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.

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.

The best conferences are often those where the participants are from a mixture of different disciplines. There is a cross fertilization of ideas and a wider perspective of common problems. The 6th International Meeting on Clinical Laboratory Organization and Management, held in Noordwijkerhout, The Netherlands, on 24th-28th June 1987 lived up to its promise of a stimu lating program and differing views from a wide range of international par ticipants. The theme of the conference was "Laboratory Data and Patient Care" and this provided a forum for discussion of many aspects of laboratory input into the diagnosis and monitoring of disease. The titles of the papers in this book of the proceedings will give some indication of the breadth of topics discussed, ranging from problems of laboratory management and pro fessional leadership to educating the clinician in the most cost effective testing strategies; and computer aided diagnosis to the best presentation of data and graphical displays. The backgrounds of the participants were equally wide, ranging from medical statisticians and computer experts to practising clinicians and heads of clinical laboratories. There was also a significant number of delegates from commercial companies who were able to inject a different perspective on many problems. This blend of backgrounds and disciplines promoted much discussion and new avenues for research and development."

Parasitic Disease, second edition remains unique in its emphasis on depictions of complete life cycles and its skillful knitting of basic and clinical information. Superbly illustrated with black and white and color photomicrographs and halftone drawings, it is an ideal text for medical, graduate, and advanced undergraduate students of parasitology and an excellent reference for physicians and researchers.

This is the second of a number of international symposia which will, I hope, continue to be held until atherosclerosis is no longer a major problem. The first symposium was held three years ago in Athens, Greece, under the chairmanship 1 of Dr. Constantinos]. Miras , who, although he could not attend this symposium, participated actively in the deliberations of this Program Committee. Atherosclerosis together with its sequelae constitute the most important source of morbidity and mortality in civilized countries. While a major attack is being made on the consequences, the sequelae of this disease, not enough attention is being paid to the basic cause, atherosclerosis. Yet, if the basic disease were eradicated, the major concern of this symposium, the sequelae would constitute only a minor and rare disease group. The approach of the Program Committee was to bring together experts in the multiple disciplines which have a bearing on atherosclerosis. There is a great need for an exchange of ideas from various groups studying the basic process in many divergent ways. The hope we have is that those present (or those later studying the Proceedings) may be stimulated to attack the problem in new ways. Perhaps a breakthrough will be made or, at least, a brick or two added to build the structure, a rampart needed to defend against atherosclerosis. Better still, their contributions may help to confine it to a small area.

Alcohol abuse is this culture's most important drug problem. Statistics indicate that it is exacting a great and relentlessly increasing toll of human suffering. It is clear that the problem is not being dealt with in any effective manner. At the invitation of the. Canadian Hepatic Foundation, many of the world's experts gathered in Toronto, May 14-15 1976, to focus attention on one of the most important aspects of the alcohol problem -alcohol induced liver damage. The epidemiology of alcohol induced liver disease was discussed and current views on the pathogenesis of the problem were reviewed. New insight into the pathological alterations of the liver was presented and some of our current therapeutic capabilities were discussed. Dr. Hans Popper summarized the Symposium and presented some of his views on those aspects of the problem which will require early attention by the research community. The Symposium achieved its immediate objective -that of bringing together the committed experts of various disciplines for an updating of our understanding of alcohol and the liver and for a discussion of new approaches to the problem. As a backdrop to the Symposium, however, was large writing on the wall to the effect that we are expending our research talents and efforts on a totally unnecessary problem. Right now we probably know enough and have sufficient resources at our disposal to solve the problem.

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 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).

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."

Completely revised and including new additional material, this second edition of the bestselling Get Through MRCGP: Clinical Skills Assessment provides candidates with a definitive, one-stop revision resource for the CSA part of the MRCGP examination.

• Fully revised in accordance with the current MRCGP and MRCGP(INT) curriculum
• Mock examinations cover a spread of topics and skills outlined in the RCGP curriculum
• Comprehensive discussion of areas that stations test and detailing points needing to be covered to achieve the best results
• Brand new material including six new cases and task boxes to refocus the reader's attention on the different challenges of each station
• Completely rewritten introductory chapter
• Offers valuable advice on how to approach the exam, focus time in day-to-day GP surgeries and how to develop skills required to pass the CSA

Written by an experienced author team that has extensive knowledge of both national and international primary care clinical skills assessment, Get Through MRCGP: Clinical Skills Assessment, Second Edition is essential reading for postgraduate candidates preparing for this challenging examination.

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.

Free radicals appear to play a mojor role in many neurological (and non neurological) dieseases. Both acute and degenerative disorders are thought to involve free radicals reactions in tissue injury (for a list see this book page 18). This issue is very important for basic science and for therapeuthic approach as well. In order to review and discuss the place of free radicals in psychiatry and neurology, a joint meeting was initiated by the World Health Organization and the Fondation Ipsen in Paris on June 17-18,1991. This book contains the papers presented during this meeting. Although the papers included in this volume have been produced in the framework of WHO/Fondation Ipsen review of knowledge about free radicals and brain disorders, they express the views of the individual authors rather than a consensus of the participants at the meeting. They do not necessarily represent the decision or stated policy of the World Health Organiszation or the Fondation Ipsen. The editors wish to express their appreciation to Mrs Mervaillie for the organization of the meeting and Mrs M.-L. Gage for her editorial assis tance. L. Packer, L. Prilipko, Y Christen Contents Free Radical Scavengers and Antioxidants in Prophylaxy and Treatment of Brain Diseases L. Packer ........................................... 1 Reactive Oxygen Species and the Central Nervous System B. Halliwell .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 . . . . . . . . .

Six members of the Herpesviridae family are human pathogens, including herpes and 2 (HSV-I and 2), Epstein-Barr virus (EBV), varicella zoster simplex virus I virus (VZV), human cytomegalovirus (HCMV), and human herpesvirus 6 (HHV 6). Each of these viruses is capable of causing distinct diseases of varying severity in children, young adults, and the aged. The diseases range from infection of epithelial tissue to the infection of internal organs and white blood cells. A common feature of the six pathogenic human herpesviruses is their ability to latently infect different cell types in which the viral DNA is not integrated and is unable to express its pathogenicity. Reactivation of the herpesviruses is a result of cellular processes which reactivate viral genes, leading to virus progeny and to signs of infection. Due to their ability to become latent after initial infection, once the pathogenic herpesviruses infect children they are maintained throughout life, having the potential of cause various diseases upon reactivation.

The proliferation of information on rotaviruses in the twenty years since their description as human pathogens has made it difficult to keep up with the latest developments in the field. Numerous aspects of rotavirus biology have been addressed in reviews, but these have been infrequent and quite selective in the material covered. The time appeared right to attempt to gather, into a single source, an overview of what we have learned. This volume is the result of that attempt. I hope that the reader will find in this single source, the core of information covering our current state of knowledge. I acknowledge my debt to the authors of the various chapters, for it is they who performed the tedious process of reviewing the literature and synthesizing and organizing it into concise works. R.F. RAMIG Contents Introduction and Overview R.F. RAMIG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Structure of Rotavirus B.V.V. PRASAD and W. CHIU .................... 9 The Rotavirus Genome U. DESSELBERGER and M.A. MCCRAE . . . . . . . . . . . 31 . . Rotavirus Protein Structure and Function G.W. BOTH, AR. BELLAMY, and D.B. MITCHELL 67 Rotavirus Replication J.T. PATTON . . . . . . . . . . . . . . . . . . . . . . .. . . . 107 . . . . . . .

The Fifth World Congress of the International Society for Diseases of the Esophagus was held in the historic city of Kyoto, Japan, from August 5 through 8, 1992. Approximately 40 countries throughout the world participated and roughly 500 presentations were made. Excellent authors were selected and they were requested to send in their manuscripts for publication of this book. It is our ardent hope that this book will prove to be beneficial to the doctor interested in the esophagus and that it will provide the reader with first-hand information from leading scientists and clinicians in this field. The incidence of esophageal diseases vary greatly from country to country and in recent years, worldwide interest in these diseases has resulted in various international studies. The International Society for Diseases of the Esophagus was inaugurated by Professor Komei Nakayama in 1979 and since that time it has actively contributed to the exchange of information regarding these diseases and has made endeavors in bringing about advancement in the struggle against diseases of the esophagus in every way possible.

On the occasion of a research visit to Thailand in my capacity as a member of the governing board of the South Asia Institute of the University of Heidelberg, I saw for the first time the severe clinical picture of dengue with haemorrhagic symptoms among Thai children. This visit had been made possible by Profes sor Dr. med. Dr. rer. nat. Ouay Ketusinh of Bangkok, to whom I wish to express my sincere thanks in this place. In 1972 the German medical literature - the periodical Medizinische Klinik, vol. 87, pp. 152-56, to be precise - had drawn attention to this new phenomenon in the disease panorama of South East Asia, indicating a change in dengue fever from being a relatively benign tropical dis ease to a form having serious clinical and epidemiological ramifications. During the ten years following my first publication the new clinical picture, described as "dengue haemorrhagic fever," has become a standard component in the Thailand's system of notifiable diseases. So too, the World Health Orga nization publishes regular reports in its Weekly Records. On March 30/31, 1981, its Regional Office for South East Asia convened a special conference in New Delhi, thus emphasizing the significance of the diffusion of this new clini cal picture in the states of South East Asia."

Bronchoscopy means pictures: but to comprehend an image we have to learn to see. These excellent photographs, all taken by the author himself, not only instruct us in the art of seeing just about all there is to see in the bronchial system but also illustrate many relationships between visual appearances and the clinical situation. They go even further in correlating bronchoscopic find ings with the function of the lung. Treated in this way, the image comes alive. Anyone who has come to know DE KOCK as a brilliant clini cian, or who has worked with him in the lung function labo ratory - he has made important contributions in this field also would have expected him to produce a monograph of this calibre. Now we have such a book. It contains the selected results of many years' solid work. Due attention is, of course, also accorded the merits of the various bronchoscopic techniques which provide the essential background to satisfactory results. In writing this book DE KOCK has succeeded in projecting a vivid image of the bronchi and the functional lung into our mind's eye. This work undoubtedly opens new prospects in improved care of our patients.

Experimental gerontological research is necessary to obtain optimal information and thus ensure proper drug therapy for the elderly. Most older persons acquire multiple diseases, first of all chronic diseases. They involve complex problems of a physical, social, and psychological nature. The multimorbidity of the elderly raises many questions in drug therapy. By contrast with our extensive knowledge of pharmacokinetics and pharmacodynamics in younger age groups, few facts are available in respect of the elderly. A variety of factors may influence drug therapy. Physiological and pathological age-related changes of molecules, cells, organs, and the total organism may interact to enhance or inhibit drug therapy in higher age groups. It is well known that elderly patients are overmedicated and therefore the incidence of adverse drug reactions increases with age. Elderly patients with multimorbidity often have a diminished body clearance of drugs; age-related changes of the kidney seems to be one of the most important factors in this regard. Far less important than the elimination of drugs through the kidney is their excretion in the bile. So far results have disclosed that oxidative steps in drug clearance are more likely to be disturbed than phase II reactions. Furthermore; changes in distribution volume and age-related alterations in receptor sensitivity also influence the clearance of drugs in the elderly.

Infectious diseases are transmitted through various different mechanisms including person to person interactions, by insect vectors and via vertical transmission from a parent to an unborn offspring. The population dynamics of such disease transmission can be very complicated and the development of rational strategies for controlling and preventing the spread of these diseases requires careful modeling and analysis. The book describes current methods for formulating models and analyzing the dynamics of the propagation of diseases which include vertical transmission as one of the mechanisms for their spread. Generic models that describe broad classes of diseases as well as models that are tailored to the dynamics of a specific infection are formulated and analyzed. The effects of incubation periods, maturation delays, and age-structure, interactions between disease transmission and demographic changes, population crowding, spatial spread, chaotic dynamic behavior, seasonal periodicities and discrete time interval events are studied within the context of specific disease transmission models. No previous background in disease transmission modeling and analysis is assumedand the required biological concepts and mathematical methods are gradually introduced within the context of specific disease transmission models. Graphs are widely used to illustrate and explain the modeling assumptions and results. REMARKS: NOTE: the authors have supplied variants on the promotion text that are more suitable for promotionin different fields (by virtue of different emphasis in the content). They are not enclosed, but in the mathematics editorial.

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.