine in which knowledge has increased considerably. The application of the findings of molecular biology to clinical practice and continual technical improvements in diagnostic imaging have clarified the ...

Just another book on inflammatory bowel disease? Certainly, the hardcover binding and the thick paper suggest a rather conventional, textbook approach. I was pleasantly surprised, however. This book aims to provide an evidence-based, up-to-date, and ...

Case Records of the Massachusetts General Hospital (Case 16-2000) Case Records of the Massachusetts General Hospital, N Engl J Med 2000:342;1590-1597.. On page 1595, the Clinical Diagnosis should have read, “Lymphadenopathy of unknown cause, with ...