A practical and richly illustrated step-by-step guide to successfully performing shoulder arthroplasty. The comprehensive text covers various topics, and also provides specific examples of complications and how to avoid and correct them.

According to popular belief, technical skill is far more important for surgeons than thoughtful deliberation. Nothing could be further from the truth. Although surgeons must sometimes make decisions rapidly on the basis of incomplete evidence and must respond to unexpected catastrophes in the operating room rapidly, those events are intermittent - most of the time surgeons deliberate on diagnostic problems and thoughtfully manage postoperative care, which is often intellectually challenging. The relationship of surgeons with their patients is, in a real sense, far more intimate and trusting than that of any other professional, a claim that is supported by the fact that patients surrender their bodies to their surgeons in a state of total helplessness and vulnerability when they undergo anesthesia. Because of that responsibility, no other professional group has a greater sense of dedication to the welfare of their patients than surgeons. Surgical culture is deeply steeped in ethics, and surgeons confront and resolve ethical dilemmas as much or more than most other professionals, although they often may not recognize the situations they resolve are problems in ethics - they are just part of the daily routine. This book is a compendium of articles from the recent surgical literature that address ethical issues chosen by surgeons because they are controversial and pertinent to the practice of surgery. The reader will not find a great deal of sophisticated dissection of fine philosophical distinctions in these discussions of ethical conflicts and controversies in surgery. Instead, they will discover differing viewpoints from thoughtful essayists, mostly surgeons, whose feet are firmly in contact with the ground and who have extensive experience in the real world of surgery, medicine, and law.

Endocrine Neoplasia is a comprehensive, updated, and clearly-written text covering the diseases for which endocrine surgical expertise is often needed. We look towards advances in the science and the art of endocrine surgery to continuously improve outcomes for our patients. The goal of this text was to provide a detailed description of both the underlying science of disease as well as the art of clinical management.

The book is divided into five sections addressing neoplasms of the thyroid, parathyroid, adrenal gland, neuroendocrine pancreas, and multiple endocrine neoplasia. Experts from the United States, Canada, and Australia have contributed chapters addressing both the biology of endocrine tumors and the clinical management of disease. Recent discoveries regarding the genetic underpinnings of disease are highlighted. Updated consensus guidelines were used for clinical recommendations. The management of complex and often confusing clinical problems is discussed in detail.

Technical and Biological Components of Marrow Transplantation presents up to date information on the scientific and technological advances that will extend and improve the clinical application of bone marrow transplantation. The book includes the latest information on chronic myeloid leukemia and thalassemia; advances in supportive care: cytokines and progenitor expansion; and cord stem cell technology. Soon more of patients will receive marrow transplants as part of the therapy for solid tumors and metabolic disease than for the treatment of hematologic disease. The contributors to this volume describe some of these applications, hinting at yet further, exciting possibilities.

This book provides a comprehensive overview of the cascade of events activated in the body following the implant of biomaterials and devices. It is one of the first books to shed light on the role of the host immune response on therapeutic efficacy, and reviews the state-of-the-art for both basic science and medical applications. The text examines advantages and disadvantages of the use of synthetic versus natural biomaterials. Particular emphasis is placed on the role of biomimicry in the development of smart strategies able to modulate infiltrating immune cells, thus reducing side effects (such as acute and chronic inflammation, fibrosis and/or implant rejection) and improving the therapeutic outcome (healing, tissue restoration). Current cutting-edge approaches in tissue engineering, regenerative medicine, and nanomedicine offer the latest insights into the role immunomodulation in improving tolerance during tissue transplant in the treatment of orthopaedic, pancreatic, and hepatic diseases. "Immune Response to Implanted Materials and Devices" is intended for an audience of graduate students and professional researchers in both academia and industry interested in the development of smart strategies, which are able to exploit the self-healing properties of the body and achieve functional tissue restoration.

Even the best hernia repair can result in postoperative difficulties for the patient caused by repair sequelae as for example pain, infertility, infection, adhesion and dislocation of the protheses. That can happen many years later and now, where the general principle of hernia repair is well understood all over the world, these sequelae are noticed more and more. To define them, to evaluate the absolute and relative risk of these sequelaes and to describe the ways of their prevention, diagnosis and treatment, the 5th Suvretta meeting had focussed on this subject. We discussed if there 's a principle risk by technique, material or both. The results of these discussions and the future handling and evaluation of this problem was the aim of this meeting. Even the best method can be made better by optimization of its single components.

Even the best hernia repair can result in postoperative difficulties for the patient caused by repair sequelae such as pain, infertility, infection, adhesion and dislocation of the prostheses. This can happen many years later, and now that the general principle of hernia repair is broadly understood all over the world, these sequelae are being noticed more and more. The 5th Suvretta meeting was held in order to define these sequelae, to evaluate the absolute and relative risks they pose, and to discuss the methods of their prevention, diagnosis and treatment. We discussed whether the principal risk was related to technique, material or both. This discussion and the future approach to and evaluation of this problem were the aims of the meeting, working on the premise that even the best method can be made better by optimizing its individual components.

Cataract Surgery: Maximizing Outcomes Through Research provides cataract surgeons with helpful information about cataract operations based on the latest fundamental and clinical research. This book comprehensively covers a wide range of topics from the basic principles of each treatment to today's hot topics such as femtosecond laser application, cataract surgery, and new intraocular lenses (IOLs) with accommodating or light-adjustable function. Detailed cutting-edge discussion is provided in each chapter with the addition of diagrams, photographs, and tables to help readers better understand the subject. Authored by leading international experts, the book covers topics from preoperative evaluations to postoperative care including evaluation of accommodation and pseudo-accommodation, glistening and visual function, the eye's image quality with a premium IOL, IOL power calculations, pupil size and postoperative visual function, posterior capsular opacity, corneal astigmatism, femtosecond laser techniques, and more. Cataract Surgery: Maximizing Outcomes Through Research is the perfect book for cataract surgeons and general ophthalmologists who wish to update their knowledge and make use of it in their everyday medical practice.

This book deals with heart failure in all its aspects, in- cluding chapters relating to receptor physiology and patho- physiological mechanisms, ventricular function and its assessment and the clinical aspects of heart failure in ischemic heart failure, cardiomyopathy, rheumatic heart disease and the timing of valve replacement. The pharmaco- therapy of heart failure deals with inotropic drugs, ACE in- hibitors, nitrates and calcium antagonists. Extending into the newer interventional techniques and surgical techniques the book includes chapters on balloon valvuloplasty, the po- tential use of the laser, the Jarvik artificial heart, car- diomyoplasty, left ventriculoplasty and heart and heart/lung transplantation.

This book, Recent Advances in Geriatrics, is based on the proceedings of the 8th Course of the School of Gerontology and Geriatrics held in Erice (Trapani, Italy) at the In ternational Centre for Scientific Culture "Ettore Majorana" on March 20-25, 1997. This international effort was organized jointly by professors from the University of Palermo (It aly) and from Wayne State University (Michigan, USA) as a result of a cross-cultural col laboration of several years. _ The increasing average age of the populations in industrialized countries has re sulted in increased interest in the different biological, medical, psychological, and eco nomic aspects related to the health and social care of the elderly. Physicians and health care practitioners are realizing the need for a revised approach to geriatric care. Comprising contributions of clinicians and scientists from Italy and North America, the present volume provides a multidisciplinary approach to many gerontological and geriatric problems, examined from a scientific and a practical point of view. Several of the most important aspects of the aging process - the genetics of aging, body composition modification, immunological, endocrinological, and renal physiology changes - have been addressed. Data from a multi-center Italian study on centenarians is reported, to gether with an update on clinical and pharmacological approaches to dementia syndromes and economic and social aspects related to the care of the elderly."

Infectious Complications in Transplant Patients has been uniquely designed and formatted to address issues and trends pertaining to pathogens deemed important in critically ill transplant patients. The chapters have been carefully selected so as to direct the focus of the book towards current approaches to controversial, emerging or topical problems in these patients. Each chapter has been authored by a North American and a European specialist. This format serves to impart an added dimension reflective of the diversity of opinions and practices pertaining to unresolved or controversial issues. The authors are recognized experts in their respective fields.

Among the readily available -emitting radionuclides, the nuclides of iodine have the greatest versatility in labeling both the hydrophilic and the lipophilic compounds that are used in biology and medicine. Biologically important micrmolecules, semimacromolecules, and macromolecules have been identified which, after iodination, almost maintain the same molecular configuration and similar biologic specificity as those of the parent molecules. The multiple techniques for iodination and the clinical use of iodinated products have made possible the present status of the development of diagnostic nuclear medicine. 125r, with a half-life of 60 days, has a crucial role in competitive protein-binding studies. 131r is useful for measuring thyroid uptake, for the diagnosis of thyroid carcinoma and metastasis, and for therapy. 1nr , with a reasonably shorter half-life, is almost ideal for thyroid workup and for a few useful labeled radiopharmaceutical. Although ~c is used more widely in diagnostic procedures, the radionuclides of iodine will always have a major role in biology and medicine. A considerable amount of information is scattered in the literature regarding the chemistry of radioiodination and the mechanism of tracer localization in cells and tissues. Labeled peptides, proteins, and antibodies are extensively used for protein turnover studies, receptor binding and tumor imaging studies, and radioimmunoassay. The general trend in the use of tracers in clinical nuclear medicine has been an evolution from 3H, 14C, 11C, and 13 to 125 , 131 and 123r to ~c and 111rn.

Written for residents and practitioners of otolaryngology, medical oncology, radiation oncology, and maxiollofacial surgery, this book provides the reader with a comprehensive, concise discussion of the best evidence available on which to base clinical decisions needed when managing patients with squamous cell carcinomas of the oral cavity, pharynx and larynx. Because of its accessible and practical format, this book is considerably different than other related titles on the market. Formatted with questions at the beginning of each chapter that are then answered with evidence and best practices available for each case, each chapter addresses situations the clinician is likely to face in the diagnostic evaluation and treatment of a patient with cancer of the head and neck. Most clinical decisions in the management of cancers of the head and neck region are based on the results of a few controlled, randomized clinical trial trials (Evidence Level I). However, most decision-making is based on the results of case-control studies (Evidence Level II), descriptive studies, reports of expert committees, or opinions of respected authorities (Evidence Level III). This information is scattered throughout the literature and often comingled with information about other topics. Therefore, there is a need for a publication in which the evidence pertinent to making decisions regarding a particular clinical problem is distilled from the literature and presented in a single concise, clinical, situation-driven source. Cancer of the Oral Cavity, Pharynx and Larynx: Evidence-Based Decision Making is just such a resource.

This series, sponsored by the European Association of Neurosurgical Societies, has already become a classic. In general, one volume is published per year. The Advances section presents fields of neurosurgery and related areas in which important recent progress has been made. The Technical Standards section features detailed description of standard procedures to assist young neurosurgeons in their post-graduate training. The contributions are written by experienced clinicians and are reviewed by all members of the Editorial Board.

The symposium from which this book originates represents a sig nificant watershed in the field of intraoperative neural monitoring, since the participants concluded that electrophysiologic monitoring techniques should be considered a "standard of care" for surgical pro cedures that place the central nervous system (CNS) at risk for injury. Specifically, it was agreed that the somatosensory-evoked potential (SEP) is a remarkably reliable and sensitive indicator of several aspects of CNS function, and should be routinely employed as an intraopera tive monitor during many neurosurgical and orthopedic procedures. The significance of this conclusion cannot be overstated, for at the time of this writing, intraoperative monitoring methods based on evoked-potential analyses are still considered experimental and are not in routine use. The reasons for this are not clear, given the accu mulation of literature and expertise on this subject over the past five years. Granted, the cost of electrophysiological monitoring equip ment is high, but only initially. The benefits of injury prevention far outweigh these costs, from both medical and economic viewpoints. It is our sincere hope and goal that the medical community be made aware of the value of intraoperative neural monitoring."

Anesthesia and the Central Nervous System is a textbook for a postgraduate course as well as a reference for all anesthesiologists which presents many of the latest concepts in anesthesiology within a brief formal presentation. An outstanding faculty presents topics relating to the biochemistry, physiology, and pharmacology of the nervous system, the anesthetic management of intracranial and spinal cord surgery, and the intensive care management of central nervous system disease. Each chapter is a brief but sharply focused glimpse of the interests in anesthesia. This textbook is the eleventh in a continuing series documenting the proceedings of the Postgraduate Course in Salt Lake City.

William P. Cooney III, R. A. Berger, and K. N. An Orthopedic Biomechanics Laboratory Department of Orthopedic Surgery Mayo Clinic and Mayo Foundation Rochester, MN 55905, U. S. A. As surgeons struggle to find new insights into the complex diseases and deformities that involve the wrist and hand, new insights are being provided by applied anatomy, physiology and biomechanics to these important areas. Indeed, a fresh new interaction of disciplines has immersed in which anatomists, bioengineers and surgeons examine together basic functions and principles that can provide a strong foundation for future growth. Clinical interest in the hand and wrist are now at a peak on an international level. Economic implications of disability affecting the hand and wrist are recognized that have international scope crossing oceans, cultures, languages and political philosophies. As with any struggle, a common ground for understanding is essential. NATO conferences such as this symposium on Biomechanics of the Hand and Wrist provides such a basis upon which to build discernment of fundamental postulates. As a start, basic research directed at studies of anatomy, pathology and pathophysiology and mechanical modeling is essential. To take these important steps further forward, funding from government and industry are needed to consider fundamental principles within the material sciences, biomechanical disciplines, applied anatomy and physiology and concepts of engineering modeling that have been applied to other areas of the musculoskeletal system.

Recent years have seen important advances in the technology and techniques available to surgeons performing gynecologic surgery as well as reconstructive of clinical pelvic procedures. These developments took place in a wide variety settings from regional teaching centers to private clinical facilities. In 1996, the leading investigators from around the world gathered to discuss the present status of pelvic surgery and adhesion prevention with a look toward the future of patient care. This volume contains the proceedings of that meeting: the Third Interna tional Congress on Pelvic Surgery and Adhesion Prevention. Each chapter in cludes the material presented at the congress as well as a timely update of the authors' latest research and clinical thinking. Presentation integrating basic and clinical science provide the basis for con sidering peritoneal repair after surgery including the interaction of growth factors and other biochemical messengers. Research has increased the understanding of mesothelial reepithelialization and has led to new surgical technologies to reduce adhesion fonnation. A state-of-the-art review of emerging surgical adjuvants for adhesion prevention is provided, including discussion of barriers, gels, and poly mers as well as "designer" drugs effective at modifying the peritoneal response to injury. Assessment of clinical outcome in a wide variety of gynecologic surgical procedures brings into focus the benefits available as a result of these new tech nologies."

Concise - designed specifically for the undergraduate medical student by a highly experienced team of surgical educators. Accessible - bullet text ideal for rapid reference, supported by key points boxes, tables and illustrations. Flexible - ideal for use when on the ward and during finals revision. Complete - print book supplemented by video clips and online question and answer material for the full learning and revision package.