Volume 10 of Advances in Disease Vector Research consists of seven chapters on vectors that affect human or animal health and six chapters on plant pathogens and their vectors. In Chapter 1, Yasuo Chinzei and DeMar Taylor discuss hormonal regulation of vitellogenesis in ticks. Many blood sucking insects and ticks transmit pathogens by engorgement, which induces vitellogenesis and oviposition in adult animals. To investigate the pathogen transmission mechanism in vector animals, information on the host physiological and endocrinological conditions after engorgement is useful and important because pathogen development or proliferation occurs in the vector hosts at the same time as the host reproduction. Chinzei and Taylor have shown that in ticks, juvenile hormone (JH) is not involved in the endocrinological processes inducing vitellogenin biosynthesis. Synganglion (tick brain) factor(s) (vitellogenesis inducing factor, VIF) is more important to initiate vitellogenesis after engorgement, and ecdysteroids are also related to induction of vitellogenin synthesis. In their chapter, based mainly on their own experimental data, the authors discuss the characterization of main yolk protein, vitellogenin (Vg) , biosynthesis and processing in the fat body, and hormonal regulation of Vg synthesis in tick systems, including ixodid and argasid ticks.

A HISTORY OF MALIGNANT HYPERTHERMIA Malignant hyperthermia (MH) is a hereditary disorder of muscle. Undoubtedly, individuals have possessed this trait since time immemorial. However, because the trait is usually only unmasked in the presence of potent inhalational anaesthetic agents or non-depolarizing skeletal muscle relaxants, the existence of malignant hyperthermia was not suspected until we" after the dawn of the modern anaesthetic era. In the early years of ether and chloroform anaesthesia, monitoring was minimal. Body temperature was never measured. A finger on the pulse, and observation of respirations and skin colour were the most that could be expected. Death was not infrequent and usually unexplained (1). By the beginning of the twentieth century, reports of fulminant fever and tachycardia (rapid heart rate) during or immediately after anaesthesia often ending in death, were being described with increasing frequency in the medical literature (2-6). As a number of cases from New York had occurred during summer months, they were initially thought to be a form of heat stroke due to overly hot operating theatres (2-6). However, one enterprising anaesthetist (5: ' checked the weather reports for the days on which some of these so called "heat strokes" had occurred. He found that on the days i'n question the ambient 0 temperature had never been in excess of 72 F. Environmental heat, therefore, could not have been a cause of at least some of these reactions.

A concise yet complete overview of the treatment of cardiovascular instability in the critically ill patient. The authors consider all aspects, ranging from basic physiology and pathophysiology to diagnostic tools and established and novel forms of therapy. The whole is rounded off with an integration of these principles into a series of clinically relevant scenarios.

After a long period of neglect, the gastrointestinal tract is increasingly being recog nized as an important target of anesthetics and anesthesia-related processes, as well as of conditions and treatments related to peri- and postoperative period and inten sive care. Drugs used in anesthesia and intensive care and physiological or pathologi cal changes in the perioperative period affect the digestive system in its function from the pharynx to the colon. Prolonged postoperative ileus or stasis of propulsive peri stalsis in the critically ill or multiply injured patient may impair enteral nutrition and give rise to complications such as sepsis or multiple organ failure. In view of this new understanding of the clinical relevance of gut function, we felt that a book on problems of the gastrointestinal tract in anesthesia, the perioperative period, and intensive care was badly needed. The present volume is the product of an international symposium which brought together physiologists, pharmacologists, experimental and clinical anesthetists, gastroenterologists, surgeons, and intensive care physicians to discuss all major contemporary aspects of bowel function in health and under the influence of anesthesia, surgery, and intensive care."

The very first international working discussion on slow infections of the nervous system was entitled "Slow, Latent, and Temperate Virus Infec tions" and was held at the National Institutes of Health (NIH) in December 1964. The primary impetus was the discovery and investigation of kuru in New Guinea by D. Carleton Gajdusek, M. D. This working discussion brought together investigators in human and veterinary medicine, virolo gists, microbiologists, and neuropathologists actively engaged in laboratory work with viruses that illustrated properties of latency, masking, slowness, or temperateness, with emphasis on subacute and chronic neurologic dis eases of unknown etiology. In the Preface to the monograph of published papers presented at the working discussion, Gajdusek and Gibbs wrote the following: After microbiology had given solution to the etiology of most acute infections of the central nervous system and after fungi and bacteria had been incriminated in impor tant chronic disorders of the nervous system such as torula and tuberculosis men ingitis, we have been left, in neurology, with a wide range of subacute and chronic affections of the central nervous systems of unknown etiology. Some of these diseases, still listed as idiopathic, are among the most prevalent afflictions of the central nervous system. Many others with familial patterns of occurrence do not yet have their basic pathogenesis or underlying metabolic defect elucidated, although we tend to think of them as genetically mediated."

Our aim in this volume, as in Volume I, HormonaI Correlates of Behavior: A Life Span View, has been to provide a critical assess ment of the state of behavioral endocrinology as weIl as the more usual summary of extant data. Each contributor was asked to probe the strengths and weaknesses of his area as candidly as possible. As aresult, we hope the reader will find this Volume useful as a reference source and as an honest evaluation of our present know ledge of the interaction between hormones and behavior. R. L. Sprott Bar Harbor, 1975 B. E. Eleftheriou v CONTRIBUTORS Robert Ader, Ph.D., Department of Psychiatry, University of Rochester Schoo1 of Medicine and Dentistry, Rochester, New York 14642. F. R. Brush, Ph.D., Experimental Psychology Laboratory, Syracuse University, Syracuse, New York 13210. Robert M. Benson, M.D., Pediatric Endocrine Clinic, Children's Medical and Surgical Center, The Johns Hopkins Hospital and University, Baltimore, Maryland 21205. John J. Christian, Sc.D., Department of Biological Sciences, Univer sity of New York at Binghamton, Binghamton, New York 13901. David A. Edwards, Ph.D., Department of Psychology, Emory University, Atlanta, Georgia 30304. Carl Eisdorfer, Ph.D., M.D., Department of Psychiatry and Behaviora1 Sciences, School of Medicine, University of Washington, Seattle, Washington 98101. Basil E. Eleftheriou, Ph.D., The Jackson Laboratory, Bar Harbor, Maine 04609. Merri11 F. Elias, Ph.D., Department of Psychology and All-University Gerontology Center, Syracuse University, Syracuse, New York 13210.

With the advent of enzyme histochemistry, which this field and simplistic theories will be expanded or revealed hitherto unseen pathological differences discarded. between muscle disorders, muscle biopsy assumed Diseased muscle cells, as any other cell type, show an important diagnostic role. The investigation is easily only limited morphological changes. However bizarre, performed and is being undertaken with increasing very few of these changes, if any, are pathognomonic of frequency. Nevertheless there is still a tendency to a single disease. The exact significance of microscopic regard its interpretation as highly specialized and out findings is to a large extent determined by their clinical side the province of the general histopathologist. In this context. Thus, although this is an atlas, it is definitely atlas I have tried to lift the veil of neuropathological not designed to promote 'spot' histological diagnoses. I mystique and to describe and illustrate the basic have aimed to provide a guide to pathological reactions reactions of muscle cells. of muscle which will be useful to the practising histo Interpretation of the biopsy depends not only upon pathologist and all students of neuro-muscular disease. recognition of morphological abnormalities, but upon I hope that recognition of the lack of specificity of understanding why they occur. Throughout the atlas I individual morphological features will encourage the have attempted to correlate morphological changes . close clinico-pathological correlation which is essential with pathogenetic mechanisms."

Clinical research represents an integration of many procedures from the social, biological, and natural sciences. Critical examination of the spectrum of medical inquiries will reveal the full gamut of research activities. Under standing the processes involved in the integration of these investigative and cognitive functions may lead to further advances in creative behavior. The purpose of this book is to formalize this process by identifying, collecting, and organizing the elements and issues involved. During the past thirty years, there have been significant advances in research methodology, many of them stimulated by multi-disciplinary collabo ration. The anticipated barriers to communication were not realized in prac tice. Scientists engaged in mutual problem-solving could accomplish more than their colleagues working in relative isolation. In the, r productive fashion, these multi-disciplinary teams, by pooling their knowledge sets and by devel oping communication mechanisms, created the interfaces between the clini cal, analytical, and communication sciences. These interfaces, while neither complete nor perfect, represent the methodology of interest in accomplishing the capture, evaluation, and utilization of information, or Information Process ing. The list of contributors to this methodology is virtually endless and we acknowledge their enormous and significant efforts."

An ever greater number of our contemporaries will reach a very much greater age than their ancestors. Longevity is one of the most fertile fields for paradoxes: it is clear that the same causes do not produce the same effects at the age of ten and at the age of one hundred! On the subject of longevity, the "recipe book" is far from having been written. Nevertheless, the Fondation IPSEN has chosen a few of these paradoxes to discuss and try and explain them.

Now, in one volume, the latest research from the areas of molcular biology, neurochemistry and behavior analysis of drug abuse and dependence, with, wherever possible, an integration of the data from these various levels of analysis. The ensuing reports point to the complexity of the phenomenon of abuse and dependence and clearly demonstrate that it is determined by a variety of variables from molecular biology and genetics through behavioral history. This complexity is shown, however, to be responsive to rigorous scientific analysis and our success to date gives rise to hope that this distressing public health problem can ultimately be brought under control. Each of the chapters is written by a leading researcher in the field.

Intensive Care Medicine has been continuously growing and expanding, culturally, technically and geographically. Monitoring and instrumentation are continuously improving and more and more hospitals are getting Intensive Care facilities. The costs have proportionally increased over the years, so that ICUs represent today a major cost for health structures. Since the available resources are limited, a real need is emerging to set the limits and indications of Intensive Care. It is understood that the problem not only involves medical considerations, but also ethical and economical aspects of the utmost importance. For the first time in Europe, this book edited by Reis Miranda and his colleagues tackles systematically the many structural aspects of the European Intensive Care. The organisation and financing of health care in the Old Continent is deeply different from the American one, and the results and consequent proposals obtained in the USA cannot simply be transferred to this side of the Atlantic Ocean. Weare extremely pleased to welcome this first European attempt to discuss the Intensive Care problem. It lays no claims to giving definite replies in a continuously developing field, but it will surely become the basis for future discussions and proposals. I am particularly happy that this work has mainly developed within the European Society of Intensive Care, whose final target is to ensure a common standard of therapy in our old Europe, beyond national differences. We warmly congratulate the authors, and I am sure that their work will find wide diffusion and consent.

In this exploration of the significance of illness in the Victorian literary imagination Miriam Bailin maps the cultural implications and narrative effects of the sickroom as an important symbolic space in nineteenth-century life and literature. Dr Bailin draws on non-fictional accounts of illness by Julia Stephen, Harriet Martineau and others to illuminate the presentation of illness and ministration, patient and nurse, in the fiction of Charlotte Bronte, Charles Dickens and George Eliot. She argues that the sickroom functions as an imagined retreat from conflicts in Victorian society, and that fictional representations of illness serve to resolve both social conflict and aesthetic tension. Her concentration on the sickroom scene as a compositional response to insistent formal as well as social problems yields fresh readings of canonical works and approaches to the constituent elements of Victorian realist narrative.

Oxidative stress and inflammation are among the most important factors of disease. Chronic infections, obesity, alcohol and tobacco usage, radiation, environmental pollutants, and high-calorie diets have been recognized as major risk factors for a variety of chronic diseases from cancer to metabolic diseases. All these risk factors are linked to chronic diseases through inflammation. While short-term, acute inflammation generated by the immune system serves a therapeutic role, chronic low-level inflammation that may persist "silently" for decades is responsible for chronic diseases. Inflammation, Lifestyle, and Chronic Diseases: The Silent Link describes the role of dysregulated inflammation in persistent and recurring diseases. It investigates links to lifestyle and presents research on how the suppression of proinflammatory pathways may provide opportunities for both prevention and treatment of chronic diseases. The book covers neurodegenerative diseases, pulmonary diseases, asthma, rheumatic and arthritic diseases, skin disease, heart disease, chronic wounds, infectious disease, neuropsychiatric disorders such as depression, gastrointestinal diseases, insulin resistance, and cancer, many of which are also diseases of old age. For each chronic disease, contributors review the clinical and scientific literature and examine current and potential therapies, including conventional pharmacotherapies as well as natural products. Noting that the long-term use of steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) can cause adverse side effects, many of the chapters address the role of dietary agents such as fruits, vegetables, legumes, pulses, nuts, and spices as ideal anti-inflammatory agents that can be consumed regularly. The book also suggests directions for further research. Clinical and science researchers, students, and health professionals interested in the link between inflammation, lifestyle, and chronic diseases will find this an informative resource.

From probe design to applications in clinical settings, this book provides a diverse set of instructive examples, guided by experts in the field who offer easy-to-follow experimentals. The book first offers an introduction to the basic principles of fluorescence and then describes applications of fluorogenic probes in real-time PCR, which currently is the gold standard for quantitative DNA and RNA analysis.

Coverage extends the potential of realtime as well as advocates simplifications of the probe technologies. It also presents a new simplified molecular beacon design, EasyBeacons, and demonstrates the utility in DNA methylation profiling.

When I was about fifteen, my Biological Seiences teacher, Prof. N. Benacchio, lent me a book by Paul de Kruif "The Microbe Hunters" and I remained fascinated by infectious diseases. I was intrigued by the potency of virulent bacteria which are constantly trying to invade our bodies and often overcome what today we call innate and adoptive immunity. Indeed, shortly after that, I was struck by his tragic death due to peritonitis. Later, while studying medicine (although medical knowledge in the 1950s was almost primordial compared with today), I soon realised how the various biological systems were wonderfully organised but at the same time frail and how our life could end in a few minutes. Slowly it became obvious that our "wellness" was the result of a dynamic and very unstable equilibrium between health and disease. This unstable equilibrium could be broken forever if the body's response could not reverse the pathological state. I stuck a sort ofposter on the wall ofmy room with these three words and connecting arrows: HEALTH -? DISEASE -? DEATH As I don't believe in another world after death, it became obvious to me that we should make every possible effort not only to delay death, but to try always to shift the equilibrium to the left. In this book, I will try to show that this can be achieved, as a last resort, even with ozonetherapy.

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PATIENT FLOW: Reducing Delay in Healthcare Delivery is dedicated to improving healthcare through reducing the delays experienced by patients. One aspect of this goal is to improve the flow of patients, so that they do not experience unnecessary waits as they flow through a healthcare system. Another aspect is ensuring that services are closely synchronized with patterns of patient demand. Still another aspect is ensuring that ancillary services, such as housekeeping and transportation, are fully coordinate with direct patient care. Past experience shows that effective management of healthcare delays can produce dramatic improvements in medical outcomes, patient satisfaction, and access to service, while also reducing the cost of healthcare. The 15 chapters of this book exposes the healthcare community of researchers, practitioners and administrators to a set of techniques and strategies that can be used by clinicians and administrators to substantially reduce delays in healthcare delivery. It is the first book treatment to have reduction in patient delay as its sole focus, and therefore, provides the foundation by which hospitals can implement change. Reflecting the highly interdisciplinary and practitioner nature of this book, the chapters have been written by doctors, nurses, industrial engineers, system engineers and geographers, and thus, these perspectives provide the comprehensive view needed to address the problem of patient delay.

The book provides a "hands-on" discussion and methods for solving a variety of problems that inhibit prompt and swift health care delivery. Some examples are:

• presents a set of breakthrough strategies that use "real-time" monitoring systems for continuous improvement;
• offers techniques for scheduling staff needs to match patterns in patient demand, and thus reduce predictable delays;
• utilizes simulation modeling techniques for both healthcare design and process improvement;
• provides methods for forecasting the demand for healthcare on a region-wide basis;
• presents queueing theory as a general method for modeling patient waits in healthcare;
• outlines rapid delivery of medication in the event of a catastrophic event, such as a pandemic or terrorist attack;
• demonstrates the importance of optimizing care as patients transition from one care setting to the next care setting with an emphasis on clinical outcomes and the business case;
• provides project management tools to guide the implementation of patient flow projects.

This book provides a state-of-the-art, comprehensive overview of the diagnosis and treatment of sleep disorders. It details evidence-based practice recommendations using parameters primarily developed by the American Academy of Sleep Medicine. The book offers a thorough and extensive board review for specialization in sleep medicine and supports primary care clinicians in appropriately using sleep diagnostic testing results in clinical practice.

Few clinical disciplines have been transformed so dramatically by advancements in science and technology as gastrointestinal surgery. To begin with, modern ph- macology has virtually eliminated some kinds of surgery altogether. If one were to take a peek at a typical operating room schedule in a busy hospital of the 1960s, gastrectomies of one kind or another would have constituted a large block of the major surgeries. The advent of effective H2-histamine receptor antagonists and, more ] + recently, the H, K -ATPase (proton pump) inhibitors led to a precipitous decline in those procedures such that they are rarely performed today. Exciting new approaches to treating inflammatory bowel diseases and their complications-such as fistulas- with anticytokine therapy may one day have a similarly profound effect on surgery for this condition as well. Beyond pharmaceutics, advances in imaging techniques have greatly facilitated the identification and characterization of pathology in the gastrointestinal tract in a way that would have been unimaginable only a few years ago. Just to visualize the pancreas in some way was a horrendous task until abdominal ultrasound, magnetic resonance imaging, or computer tomography made it simple. The fact that the gut is a hollow organ that can be accessed through the mouth, anus, or even through the wall of the abdomen has been fully exploited with fiberoptic endoscopes that can bend around corners with ease and permit surgery to be conducted through them.

This timely and important work looks at the collaborative health care model for the delivery of mental health care in a primary care setting. This has become the ideal model for the treatment of comorbid medical and psychiatric or psychological disorders. There is also an increased awareness that pharmacological intervention, the most frequently delivered intervention for psychological disorders, is often of limited effectiveness without concurrent specific psychological intervention. The book includes more than two dozen case studies, co-written by clinical psychologists and primary care physicians. It is essential reading for any psychology practitioner in a clinical setting, as well as for health care administrators.

Metabolome analysis is now recognized as a crucial component of functional genomic and systems biology investigations. Innovative approaches to the study of metabolic regulation in microbial, plant and animal systems are increasingly facilitating the emergence of systems approaches in biology. This book highlights analytical and bioinformatics strategies now available for investigating metabolic networks in microbial, plant and animal systems.

The contributing authors are world leaders in this field and they present an unambiguous case for pursuing metabolome analysis as a means to attain a systems level understanding of complex biological systems.

The book aims to review knowledge on the disorders of eating behaviour and body composition in some of the non-primate higher animals and to relate these to similar conditions in humans. With advances in understanding the nature of these disorders and their biological basis, it seems timely to assess what cross-species comparisons can tell us about the general underlying factors at work. This may also help to delineate what may be a general biological basis that humans share with their higher animal comrade species and what may distinguish human from non-human, particularly in a cultural context. This could help in combating better the problems of these conditions in the animal species as well as in man and in suggesting well-based preventive measures. As far as people are concerned the last two decades of the 20th century have shown a significant increase in obesity in the richer countries, particularly the USA (Table 1). Possibly associated with the obesity boom, there is an increasing awareness of other disorders of eating behaviour and body composition. These range from anorexia nervosa, at the other end of body composition to obesity, to others, such as bulimia, with more variable effects on body composition.

I opened my series editor manuscript of The Handbook of Contraception: A Guide for Practical Management, edited by Drs. Donna Shoupe and Siri Kjos, on a tiny plane on the way to giving a lecture in Albany, NY. I expected to peruse the ma- script, and found that I could not put it down. The Handbook of Contraception: A Guide for Practical Management is an incredibly informative and enjoyable read. In keeping with the objective of this series for primary care clinicians, there is a quality in this title that is uncommon among medical textbooks. The chapters of this book are written with extraordinary intelligence and und- standing, and with attention to practical considerations in the selection and mana- ment of contraceptive options. The authors have reviewed the science behind contraception, including the chemical structure and effects of hormonal contraception, physiology of contraception, efficacy rates, and side effects, as well as the practical considerations that are relevant in helping patients choose between different cont- ceptive options. They do this with a clarity of language and intent that lets the book cover with sufficient detail the full range of questions that any primary care clinician will have regarding any of the traditional or new contraceptive options. Also included in each chapter is a section on "counseling tips," which explicitly answers many of the questions that clinicians and their patients often have when discussing contraceptive options. For a book so useful and well done, the editors and authors deserve our thanks.

The Indian subcontinent is a vast land mass inhabited by over one billion people. Its rich and varied history is reflected by its numerous racial and ethnic groups and its distinct religious, cultural and social characteristics. Like many developing countries in Asia, it is passing through both demographic and epidemiological transitions whereby, at least in some parts, the diseases of severe poverty are being replaced by those of Westemisation; obesity, diabetes, and heart disease, for example. Indeed, as we move into the new millennium India has become a land of opposites; on the one hand there is still extensive poverty yet, on the other hand, some of the most remarkable developments in commerce and technology in Asia are taking place, notably in the fields of information technology and biotechnology. India has always fascinated human geneticists and a considerable amount of work has been done towards tracing the origins of its different ethnic groups. In the current excitement generated by the human genome project and the molecular and genetic approach to the study of human disease, there is little doubt that this field will develop and flourish in India in the future. Although so far there are limited data about genetic diseases in India, enough is known already to suggest that this will be an extremely fruitful area of research.