Thisisthefirstvolumeinthe CerelJral Cortexseriesdevotedtomathematicalmodels ofthecortex. Itwasmotivatedbytherealizationthatcomputationalmodelsof individualneuronsandensemblesofneuronsareincreasinglyusedinresearchon corticalorganizationandfunction. Thisis,inpart,becauseofthenowubiquitous presenceofpowerfulandaffordablecomputers. Suitablemachineswereformerly rareinresearchlaboratoriesandrequiredsubstantialprogrammingexpertisetobe usedinconstructingandusingneuronalmodels. However,computersarenow routinelyusedinallareasofneurobiologyandanumberofsoftwarepackagesallow scientistswithminimalcomputerscienceandmathematicalbackgroundstocon- structseriousneuronalmodels. Asecondfactorleadingtotheproliferationof modelingstudiesisthedevelopmentoftechnologiesthatallowthekindsofdata collectionneededtodeveloprealisticmodelsofcorticalneurons. Characterization ofthekineticsofvoltage-andligand-gatedchannelsandreceptorshadbeenlim- itedtorelativelylargeneurons. However,therapiddevelopmentofsliceprepara- tions,patch-clampmethods,andimagingmethodsbasedonvoltage-sensitivedyes andintracellularcalciumindicatorshasresultedinasignificantdatabaseonthe biophysicalfeaturesofcorticalneurons. Thescopeofmodelingapproachestocorticalneuronsandfunctionsiswide anditseemednecessarytolimitthepurviewofthevolume. Thefocusisonattempts tounderstandthepropertiesofindividualcorticalneuronsandneuronalcircuitry throughmodelsthatincorporatesignificantfeaturesofcellularmorphologyand physiology. Noattemptwasmadetoincludemodelingapproachestounderstanding corticaldevelopmentandplasticity. Thus,workdealingwiththedevelopmentof oculardominancecolumnsandtheorientationselectivityofneuronsinvisualcortex isnotconsidered. Similarly,modelsdealingwiththecellularmechanismsunderlying long-termplasticityandwithapproachestolearningandmemorybasedonmodifica- tionofHebbiansynapsesarenotconsidered. Relativelyabstractattemptstounder- standhigherlevelandcognitiveprocessesbasedonneuralnetsrepresentasecond, majorareaofworkthatisnottreated. Modelsofcognitiveprocessesbasedon dynamicalsystemsmethodsinwhichnoattemptismadetoincludethebiophysical featuresofindividualneuronsarealsonotconsidered. vii viii Thetenmajorchaptersfallintothreegroups. Thefirstgroupdealswith compartmentalmodelsofindividualcorticalneurons. LyleBorg-Grahamprovides PREFACE anintroductiontothemethodsinvolvedinconstructingcompartmentalmodels andthenreviewstheexistingmodelsofhippocampalpyramidalcells. Becauseof theeffectivenessofhippocampalslicepreparations,theseneuronshavewell-ehar- acterizedbiophysicalproperties. Thischapterillustrateshowcompartmentalmod- elscanbeusedtosynthesizeexperimentaldataandprovideanintegrativeviewof thepropertiesofindividualneurons. PaulRhodescontinuesthethemebyfocusing ontheroleofvoltage-gatedchannelslocatedonthedendritesofcorticalneurons. Thisisanareainwhichtechnologicaladvancesinthevisualizationofneuronsin slicepreparationsbasedoninfraredmicroscopyhavegreatlyexpandedtheinfor- mationavailableondendriticfunctioninjustafewyears. Thechapterbothreviews theexperimentaldataonactivedendriticconductancesandemphasizestheirpo- tentialfunctionalroles. Thesecondgroupofchaptersdealwiththegenerationofreceptivefield propertiesofneuronswithinvisualcortex. Theyaddressissuesstemmingfromthe originalattempttounderstandhowthereceptivefieldpropertiesofneuronsincat andmonkeyprimaryvisualcortexaregeneratedbyinteractionsbetweengenicu- lateafferentsandcorticalneurons. ThechapterbyFlorentinWorgotterevaluates modelsthathavebeenusedtoanalyzethegenerationofreceptivefieldproperties. RodneyDouglasandhiscolleaguesaddressaspecificsetofissuesdealingwiththe roleofintracorticalexcitationmediatedbypyramidalcellcollaterals. Animportant featureofthischapterisitsrelationtoattempttoconstructfabricatedcircuitsthat duplicatethefunctionsofcorticalcircuits. ThechapterbyPhilipUlinskifocuseson thegenerationofmotion-selectivepropertiesincorticalneurons. Itseekstoidenti- tycellularmechanismsusedbyneuronsthatrespondpreferentiallytovisualstimuli movingwithparticularspeedsordirections. MatteoCarandiniandhiscolleagues discussthefeatureofcorticalneurons,knownasgaincontrol,thatallowsneurons torespondeffectivelytovisualstimulibypoolinginformationacrosspopulationsof corticalneurons. ThechapterbyHughWilsondealswiththereceptivefieldproper- tiesofextrastriateareasandintroducesnewworkanalyzingface-selectiveneurons. Thefinalsetofchaptersconsidermodelsofensemblesofthalamicandcortical neurons. ThechapterbyWilliamLyttonandElizabethThomasusesthetheoryof dynamicalsystemstoanalyzethetemporalrelationshipsbetweenthalamicand corticalneurons. Animportantfeatureoftheinteractionbetweenthalamusand cortexisthepresenceofoscillationsthatdependinpartuponthevoltage-gated conductancespresentonindividualneuronsandinpartonthestructureofthe overallnetwork. PaulBushcontinuesthisemphasisonoscillationsbydiscussinga modelthatdealswiththegenerationofsynchronizedoscillationsinvisualcortex. Oscillationsofthiskindhaveattractedsubstantialattentioninrecentyearsbecause oftheirpotentialroleincognitiveprocesses. Thelastchapter,byMichaelHasselmo andChristianeLinster,reviewstheirworkonmodelingpiriformcortex,emphasiz- ingtheroleofcholinergicmechanismsinmodulatingtheactivityofcorticalneu- rons. Anattempthasbeenmadethroughouttomakethevolumeaccessibleto readerswithminimalmathematicalbackgrounds. Thevolumethusbeginswitha shorthistoryofmodelsofcorticalneuronsandcircuitrythatintroducestheprinci- palmodelingstyles. ThechaptersbyWorgotterandUlinskicontainmoreextensive ix introductionstosomeofthemodelingmethodsthathavebeenusedtostudyvisual cortex,andthemathematicallychallengedreaderwillfindthatthechapterby PREFACE LyttonandThomascontainsareadableintroductiontotheuseofdynamical systemstheoryinneurobiology. PhilipS. Ulinski EdwardG. Jones Chicago and Davis Contents Chapter 1 ModelingCorticalCircuitry:AHistoryandProspectus PhilipS. Ulinski 1. Introduction "...1 2. LorentedeNothroughDynamicalSystemsModels...2 2. 1. LorentedeNo...2 2. 2. CellAssembliesandNeuralNets...3 2. 3. DynamicSystemsModels...8 3. HodgkinandHuxleythroughNetworkModels...11 3. 1. HodgkinandHuxley...11 3. 2. WilfridRall...11 3. 3. SoftwarePackages...13 3. 4. RealisticModelsofCorticalNetworks...14 4. Prospectus...14 5. References...15 Chapter 2 InterpretationsofDataandMechanismsforHippocampalPyramidal CellModels LyleJ Borg-Graham 1. Introduction...19 1. 1. NeuronModelEvolution-followingElectrophysiology...19 1. 2. NeuronModelEvaluation-followingtheParameters...21 1. 3. WhyHippocampus? 21 1. 4. OrganizationofThisChapter...22 xi xii 2. TheDatabaseforSingle-NeuronModels...23 2. 1. VoltageClampversusCurrentClamp...23 CONTENTS 2. 2. Single-ChannelversusMacroscopicCurrents...24 2. 3. TypeofPreparation...24 2. 4. KineticandPharmacologicalDissection...25 2. 5. TemperatureDependence...26 2. 6. AgeDependence...27 2. 7. HippocampalSubfieldDependence...27 2. 8. DifferencesinFiringPropertiesbetweenSharpversusPatch Recordings...28 2. 9. TheMeasuredVoltage...

This book discusses contemporary features of ject, creating, therefore, a lacuna the could be diagnosis of endocrine diseases using the filled by this project. radiologic technique of percutaneous venous This book is intended to be a practical guide blood sampling for hormone assay. A compre- for vascular and interventional radiologists, in- hensive survey of the field is provided by the ternists, surgeons, endocrinologists, and other contributing authors, who have considerable physicians who care for patients with endocrine expertise in the subject. Some have published diseases. The intention is to provide a practical several articles in the literature; others have text covering anatomical data, clinical prob- extensive clinical experience. lems related to the diagnosis of the endocrine The approach to many of the endocrine dis- diseases, patient preparation for the sampling, eases has been markedly improved ~uring the blood sampling techniques, sample manipula- last two decades because of selective venous tion and storage, laboratory data, and clinical blood sampling, not only in the diagnosis of the significance of the hormone sampling and condition but especially in the precise localiza- assay. tion of the hormone-producing lesion and its clinical significance. Scattered informationbn venous blood sam- pling is available in the literature, but there is Renan Uftacker no comprehensive text dealing with the sub- Reingard Sorensen Contents Preface v Contributors xi 1 Selective Venous Sampling for the Differential Diagnosis of Female Hyperandrogenemia 1 Lathar Moltz and Reingard Sorensen Introduction ...1 Diagnostic Procedures ...2 Indications ...4 Anatomy and Anatomical Variations...

The papers presented at the Fifth International Symposium on Heart Valves and published in this volume discuss clinical experience with heart valve replacement in pediatric patients, in adults (age 65 and younger), and in the elderly (age 66 and older). Special considerations in heart valve replacement, such as valve selection, reoperation, results of double valve implantation, quality of life, and the use of valved conduits are also included. Finally, long term clinical follow-up with the ST. JUDE MEDICAL (R) heart valve, giving 7- and 8-year data is discussed. HEART VALVE REPLACEMENT IN PEDIATRIC PATIENTS Anticoagulation Anticoagulation in children is a difficult and interesting problem. Three princi pal considerations in the use of anticoagulants are patient education, timing, and anticoagulating substance. Additional considerations are patient tolerance and compliance. Generally, the findings indicate, if pediatric patients receive anticoagulation following mechanical valve replacement, it is well accepted and results in few complications. If children are not anticoagulated, complications arise. Conflicting results regarding the efficacy of PERSANTINE (R) and the use of aspirin vs. COUMADIN (R) were reported. Doctor Sade's data address some of these questions. * After a 5-year study in * See J Thorac Cardiovasc Surgery 1988; 95:533-561.

All diseases involving the lung are presented in alphabetical order. Each is discussed in the same way under the subheadings of definition, epidemiology, pathophysio- logy, clinical prognosis, radiology, gross and micro patho- logy, histomorphological descriptors, special stains, hall- mark of diagnosis and differential diagnosis.
"An encyclopedic collection of terms dealing with diseases and/or pathological conditions of the respiratory organs with the aim to give the reader rapid information about the essential aspects. This encyclopedic source can be recommended not only to pathologists but also to clinicians and practitioners faced with pulmonary diseases." (Experimental and Toxicologic Pathology)

The incidence of concomitant disease in patients referred for cardiac surgery has increased substantially throughout the years. Years ago a significant proportion of patients due for cardiac surgery would not have been operated on, as the risk of concomitant disease were estimated as being too high. Over the years techniques in cardiac surgery, anaesthesiology and intensive care treatment have improved, thus, enabling us to operate on and to treat more severely ill patients and those with extraneous complications. Cardiac Surgery and Concomitant Disease presents the current knowledge in dealing with high risk patients scheduled for cardiac surgery.

With the growing age of the general population, the proportion of elderly patients with diffuse coronary artery disease and severe comorbidities is increasing. When medical therapy cannot relieve the symptoms in these patients, their characteristics render them unsuitable for currently rec- ognized invasive procedures, namely coronary artery bypass grafting and percutaneous transluminal angioplasty. There is an urgent need for new treatment modalities which can alleviate their symptoms and increase blood flow to the ischemic myocardium while being less inva- sive for their fragile condition. The idea for this book was to relate my personal experience in the research and clinical fields and the current state of knowledge as reported in the literature. An additional aim was to provide anatomical and physiological background as well as a complete review of the new methods of revascularization currently being developed. To this purpose, I have analyzed many studies on the microvascula- ture of the heart, the historical forerunners of the new procedures, and the new treatment modalities themselves: transmyocardiallaser revascu- larization, therapeutic angiogenesis, and neurostimulation. I wish to thank my teachers in surgery, cardiology, and medicine: B. Faidutti (Geneva), J.-P. Berger (Vevey), 1. Kappenberger (Lausanne), F. Harder (Basel), T. Amery (Frimley), K. Arnold (Brig), and especially 1.K.

In recent years much enthusiasm and energy has been directed toward the development of human gene therapies, especially for inherited conditions and cancers. However, current gene transfer technology is limited in its transduction efficiency and ability to permanently and safely correct genomic defects. Thus the promise of gene therapy for these conditions is as yet unrealized. The progression of gene transfer technology will eventually surmount these limitations. Gene Therapy for Acute and Acquired Diseases includes selected examples of ongoing studies in molecular genetics that have the potential to evolve into human therapies for acute illnesses. These chapters are intended to highlight lesser known applications of gene therapy for acquired disorders. It is expected that human gene therapy trials for these conditions will be forthcoming in the near future, leading to previously unimaginable therapies. Thus, this first-ever book about gene therapy for acute and acquired diseases is intended to serve as a glimpse into the future.

Modern Cardiac Surgery is based on, but does not consist completely of, papers submitted at the annual course of cardiac surgery run by the combined Institutes and Post-Graduate Hospitals involved in cardiac surgery in London (1977). The subjects which have been chosen and included fulfil one of two criteria; either they are subjects which were not included in the previous book, The Current Status of Cardiac Surgery, or they cover subjects which needed to be updated. Because this is a teaching course and not a symposium, the emphasis has been on being informative rather than on presenting masses of results. The book has been prepared partly from manuscripts submitted by the authors and partly from annotated tapes of the proceedings of the meeting. Through out the editing and production of this book careful consideration has been given to the requirements of the readership. The book is aimed at all students of cardiac surgery and cardiology at all levels, and as much information as possible has been packed into it. Neverthe less, the editor wishes to thank the authors for the efforts they have made to be concise and clear in their presentation and for their tremendous co-opera tion in alterations which have been incorporated to make it a more readable treatise. This means that this is a book which is of value to nurses interested in cardiology in intensive care, to physiotherapists and students wishing to look up particular topics before their final examinations."

Over 10 years have passed since the first edition of The Mediastinum was published in 1977. I have been very gratified by the response to the first edition and determined to do a second edition as soon as possible. However, good intentions are sometimes difficult to achieve and a decade has passed. This period has been one of enormous growth in the discipline of diagnostic imaging. In the study of the mediastinum, computed tomog raphy, and more recently magnetic resonance, have revolutionized our diagnostic capabilities. This second edition of the mediastinum is in tended to emphasize the importance of these modalities to the evalua tion of mediastinal disease. In addition, an attempt will be made to integrate into the text the many new and important observations relat ing to all aspects of mediastinal imaging which have appeared in the literature since 1977. The overall emphasis, however, will remain the same: that accurate radiologic diagnosis is based upon a thorough understanding of corre lated radiographic anatomy and pathology. No matter what the imag ing modality, this principle remains fundamental to each and every radiographic interpretation. I would like to express once again my deep appreciation to Dr. Stephen A. Kieffer, Chairman of the Department of Radiology at the State University of New York Health Science Center at Syracuse for his continued support and encouragement."

In July 2008, European and Japanese specialists in neurosurgery, neurology, interventional neuroradiology and neurointensive care joined together to discuss the latest developments in the management of cerebrovascular disorders at the 4th European Japanese Joint Conference on Stroke Surgery, held in Helsinki, Finland. This collection of papers from the meeting deal with aneurysm surgery and management of subarachnoid hemorrhage and stroke, arterial dissection, intracranial arteriovenous malformations and fistulas, and microneurosurgical bypass and revascularization techniques.

Few diagnostic methods in Cardiology have heralded such revolutionary developments as the introduction of coronary arteriography. When, in the early 1960's, Dr. F. Mason Sones demonstrated that visualization of the coronary anatomy in living humans was not only feasible but sufficiently safe and reliable to be used as a clinical tool in the evaluation of patients with known or suspected ischemic heart disease, the thus far somewhat neglected area of coronary circulation became the focus of interest. Naturally, for a considerable period of time a great deal of emphasis was placed upon coronary anatomy. Simple relations between narrowing lesions, impediment to flow, and prognosis were assumed to exist. Spectacular results of surgical coronary revascularization seemed to confirm this concept. Gradually it has become evident that the pathophysiology of coronary artery disease is considerably more complex. Diagnostic methods were introduced to assess and quantify exercise-induced myocardial ischemia. At first, these tests were used mainly to achieve a more discriminative selection of candidates for coronary arteriography and the coronary arteriogram remained the gold standard. Currently, these techniques have evolved to the point where they provide valuable functional and metabolic information. They have become powerful independent tools in clinical investigations and evaluation of individual patients.

A pioneering group of authors describes in this book, for the first time, the state of the art of spinal cord stimulation for chronic critical limb ischemia. This method, a progeny of pacemaking in cardiac rhythm disorders, is a promising, innovative procedure; it presents a modern challenge in treatment of endstage peripheral vascular disease or neuropathic pains. Spinal cord stimulation may have a tremendous future if it further develops to become a standard treatment in special indications.

Over the past 15 years, mechanical valves, and in particular, bileaflet mechanical valves, have made considerable strides in durability and hemodynamic per- formance. However, biocompatibility in terms of thrombo- embolism, thrombosis, and hemolysis has remained an area where improvement is needed. "New Development in Bileaflet Mechanical Heart Valve" discusses advances in these important areas of prosthetic valve function and provides clinical experience with a new open pivot, bileaflet mechanical valve.

Prior to the virtual atomic explosion of medical knowledge, at a time when communica tion was very much slower, a medical book, to be authoritative and believable, had to be written by a very knowledgable, and, per force, usually quite senior person. The choice of texts was limited and tended to be dominated by a few "classic" (a phrase not quite synonymous with dogma). Following the information explosion, the scenario is quite different. Not only is there a geometric progression in the quantity and speed of devel opment of new medical knowledge, but also this development is occurring at very dif ferent rates in different countries. This is particularly true in medical imaging. The result is that it is now virtually impossible to produce a "single author" book that can cover the field or even a subdivi sion of it. This absolute requirement for multiple authors has in turn created the need for a new type of editor/author who must be multinational in approach, have a uniquely informed appreciation of what is going on in medical imaging research throughout the entire world and possess the depth of personal knowledge and experience to judge cor rectly what work is the most rigorous and likely to have the greatest impact."

On the occasion of the inauguration of the Department of Heart Surgery at the Rehabilitation Center in Bad Krozingen, we held under the aus pices of the European Society of Cardiology an International Symposium on March 17 to 18, 1978 with the topic: . "Coronary Heart Surgery - a Rehabilitation Measure" This book contains the papers given at that time. The editors of this book, together with the other members of the sci entific committee - H. Denolin from Brussels, Ch. Hahn from Geneva, and F. Loogen from DUsseldorf - aimed at selecting controversial top ics as well as speakers representing different viewpoints. Thus avoid ing portrayal of an image of a world of coronary bypass surgery in which all problems have found a solution. In keeping with the topic of the meeting, special emphasis was drawn to the long-term functional results of aortocoronary bypass surgery; symptomatic imprQvement be ing, in most patients, significant enough and lasting for at least some years, thus allowing the patients to return to work. However, a combination of social, economic, and psychological factors may hamper optimal rehabilitation, as can be seen from some of the following papers. The incorporation of heart surgery into a rehabilitation center - being the motif of this symposium - may hopefully stimulate a global approach to cardiac rehabilitation which includes surgical, medical, psychological, vocational, and social rehabilitation mea sures. Bad Krozingen, January 1979 H. Roskamm M. Schmuziger Table of Contents 1."

Posttraumatic stump formation and replantation of the severed limb are both reconstructive plastic operations which may lead to the improvement or destruction of a patient's lifestyle. For the primary attending surgeon, the decision whether to undertake such an operation depends on the patient's clinical condition, the operational circumstances, the psychological and social aspects and, last but not least, on the surgeon's own abilities. This monograph is designed as a synopsis of the great number of patho-physiological parameters and surgical and rehabilitational aspects which must be considered in the analysis of complications in major limb replantation. In addition, basic information about the key role of ischemic myopathy and microangiopathy is supplied to encourage further experimental investigations.

Despite a worldwide reduction in its incidence, stroke remains one of the most common diseases generally and the most important cause of premature and persistent disability in the industrialized countries. The most frequent cause of stroke is a localized disturbance of cerebral circulation, i.e., cerebral ischemia. Less common are spon taneous intracerebral and subarachnoid hemorrhages and sinus ve nous thromboses. The introduction of new diagnostic procedures such as cranial computed tomography, magnetic resonance imaging, digi tal subtraction radiologic techniques, and various ultrasound tech niques has led to impressive advances in the diagnosis of stroke. Through the planned application of these techniques, it is even possible to identify the pathogenetic mechanisms underlying focal cerebral ischemia in humans. However, these diagnostic advances have made the gap between diagnostic accuracy and therapeutic implications even greater than before. This fact can be easily explained. In the past, therapeutic studies had to be based on the symptoms and temporal aspects of stroke; it was impossible for early investigations to consider the various pathogeneses of cerebral ischemia. Inevitably, stroke patients were treated as suffering from a uniform disease.

The European School of Oncology came into existence to respond to a need for informa tion, education and training in the field of the diagnosis and treatment of cancer. There are two main reasons why such an initiative was considered necessary. Firstly, the teaching of oncology requires a rigorously multidisciplinary approach which is difficult for the Univer sities to put into practice since their system is mainly disciplinary orientated. Secondly, the rate of technological development that impinges on the diagnosis and treatment of cancer has been so rapid that it is not an easy task for medical faculties to adapt their curricula flexibly. With its residential courses for organ pathologies and the seminars on new techniques (laser, monoclonal antibodies, imaging techniques etc.) or on the principal therapeutic controversies (conservative or mutilating surgery, primary or adjuvant chemotherapy, radiotherapy alone or integrated), it is the ambition of the European School of Oncology to fill a cultural and scientific gap and, thereby, create a bridge between the University and Industry and between these two and daily medical practice. One of the more recent initiatives of ESO has been the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on future developments in specific fields of oncology.

With an emphasis on the "how and why" of contemporary surgery, Operative Techniques in Surgery, Second Edition, features concise, bulleted text, full-color illustrations, and intraoperative photographs to clarify exactly what to look for and how to proceed. Meticulously edited by Drs. Mary T. Hawn, Aurora D. Pryor, Steven J. Hughes, Michael S. Sabel, Kellie R. Brown and Amy J. Goldberg, this comprehensive, two-volume surgical atlas focuses on the steps of each technique, rapidly directing you to the information you need to choose the right approach for each patient, perform it successfully, and achieve the best possible results. Coverage includes open as well as laparoscopic, robotic, endoscopic, and endovascular procedures in gastrointestinal, thoracic, esophageal, colorectal, hepatobiliary, breast, endocrine, dermatologic, vascular, and trauma surgery New, comprehensive section on trauma surgery, helmed by trauma expert Dr. Amy J. Goldberg New section editors for esophageal and foregut surgery and vascular surgery, Dr. Aurora D. Pryor minimally invasive surgery leader and Kellie R. Brown, expert in vascular surgery. New videos, personally selected by contributing authors and editors, accompany numerous chapters throughout the book Extensive updates throughout, including new coverage of the American Board of Surgery's SCORE Curricula for General Surgery and for Complex General Surgical Oncology Each procedure follows the same format: differential diagnosis, patient history and physical findings, imaging and other diagnostic studies, surgical management, techniques, pearls and pitfalls, postoperative care, outcomes, and complications Enrich Your eBook Reading Experience Read directly on your preferred device(s), such as computer, tablet, or smartphone. Easily convert to audiobook, powering your content with natural language text-to-speech.

Controlled and predictable interference with hormonal feed- back mechanisms has become a major direction of preclinical and clinical research. There is a steadily increasing number of hormonal pep tides detected and characterized that are re- sponsible for endo-, para-, and autocrine cellular actions. Naturally, these peptides have been studied with regard to their cell growth stimulatory action and, in parallel, the re- spective antagonists are being investigated in terms of their antiproliferative (antineoplastic) function. Among the numerous pep tides of interest in this respect, somatostatin (somatotropin release inhibitory factor) and bombesin antagonizing factors have been the topic of inten- sive research during recent years. No presentation of the role of pep tides in oncology would be complete without a compre- hensive treatise of their physiological, preclinical and clinical functions in the context of their antineoplastic mechanism of action. Somatostatin and its various short- and long-acting analogs have the unique feature of suppressing and inhibiting a wide range of cellular processes including cell proliferation. Recep- tors for these peptides, which belong in a wider sense to the family of neuropeptides or neurotransmitters, are widely dis- tributed, a feature which is not in keeping with the general view of a growth hormone regulatory system. Thus, these substances are found in the gut in a variety of endocrine and exocrine glands including breast, pancreas, and prostate, and in the nervous system.

After decades of laboratory investigations mechanical circulatory support for the failing heart has entered the clinical arena. Today, a growing number of patients with progressive myocardial failure awaiting cardiac transplantation is successfully bridged to transplantation with ventricular assist devices. The proceedings of the "Mechanical Circulatory Support"-meeting, held in Berlin, October 21-22, 1995, present new aspects of mechanical circulatory support, recent experience with MCS in newborns and children using specially developed small devices, and the results of long-term mechanical assistance. The ability of the myocardium to recover under pressure de-loading and reduced workload is discussed. All these topics open up new perspectives for the use of mechanical circulatory support, not only as a bridge to transplantation, but also as a definitive approach for treating patients with end-stage heart failure. Some of these concepts may even provide real alternatives to heart transplantation, these being sorely needed in light of the severe donor organ shortage. Regulatory as well as ethical aspects of the extended use of mechanical circulatory support systems and new technical developments in the field are discussed by internationally distinguished experts.

Cardiovascular Biomaterials presents current research mate- rial developed by contributors from universities und profes- sional laboratories in the UK, USA, Canada, and Germany, each recognised for their abilities in this field.The book begins with an introduction to the work of developing a new artificial artery, and proceeds through the topics of the problems and developments in heart valve replacements, car- diac assist devices, mechanical properties of arteries and arterial grafts, biostability of vascular prostheses, blood compatibility in cardiopulmonary bypass, collagenin cardio- vascular tissues and the pacemaker system. Researchers, practitioners, graduate students, and libraries will find the book of interest.

It was the genius of Gordon Murray in Toronto that introduced the use of allografts into cardiac surgery in the 1950s. Soon after this on opposite sides ofthe world, Sir Brian Barratt-Boyes in Auckland, New Zealand, and Mr. Donald Ross in London, undertook to use allografts for the replacement of diseased aortic valves. Since that time the global interest in allografts has been patchy, episodic, and without a con sensus. Nonetheless, for the last 20 years at least three groups in the world have steadfastly pursued the development of new and relevant information concerning the use of allograft valves in humans. These are the centres of Sir Brian Barratt Boyes, Mr. Donald Ross, and Mark O'Brien in Brisbane. More recently, talented investigators, including Drs. Yankah, Yacoub, and others, have been developing information concerning the immunological aspects of the use of allografts, as well as their clinical use. No doubt, at present, cardiac valve allografts of one sort or another are the devices of choice for conduits and have an important place in the surgery of aortic valve replacement. Even so, in the mind of this writer at least, the future usefulness of allografts for the replacement of diseased cardiac valves and conduits between a ventricle and the pulmonary artery, remains problematic, and depends upon improvements in other devices for this purpose and upon improve ments that may be made in preparing and using allografts."

This book represents the first European effort to provide a collection of test descriptions used in evaluation of the compatibility of biomaterials in contact with tissues and blood. The urge to compile this book arose from the fact that it is the properties of the material which ultimatively seem to determine the functional outcome of a medical device, almost regardless of how ingenious the construction of the very device is. The longer the exposure is, the more important these basic properties become. Unfortunately only a small part of the interactive phenomena is fully elucidated and understood. This challenge reflects itself in an effort to cover numerous aspects of testing, beginning with fundamental analysis of the material, continuing with the mechanical properties, the resistance to degradation and the analysis of surface and chemical properties including adsorption patterns of proteins ending with test on cell cultures, ex vivo and in vivo. A number of the tests which are generally accepted as being important are already described as official requirements (primarily Pharmacopeas). These official requirements are not included in order to limit the size of the book. It is the aim of this book to present the tests like a recipe in a uniform way to ease the reader in finding his/her way through the material and to present it as a kind of "cook-book" in an order to provide an easy access to copy the procedures. This has unfortunately not been possible in all circumstances.

Coronary heart disease is one of the major health problems in indus trialized nations because of its high incidence and severity. Recent innovations in medical and surgical treatment of coronary heart dis ease have increased the importance of accurate diagnostic methods for determining the severity of coronary disease, identifying potential treatment alternatives, and evaluating the results of treatment. Great advances have also been made in basic research on coronary circula tion and its interaction with myocardial contraction and relaxation and neural and humoral control. With respect to these developments, the papers included in the present monograph deal with important topics concerned with the basic mechanism of coronary circulation as well as ones of clinical relevance. It is directed toward physicians (cardiologists, cardiac surgeons, cardiac radiologists, anestheologists, and others) and basic scientists (e.g., physiologists, bioengineers). We would like to em phasize the importance of a multidisciplinary approach in which basic scientists and clinicians work closely together. This volume consists of nine chapters. Chapter 1 contains macro scopic and microscopic descriptions of coronary vascular anatomy, which is closely related to the functions of coronary circulation. In Chap. 2 two methods in current use to evaluate phasic coronary blood velocity waveforms are presented, i.e., the laser Doppler and ultrasound Doppler methods. Chapter 3 describes the mechanical properties of coronary circulation, a knowledge of which is indispens able for an understanding of coronary arterial and venous blood flow velocity waveforms in relation to cardiac contraction and relaxation."