Chronic myeloid leukemia (CML) is a clonal disorder in which cells of the myeloid lineage undergo massive clonal expansion. The disease progresses through three distinct phases — chronic phase, accelerated phase, and blast crisis — during which the ...

The BCR-ABL tyrosine kinase, the product of the chimeric gene produced by the Philadelphia (Ph) chromosome, is the molecular abnormality that causes chronic myeloid leukemia (CML). During the chronic phase of the disease, there is massive clonal expansion ...

Atrial fibrillation is associated with increased morbidity and mortality¹–⁵ and is an independent risk factor for stroke.⁶,⁷ Although the association between atrial fibrillation and mortality has been debated, a recent report showed that atrial ...

Gastrointestinal stromal tumors are a group of mesenchymal neoplasms that arise from precursors of the connective-tissue cells of the gastrointestinal tract.¹ They occur predominantly in middle-aged and older persons, and approximately 70 percent of the ...

Figure 1. This 82-year-old woman was referred to a physician. What is the diagnosis?

Complement is part of the innate immune system and underlies one of the main effector mechanisms of antibody-mediated immunity. It has three overarching physiologic activities (Table 1): defending against pyogenic bacterial infection, bridging innate and ...

Electrocardiographically, atrial fibrillation is characterized by the presence of rapid, irregular, fibrillatory waves that vary in size, shape, and timing. This set of findings is usually associated with an irregular ventricular response, although ...

Stage

A 63-year-old woman presented to her physician with fatigue, weakness, anorexia, and an unintentional weight loss of 14.5 kg (32 lb) during the previous four months. She reported increased constipation in the past year, but not melena, hematochezia, ...

Chronic myeloid leukemia (CML) is one of the most remarkable cancers.¹,² It was probably the first type of leukemia to be recognized, in the 1840s, as a distinct entity. A landmark was the discovery of the Philadelphia (Ph) chromosome in 1960.³ This led ...

Managed care now dominates health care in the United States. By 1999, only 8 percent of persons with employer-sponsored health insurance coverage had traditional indemnity insurance.¹ This reflects a sea change in the past two decades — not just in the ...

To the Editor: The request by the Food and Drug Administration (FDA) for the voluntary withdrawal of all products containing phenylpropanolamine on the basis of the data of Kernan et al. (Dec. 21 issue)¹ is excessive. Although the study was rigorously ...

To the Editor: As an anatomical pathologist and paid consultant to the Ephedra Education Council, I reviewed 22 reports of adverse events received by the Food and Drug Administration (FDA) in which death had occurred and assessed the likelihood that ...

To the Editor: We share the concern of Irwin and Madison (Dec. 7 issue)¹ about the unnecessary treatment of acute cough with antibiotics, which recent meta-analyses have shown has no clinically significant benefit.²–⁴ However, we disagree with the ...

To the Editor: Kapoor's excellent review of syncope (Dec. 21 issue)¹ failed to mention arrhythmogenic right ventricular dysplasia as a possible cause of syncope. Although rare, this condition affects otherwise healthy young persons and can be fatal. ...

To the Editor: A 25-year-old man with fistulizing Crohn's disease began to have high fever, dyspnea, and a productive cough five days after he received a single intravenous dose of 5 mg of a monoclonal antibody against tumor necrosis factor α (anti–TNF-α ...

The writing in medical journals is deliberately devoid of emotion, which may explain why writers of books about science are flourishing these days. They can add drama and elucidate complexities. A scientific autobiography written with a journalist can be ...

Great conceptual advances in science are often based on great technical advances. Either type of discovery can bring scientific fame. In 1896 Riva-Rocci devised the mercury sphygmomanometer for measuring blood pressure, but it took several decades for ...

What would happen if a modern biologist could get in touch with Charles Darwin and enter into a lively and stimulating discussion about recent developments in evolutionary theory? Here, we have the answer. Molecular biologist Gabriel Dover uses imaginary ...

Conjoined twins have been the subject of scientific exhibits, medical study, human curiosity, and even entertainment, but until the year 2000, conjoined twins had never been the subject of a courtroom battle. A unique case that was the subject of two ...