rope it was mainly the states of the northern and centrat European areas which succeeded in achieving the extermi nation or at least the regression of brucellosis. (The origi nal plan to present the conditions in Asia and Oceania, in cluding Australia, in maps as weil, and thereby to achieve a comprehensive worldwide review of the known and as certainable distribution of brucellosis, was not, however, practicable. ) Information available from these parts of the world, especially from Asia, is so fragmentary that the great expense required for the compilation of the map did not seem justified. On the other hand it seemed desirable to collate and document these data which had been ac quired as a basis for future research. It is tobe hoped that, at a later date, when more comprehensive data become available, the Heidelberg Academy will be able to decide to support a cartographic presentation of the occurrence of brucellosis in these parts of the world as weil. Last, but not least, the intensive research carried out by bacteriologists had led to the discovery of new species of Brucella, such as B. ovis, B. canis and B. neotomae. Further types - such as Type 4 of B. suis which occurs in reindeer and caribou - were identified. Though these new species and types, which are undoubtedly to be classed with the brucellae, have achieved regional significance in places, the three dassie species B. melitensis, B. abortus and B."

1 Einfuhrung.- 2 Diagnostische Verfahren in der Gerontopsychiatrie.- 2.1 Screening.- 2.2 Klinische Untersuchung.- 2.3 Neuropsychologische Tests.- 2.4 Elektrophysiologische Verfahren.- 2.5 Bildgebende Verfahren.- 2.6 Sonstige apparative Verfahren.- 2.7 Laborchemische Verfahren.- 3 Grundlagen der Therapie.- 3.1 Therapieziele.- 3.2 Therapeutische Grundhaltung.- 3.3 Hilfe fur Angehoerige.- 4 Typische gerontopsychiatrische Krankheitsbilder.- 4.1 Normales Altern.- 4.2 Amnesie (Gedachtnisstoerungen).- 4.3 Delir.- 4.4 Demenz.- 4.5 Depressive Stoerungen im Alter.- 4.6 Schizophrenie und andere Wahnerkrankungen.- 4.7 Neurotische Stoerungen, insbesondere Angststoerungen im Alter.- 4.8 Suchterkrankungen im Alter.- 5 Verhaltensauffalligkeiten.- 5.1 Aggression.- 5.2 Antriebssteigerung/motorische Unruhe/Erregungszustand.- 5.3 Antriebsminderung (Apathie).- 5.4 Emotionale Instabilitat (Affektlabilitat), Reizbarkeit.- 5.5 Gangstoerungen und andere Bewegungsstoerungen.- 5.6 Veranderte Nahrungsaufnahme.- 5.7 Schlafstoerungen.- 6 Rechtliche Aspekte.- 6.1 Betreuungsgesetz.- 6.2 Strafrecht.- 6.3 Zivilrecht.- 6.4 Sozialrecht (Pflegeversicherung).- 7 Medikamente.- Literatur.

Throughout the world, scientists and the general with environmental illness. Part II presents an over public are concerned about the adverse effects of view of chemical and physical agents commonly toxic agents found in contaminated air, water, food, found in contaminated air, water, food, and soil. and soil. In the past, attention has focused on haz The problem of hazardous wastes is also discussed. ards originating in the workplace. As a consequence, Part III characterizes the body's defense against occupational medicine has become a well-recognized such exposure. Defenses at the portals of entry are and established clinical discipline. Much less atten discussed, with emphasis placed on the role of tion has been paid to nonoccupational hazards. There nutrition. Detoxication and immunologic defense is a growing awareness, however, of the dangers of mechanisms are described. Part IV indicates the exposure to toxic chemical and physical agents in importance of and provides instruction on the the homes, community, and general environment, method of including occupational and environmen especially for the fetus, the infant, the very young, tal factors in the routine medical history. The role of the elderly, and the chronically ill, those most sus enhanced susceptibility as a factor in an individual's ceptible. Environmental medicine, fOCUSing on the response to toxic exposure is discussed."

The NATO-Advanced Research Workshop "Esterases, Lipases and Phospholipases: From Structure to Clinical Significance" was held at the University of Bordeaux II, France from 22nd- 24th September 1993 under the Directorship of Professor Michel Clerc of the University of Bordeaux II. The meeting was organised by Hugues Chap (INSERM U 326, Toulouse, France), Georges Ferard (University of Strasbourg, France), Wolfgang Junge (University of Kiel, Germany) and Michael Mackness (University of Manchester, UK). In recent years it has become increasingly apparent that hydrolytic enzymes of the esterase, lipase and phospholipase type play central roles in the pathophysiology of many human diseases. The purpose of this NATO-ARW was to bring together experts (both clinical and scientific) in all three interrelated fields to review the current basic and clinical position and discuss future developments particularly with respect to future research aimed at determining the basic biochemical lesion involving hydrolytic enzymes involved in human disease and the use of these enzymes in diagnosis. As well as formal lectures from established researchers, the meeting also involved a number of lively round-table discussions on future developments and presentations from younger research workers, all of which are recorded in this Proceedings and which contribute to the success of the meeting.

Current Review of Asthma comprises up-to-date information related to the field of asthma diagnosis and treatment. The book has broad appeal, because it features in-depth, concise discussions on concomitant diseases and treatment choices. Examples of some of these chapters include epidemiology, pathology, airway remodeling, and pathophysiology. The 37 contributors are well-known scientists and clinicians from the US and UK. Each chapter establishes an overview of the topic, followed by a detailed analysis of the information at hand, which is supplemented by charts, tables, and graphs. In addition, editor Dr. Michael A. Kaliner contributes his own chapter, entitled "The Pathogenesis of Bronchial Asthma," written from 30 years of experience treating patients with asthma. This book is an invaluable resource to both the primary care physician and the asthma specialist.

In September 1991, Victor Zammit and I were in the Department of Biochemistry, the University of Cambridge, discussing ou r collaborative research project when we real ized thepotential value and need fora conference specifically concerned with fatty acid oxidation and ketogenesis. Thei dea, onceseeded, was indulged and flourished into the first "Fatty Acid Oxidation & Ketogenesis (FAOx&K) Conference"t hatwas held in the Department at Eastertime, 1992. Itw as attended byc olleagues mainly from the U. K. , France and Spain. From these modest beginnings atradition for holding a conference every second yearh asgrown and this Book results from the 4th International FAOx&K Conference that was held in London at the Institute of Child Health & Great Ormond Street Hospital forChildren NHSTrust, University College London Medical School in the new Conference Suite and was attended by colleagues from over twenty c ountries and five different c ontinents. I would like to thank allm y colleagues who havec ontributed to the conferences and, mos t importantly, to this Book. The first two c onferences were held in the University of Cambridge and were orga nized entirely by me but Simon Eaton, who came to work in London with me in Febru ary 1997,b ecame Conference Secretary andco organized the last two meetings. His contribution tot he conferences has been invaluable and w ithout hisdedicated help and effort neither the latermeetings n ort his Book would haveb een possible.

Volume 15 follows the format of earlier volumes in the series. The contents give the next installment in the varied aspects of acoustical imaging research. On this occasion, some emphasis was placed on the rela tionship of l1nderwater acoustics to acoustical imaging and a volume of papers under the title "Underwater Acoustics Proceedings from the 12th ICA Symposium held in Halifax," will appear at roughly the same time as this volume. There is no duplication in these volumes but they are in terlinked, at least to the extent that papers from common conference sessions appear in one or another volume. An innovation is the review paper presented at the beginning of the volume "A History of Acoustical Imaging," by G Wade. This fairly detailed review comes at a point in time when so much has been achieved and in some cases passed by, that a record of some of the earlier work might help to keep a balance with the large collections of research papers which have appeared in the many volumes."

There are many unanswered questions regarding the molecular nature of antibodies, components of complement, and other substances which participate in the immune response. The list of substances which need to be analyzed chemically is increasing. Plasma cell products, of course, have long been of great interest because the most prevalent ones are immunoglobulins. Other cell types, however, are the source of the broad spectrum of additional substances which classically fall into the sanctum of the molecular immunologist. It is these substances, and especially those more recently discovered, which are responsible for the broadening investigative interests of immunologists. In this volume we have provided you with descriptions of research being done with immunoglobulins and with complement. Additionally, we have in cluded two reports that deal with molecules which are among the more recent acquisitions of the molecular immunologist. The components of complement are known to react in a cascading manner which results in the lysis of cellular antigens. The first step in the classical pathway requires the activation of CI by the antibody-antigen aggregates. This volume of Contemporary Topics in Molecular Immunology begins with the report of Reid and Porter which describes their investigation of the mechanism of activation of C I. Their descriptions of C I q and of the reaction of C I with immunoglobulins are especially intriguing. It is clearly apparent from their report that activation of the components of complement is a complex phenome non.

Proceedings of the Third International Symposium on Frontiers in Biomedical Polymers including Polymer Therapeutics: From Laboratory to Clinical Practice, held May 23-27, 1999, in Shiga, Japan. This book focuses on the progress and unique discoveries in the interdisciplinary scientific and technological area of biomedical application of polymers. The topics include polymeric materials for biomedical and pharmaceutical applications, as well as polymeric materials in therapeutics.

To integrate current knowledge in terms of basic and clinical science and to highlight problems, thirty world-renowned experts in the field of acute lung injury describe the state of up to date knowledge regarding the epidemiology, pathophysiology, and clinical management of acute lung injury. Novel techniques for the clinical support of these difficult patients are discussed in full. Prospects for successful pharmacological intervention are also outlined. This book is aimed at those practising within the field of critical care and is likely to become an indispensable aid to all concerned with the investigation and management of patients with severe respiratory failure.

The recent sequencing of mycoplasma genomes has marked a turning point in the molecular genetic analysis of these microorganisms. Transcriptome and proteome analyses promise to provide the first definition of the total protein complement of a cell. The mycoplasma group includes the smallest known self-replicating organisms carrying the smallest number of genes. No wonder, therefore, that mycoplasmas have a special appeal to those interested in deciphering the minimal set of genes essential for life. Mycoplasma genomics facilitated better understanding of mycoplasma pathogenesis. Most impressive are the findings concerning the interaction of mycoplasmas with the immune system, macrophage activation, cytokine induction, mycoplasma cell components acting as superantigens, and autoimmune manifestations. The molecular definition of mycoplasmal adhesins responsible for mycoplasma attachment to host cells and evasion of the host immune system by antigenic variation of mycoplasmal surface components are other 'hot' subjects of research.Demonstration of the ability of mycoplasmas to enter host cells, cause fusogenic, apoptotic and oncogenic effects, as well as the possible association of mycoplasmas with arthritis, had their share in intensifying research on mycoplasma pathogenesis, bringing more researchers into the circle of those interested in this group of organisms. The present book is a comprehensive, up-to-date, multi-authored treatise.

Here, Erich H. Loewy expands on his earlier book Textbook of Medical Ethics (1989) offering healthcare workers and students a new perspective on ethical practice. Textbook of Healthcare Ethics focuses on the social conditions in which medical practice occurs and how ethical healthcare decisions involves nurses, social workers, psychologists, technicians, and patients as well as physicians. This thoroughly revised and expanded edition addresses historical and theoretical underpinnings and practical concerns. A series of case studies serve as a guideline for further discussion. The text examines provocative issues such as organ donation, care of the terminally ill, abortion, HIV-positive healthcare professionals, physician-assisted suicide, and experimentation with fetal tissue. This is an ideal book for all members of the healthcare team as well as students and residents in any discipline of medicine.

2 Vol. 3: Hormones, Psychology and Behavior (1952). A range of interests was covered in respect to the influence of glucocorticoids on behavioral responses, as well as to the glucocorticoid status in various behavioral states and disorders. Vol. 4: Anterior Pituitary Secretion and Hormonal Influence in Water Metab olism (1952). Book II of this volume contains considerable detail about the various relationships of the glucocorticoids to other hormones with respect to their influence on water and electrolyte excretion. Vol. 5: Bioassay of Anterior Pituitary and Adrenal Cortical Hormones (1953). An entire section was devoted to chemical measurement and bioassay of gluco corticoids in blood and urine, with a comparison of these methods. Vol. 7: Synthesis and Metabolism of Adrenal Cortical Steroids (1954). Additional data on the intermediary metabolism and biosynthesis of the glucocorticoids are available in this volume and supplement the review by HECHTER and PINCUS listed below (cf. DoRFMAN, Chapter 3, Part 1 of this Handbuch volume). Vol. 8: The Human Adrenal Cortex (1955). A very wide range of articles was presented which extended from studies of the adrenal cortex itself to studies of adrenal function in a variety of human somatic and psychological stressful situa tions, and clinical conditions. DEBono, R. C., and N. ALTSZULER: Insulin Hypersensitivity and Physiological Insulin Antagonists. Physiol. Rev. 38: 389-445 (1958). The subject of this review went beyond glucocorticoids, but the influence and role of these steroids in relation to insulin, other hormones and carbohydrate metabolism was thoroughly handled."

In this excellent new book, specialist dietitians Isabel Skypala and Carina Venter bring together a team of expert authors to separate fact from fiction and provide the reader with an authoritative and practical guide to diagnosing, managing and preventing food allergy and intolerance.

This second International Symposium on Mucus in Health and Disease once again brings together basic scientists such as Biochemists, Anatomists, Biologists and Clinicians who are dealing with aspects of mucus in the various tracts of the body where it is of such great functional importance. It is fitting that the meeting should take place at Manchester University where there is so much activity in this field and our grateful thanks are due to Or Eric Chantler for his untiring efforts in organising this meeting. At the first Mucus meeting, Sir Francis Avery Jones stated "this is a subject which will justify further Symposia, both local and international." As he predicted, this meeting succeeds the first and adds further to our progress in understanding the complex and unique structure and function of the mucus secretion in its various sites of the body. Much was learned from the first meeting and it is hoped that the second will be an appropriate successor to it. The emphasis in this meeting has been to encourage discussion and the presentation of research material. In this respect, review articles have been kept to a minimum. The structure of the Conference has been organised around eight keynote addresses: one on the biosyn thesis of the general mucus glycoproteins and another on its physical properties. Other keynote papers are on the biochemical and clinical aspects of mucus in the respiratory, gastrointestinal and urogenital tracts by recognised authorities in these subjects."

The Sapporo International Symposium on "Recent Advances in Nitric Oxide Research" was held in Sapporo, Japan, in 1997, following the Fifth International Meeting on the Biology of Nitric Oxide in Kyoto, Japan, organized by Dr. Salvador Moncada, Dr. Noboru Toda, and Dr. Hiroshi Maeda. The field of nitric oxide research continues to expand rapidly, and our understanding of the physiological and pathophysiological roles of NO has increased greatly. The Kyoto Meeting was stimulating and informative, providing impetus for the Sapporo Symposium, which I had the great honor to organize. To communicate the information from these events, Dr. Ichiro Sakuma and I decided to publish this book. The contents of its chapters were contributed by the participants who were active at the Sapporo symposium and cover the majority of the presentations made during that symposium. Dr. Csaba Szabo of Children's Hospital Medical Center in Cincinnati (U. S. A. ) reviews the roles of peroxynitrite and poly(ADP-ribose)synthetase in shock, inflammation, and reperfusion injury, and Dr. David A. Geller and his colleagues of the University of Pittsburgh (U. S. A. ) review the regulation and function of NO in the liver. As contributions from the Hokkaido University School of Medicine (Sapporo), Dr. Hiroko Togashi and colleagues present their data on transient cerebral ischemia and NO production, Dr.

Today we are on the brink of a much-needed transformative moment for health care. The U.S. health care system is designed to be reactive instead of preventive. The result is diagnoses that are too late and outcomes that are far worse than our level of spending should deliver. In recent years, U.S. life expectancy has been declining. Fundamental to realizing better health, and a more effective health care system, is advancing the disruptive thinking that has spawned innovation in Silicon Valley and throughout the world. That's exactly what Stanford Medicine has done by proposing a new vision for health and health care. In Discovering Precision Health, Lloyd Minor and Matthew Rees describe a holistic approach that will set health care on the right track: keep people healthy by preventing disease before it starts and personalize the treatment of individuals precisely, based on their specific profile. With descriptions of the pioneering work undertaken at Stanford Medicine, complemented by fascinating case studies of innovations from entities including the Chan Zuckerberg Biohub, GRAIL, and Impossible Foods, Minor and Rees present a dynamic vision for the future of individual health and health care. You ll see how tools from smartphone technology to genome sequencing to routine blood tests are helping avert illness and promote health. And you'll learn about the promising progress already underway in bringing greater precision to the process of predicting, preventing, and treating a range of conditions, including allergies, mental illness, preterm birth, cancer, stroke, and autism. The book highlights how biomedical advances are dramatically improving our ability to treat and cure complex diseases, while emphasizing the need to devote more attention to social, behavioral, and environmental factors that are often the primary determinants of health. The authors explore thought-provoking topics including: The unlikely role of Google Glass in treating autism How gene editing can advance precision in treating disease What medicine can learn from aviation Discovering Precision Health showcases entirely new ways of thinking about health and health care and can help empower us to lead healthier lives.

Computing and information management technologies touch our lives in the environments where we live, play and, work. High tech is becoming the standard. Those of use who work in a laboratory environment are faced with an obvious challenge. How do we best apply these technol ogies to make money for our companies? The first level of deliverable benefits is achieved through task automation. The second level is ob tained by integrating the individual islands of automation. The third, or top level, of benefits is related to applying intelligence to computing applications. The use of computing technology, at level one, to automate lab pro cedures, methods, and instruments has been profitable for many years. We can easily find yearly returns in the range of 10-50% for investments at this level. For level two, the integration of some applications has evolved and has led to data management systems and local area net working in the lab environment. Investment paybacks at level two are substantially higher, in the range of 200-400%. Examples of applications at the top level, that of intelligent systems and applications, are few and far between. And what about the payback for investments at this level? With such limited experience at level three, we can only estimate the benefits. But again, they appear to be much higher, in the range of 2000- 4000%."

Bone is a sex hormone-dependent organ, which has important implications for current therapeutic strategies in the prevention and possible treatment of bone loss in the elderly. This book contains the proceedings of the Schering Workshop on "Sex Steroids and Bone." The various chapters by leading experts give and overall view of current knowledge on the control of bone hemostasis by sex steroids and new ideas on how this controlcould be exerted. It was also of particular concern to integrate a general survey of in vivo experimentation and histomorphometric evaluation of bone tissue. The organizers of the workshop and editors of this volume hope that it will contribute to a better understanding of the role of sex steroids in bone and thus pave the way for a better experimental approach instudying drug effects on bone with the ultimate goal of improving therapy in bone diseases.

Teach us to live that we may dread Unnecessary time in bed Get people up and we may save Our patients from an early grave. A most revealing paraphrase by Asher* of a verse by Bishop Thomas Ken more than adequately summarizes the plight of the immobilized patient, who often lies dormant and de pressed for years on end. In this volume, Dr. Steinberg has offered the reader a unique opportunity to share his many years of experience in caring for the immobilized patient. His careful attempt to explore the pathophysiologic effects of immobilization on a number of organ systems, combined with a host of practical aspects with regard to patient care, is unique and refreshing. This text should command the re spect of any physician faced with the vicissitudes and frus trations of caring for the immobilized. The final chapter de tailing "The Psychological Aspects of Immobilization," by Hammer and Kenan, offers the reader considerable insight into the essentials and value of occupational and physical therapy. It should prove most valuable to physicians as well "Asher, R. A. ]. Dangers of going to bed. Br. Med. J. 2:907, 1947. v vi FOREWORD as social workers, paramedical personnel, and the many physical therapists who come into daily contact with the nonambulatory patient. L. V. Avioli St. Louis Preface It may be a paradox that the importance of disability and immobilization has been enhanced by the very progress of medical science."

Historical Introduction The Marfan Syndrome: From Clinical Delineation to Mutational Characterization, a Semiautobiographic Account VictorA. McKusick l n 1876, E. Williams, an ophthalmologistin Cincinnati, Ohio, described ectopia lentis in a brother and sister who were exceptionally tall and had been loosejointed from birth. I Although there is a Williams syndrome that has aortic manifestations (supravalvar aortic stenosis), the name Williams was never associated with the disorder we now call Marfan syndrome. The reason is clear: Williamswas geographically removed from the leading medical centers and published in the Transactions of the American Ophthalmological Society; surely his report attracted little attention and the non-ocular features were not emphasized. 2 The case report that brought the disorder to attention was provided by a prominent Pari- sian professor of pediatrics, Antoine Bernard-Jean Marfan (1858-1942), who did much to establish pediatrics as a specialty in France and elsewhere. He was the author of widely read textbooks and monographson pediatrictopics and waseditor of Le Nourrisson for a great many years. In addition to the syndromeunder discussion here, his name is often attached to "Marfan's law" (that immunity to pulmonary phthisis is conferred by the healing of a local tuberculous 3 lesion) and Marfan's subxiphoid approach for aspiratingfluid from the pericardial sac. (Please pardon my use of the possessive form of the eponym in these two instances!) Pictures of Marfan (Fig.

"Infection in the Compromised Host" has become a classic chapter in textbooks devoted to infectious diseases and internal medicine. The numbers of compromised hosts are increasing in the era of modem medicine because of our expanded capabilities to deal with difficult diseases, especially neoplasms. As a consequence, microbiologic complications related to the intensive care administered to these patients are increasing as well. Under these circum stances, not only does the underlying illness create conditions favorable for the development of unusual infections, but often the therapy contributes to the acquisition of potential pathogens that turn into agents responsible for severe and frequently fatal disease. Granulocytopenia and immunosuppression have been the two key fac tors in predisposing patients with cancer and other serious diseases to severe bacterial infections. Colonization by hospital-acquired pathogens and breaks in the anatomic barriers-as a result of disease or medical intervention-have contributed to the high incidence of infectious diseases in these patients. Although there is some overlap between the types of infection in granulocytopenic and immunosuppressed hosts, each ofthese clinical entities has distinctive features thatjustify considering them separately, reserving the term immunocompromised hosts only when refer ring to patients who are predisposed to opportunistic infections. For about two decades, infections in granulocytopenic patients have attracted the atten tion of clinicians because they represent a model for the study of antimicrobial drugs in hosts deprived of an essential element of defense against bacterial infection, that is, an adequate number of normally functioning granulocytes.

A pioneering guide for the management of tics and habit disorders Managing Tic and Habit Disorders: A Cognitive Psychophysiological Approach with Acceptance Strategies is a complete client and therapist program for dealing with tics and habit disorders. Groundbreaking and evidence-based, it considers tics and habit disorders as part of the same spectrum and focuses on the personal processes that are activated prior to a tic and habit rather than the tic or habit itself. By drawing on acceptance and mindfulness strategies to achieve mental and physical flexibility in preparing action, individuals can release unnecessary tension, expend less effort and ultimately establish control over their tic or habit. The authors explain how to identify the contexts of thoughts, feelings and activities that precede tic or habit onset, understand how self-talk and language can trigger tic onset, and move beyond unhelpful ways of dealing with emotions - particularly in taking thoughts about emotions literally. They also explore how individuals can plan action more smoothly by drawing on existing skills and strengths, and overcome shame by becoming less self-critical and more self-compassionate. They conclude with material on maintaining gains, developing new goals, and creating a more confident and controlled lifestyle. Managing Tic and Habit Disorders is a thoughtful and timely guide for those suffering from this sometimes all-consuming disorder, and the professionals who set out to help them.

One of the fascinations of psychiatry is that it is amenable to many different approaches. In seeking to account for mental disorder, for example, it is pos sible to explore the meaning and significance of symptoms in the psychody namic sense, to examine the social determinants of illness, or to adopt an es sentially biological viewpoint in investigating links between physiological and psychological dysfunction .. As a clinical discipline it may be practiced in the community, in the specialized clinic or hospital, or shoulder-to-shoulder with other medical practitioners in the general hospital. This richness and diversity are at once a strength and a weakness, attracting practitioners with a wide range of talents and interests, yet sometimes leading to polarizations and false an titheses. The so-called "medical model" of psychiatry has come under a good deal of attack, and deservedly so when claiming an exclusive provenance over all types and aspects of mental disorder. What cannot be gainsaid, however, is the central role of medicine in relation to many parts of the field, and the success in terms of understanding and therapy that has resulted from medicine's in volvement. Nor can it be doubted, after the most cursory acquaintance with the physically or mentally ill, that the relationship between these two forms of suffering is often so close and so mutually reinforcing that distinctions are drawn somewhat arbitrarily. This last is perhaps the cardinal reason for the alliance between medicine and psychiatry."