Apart from the articles on history and nursing, the con- ditions discussed include Mediastinal Masses in childhood seen from a Pathologist's point of view, Intrapulmonary se- questration, lymphangiomata involving the neck as well as thorax, unusual forms of Diaphragmatic Hernia and Congenital Heart Disease. Such a volume would hardly be complete with- out some references to Oesophageal Atresia and one article discusses The Influence Of Anatomy And Physiology On The Ma- nagement Of Oesophageal Atresia.

This book represents the proceedings from a conference that took place in Dallas in the spring of 1999 which was entitled "Pediatric Gender Assignment - A Critical Reappraisal". Some participants rightfully argued that the conference really focused on the issue of pediatric gender assignment, and that reassignment was not applied in most cases. Their comments were reflected in the title of this monograph. This multidisciplinary meeting was sponsored by a conference grant from the National Institutes of Health, and a broad inquiry into this complex topic took place from many points of view. Basic scientists offered insight into mechanisms of sexual differentiation of the gonads, physical phenotype and imprinting of the central nervous system. Endocrinologists reviewed their experience in diagnosis and management, surgeons described traditional as well as innovative approaches, and there was strong representation from the ethical and behavioral sciences. In putting together such a panel, it was essential that we identify a cast of speakers who could address their viewpoints with strong convictions, and yet not let their passions render the meeting counter productive. We were not disappointed. While many differing points of view were firmly expressed by the panelists and audience, all viewpoints were accorded the respect they deserved. The concept behind the meeting and this book really originated in 1997 shortly after Diamond and Sigmundson published their long term follow up study of the John/Joan case.

The advent in the 1960s of the unique and exciting new form of energy called laser brought to medicine a marvelous tool that could accomplish new treatments of previously untreatable disorders as well as improved treat ment of mundane problems. This brilliant form of light energy is many times more powerful than the energy of the sun yet can be focused microscopically to spot sizes as small as 30 microns. Lasers can be directed into seemingly inaccessible areas by mirrors or fiberoptic cables or can be directly applied into sensitive areas such as the retina without damage to intervening structures. There has been a rapid proliferation in the use of lasers in all surgical specialties. Starting with bold ideas and experiments of "thought leaders" in each specialty, the application of lasers has evolved into commonplace usage. Beginning with the era when laser presentations and publications were an oddity, now nearly all specialty areas have whole sections of meetings or journals devoted exclusively to laser usage. Laser specialty societies within a specialty have developed and residency training programs routinely instruct trainees in laser techniques. Basic science and clinical experimentation has supported laser knowledge. Laser usage has also become international. Newer wavelengths and accessories have added to the armamentarium of laser usage. Despite the rapid growth in laser interest, no single source exists to instruct the many new laser users in proper, safe, and effective use of this new modality."

Professor Philip Bromage From the earliest stirrings of modern surgical anesthesia, novice surgeons struggling to learn from the living what there was a strong intuitive feeling that anesthesia of part they were denied an opportunity to learn from the dead_ of the body would be better for the patient than complete But that is largely nostalgia for a past era_ Today, the visual anesthesia of the whole organism. In 1848, James Young arts and the plastics industry have united to give us superb Simpson spent some time and effort seeking this elusive teaching models and techniques that did not exist a few goal, but after a few ingenious though unsuccessful experi decades ago, and they have developed two- and three ments, he gave up the search and turned back to general dimensional surrogate cadavers that are imbued with a anesthesia as the only practical solution to surgical pain more vivid artistry than ever existed on the marble slabs relief at that time_ amid the formalin reek of our old dissecting rooms_ earl Koller's simple but brilliant application of cocaine to This book is a fresh and highly successful attempt to repair some of the bridges that were burnt with the passing of the the eye in 1884 opened the door to a whole new universe of neural anatomy and pharmacology_ Within a decade or old anatomy days_ Together, the authors have contributed"

Professor George Fegan is a world authority on the use of sclerotherapy for the treatment of varicose veins. His technique for injecting varicose veins is regarded by many to be the best method for achieving success with sclerotherapy. Professor Fegan first published his method in 1963. This book is an update to his previous work and describes his method step by step as well as relevant information on the anatomy, physiology, pathology and investigations of varicose veins. Sclerotherapy is finding its place as an effective weapon in the phlebologist's armamentarium, and its indications are becoming clearer. All involved in the care of patients with venous disease will find this an invaluable read.

Alessandro Condivilla of Bologna first attempted a resection of the head of the pan creas in 1898, but several decades of further trial-and-error attempts ensued before the prototype procedure of pancreatoduodenectomy (PD) was established by Whipple in 1935. In the half-century following that landmark, refinements of surgical technique, including pancreatico-and bilio-entero anastomosis as well as develop ment of new technology to support perioperative management and patient care have contributed to the decrease in mortality and morbidity rates for obstructive jaundice and pancreatic fistula. The improvement in mortality and morbidity rates associated with PD has led to an increase in the number of patients undergoing the procedure and in the number of institutions performing it. Indications for PD have also been expanded. In the early years after PD was established as a viable procedure, periampullary carcinoma was the most common indication; now PD is indicated for a number of benign and malignant diseases. Some surgeons believe that PD is the procedure of choice for certain types of chronic pancreatitis, pancreatico-biliary maljunction, and pancreatic and duodenal trauma. Other surgeons have reported the necessity of PD for lymph node dissection of gallbladder carcinoma. Consequently, the basic procedure has been greatly modi fied to accommodate the specific conditions of each disease. For patients with malig nancy, extended procedures have been developed to improve the curative resection rate and ensure complete lymph node dissection."

The result of a European-American co-operation, whose joint efforts have dramatically reduced the rate of recurrent groin hernia, burst abdomen and incisional hernia in patients.
The contributors to this updated volume are among the most renowned specialists in the field and here they present personal accounts of the once controversial techniques they have now perfected.
New sections have been added to include such revolutionary techniques as prosthetic mesh and laparoscopic surgery.

Both the investigation and treatment of cancer of the oesophagus are comprehensively presented in Management of Oesophageal Carcinoma. This information is otherwise not easily available in one source. The chapters are written by experts in the fields of anatomy, cancer research, radiology, and thoracic surgery and give up-to-date information on this difficult disease. All aspects are covered: anatomy, epidemiology, endoscopic and radiologic diagnosis, pathology, surgical treatment, radiotherapy, palliative and laser therapy, and the management of complications. Surgeons will be especially interested in the discussion of the recent technique of oesophagectomy without formal thoracotomy, and the use of stapling devices. This complete reference is ideal for all clinics and medical centers specializing in thoracic surgery or treatment of oesophageal carcinoma.

Bone Metastases brings together the many recent developments that are gradually improving the prospects for patients with secondary involvement of the skeleton in a primary cancer elsewhere. The morbidity from bone metastases is extensive, and the palliative and supportive treatment that sufferers require for many months or even years constitutes a major health problem. A multidisciplinary approach is essential since a variety of specialists are involved: radiation and medical oncologists, general and orthopaedic surgeons, general physicians, radiologists and nuclear medicine physicians, symptom control and terminal care specialists. The book's editors, themselves authorities in the fields of oncology and bone disease respectively, have brought together experts from all these disciplines to provide comprehensive coverage of metastatic bone disease. They cover the biology and pathophysiology, hypercalcaemia, imaging, assessment of response to treatment, types of treatment (systemic, radiotherapy, surgery), and symptomatic and supportive care. Particularly new approaches included are magnetic resonance imaging, the assessment of skeletal response and isotope therapy.

Endoscopic surgery in children is a rapidly expanding field in pediatric surgery. This book represents the state of the art, and explains why endoscopic surgery in children is so important. General aspects are discussed and detailed information is provided on many specific operations both in the chest as well as in the abdomen, including endoscopic treatment of throracic scoliosis, of urogenital conditions, and of neurosurgical conditions. Application of endoscopic techniques in oncology is discussed as well. A special chapter deals with complications.

In an attempt to attain the best possible delimitation of all the problems posed today by benign diseases of the esophagus, 181 authors each agreed to answer one or more of 210 questions that had been drawn up on the subject. These questions, each one deliberately limited and difficult, mostly concerned reflux esophagitis: its natural history, the means of its diagnosis, all existing treatments, and its eventual degeneration. The authors approached are today's most reputed specialists in the fields of epidemiology, gastroenterology, endoscopy, pathology, and surgery of esophageal diseases. The authors were all assigned one or more questions in their own field, none of which was simple: all did their best to synthesize in their replies their own experience on the precise point under review and included all the most useful bibliographical references on the topic. The book is thus the result of an original, individual approach to try to pinpoint the heart of a problem. The 210 answers succeed one another in logical progression according to the different diagnostic and therapeutic stages, specifying, at each step, the degree of precision sought. Consequently, the reader has at his disposal an exceptional synthesis of facts and concepts. Opening the book at random he will find at once the detail he is looking for, the professional opinion he is lacking, or the development of a question he had perhaps not yet asked himself.

Recent developments have favourably and extensively altered general surgical practice. As editor I have happily been able to select certain topics of new and major interest for detailed discussion and have thus had the opportunity to collect these authoritative submissions within the covers of one text. The range of topics is broad. Endoscopy has changed the nature of both investigation and treatment of much gastrointestinal disease and the therapeutic uses of endoscopy continue to grow. That sophisticated new tool of the radiologist, computerized axial tomography, has revolu tionized the diagnosis of intra-abdominal disease, very often permitting precise localization of hitherto occult disease, and, as might be expect ed, it has become helpful in determining both the nature and extent of surgical and other therapy. Although an invasive procedure, intra abdominal angiography has similarly come of age as a means of localiz ing gastrointestinal haemorrhage and controlling such bleeding. Unfortunately, intra-abdominal malignancy continues to be a major source of concern to the general surgeon and the discovery that such tumours are associated with unusual markers, termed oncofetal anti gens, suggests that early diagnosis and early detection of recurrence may yet be feasible. Adjuvant or post-surgical therapy is an exciting de velopment in terms of prolonging the disease-free interval in women with breast cancer limited to regional lymph nodes. Equally efficacious therapy is not yet available for patients with gastrointestinal cancer, highlighting the need for more specific drugs and drug combinations."

Pelvic pain in the female patient is common in gynaecological practice, but the specialties of general surgery, urology and orthopaedics provide a significant number of patients and problems. These patients may suffer a multitude of symptoms, and only careful analysis and investigation of each individual problem by the doctor concerned will lead to correct diagnosis and management. The subject matter of this book lies in the practice of many specialties, and all are combined here in a coherent whole. This emphasises the close collaboration necessary between family practitioners, junior hospital staff and consultants. The authors are consultants who work together in a busy district general hospital, and their experience and collaboration is evident in the approach to the diagnosis and management of pelvic pain in the female. Emphasis is laid on the careful evaluation of history and examination and the correct interpretation of diagnostic investigations. Full details of radiology, ultrasound scanning, endoscopy, peritoneoscopy and bacteriological investigation are given. Full consultation between members of staff who have special experience in these investigative procedures is of paramount importance. Details of treatment for relief of pain are important to all doctors concerned with this aspect of clinical management. and this section will be of particular value. The blending of these specialties allows full consideration of the problems affecting the patients. Careful management leads to better treatment for the patient and better satisfaction for the doctor.

Although the number of published papers on traumatic hip disloca tion in childhood is large, our actual current knowledge on this inju ry in this age group is still full of obscure points and unsolved prob lems. Luxation of the hip of traumatic origin in children is infrequent, and the small number of cases reported by authors and institutions, as well as the usually short follow-up in many cases, are responsible for the many doubts and questions, especially related to complications and outcome following the injury. Consequently the treatment, especially the postreduction management, has not been adequately defined. Dr. Antonio Barquet has made the great effort to analyze the ex perience gained from 38 cases in Uruguay and to review more than 500 references related to the subject, covering more than 1400 cases. He began to study this topic in 1976. It was the subject of his postgraduate monograph in 1979, which was followed by a statisti cal analysis of the major complication, i. e., avascular necrosis of the proximal femoral extremity, which was presented as his doctoral thesis in 1981. In addition, he has published numerous papers deal ing with several aspects of traumatic hip dislocation in children."

Inflammatory dieseases of the pancreas occur with increasing incidence in western industrialized countries. This volume deals with all aspects of CHRONIC PANCREATITIS including epidemiology, etiology, morphology and pathophysiology, dia- gnostic imaging as well as conservative and operative treat- ment. Very recent data based on experimental and clinical research projects are presented. The contributions have all been written by a team of internationally well recognized authorities in the various fields involved. Topics of parti- cular interest include feed-back regulation, new aspects of conservative and interventional treatment as well as modern surgical approaches including organ-preserving procedures.

Material for this book was gathered in the early 1980's in Manchester, where a higher incidence than usual of complications in the gastro-intestinal and urinary tract was observed. Part I describes the principles and methods of radiotherapy for pelvic tumours, pathological features and radiological analysis of bowel and urinary tract changes. Parts II and III are devoted to clinical assessment and management, where the need for a multi-diciplinary approach is emphasized.

In 1988 we presented our Guide to Bone Marrow Transplan tation. The reception has been enthusiastic and we have re ceived a flood of critical comments, suggestions and requests to provide an update in due time. Although several books on marrow transplantation have recently been published, their scope and goal have generally been different. Hence, we have decided to prepare a second edition of the Guide. Our aim was to maintain a short, concise text which never theless would incorporate changes that have occurred over the past four or five years. We have streamlined the description of pretransplant considerations, by condensing two sections into one (Treatment Planning and Timing of Transplantation). This also facilitated the review of controversial indications for marrow transplantation, for example in patients with acute myelogenous leukemia in first chemotherapy-induced remission. We have updated the chapter dealing with conditioning regimens and have expanded the section on donor selection, in particular in regard to the current level of tissue typing and the identification of unrelated volunteer donors. In the chapter on collection, processing, and infusion of marrow, we have incorporated recent developments, for example, the use of closed systems for marrow harvesting and processing and the use of solid phase separation of stem cells."

This book reviews the most recent developments in the patho- physiology and therapy of ventilatory failure. It contains contributions by twenty-five internationally recognized aut- horities on respiratory muscle function and investigators actively contributing to our knowledge of the cause, diagno- sis and therapy of ventilatory failure. Of particular inter- estare the descriptions of new modalities of partial and complete ventilatory assistance as well as new knowledge re- garding ventilatory control and fatigue during stressful breathing. The reader will find here a state-of-the-art re- view of the latest research and practical applications in this most critical area of intensive care medicine.

Besides the mortality rate the value of an operative procedure is measured against the incidence and the degree of undesirable postoperative sequelae. In the surgical treatment of gastroduo denal ulcerations vagotomy is now competing with the success fully established resection therapy. Since this latter method has been further developed during the last years and late results are rare, a comparison between both types of operation is difficult. Meritoriously, the authors have tried to perform a comprehensive analysis. Due to the complexity of postoperative syndromes the diagnostic procedure and treatment can be successful only after integrated cooperation by gastroenterologists and surgeons. This is documented by the current monograph which originates from a cooperation of several years and an active exchange of scientific will facilitate the indica and practical experience. The monograph tion for the primary surgical procedure by critical confrontation of the postoperative syndromes and provide advice in treating postoperative complaints. We hope that the monograph will have the expected impact, which means the spreading of the actual knowledge of post gastrectomy and postvagotomy syndromes.

Surgery an essentially manual exercise in its early days, has progressively grown richer in complementary techniques helping the surgeon to perfect his movements and increase efficiency. This is particularly the case with digestive surgery, which has been thoroughly transformed by radiology, endoscopy and extemporaneous examinations effected during surgical intervention. Such methods make it possible for surgeons to develop subtle nuances in operative techniques and to specify indi cations more and more precisely. Ultrasonography must now be included among such techniques. It supplements them and can sometimes even replace them. For these reasons, this work devoted to the use of ultrasound by the surgeon during surgical intervention is of great interest. Two general conditions had to be met before ultrasonography could be em ployed in abdominal surgery: the method and apparatus had to be adapted to its surgical utilization, and the surgeon had to adapt to a nonsurgical technique. The first condition has been fulfilled for all purposes. Intraoperative sonograms can be generated at a very high rate and are proving to be more and more useful. The miniaturization of probes permits their application almost everywhere with opti mal results. Of course, the costs are still high, but one can expect them to decrease.

Over the past ten years, carbon dioxide laser surgery has made impressive strides and is now applied to every field of surgery without exception. It is the intention of this book to record the work done in this field in the Department of Plastic and Maxillofacial Surgery of the Beilinson Medical Center and Tel Aviv University Medical School, Israel, as well as that performed in association with other depart ments. In this context, one feels that it is incumbent upon one to acknowledge the cooperation of the medical and paramedical staff of the Department of Plastic and Maxillofacial Surgery of the Beilinson Medical Center, as well as that of Prof. Yehuda Shindel and Dr. Daniel Katenelson of the Department of Ear, Nose and Throat, Dr. Y ona Tadir of the Department of Obstetrics and Gynecology and Dr. Itamar Kott of the Department of General Surgery. I should like to make special mention of Dr. Ralph Ger of New York, who worked with me on the original clinical trials, and the engineer Uzi Sharon, who developed the Sharplan Laser with me. The progress of Laser Surgery is well demonstrated by the participation in the four meetings of the International Society for Laser Surgery, the first of which was held in Tel Aviv in 1975 with an attendance of 65 and the last in Tokyo in 1981 with an attendance of 1200.

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.

One out of every two men over eigthy suffers from carcinoma of the prostate.It is discovered incidentally in many patients with an alleged benign prostatic hyperplasia. In treating patients, the authors make clear that primary radical prostatectomy is preferred over transurethral resection due to the lower complication rate.

Leading medical ethicists, theologists, lawyers, transplant surgeons and physicians discuss 5 major ethical topics concerning the transplantation of human organs.

Rapid developments in this successful diagnostic and operative technique have called for a new edition of "Arthroscopy of the Knee Joint." This second edition has been completely revised and retains very little material from the first edition. The diagnostic section has been considerably expanded and elucidated and the operative section adapted to modern technology. The first part of the book presents the external conditions and pre-requisites for diagnostic arthroscopy. The endoscopic anatomy and pathology of the knee joint are covered in detail. Particular emphasis is placed on practical hints for accurate arthroscopic procedures. The second part then discusses operative techniques. The reader discovers step-by-step how and which pathological findings should, in the author's opinion, be treated. Here, too, the problems and possible complications of arthroscopic surgery relevant to the individual techniques are dealt with in detail. Equipped with this book, the reader will be thoroughly informed on all current arthroscopic methods and possibilities.