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The Cleveland Clinic Journal of Medicine is published twelve times yearly by the Cleveland Clinic. Subscription Rates: US possessions: personal $108; institutional $134; single copy/back issue $20. Foreign: $134; single copy/back issue $20. Institutional (multiple-reader rate) applies to libraries, schools, hospitals, and federal, commercial, and private institutions and organizations. Individual subscriptions must be in the names of, billed to, and paid by individuals. Please send subscription and reprint requests, editorial comments, and correspondence to:

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