Join the 200th Anniversary Celebration

Issue IndexA searchable index of tables of contents

Find An Issue

By Volume and Issue
By Date

Table of contents for

December 20, 2007  Vol. 357 No. 25

Audio Summary of this Issue

Perspective
2533-2536

Dr. Gretchen Berland gave video cameras to volunteers in wheelchairs in order to understand the experience of being disabled. She writes that the project taught her to see the world in ways she had never imagined. Dr. Gretchen Berland and J. Galen ...

2534-2535
  • Free Full Text

In this first-person account, J. Galen Buckwalter, a disabled person in a wheelchair, describes his experience of looking at his life through a camera lens. He writes that it gave him a different view of his disability and his interactions with others.

2537-2538

The specific intervention of stromal paracrine secretion might substantially suppress the progression of breast cancer. Dr. Edison Liu discusses the mechanism of tumor-associated stromal fibroblasts in breast cancer.

2539-2541

The p53 protein controls the expression of a wide range of genes with disparate functions. William Foulkes explains what p53 is and why it is important in cancer.

Original Articles
2543-2551

A laser-capture microdissection technique was used to pluck individual breast-cancer epithelial cells and surrounding stromal cells from pathology slides for studies of the TP53 gene and loss of heterozygosity across the genome. Mutations of the gene and loss of heterozygosity were found in normal-appearing stromal cells, findings that were associated with the presence of lymph-node metastases. These results suggest that genetic alterations in cells of the microenvironment accelerate the spread of a tumor.

2552-2561

TP53, the gene for the tumor-suppressor protein p53, is the most commonly mutated gene in cancer cells. In this study of head and neck cancer, about half the tumors had a TP53 mutation. The presence of mutations that could disrupt the binding of p53 to a DNA target had the strongest association with decreased survival. The results indicate that a disruptive mutation of TP53 is an independent risk factor for death among patients with head and neck cancer.

2562-2575

This study examines the toxicity of immunosuppressive regimens in renal-transplant recipients. A regimen containing mycophenolate mofetil, daclizumab, low-dose tacrolimus, and corticosteroids appeared to be the most effective with respect to the glomerular filtration rate, allograft survival, and acute rejection, as compared with regimens containing dacluzimab induction plus either low-dose cyclosporine or low-dose sirolimus and with standard-dose cyclosporine without induction.

2576-2588

In this randomized trial comparing telbivudine and lamivudine in patients with chronic hepatitis B, telbivudine was associated with higher rates of response at 1 year among HBeAg-positive patients (75.3% vs. 67.0%, P=0.005); the rates of response to telbivudine and lamivudine among HBeAg-negative patients were similar (75.2% and 77.2%, respectively; P=0.62). Telbivudine was associated with elevated creatine kinase levels.

Special Article
2589-2600

In this large retrospective cohort study of hospitalized adults, patients cared for by hospitalist physicians had modestly shorter hospital stays than patients treated by general internists or family physicians but similar in-hospital mortality.

Review Article
2601-2614

Increasingly potent immunosuppressive agents have dramatically reduced the incidence of rejection of transplanted organs while increasing susceptibility to opportunistic infections and cancer. This article reviews general concepts for the management of transplantation-associated infections and discusses recent advances and challenges.

Images in Clinical Medicine
2615
  • Free Full Text

A 36-year-old woman presented with painless, subcutaneous nodules that had developed during the previous 5 months on her buttocks, shoulders, and left wrist (Panel A). Her medical history was notable for glomerulonephritis leading to dialysis at 14 years ...

e29
  • Free Full Text

This 44-year-old man with chronic liver disease presented with recurrent upper gastrointestinal bleeding. Computed tomography revealed a suprahepatic inferior vena caval web.

Case Records of the Massachusetts General Hospital
2616-2623

    A 5-month-old girl was seen in the pediatric dermatology clinic because of a rash. At the age of 3 months, a red papule had developed on her cheek, followed by a generalized eruption. She was well except for the skin lesions. A diagnostic procedure was performed.

    Editorials
    2625-2627

    Although protocols differ among transplantation centers, most immunosuppressive strategies for kidney-transplant recipients are built on two core practices: delivery of immunosuppression in two phases, usually termed induction and maintenance, and the ...

    2627-2629
    • Free Full Text

    The rapid emergence of hospitalist care in the United States has been extraordinary, with more than 20,000 hospitalists practicing today.1 Several factors underlie this growth, including the increased demands placed on primary care physicians that make ...

    Clinical Implications of Basic Research
    2630-2632

    The human cytomegalovirus generates noncoding RNAs that allow viruses to persist by enhancing the survival of infected cells and shielding them from attack by natural killer cells.

    Correspondence
    2633-2634

    To the Editor: Sjöström et al. (Aug. 23 issue)1 report that bariatric surgery was associated with decreased long-term overall mortality, but because of statistical limitations, they were not able to determine definitively whether this finding could be ...

    2634-2636

    To the Editor: The Saline versus Albumin Fluid Evaluation (SAFE) study investigators (Aug. 30 issue)1 report that in their post hoc follow-up study of patients from the SAFE study who had traumatic brain injury (the SAFE–TBI study), resuscitation with 4% ...

    2636-2637
    • Free Full Text

    To the Editor: In his review of gynecomastia, Dr. Braunstein (Sept. 20 issue)1 includes numerous medications that may be associated with gynecomastia but does not mention a potential link of statins to gynecomastia. The only medication used by the ...

    2637-2638

    To the Editor: Children with congenital complete atrioventricular block often require lifelong pacemaker therapy. Although such therapy restores a normal heart rate, it also results in dyssynchronous left ventricular activation and contraction and ...

    2638-2639

    To the Editor: The longevity of pulse-generator batteries for cardiac pacemakers is still of some interest. On April 10, 1973, my colleagues and I implanted a plutonium-238 radioisotope pacemaker in a 20-year-old woman who had complete atrioventricular ...

    Book Reviews
    2640
    • Free Full Text

    Vitamin A, part of the Vitamins and Hormones series from Elsevier Academic Press, is a timely, comprehensive, and well-organized collection of reviews on various aspects of the role of vitamin A in health and disease. It serves as a “one-stop shop” for ...

    2640-2641

    Among medical disorders, Gilles de la Tourette's syndrome, or Tourette's syndrome, crosses the spectrum of age groups and has both primary and secondary neurologic, psychiatric, and psychological manifestations. The disorder is clinically complex, has a ...

    2641-2642

    Dr. Carl Bartecchi was drafted to serve as a doctor early in the Vietnam War, and like many of us who were in Vietnam — a beautiful and exotic land — he has had a continuing desire to learn about and help the country and its people. In A Doctor's Vietnam ...