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."

Multiple sclerosis is an unique disease with a tremendous impact on social life in countries with moderate climates. Its cause is unknown. In recent years however hopes have been raised that the disease might be fought, and possibly cured. With the disappearance of poliomyelitis as the main paralyzing disease multiple sclerosis has taken its place as the single disease that is responsible for paralyzing the young with an incurable affliction of long duration, for social disruption and for an 1 economic impact that is estimated to be higher than heart disease * A multi-national, mUlti-disciplinary approach to this extremely disabling disease is urgently needed in this phase of hopeful scientific developments. The Commission of the European Communities therefore sponsored a Con ference on Multiple Sclerosis Research in Europe on 29,30 and 31 January 1985 in Nijmegen, The Netherlands, with the aim of formulating practical proposals for such cooperation in the Communities. This volume contains the papers read at that conference.

The revised fourth edition of Evidence-Based Gastroenterology and Hepatology continues to provide the most current, evidence-based information for determining the appropriate medical and surgical options for screening for, diagnosing, and treating gastrointestinal conditions. With contributions from an international team of leading experts in the field, the 4th edition includes practical recommendations for the care of individual patients based on the latest scientific evidence.

For some time now, the study of cognitive development has been far and away the most active discipline within developmental psychology. Although there would be much disagreement as to the exact proportion of papers published in developmental journals that could be considered cognitive, 50% seems like a conservative estimate. Hence, a series of scholarly books devoted to work in cognitive development is especially appropriate at this time. The Springer Series in Cognitive Developmemt contains two basic types of books, namely, edited collections of original chapters by several authors, and original volumes written by one author or a small group of authors. The flagship for the Springer Series is a serial publication of the "advances" type, carrying the subtitle Progress in Cognitive Development Research. Each volume in the Progress sequence is strongly thematic, in that it is limited to some well defined domain of cognitive-developmental research (e. g., logical and math ematical development, development of learning). All Progress volumes will be edited collections. Editors of such collections, upon consultation with the Series Editor, may elect to have their books published either as contributions to the Progress sequence or as separate volumes. All books written by one author or a small group of authors are being published as separate volumes within the series. A fairly broad definition of cognitive development is being used in the selection of books for this series."

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.

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."

Over the years a number of excellent books have classified and detailed drug drug interactions into their respective categories, e.g. interactions at plasma protein binding sites; those altering intestinal absorption or bioavailability; those involving hepatic metabolising enzymes; those involving competition or antagonism for receptor sites, and drug interactions modifying excretory mechanisms. Such books have presented extensive tables of interactions and their management. Although of considerable value to clinicians, such publica tions have not, however, been so expressive about the individual mechanisms that underlie these interactions. It is within this sphere of "mechanisms" that this present volume specialises. It deals with mechanisms of in vitro and in vivo, drug-drug, drug food and drug-herbals interactions and those that cause drugs to interfere with diagnostic laboratory tests. We believe that an explanation of the mechanisms of such interactions will enable practitioners to understand more fully the nature of the interactions and thus enable them to manage better their clinical outcome. If mechanisms of interactions are better understood, then it may be pos sible for the researcher to develop meaningful animal/biochemical/tissue cul ture or physicochemical models to which new molecules could be exposed during their development stages. The present position, which largely relies on patients experiencing adverse interactions before they can be established or documented, can hardly be regarded as satisfactory. This present volume is classified into two major parts; firstly, pharmacoki netic drug interactions and, secondly, pharmacodynamic drug interactions."

The seventeenth annual symposium sponsored by the Texas Research Institute of Mental Sciences was held October 23-26, 1983, in Houston, Texas. The theme was Aging 2000: Our Health Care Destiny. This volume on social, psychological, economic, and ethical aspects and a companion volume (Volume I) on biomedical aspects include edited versions of the presentations by about 80 speakers. Their papers were directed at practitioners, researchers, and medical educators who will be active and productive in the year 2000, and we focused on those who would influence the evolution of care of elderly persons during the next 17 years. We chose topics that would be of particular interest to teachers and current planners in the disciplines concerned with delivery of health and social services. We believe that having a core of more qualified and better trained practitioners will help the population of aged persons achieve a higher level of physical and mental health, life satisfaction and happiness, find better coping techniques and control of environmental stresses, and attain personal and social goals. Our Goals While preparing for the symposium we knew that the status ofthe art in 1983 obviously would be the base from which we would work, but we asked our speakers to give priority to future planning and directions.

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."

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.

The introduction of low temperature plasma technology to medical research and to the healthcare arena in general is set to revolutionise the way we cure diseases. This innovative medium offers a valid and advantageous replacement of traditional chemical-based medications. Its application in the inactivation of pathogens in particular, avoids the recurrent problem of drug resistant microorganisms. This is the first book dedicated exclusively to the emerging interdisciplinary field of plasma medicine. The opening chapters discuss plasmas and plasma chemistry, the fundamentals of non-equilibrium plasmas and cell biology. The rest of the book is dedicated to current applications, illustrating a plasma-based approach to wound healing, electrosurgery, cancer treatment and even dentistry. The text provides a clear and integrated introduction to plasma technology and has been devised to answer the needs of researchers from different communities. It will appeal to graduate students and physicists, engineers, biologists, medical doctors and biochemists.

Human Health: The Contribution of Microorganisms is the first major work to concentrate on probiotics in humans. It presents both new and established data on the origins and importance of commensal floras, the history and characteristics of probiotics, the use of probiotics in clinical situations, and preclinical and volunteer studies. It also covers commercial issues such as the difficulties involved in the large scale production and formulation of live microorganisms, and the marketing techniques used to sell products containing bacteria. It contains contributions from internationally recognised experts in both science and industry. Written with both professional and lay audiences in mind, Human Health: The Contribution of Microorganisms will be an indispensable text and reference source for scientists, clinicians, and pharmaceutical/food technologists.

This book assumes that it is no longer tenable to work in healthcare without considering the person as a whole being constituted by a rich weaving of mind, body, culture, family, spirit and ecology. The MindBody approach embraces this "whole." But how does it transform clinical practice and training for the clinician and treatment for the patient/client? The book collects together the experiences from a diverse range of clinical practitioners (including psychotherapy, specialist medicine, general practice, physiotherapy, occupational therapy, dietetics, nursing, and complementary and alternative medicine practitioners) who have deliberately chosen to integrate a MindBody philosophy and skill set in their clinical practices. All reflect deeply on their unique journeys in transforming their clinical encounters. Most have been trained in the dominant Western framework and have inherited the classical dualistic approach which typically keeps mind and body apart. This dualistic clinical ethos values clinician expertise, labeling, diagnosis, measurement, and grouped phenomena. The MindBody approach retains the best of the classical model as well as valuing personal experience, patient/client story, the unique patterning of the individual s illness and disease, and the healing elements of the relationship between the clinician and the patient/client. The MindBody transformation of the clinician is a challenging journey, and each clinician experiences this uniquely. From these stories the reader can see vividly the ways in which conventional healthcare can break out of its current restrictive paradigm creating new satisfaction for the clinicians and much wider treatment outcomes for patients and clients."

The danger of infection remains the most serious drawback to internal fixation. Prevention, using all available prophylactic measures should be the central feature in every surgical department. Though the infection rate may remain below the acceptable level of 2 %, the infected patient derives little comfort from the large number of excellent results in other people. We must discover the best way to offer these patients a favourable prognosis. This should not be based on intuition but on clear proven guiding principles. Planning the treatment for a patient whose internal fixation has become septic must decide between steps which may have advantages or disadvan tages. The disadvantage of the presence of a foreign body must be weighed against the advantage of rigidity. The authors have taken up this challenge by planned animal experiments to study the healing of internally fixed fractures which have been infected with staphylococci. They have shown that under stable conditions, even massive infection did not destroy the healing process in cortical bone. Even under these circumstances fracture union, in the form of primary bone healing, can occur even if with less regularity than in unin fected internal fixation.

This volume contains the proceedings of a symposium held in Marseille on April 6, 1992, on the topic "Heterogeneity of Alzheimer's disease. " This was the eighth of a continuing and very successful series of meetings related to Alzheimer's disease organized by the Fondation Ipsen pour la Recherche Therapeutique. These symposia, known as "Colloques medecine et recherche," started in 1987 and have dealt with widely different aspects of the disease such as immunology, genetics, neuronal grafting, biological markers, imaging, growth factors, and last year's less conventional topic of Neurophilo- sophy and Alzheimer's disease. The next IPSEN symposium dedicatet to Alz- heimer's disease will take place in Lyon on June 21, 1993, and will deal with "Amyloid protein precursors in development, aging, and alzheimer's disease. " It is being organized by Konrad Beyreuther, Colin Masters, Marc Trillet, and Yves Christen. Until a few years ago, several names were used to refer to the most common cause of dementia in the elderly. They included such terms as "senile psycho- sis," "organic brain syndrome," and "senile dementia. " Following Kraepelin, the term "Alzheimer's disease" was often restricted to an uncommon condition starting at a younger age (before 60 or 65 years of age).

This book brings together a range of academic, industry and practitioner perspectives on translational medicine (TM). It enhances conceptual and practical understanding of the emergence and progress of the field and its potential impact on basic research, therapeutic development, and institutional infrastructure. In recognition of the various implications TM has for public health policy and commercial innovation, the book addresses the major systemic aspects of the field. The contributors explore the dynamic interactions and key challenges in translating new science into viable therapies for the clinic, which includes recognizing the importance of social, commercial, and regulatory environments in addition to good science.

LEADERSHIP IN VETERINARY MEDICINE Leadership in Veterinary Medicine provides both theoretical and practical information for veterinary professionals who are contemplating leadership or currently facing day-to-day leadership challenges. This much-needed book introduces and explores key leadership concepts in the veterinary context whilst encouraging self-reflection through real-world scenarios. Each chapter outlines a particular leadership concept or issue and includes a topic summary, discussion questions, full references and further reading suggestions. This thought-provoking text: Explores the principal areas of leadership for both veterinary professionals and for those leading veterinary professionals Discusses various leadership styles, competencies, behaviours and perspectives Addresses topics such as leadership assessment, organisational dynamics, interpersonal communication, remote and virtual leadership, and collaboration skills Assists readers in developing strategy, leading change, creating effective teams and improving staff engagement Includes practical cases and examples highlighting challenges in veterinary leadership Leadership in Veterinary Medicine is a must-read for all veterinary professionals in leadership posts, for those aspiring to be leaders and for instructors in veterinary schools and veterinary nursing training organisations.

It has been over 30 years since the first clinically important member of the quinolone class, nalidixic acid, was introduced into medical practice. The modification produced in the quinolone nucleus by introducing a fluorine at the 6-position led to the discovery of the newer fluoroquinolones with enhanced antibacterial activities as compared to nalidixic acid. By now a great deal of preclinical and clinical experience has been obtained with these agents. The intense interest in this class of antibacterial agents by chemists, micro biologists, toxicologists, pharmacologists, clinical pharmacologists, and clini cians in various disciplines encouraged us to summarize the information on the history, chemistry, mode of action and in vitro properties, kinetics and efficacy in animals, mechanisms of resistance, toxicity, clinical pharmacology, clinical experience, and future prospects in one volume of the Handbook of Experimental Pharmacology. As this series deals predominantly with "experimental" characteristics of drugs, our volume is dedicated specifically to quinolones and emphasizes principally their preclinical and clinical phar macological characteristics, despite the existence of several summaries on quinolones. The chemistry of the quinolones is described in detail. The chapter on the mode of action of quinolones reports the conclusive evidence that gyrase is the intracellular target of the quinolones; however, another enzyme, topoisomerase IV, may also be a target for quinolones, and the exact mechanisms by which quinolones act bactericidally are far from being understood."

On the occasion of a symposium in Salzburg, an international team of clinicians and pharmacologists presented recent results in profile efficacy, safety and therapeutic use of the antibiotic substance Ciprofloxacin. Of special interest for clinicians will be the clinical outcome in patients with nosocomial pneumonia and other infections of the lower respiratory tract.

Nutritional support of critically ill patients is a major treatment modality which will enhance recovery and shorten convalescence. New knowledge has emphasized that much of the organ dysfunction associated with sepsis and altered blood flow is related to oxidative injury. Specific nutrients are highly effective in counteracting these effects and their early administration may attenuate cellular damage and multi-organ failure. Patient outcome may also be enhanced by the route of feeding, administration of newer nutrient combinations, utilization of evolving methods of monitoring and the use of growth factors. This new knowledge has evolved to a new area of metabolic support which is addressed for the first time by a group of international experts. The topics presented and general conclusions are of major importance to the practitioners in this field, for they show, for the first time, a departure from the more traditional approaches of nutritional support in patients with life-threatening diseases.

In 1960, Dr. Van R. Potter and Dr. Henry Pitot (at McCardle Laboratory in Madison, Wisconsin), Dr. Tetsuo Ono (then at McCardle Laboratory and now at the Japanese Foundation for Cancer Research in Tokyo, Japan) and Dr. Harold P. Morris (then at the National Cancer Institute and now at Howard University, Washington, D. C. ) decided that an experimental cancer model would be an invaluable tool to examine neoplastic changes in cells. Since they were study ing the various highly specific metabolic processes which are unique to liver tissues, they determined that a transplantable liver cancer model would be the ideal system to work with. This system would provide for comparison of normal liver tissue of the non-tumor bear ing animal, the tumor bearing animal's (host) liver and the liver cancer. Dr. Morris undertook a series of rat studies employing several chemicals known to cause liver cancer. Soon the first Morris hepatomas (#3683, 3924A, 5123) were being studied by several labs. During the next 18 years, Dr. Morris developed and transplanted numerous strains of hepatomas of which no two were identical. These tumors ranged from the very slowly-growing, highly differentiated cancer tissues, e. g., 96l8A which is a diploid tumor containing gly cogen and a "nearly normal" complement of enzymes, to a large group of rapidly-growing, poorly differentiated cancer tissues, e. g."

This book presents a unique collection of clinical cases to help combat the difficulty of diagnosis and treatment of Syncope. Medical professionals using this book are provided with a reference to a large array of succinctly described and illustrated clinical scenarios. Each case is presented with the results of appropriate tests and critical comments about the evaluation, diagnosis and treatment according to guidelines. Syncope is considered a difficult diagnostic and treatment problem for all who work in the field. Regardless of your prior knowledge, you will find the case studies easy to digest, enlightening, and immediately pertinent to improving the care patients - giving you confidence in your diagnosis and your advice. The editors have developed a lively and easy-to-read book with a focused expert editorial commentary, offering the reader a broader and easily understood context for each case, as well as key citations from the literature. Syncope Cases is a valuable contribution to your collection; edited by seven prominent authorities on the management of syncope from four countries, with more than 130 contributors, this book provides a unique additional step in the fostering of a better understanding of the many factors that can cause syncope, with the ultimate goal of facilitating the delivery of more precise and cost-effective care for syncope patients. It is a contribution that should be widely read, and one that offers the possibility of distinctly enhancing medical care of the syncope patient.