Thyroid carcinoma is an uncommon malignan ing the available non-human lines, as models cy. In the vast majority of patients, if treated for cell cycle studies and oncogene/anti appropriately, it is associated with a benign oncogene regulation, because they are unaware clinical course. Why then does it hold a con of the often fundamental dichotomy between tinuing fascination for so many physicians? thyroid malignancy and prognosis. Third, the The answer is probably directly dependent very nature of the benign clinical course has suggested to the major health research fund on the very benign nature of most thyroid ing agencies that thyroid cancer is not worthy maligllancies. While there are terrible excep of study in a time of scarce resources. tions, the follicular and papillary thyroid can Nothing could be further from the truth. cers behave in a way quite alien to "common" This gratifying clinical course is the very reason neoplasia, since they grow and metastasize why the study of human thyroid cancer has the slowly. We believe that if only we could under potential for contributing further to our fun stand such a transformed state, we would be able to learn a great deal about the normal and damental understanding of malignancy and, abnormal regulation of the cell cycle and im perhaps more importantly, the mechanisms by prove our understanding of cancer. which the human body can resist neoplastic However, recent advances in the biology of cells."

Distinguishing between CVDs, e. g. , hemangiomas and vascular malformations, often presents special problems. The clinical symptoms can be misleading and di- agnosis requires complete and careful evaluation of the patient's history and in some cases further diagnostic measures. A clear histologic classification is limited to cases in which a surgical resection is indicated and the minimally invasive therapy is no longer possible. However, the diagnosis should be made in a very early stage as the different types of congenital vascular disorders require different types of management. While hemangiomas should be treated in their very early stages, the treatment of some vascular malformations can be postponed until the diagnostic and therapeutic measures are of acceptable risk for the patient. References 1. Belov S, Loose DA, Weber J (1989) Vascular malformations. Einhorn, Reinbeck (Periodica Angiolo- gica 16), pp 19-30 2. Berlien HP, Cremer H, Djawari D, Grantzow R, Gubisch W (199311994) Leitlinien zur Behandlung angeborener GefaBerkrankungen. Paediatr Prax 46: 87-92 3. Finn Me, Glowacki J, Mulliken JB (1983) Congenital vascular lesions: clinical application of a new classification. J Pediatri Surg 18 (6): 894-900 4. Grantzow R, Schmittenbecher PP, Klima-Lange D, Spreng G (199011991) Problematik der Therapie von Riesenhamangiomen. Paediatr Prax 41: 311-320 5. Jacobs AH, Walton RG (1976) The incidence of birthmarks in the neonate. Pediatrics 58 (2): 218-222 6. Philipp e, Poetke M, Berlien HP (199311994) Klinik und Klassifikation angeborener GefaBerkrank- ungen.

The most complete presentation of basic and advanced laparoscopic techniques available, due to its integration of procedures from general surgery and other subspecialities. Enhanced by over 750 illustrations (113 of them in full colour) and written by no less than 132 international, interdisciplinary experts, this definitive reference covers all aspects of this still new and expanding technique. Four main sections deal with: basic laparoscopy; laparoscopy and thoracoscopy in general surgery; laparoscopy in surgical subspecialities (gynaecology, urology, angioscopy); plus the technological aspects of laparoscopy. Throughout this authoritative volume, the surgeon will find in-depth reviews of the literature and extensive clinical and scientific data on the rationale for using laparoscopic procedures.
Certain to become a standard in the field.

Pancreatic Disease: Towards the Year 2000 provides a clear picture of the current research activity in pancreatic disease and its related basic science. Experts currently contributing to advances in understanding and treatment have provided concise and clear reviews of their subject. Each contribution summarises the relevant literature and describes recent advances whilst highlighting those areas where current research will impinge on clinical practice in the next few years. The reader will find in this book all the latest material related to pancreatic disease, cancer, acute and chronic pancreatitis and a number of other topics including transplantation and the relationship between endocrine and exocrine disease and cystic fibrosis. The book will supplement existing texts and will be of value to practising specialists who deal with pancreatic disease as well as specialist trainees in surgery and medical gastroenterology.

Recent Advances in Coloproctology provides a thorough overview of modern developments in the surgical treatment of disorders of the lower intestine including ulcerative colitis/severe acute colitis, Crohn's disease, carcinomas, haemorrhoids and anal incontinence. Recognizing that the surgeon does not work in isolation, the book also integrates recent progress in imaging techniques for the anal canal and rectum, and highlights medico-legal considerations in separate chapters. Aimed at current practitioners and trainees, Recent Advances in Coloproctology discusses key concepts that will assist general surgeons and colorectal consultants in their management of patients with a broad spectrum of anorectal and colonic disorders. With a problem-oriented slant, this book is essential reading for all those with interest in coloproctology.

Endoscopic Sinus Surgery examines the surgical techniques for tackling nose and sinus disease. With the advent of multi-angled endoscopes, better optical instruments and imaging techniques, the impact of endoscopic sinus surgery has been greatly increased in recent years as it considers the problem at its root cause. The book combines a clear, practical text with extensive visual material and many colour illustrations. All aspects of functional endoscopic sinus surgery are covered including an assessment of the technique and a detailed account of both morbid and endos copic anatomy which are important to an understanding of the techniques involved. Post-operative care, complications (and how to avoid them) and radiology of the sinuses are also covered. This is an accessible and practical book for the novice which will broaden diagnostic skill and improve patient care. The many tips included will also aid established surgeons.

Posttraumatic cerebral contusions, lacerations and hematomas in the past could often only be suspected by clinical symptomatology and be visualized by angiography in a restricted manner, but they are now diag nosed with precision through CT and MRI; they remain in the limelight in our daily management of severe head injuries. Stalhammar's longlasting research in biomechanics is he re condensed in a concise review of the current knowledge in this field, thus providing the basis for our understanding of the parenchymal cerebral posttraumatic lesions. The neuropathological investigations and findings remain fundamental to the clinical features, and in this text there is the advantage that they were carried out and interpreted by a very experienced neurasurgeon, Ion Oprescu, who most regretfully died before the completion of this volume. The special morphological and clinical investigations by Nakamura, concerning diffuse brain injury, contribute to our necessary diagnosis and treatment of this phenomenon where, without grass visible lesions of cerebral tissue, a high mortality occurs. The clinical features, the princip1es of therapy and the outcome are described by Vigouroux and Guillermain, whose clinical study clearly demonstrates the limitations of all our efforts in severe brain injuries, in spite of decades of clinical experience and research."

Varicose veins are a very common problem. The precise aetiology of primary varicose veins remains unclear. It seems likely from the available evidence that inherited structural weakness combined with haemodynamic or microcirculatory abnormalities eventually lead to reduced vein wall elasticity, dilatation and the formation of varicosities. Increasing age, female gender, parity and occupation may all promote the development of varicose veins in susceptible individuals. Further clinical and experimental studies are necessary if the relative contribution of each of these factors is to be fully elucidated. References 1. Editorial. The treatment of varicose veins. Lancet 1975;ii:311. 2. Prerovsky I. Diseases of the veins. World Health Organisation, internal communication, MHO-PA 10964. 3. Weddell JM. Varicose veins: pilot study. Br J Surg 1969;23:179-186. 4. Hobsley M. Pathways in surgical management. 2nd ed. London: Edward Arnold, 1986. 5. Browse NL, Burnand KG, Lea Thomas M. Diseases of the veins. London: Edward Arnold, 1988. 6. Logan WPD, Brooke EM. The survey of sickness. Studies on medical and population subjects no. 12. London: General Register Office, 1957. 7. The committee on the Danish national morbidity survey. The sickness survey of Denmark. Copenhagen, 1960. 8. US Department of Health. Education and welfare: national health survey 1935-1936. Washington, DC, 1938. 9. The Department of National Health and Welfare and the Dominion Bureau of Statistics. Illness and health care in Canada. Canadian Sickness Survey 1950-1951. Ottawa, 1960.

It is an honour and a pleasure to welcome you all at this 20th annual International Symposium on Blood Transfusion in the Netherlands. This year you celebrate its 20th anniversary and I congratulate the Staff of the Blood Bank Noord Nederland and especially Dr. Smit Sibinga for this great achievement. As most of you know, the name of the person of Dr. Smit Sibinga is unbreakably con nected with the annual symposium in Groningen which he has organized each year from the very start, 20 years ago. The reputation of any symposium depends heavily on the quality of the lectures. I think it is not possible to organize 20 symposia in a row if the topics lack actual relevance and the speakers are not of excellent reputation. Dr. Smit Sibinga has proven to have a keen eye for selecting interesting themes and eminent speakers. Although a lot of different topics have been dealt with in the past 20 years, which each attracted the attention of a different group in the field of blood transfusion, it is not surprising that after a tradition of 20 years several speakers but also a lot of attendees are not for the first time in Groningen to participate in this event. It gives the symposium a unique atmosphere of intimacy. It is not hard to admit that most of the newer developments in transfusion medicine take place outside the Netherlands."

This user-friendly definitive reference work presents the full spectrum of current cancer treatment options available to the practicing general surgeon or trainee. Through the pairing of 4-color algorithms and concise, clinically oriented text, the reader can quickly visualize and understand the decision-making process. Separate algorithmic branches highlight surgical treatment, adjuvant therapies such as chemotherapy and radiation therapy, as well as combined modality treatment. Over 90 chapters address organ systems from head to toe and tackle special topics, including oncologic emergencies and diagnostic and therapeutic challenges, and surgical adjuncts. More than 200 illustrations augment the textbook.

This book starts appropriately in considering the principles which should govern our care of the injured child and the background factors which influence fracture epidemiology. Knowing how to manage the multiply injured child and recognizing the one who has been non-accidentally injured are essential skills in our specialty. Injuries to the growth plate are not always easy to recognize and manage but, if we fail to do so, the long-term consequences may be serious. Succeeding chapters describe childhood injuries and fractures regionally. Conservative fracture management has not been forgotten amidst the plethora of newer methods of surgical fixation.

Beginning with the scientific basis of tumors, "The Surgery of Childhood Tumors" provides up-to-date information on epidemiology, cytogenetics and molecular biology, before looking at current treatments, integrating surgery, neoadjuvant and adjuvant chemotherapy and radiation therapy. Additionally, a chapter on counseling reflects the book's holistic approach to treating children with cancer.

The chapters are written by world-renowned international authorities on pediatric cancer from major children's cancer groups in the UK, Europe and the US. Contributors discuss geographical variations in treatment for each type of tumor. Excellent full-colour pictures and detailed line drawings illustrate all aspects of managing childhood tumors, including technical details of operation which are often neglected in other texts. This comprehensive book provides a contemporary approach for pediatric, general and urological surgeons dealing with childhood tumors. New chapters in this second edition provide the latest developments and strategies in pediatric surgical oncology.

Every year, in the United States and the third world combined, 13.3 million boys and 2 million girls are circumcised. Whether because of perceived medical, cultural, or religious necessity, most of these parents feel they have no alternative but to allow their children to undergo this surgery. Sparking intense debate, the circumcision of children is a highly controversial and complex phenomenon that touches a variety of sociological areas, such as religious beliefs, identity issues, medical conceptualizations, fear, and superstition. The contributors to this volume comprise an international panel of experts in the fields of medicine, psychology, law, ethics, sociology, anthropology, history, theology, and politics. In 18 chapters they discuss the history of circumcision; document the physical and psychological consequences of circumcision; present the latest anatomical discoveries about the male prepuce; analyze the role of circumcision in various traditions; reveal the medical industry's investment in the practice; describe current legislative efforts to protect children from circumcision; and outline effective, culturally sensitive methods that are being implemented today to safeguard the human rights of at-risk children. For its insights into this troubling aspect of culture, Understanding Circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem is a critically important contribution to the growing body of literature on this subject.

Combining the clinical expertise of internationally renowned specialists with the latest research and surgical techniques, this detailed reference guides the reader through the wide range of applications for minimally invasive surgery in urology, as well as the many diagnostic and therapeutic procedures utilizing minimally invasive technologies.

Laparoscopic Colorectal Surgery, Second Edition is fully revised and updated and reflects an authoritative, team-oriented approach to the latest state-of-the-art laparoscopic colorectal procedures and surgical techniques. Written by pioneers in the field, this text will supply surgeons with all the information necessary to accomplish advanced laparoscopic procedures. Comprehensive discussions of positioning, instrumentation, cannulas, surgical techniques, special considerations, and considerations in cancer surgery are featured for a wide variety of major operative procedures.

This new Second Edition includes updated information on laparoscopic colorectal procedures, including hand-assisted laparoscopic procedures and new chapters on the physiology of pneumoperitoneum, laparoscopic anatomy of the colon and rectum, and evidence-based discussion of outcomes. The text is complemented by over 200 line drawings created exclusively for the textbook.

In 2006, when my colleague Andrea Renda proposed multiple primary malignancies (MPM) as the subject of the Biennial Report to the 2008 Congress of the Italian - ciety of Surgery, I, together with the Steering Committee, quickly agreed. Recent progress in our understanding of the etiopathology of these neoplasms has led to - novative and significant progress on the clinical level. Importantly, the incidence of the onset of two or more tumors in the same patient suggests a more than casual - lationship. Furthermore, the occurrence of MPM derives from several different me- anisms-viral, iatrogenic, immunologic, environmental, and hereditary-such that any form of treatment must take into account the etiology of these tumors. After an epidemiological introduction, this monograph analyzes various aspects of multitumoral syndromes based on the experience of the Department of Surgical Sciences, along with that of other clinical departments of the University Federico II of Naples. In the discussion of inherited tumors, reference is made to the series of patients treated at the Department of Surgery at the University of Siena. The many topics that comprise this volume range from carcinogenesis to diagnostic strategies, and from epidemiology to innovations in imaging and endoscopic techniques. Among the clinical aspects, particular emphasis is given to sporadic and hereditary syndromes, as these patients are frequently treated by general surgery departments.

Who owns your sex organs? Different cultures today and in different epochs have given a variety of answers to this question. It may seem self evident that every individual owns and has sovereignty over his or her own body parts, such as the head, legs, nose, stomach, pancreas, and other body parts. The sex organs, however, seem to be an exception. Even though they are as much an integral part of the individual as a leg or a liver, the sex organs are unique in that many cultures have established laws and taboos over the use and even the mere display of the sex organs. Thus, certain cultures have placed constraints over the individual's ownership of his or her sex organs and actively regulate and restrict the individual's access and use of those organs. In other cultures, the question of ownership of the sex organs is more decisively answered. In any culture where circumcision to any degree of either the male or female is practiced, permitted, encouraged, or even merely tolerated, it is clear that the individual is not considered to own his own sex organs. In the United States today, the medical establishment has created an is considered acceptable and desirable that anyone for environment where it any reason can authorize or execute the amputation of the foreskin from a male child's penis."

Surgery continues to be the most effective treatment of solid tumors in terms of recovery, while its combination with other treatments improves the survival curves especially in the advanced forms of the disease. The aim of my task first of all has been to provide readers with both the current and constantly evolving pathophysiologic knowledge required for building the foundation of a specific education enabling surgeons to meet the fundamental targets in surgical oncology. Secondly, this volume aims to present an update on the real possibilities offered by the cooperation between surgeon and pathologist and by chemotherapy, radiotherapy and gene therapy in the treatment of tumors in the light of the most recent scientific achievements. Lastly, the report presents the experiences and cases drawn mostly from our School regarding some of the major issues in oncologic surgery. This overview does not pretend to elucidate or to summarize all aspects of oncologic surgery, but rather to be the result of a general consideration on cancer surgery, on its rational bases, on its interaction with other treatment modalities, on its desirable and expected developments and on its probable future evolution.

Most surgeons are familiar with the techniques of laparoscopic surgery, however, in children there are variations in size and technical appraoch. The book describes the differences and characteristic aspects of laparoscopy in small children. The emphasis is on little text and numerous drawings. Technical guidelines are given on how to perform laparoscopy safely even in small children. The most frequent indications for laparoscopy in children are presented and discussed. The aim of the book is to provide surgeons with the knowledge to extend their expertise in adult laparoscopy to children.

New developments in the field of the commonly used photodiagnostic and phototherapeutic methods help to continuously improve the results in the daily practise. Edited by internationally renowned experts, the new edition offers up-to-date, comprehensive and clinically relevant information on every aspect of photodiagnostic and phototherapy. The book is structured in following parts: Photochemotherapy in daily practice, special phototherapeutic modalities and photoprotection in daily practice. Due to the detailed structure this new edition is even more reader-friendly and has a strong focus on clinical aspects. It includes: Guidelines for the treatment selections of specific diseases, practical guidelines for phototherapy with information about basic principles of photobiology, standardized test protocols for photodermatoses and diagnosis for skin tumors.

This text covers new innovations and concepts in pediatric thoracic surgery practice, basic science and evidence, and the technical aspects of common and rare operative procedures.

It is essential for pediatric surgical trainees and consultants with interest in pediatric thoracic surgery. Providing comprehensive coverage of newer developments, it is also a useful reference work for pediatric and thoracic surgeons and a valuable guide for surgeons (adult or pediatric) managing pediatric thoracic surgery on occasional basis or only during acute emergency.Covering the subjects within pediatric thoracic surgery (non-cardiac) in significant depth, this book acts as a reference text for consultants undertaking pediatric thoracic work as well as for pediatric respiratory, anesthetists and fetal medicine doctors. Topics within this book will also be of interest to pediatric respiratory physicians and pediatric oncologists.

This book is an organized approach to understanding bone growth and disease. It integrates anatomic and radiologic knowledge of enchondral and membranous bone growth and emphasizes the similarities of the physis and acrophysis in development. The artwork, jointly produced by artist and author, illustrates the concepts described. The identification of abnormality is aided by the explanations of the causes in terms of pattern recognition.

The only book to deal specifically with constipation for specialists has been updated to include all the new advances since the first edition (1995). These advances include biofeedback, surgery for constipation, sacral nerve stimulation, the use of laparoscopy for rectal prolapse, treament and our understanding of some of the psychological problems of these patients. Innovations also include Professor Norman Williams Malone Procedure and the newer pharmacologic treatments such as nitric oxide and botulinum toxin injections.

This book provides detailed guidelines to any physician treating patients with emergency vascular disorders. These might include ruptured abdominal aortic aneurysms, acute limb ischemia, vascular trauma, iatrogenic vascular injuries and complications to vascular surgery. The book provides an introduction to vascular surgical operations and focuses on how to manage patients. Numerous figures illustrate the particular points in vascular techniques and diagnostic problems in the emergency situation. This is an indispensable guide for all surgeons dealing with vascular emergencies.

Surgery of the Esophagus and Stomach provides an illustrative, instructive, and comprehensive review that depicts the rationale of basic operative principles essential to surgical therapy of the esophagus and stomach. The chapters provide pertinent and concise summaries of how to deal with various esophagus and stomach disorders, spanning benign and malignant problems and minimally invasive procedures. Stages of operative approaches with relevant technical considerations are outlined in an easily understandable manner. Complications are reviewed when appropriate for the organ system and problem. The text is illustrated throughout by line drawings and photographs that depict anatomic or technical principles. A concise, handbook-sized reference work, this book is a valuable resource for all general surgeons and residents in training.