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April 18, 2002 Vol. 346 No. 16
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Gene therapy was used in five boys with X-linked severe combined immunodeficiency disease. In this disorder, a mutation disables the common γ (γc) chain, a component of five cytokine receptors that are essential for the development of T cells and natural killer cells. The disease is fatal within the first year of life unless treated with bone marrow transplantation. The immune system was restored in four patients, who remain well and have required no further treatment during follow-up of up to two years.
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Obstructive lesions in saphenous-vein bypass grafts are a common long-term complication of coronary bypass surgery. Stenting is often performed, but its benefit is limited by restenosis. This placebo-controlled trial evaluated treatment with intravascular gamma radiation for the prevention of in-stent restenosis in coronary bypass grafts. Radiation therapy reduced the rate of restenosis and the rate of subsequent revascularization over a 12-month period.
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In a longitudinal study at an elementary school in Pittsburgh, group A streptococci with resistance to erythromycin were unexpectedly identified in surveillance throat cultures in January 2001. Through May 2001, nearly half the isolates were resistant to erythromycin, and 22 of 46 children with resistant isolates had multiple cultures that were positive for this resistant streptococcus.
A patient infected with the human immunodeficiency virus (HIV) who had xerostomia and enlargement of the parotid glands underwent a diagnostic biopsy of a labial salivary gland. Within six days, a rapidly growing, fungating mass had appeared at the biopsy site. The lesion had the histologic features of Kaposi's sarcoma and contained antigens of human herpesvirus 8. After treatment with local radiotherapy, the lesion resolved.
Schistosomiasis is a parasitic-worm infection that affects about 200 million people in 74 countries. Despite major advances in treatment and control, this tropical disease continues to spread to new geographic areas. This review summarizes the manifestations of this disease, its diagnosis, medical treatment, and prophylaxis, and the prospects for a vaccine.
Alcohol abuse is the most common cause of fatty liver disease, but it is now apparent that fat deposition in the liver, and its consequences, may occur without alcohol abuse. The principal risk factors are obesity, non-insulin-dependent diabetes mellitus, and hyperlipidemia. The disorder has a wide clinical spectrum, ranging from asymptomatic steatosis to steatohepatitis, fibrosis, and cirrhosis. This article provides a broad overview of this increasingly recognized liver disease.
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