This large prospective study shows that sentinel-node biopsy can be an important part of the management of intermediate-thickness melanoma of the skin. The biopsy not only yields clinically important prognostic information but also identifies patients with nodal metastases whose survival can be prolonged by lymphadenectomy.

Islet transplantation is an evolving therapy that may be considered for patients with type 1 diabetes mellitus complicated by severe hypoglycemia or labile diabetes, provided all other attempts to stabilize glycemic control have been exhausted. This multicenter trial confirms that islet transplantation using the Edmonton protocol can successfully restore long-term endogenous production of insulin and glycemic stability in such patients, but insulin independence is usually not sustainable.

Human herpesvirus 8 (HHV-8) is the cause of Kaposi's sarcoma, the most frequent AIDS-associated cancer. In this study of recipients of blood transfusions in Uganda, receipt of an HHV-8–seropositive blood product, as compared with a seronegative blood product, was associated with a 2.8% excess risk of seroconversion to HHV-8.

This article introduces a series of reports on medical education. It outlines the main areas of success and the problems that have arisen since the Flexner report was issued.

The tuberous sclerosis complex (TSC), a multisystem, autosomal dominant disorder affecting children and adults, results from mutations in one of two genes, TSC1 (encoding hamartin) or TSC2 (encoding tuberin). In this article, the current knowledge of the pathogenesis of the disease and its management are discussed.

A 41-year-old man was admitted to the hospital because of lymphadenopathy, fatigue, and fever, which had worsened during the previous 6 months, with weight loss and a recent onset of cough and dyspnea. He had had multiple sexual partners since a divorce 4 years earlier; there was no recent travel or exposure to ill persons. Evaluation disclosed cervical, axillary, and abdominal lymphadenopathy, hepatosplenomegaly, anemia, and thrombocytopenia. A diagnostic procedure was performed.

The author describes the U.S. military's practice of force-feeding prisoners on hunger strikes at Guantanamo Bay. He discusses the controversy surrounding this practice and the ethical issues facing physicians involved in the force-feeding of prisoners.

A gene that mediates lytic infection by the human herpesvirus (i.e., HHV-8) may be critical to tumorigenesis.

Lumbar puncture is indicated for both diagnostic and therapeutic reasons. Knowledge of the contraindications, the pertinent anatomy, and the methods to minimize the risk of complications is necessary for the safe and efficient performance of lumbar puncture. This procedure video demonstrates how to perform a lumbar puncture.