Die Konstellation scheint rar, die Loesung simpel: Wenn eine Schwangere stirbt, ihr Herz-Kreislauf-System und mithin die Schwangerschaft aber kunstlich auch nach dem Hirntod noch aufrechtzuerhalten sind, muss das Kind gerettet werden. Ist die Frau zudem Organspenderin, koennen freilich auch ihre Organe transplantiert werden. In dieser Absolutheit indes birgt dies einige medizinische wie rechtliche Fehler. In dieser Arbeit werden die medizinischen Umstande der Konstellation erlautert, um zu einer dogmatisch konsistenten wie praktikablen juristischen Loesung zu gelangen. Zu hinterfragen gilt, ob und wann die AErzte die Schwangerschaft abbrechen durfen, wann sie dem Ungeborenen Sterbehilfe leisten koennen und sollen. Zudem geht die Arbeit der Frage nach, wer entsprechende Entscheidungen trifft.

Despite the fact that the incidence of gastric cancer is declining in the Western world, it remains a significant problem with respect to accurate diagnosis and treatment since it has a high mortality rate. In June 1989 an International Conference was held at the University of Rome "La Sapienza" entitled "New Trends in Gastric Cancer: Background and videosurgery." During this meeting background information on the aetiopathogenesis of gastric cancer was presented together with talks and video presentations on the latest advances in the treatment of gastric carcinoma, both from the European and Japanese experience. Because of the poor prognosis of gastric carcinoma there is increasing pressure for early detection. Some of the problems in the early detection of gastric carcinoma are discussed together with methods of surveillance of high-risk subjects. It is generally accepted that the surgical approach to gastric carcinoma should take into account the site and extent of the lesion and there are chapters on new methods for pre and intraoperative staging of the disease which allow a more logical approach to surgery. A comparison between Japanese and Western rule and results was attempted and reasons for the differences were investigated. Since the field is still evolving not all aspects could be covered, and those angles not approached in this book will be addressed in a second International Conference to be held in Rome in June 1990.

Legal action involving doctors, either as defendants or expert witnesses, has greatly increased over the past decade and few can now remain aloof from this aspect of their profession. Written by doctors (including five Council Members of the Medical Defence Union of Great Britain) and lawyers, this practical guide offers clear and comprehensive advice to all concerned. Part I discusses how to write medical reports, especially when consent is required or confidential information is involved. Part II covers contentious issues in various clinical specialties which repeatedly arise in litigation; well-known examples are cases involving whiplash injuries or perinatal brain damage. In Part III lawyers discuss the medico-legal problems of the solicitor's role, court testimony and medical negligence. This book is a valuable reference to all members of the medical profession. Lawyers, officials and others outside the medical profession who come into contact with medical litigation but have limited medical knowledge will find much helpful information.

With this book we* want to address young graduate students, clini cians involved in transplantation, and technicians in transplantation immunology laboratories. The volume should give a comprehensive but basic, up to date introduction to the structure, function, and clinical importance of the HLA system. We believe that there is a need for such a survey, and think that the present level of our knowledge is an optimal occasion for publication. A significant number of ques tions have now been resolved, and our knowledge has reached a level of sophistication that provides the basis for additional questions and answers. Although the emphasis of this book is on the role of HLA anti gens in clinical transplantation, their involvement in other clinical contexts is also discussed. The main focus is on the human MHC an tigenic system, but MHC systems in other species are described as they contribute to our understanding of the structural and functional characteristics of HLA antigens. Some important issues related to laboratory techniques are also covered. The contributors have a close affiliation to the field of transplan tation immunology. A majority have even been playing important roles in unraveling the HLA system and its functions. We believe this has contributed significantly to the quality and clinical and practical relevance of the book. As editors, we drew up the principal guidelines and took care that the chapters can be read as separate entities, although this invariably results in some overlapping.

The title of this book is a challenge. Anyone with the least knowledge of present day urology will know that there are many very controversial aspects of this subject. Urology is not alone in this unsettled environment for there are similar debates in almost all other aspects of surgery. In addition to the rapid changes in technology, an important part of the explanation for these controversies is simply that more surgeons are prepared to admit that no area of their work is so established that it does not bear further scrutiny and assessment. Argument can be tedious but debate is healthy. This book aims to present material that is debatable: experienced practitioners of each topic explain why an opinion or preference can be sustained. The purist might wish to have these opinions resolved by a well-planned clinical trial, but experience of clinical trials shows that they do not always produce results that are easily translated into a positive change in clinical practice. Would the reader be persuaded more by a statistically significant difference or by an experienced clinician who has reached certain conclusions? Both are risky, but since surgical techniques are often not easily converted into appropriate studies or trials the Editors have obtained the best opinion on each controversy and innovation. The media adore controversy for its own sake. The medical profession accepts controversy but knows that few events in medicine are absolute and few procedures can be done only by one method.

J.F. Crul The topic Legal Aspects of Anaesthesia is still rarely treated in book publications, but deserves increasing attention as more cases of litigation occur each year and anaesthetists also become more aware of the legal structure within which they practice their profession. I am happy to have been able to obtain the cooperation of experts in this field from various European countries. The contributing authors in this book come from both the anaesthesia and surgery side as well as from the jurisprudential background. As these two fields have their own professional jargon we have been very careful in using definitions, avoiding that a specific term might lead to misunderstanding and confusion. The international authorship did not facilitate this task. The subject of this book was also the topic of a meeting of the European Academy of Anaesthesiology held at the French Study Center, La Suquette, Saint Vincent Ie Palue~ held three years before publication of this book. The organizers G. Barrier, J.F. Crul, and J. Lassner felt the need for a book publication presenting the state of the art of anaesthesia and the law in European countries. With the present book this plan has been realized. During the meeting many subjects were thoroughly discussed and the editor considered a number of them as very informative and therefore these were included in this book.

Urinary incontinence is becoming an increasingly dominant condition in daily urological and gynaecological practice, although the total number of patients suffering from the different forms ofincontinence remains unclear. An estimated figure for The Netherlands, with a population of 14 500000, has been given as between 500000 and 600000 patients, showing that approximately 4 % of the total population suffer from this condition, the majority being female. The impact ofthis number is tremendous, not only regarding health care costs, but even more with regard to the psycho-social consequences. It is obvious that continuing efforts must be made to under stand more fully the different forms of urinary incontinence. An exact diagnosis is the first step necessary for adequate therapy. We all know how disastrous it can be to institute inappropriate treatment as a consequence of misunderstanding the proper aetiology in each individual case. What has happened in the past 15 years? During that time we have developed sophisticated machinery to diagnose in more detail the exact ori gin of each type of urinary incontinence, and on entering a urodynamic laboratory, one is struck by the complexity of measuring equipment. But how reliable are all these measurements and how can they be translated into an effective therapy? This still remains one ofthe major problems, although continuing progress has been made and will be made by the research work of many experts in the field of urinary incontinence."

2. Stone extraction via the T-tube 89 3. Endoscopic method 89 4. Preparation for stone extraction 90 5. Technique 90 6. Results 91 7. Complications 91 8. Discussion 91 Index of Subjects 99 CHAPTER 1 INTRODUCTION This book was conceived as a descriptive atlas of most reliable indication for common bile duct ex routine biliary surgery i. e., cholecystectomy and ploration. The cholangioscope allows a visual ex exploration of the common bile duct. For the pro ploration of the biliary tree and permits the re ject the two authors worked together for one week moval of common bile duct calculi and other as biopsy under direct visual con at Ninewells Hospital and Medical School, Dundee procedures such on a series of patients with biliary tract disease trol. Both procedures have been described in detail especially selected for the exercise. With the con with emphasis on the practical aspects of their use. sent of the Tayside Health Board and the patients The era of blind bilary surgery is over and the concerned, all the operations and peri-operative sooner this message is received by all concerned, procedures were filmed by the photographic mem the better the outcome of biliary surgical practice bers of the team, Mr. and Mrs. Paz-Partlow. Ad overall. ditional case material has been obtained from It has not been our intention to produce a com Cedars Sinai Medical Center, Los Angeles."

This handbook is an up-to-date, evidence based quick, easy reference guide for expert regional anesthesia providers. It will also be an invaluable tool and a great entry point for amateurs' sonographers who wish to understand the basics of ultrasound, its uses for diagnosis and treatment, current guidelines and standards of care. It presents in details challenges, stratification of risks, techniques, and approaches to facilitate effective ultrasound use in perioperative pain control and emergency room pain management. This uses an outline, schematic approach for easy understanding and retention. The applications of ultrasound are vast and cover the full spectrum of ultrasound guided regional anesthesia. This book concentrates and encompasses the most clinically relevant information as a first aid use of perioperative ultrasound. The chapters are concise, focusing on clinical presentations, diagnosis, differential diagnosis which will help you to deliver patient care in a timely and skillful manner. This compact book is packed with relevant, remarkable information related to ultrasound guided techniques and evidence-based protocols and latest guidelines for regional anesthesia, nerve blocks, and opioid-reducing analgesia to promote early recovery after surgery. Concise, practical, and clinically applicable for various specialties, this book fills the unmet need for understanding the usefulness and techniques of ultrasound and its application in perioperative pain management, in particular regional anesthesia and nerve blocks. This handbook enables every physician, nurse, resident and all medical staff to understand the essentials of ultrasound and regional anesthesia, its evolving techniques, and the use of modern equipment to provide patient care safely.

Management of salivary disorders encompasses a broad array of diseases, both benign and malignant. To better demonstrate the evolution of this field and its diagnostic and therapeutic management, the contents of this book have been organized to reflect the diverse nature of salivary gland anatomy, physiology, and dysfunction in various states of disease. This text first addresses practical office-based diagnostic approaches. It continues with congenital and acquired salivary dysfunction, including the goals for restoration of gland function. The third portion of this book provides detailed information on assessment and therapy for benign and malignant tumors of the major and minor salivary glands. Each chapter is authored by internationally known authorities in this field. Illustrative photographs and sketches are included in each chapter, to demonstrate the disorders and surgical techniques described. In summary, this comprehensive book serves as a useful reference and practical manual for clinicians dealing with salivary gland disorders. Whether as an introductory or advanced reference text, the reader will find that this book fulfills an important role in the management of salivary gland diseases.

A new, comprehensive review of the radiographic examination of the post-operative GI tract. Organized on an organ-by-organ basis, emphasis is placed on conventional studies, supplemented by cross-sectional imaging. Operative techniques and normal post-operative anatomy are depicted with many schematic line drawings. Normal changes, as well as early and late complications are discussed and abundantly illustrated. A must-have reference for general radiologists, specialists in gastrointestinal surgery and radiology medical libraries.

This book provides a complete guide to laparoscopic sleeve gastrectomy and the management of obesity. The chapters discuss guidelines for healthcare providers for the management of patients with obesity, the rationale behind choosing patients, performing the procedure in line with the patient's condition, the perioperative period, postoperative requirements, and postoperative complications. This book aims to give readers an understanding of the surgical techniques involved in laparoscopic sleeve gastrectomy and the wider treatment options available. It is relevant to bariatric, metabolic, and general surgeons, physicians, clinical nutritionists as well as students.

Leading physicians from a variety of medical specialties summarize their clinical experiences in treating pituitary adenomas in United States and the United Kingdom. Using simple language to describe their approaches, the authors describe the latest treatments for prolactinoma, acromegaly, Cushing's disease, and nonfunctioning pituitary tumors, and the latest surgical techniques. To round out the clinician's understanding of the illness, a patient describes the experience of diagnosis, treatment, and follow-up. Comprehensive and accessible, Management of Pituitary Tumors: The Clinician's Practical Guide brings together all the medical fields involved in treating pituitary tumors, both for novices in the specialties that manage these cases, and for pituitary specialists seeking to understand better the contribution of other medical disciplines to the treatment of these tumors.

James C. Fang, MD, and Gregory S. Couper, MD, have assembled a panel of prominent surgeons and cardiologists to review the latest clinical, scientific, and investigational surgical and mechanical approaches to heart failure in hopes of improving the lives of this challenging group of patients. Topics range from such traditional strategies as high-risk surgical revascularization in advanced coronary artery disease, to more novel approaches such as ventricular reconstruction and mechanical assist devices. Many chapters are contributed by the original pioneers of specific surgical techniques, which provide s invaluable perspective from personal experience.

AErzte gelten als Halbgoetter in Weiss und Chirurgen sind fur viele so etwas wie die Elite der AErzteschaft. Der Chirurg hat das Image eines Machers, er fasziniert, sein Alltag erscheint vielen unheimlich spannend und spektakular. Schliesslich verabreicht er keine Pillen, nein, er schneidet in die Haut - und das ist immer eine Grenzerfahrung. Dieses Buch ermoeglicht einen Blick hinter die hermetisch verschlossenen Turen der OP-Sale. Was geht dort vor sich? Welche Fahigkeiten muss der Operateur besitzen? Wie fokussiert er sich und wie bekommt er seine Emotionen in den Griff? Fragen wie diese werden in den dreizehn Kapiteln des Buches beantwortet - und das nicht in Form theoretischer Abhandlungen oder fiktiver Geschichten, sondern anhand ganz konkreter Erfahrungen des Autors, die er in seiner uber 40-jahrigen beruflichen Laufbahn sammeln durfte. Und es zieht Parallelen zum Leben ausserhalb der Krankenhauser, da letztlich in jedem Unternehmen und fur jeden Menschen dieselben Fahigkeiten und Eigenschaften wichtig sind: sich fokussieren und Ziele setzen, handeln und Druck von aussen managen, innovativ sein und das Team einbinden. Mit den konkreten Handlungsanleitungen gelingt die Umsetzung ganz einfach im Beruf oder privaten Alltag.

Magnetic resonance cholangiopancreatography (MRCP) is a novel non-invasive technique for diagnosis of pancreatic-biliary disease. The purpose of this book is to highlight the advantages, limitations and indications of MRCP. Specific examples have been selected to showcase the utility of this technique in a large variety of clinical conditions. Each example is purposefully used to stress important technical features, to give practical advice, or to discuss the role of MRCP in specific clinical situations. Important features of the book are the high quality of the illustrations, the reduction of the text to relevant and practically useful issues, and the simple and logic organisation of the case material. The book should show: the optimal technique in MRCP, the pitfalls and limitations.

This book discusses the management of various aspects of the professional life of newly qualified urologists as well as more experienced urologists. It features clear, easy-to-read chapters covering various topics, including clinical and surgical patient care, administrative duties, and research despite the increasing constraints on time and resources in today's hectic practice environment. Navigating Organized Urology: A Practical Guide systematically presents a range of practical strategies for a successful transition from trainee to practising urologist, while also offering more experienced urologists a fresh perspective on efficient management and successful adaptation of their practices for the modern age.

Written by leading American practitioners, the Oxford American Handbooks of Medicine each offer a pocket-sized overview of an entire specialty, featuring instant access to guidance on the conditions that are most likely to be encountered. Precise and prescriptive, the handbooks offer up-to-date advice on examination, investigations, common procedures, and in-patient care. These books will be invaluable resources for residents and students, as well as a useful reference for practitioners.
Part of the most popular medical handbook series in the world, the Oxford American Handbook of Surgery is a dependable manual geared for ultra-quick reference any time. It is comprehensive enough to serve as a mini-text, yet it is thin and light and uses concise, bulleted text, quick reference tabs, four-color presentation, and bookmark ribbons to help provide fast answers on the ward. Written by an acclaimed author, this Handbook presents information in a succinct, comprehensive, and affordable volume in the proven format of the Oxford Handbook Series.

Why choose the Oxford American Handbook of Clinical Surgery?
The design....
The Handbook uses a unique flexicover design that's durable and practical. Compact, light, and fits in your pocket Also has quick reference tabs, four-color presentation, and bookmark ribbons to help provide fast answers.
The interior layout....
The Handbook is a quick reference in a small, innovative package. With one to two topics per page, it provides easy access and the emergency sections are in red to stand out. Icons throughout aid quick reference.
The information....
The Handbook succinctly covers all the essential topics in a one or two-page spread format with colored headings that break up the text and provide a logical structure for readers of all levels. Common clinical questions are answered clearly and extensively.
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Oxford University Press is known around the world for excellence, tradition, and innovation. These handbooks are among the best selling in the world.
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You get an extremely useful tool at a great value

This comprehensive book presents the latest evidence-based data on pancreatobiliary malignancies, including the epidemiology, examination, treatment and endoscopic management. It explores a range of topics, such as risk factors, detection strategies, and novel treatment approaches like precision medicine and immunotherapy. Although there have been rapid improvements in the management of these diseases, the survival period has not yet reached a satisfactory level. This book will help those doctors needing to share the latest information with the patients and their families. It provides a wealth of practical information to help surgeons, endoscopists and oncologists as well as physicians, basic researchers and professionals at medical device and pharmaceutical companies broaden their understanding of the current treatment and management strategies for pancreatobiliary malignancies.

In 104 cases featuring over 500, high-quality images, Interventional Radiology Cases is a thorough and accessible review of the interventional procedures that radiology residents are expected to be familiar with upon completion of residency and general radiologists need to know for recertification examinations. The cases present both benign and malignant conditions and all pertinent imaging modalities incorporated including: CT, MR, PET, fluoroscopy, and ultrasound. Part of the Cases in Radiology series, this book follows the easy-to-use format of question and answer in which the patient history is provided on the first page of the case, and radiologic findings, differential diagnosis, teaching points, next steps in management, and suggestions for furthering reading are revealed on the following page.

The human face should be in perfect harmony and balance along with ideal functioning of the stomatognathic system... was a view idealised by Apollo Belvedere, who created the neoclassical Greek sculpture of the head and face. However, Nature ensures that all of us are not blessed with perfect faces. It is for the resolution of these imperfections that orthodontic treatment is sought. But for patients whose problems are so severe that neither growth nor camouflage offers an ideal solution, surgical realignment of jaws or repositioning of dentoalveolar segments is the only choice. Surgery is not a substitute for orthodontics in these patients; instead, it must be properly coordinated with orthodontics and other dental treatment to achieve overall positive results. With recent advances in surgical technology, it is now possible to treat these patients successfully for whom orthodontic camouflage would have resulted in esthetically unacceptable and often unstable results. This art and science of diagnosis, treatment planning, and execution of treatment of dentofacial deformities by combining orthodontics, oral and maxillofacial surgery to correct severe musculoskeletal, dento-osseous, and soft tissue deformities of the jaws and associated structures is called orthognathic surgery. Successful orthognathic surgery demands the understanding and cooperation of the oral and maxillofacial surgeon, orthodontist, and general dentist. Each must provide a proper diagnosis and treatment plan, perform necessary treatment and refer to necessary treatment outside his or her respective area of expertise. In order for patients to receive state-of-art care when correcting their deformities, the orthognathic team must: 1. recognise the various characteristics of malocclusion and dento-facial deformity; 2. define the nature of the problem, including the possible etiology; and 3. design a treatment strategy based on the specific needs and desires of the individual. In this modern era, the role of the doctor has shifted from that of sole decision maker in the planning process to that of a partner with the patient as co-decision-maker. Therefore, the clinician must not overlook the importance of including the patient and parents in the treatment planning process. Ackermann and Proffit have suggested that clinicians are generally more influenced by objective findings (problem list) and patients are more influenced by subjective findings (their perception of their needs and values). This dichotomy makes communication an effective tool when one is faced with the decision between orthodontic camouflage and surgical orthodontic correction. The authors' of this book examine the diagnosis and treatment planning in orthognathic surgery.

Praxiswissen kompakt: OP-Instrumente im UEberblick Dieses Buch bietet allen Mitarbeiterinnen und Mitarbeitern im OP - OP-Pflegekrafte und OTAs - einen kompakten UEberblick der wichtigsten chirurgischen Instrumente und deren Instrumentation. Gleichgultig, ob Sie schon erfahren im OP sind oder der Bereich neu fur Sie ist: hier lernen Sie OP-Instrumente sicher zu erkennen, gezielt vorzubereiten und einzusetzen. Profitieren Sie von den erfahrenen Autorinnen und meistern Sie Ihren Arbeitsalltag souveran. Ein Fachbuch fur alle OP-Mitarbeiterinnen und operations-technische Assistentinnen: Fur die Einarbeitung neuer Mitarbeiterinnen und Mitarbeiten, Grundlagenwerk fur die Fachweiterbildung oder zum Nachschlagen bei Fragen zum Instrumentarium. Neu in der 4. Auflage: Komplett aktualisiert mit uber 200 aktuellen Abbildungen.

Recent topics of interest in neurosurgery are discussed in selected papers in this volume. The first major topic deals with vascular malformations of the brain, where neuroradiological interventions and microneurosurgical treatment present major advances. The second major topic covers treatment patterns for various supratentorial tumors in Ahildhood. The interdisciplinary aspects of neurosurgical intensive care, particularly electrophysiology and anesthesia, are treated extensively.