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July 7, 2005  Vol. 353 No. 1

Perspective
1-5

Embryonic stem-cell research, more than virtually any other scientific field, has been mired in political and ethical controversy. Dr. Susan Okie writes that in recent weeks, important movement has occurred on ethical, scientific, and political fronts ...

6-8
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Dr. Gregg Bloche and Jonathan Marks write that mounting evidence from many sources, including Pentagon documents, indicates that military interrogators at Guantanamo Bay have used aggressive counter-resistance measures in systematic fashion to pressure ...

9-11

Drs. Judith Berliner and Andrew Watson explain that oxidized phospholipids are fundamentally distinct from unoxidized phospholipids in their ability to interact with cells, proteins, and the immune system in order to promote atherogenesis.

Original Articles
13-22

Premature infants with severe respiratory failure may be treated with inhaled nitric oxide, a controversial treatment that may reduce mortality or prevent bronchopulmonary dysplasia. In a randomized, placebo-controlled trial in neonates with respiratory failure after treatment with surfactant there was no difference in the rates of death or bronchopulmonary dysplasia.

23-32
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The authors previously reported the results of a single-center, randomized trial of inhaled nitric oxide in premature infants, showing reduced risks of death or chronic lung disease and of severe intraventricular hemorrhage or periventricular leukomalacia. Long-term follow-up revealed that children given nitric oxide had improved neurodevelopmental outcomes at two years of age.

33-45

The major risks in essential thrombocythemia are thrombosis and hemorrhage. In this large, randomized trial, the patients given anagrelide plus aspirin had higher rates of arterial thrombosis and serious hemorrhage, whereas the hydroxyurea group had a higher rate of venous thromboembolism. The rate of transformation to myelofibrosis was higher in the anagrelide group.

46-57

Lp(a) lipoprotein is believed to be involved in the pathogenesis of coronary artery disease. This study provides evidence that its atherogenicity is related to proinflammatory oxidized phospholipids that are bound to it.

58-63

This report describes the successful transplantation of ovarian tissue from a fertile monozygotic twin to her 24-year-old twin sister, who had a 10-year history of ovarian failure. The recipient subsequently conceived and gave birth to a girl at 38 weeks' gestation.

Review Article
64-73

An increasing number of options are available for women who wish to preserve their fertility, particularly before cancer treatment: oophorectomy with cryopreservation, embryo cryopreservation, and aspiration of oocytes for cryopreservation immediately or after ovarian hyperstimulation. This article also describes the natural process of oocyte loss and methods of testing for decreased ovarian reserve.

Images in Clinical Medicine
74
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A 33-year-old woman, para 2, presented to the emergency department with a report of vaginal bleeding and abdominal pain of several days' duration. She had no history of pelvic inflammatory disease. Right adnexal tenderness was noted on physical ...

e1

This 23-day-old term male infant presented to the emergency room with acute small-bowel evisceration. His parents had noted erythema and umbilical drainage before the evisceration.

Clinical Problem-Solving
75-80
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A 36-year-old woman in her 34th week of pregnancy presented to the emergency department after the sudden onset of severe substernal chest pain that had awoken her in the early morning. She had diaphoresis and nausea but no dyspnea, dizziness, syncope, hemoptysis, cough, or fever.

Editorials
82-84

Endogenously released nitric oxide is widely recognized to play a key role in multiple vertebrate organ systems, and its deficiency disrupts pulmonary parenchymal and vascular development. These observations have suggested that exogenously inhaled nitric ...

85-86

Essential thrombocythemia is one of the chronic myeloproliferative disorders, a heterogeneous group of diseases involving clonal hematopoietic stem cells that also includes polycythemia vera, idiopathic myelofibrosis, and chronic myelogenous leukemia.1 ...

Clinical Implications of Basic Research
87-88

The efficiency of deriving blastocysts through the nuclear transfer of embryonic stem cells has been improved by a factor of more than 14.

Correspondence
93-96

To the Editor: LaRosa and colleagues (April 7 issue)1 report that among patients with stable coronary heart disease (CHD), an intensive statin regimen provides a 22 percent reduction in the risk of cardiovascular events when compared with a standard ...

96-97

To the Editor: Four thoughtful pieces in the March 24 issue14 call attention to the need for universal health insurance and to the financial problems that must be resolved. The two Sounding Board articles, by Emanuel and Fuchs1 and Mongan and Lee,2 ...

97-98

To the Editor: In the report by Leeper et al. (April 7 issue),1 the endomyocardial-biopsy specimen in their Figures 2 and 3 shows chronic changes, including extensive fibrosis, as stated by the authors, but it does not support a diagnosis of myocarditis.

...
99-102

To the Editor: Cases of osteonecrosis of the jaw in connection with the use of bisphosphonates were reported in 2003.1,2 In 2004, the International Myeloma Foundation conducted a Web-based survey to assess the risk factors for osteonecrosis of the jaw. ...

Book Reviews
103

One of the most striking things an American observes on first arriving in a developing country is that poor people are so small and rich people so large. That physical stature so perfectly mirrors social stature is hardly surprising, given that adequate ...

103-104

Observers of the U.S. health care scene cannot help but be perplexed by the enigma of a system of funding health care that leaves so many patients financially vulnerable, in spite of per capita spending on medical care that is almost twice that of the ...

104-105

Recent findings and trends associated with health disparities, along with their causes, consequences, and potential solutions, are reviewed in Vulnerable Populations in the United States. It is an excellent primer for undergraduates and graduate students ...

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