- Unlike previous atlases that deal with overall surgical techniques, this book goes into greater detail and focuses on individual cases.

- Lavishally illustrated with 534 illustrations, 133 of which are in color.

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****VERKAUFSKATEGORIE*** 0 e

An intense discussion has recently begun regarding current standards in the diagnosis and treatment of benign prosta tic hyperplasia (BPH). A number of factors have led to this discussion. In an increasing proportion of aging men, for example, BPH causes so-called obstructive symptoms that must be relieved by medical or operative means. This entails an immense social and economic impact in terms of health costs. In addition, recent data indicate the most frequently performed operation for BPH - transurethral resection of the prostate - is associated with a higher risk of death due to cardiac disease than open prostatectomy. Furthermore, studies using the recently developed technique of uro dynamics to assess bladder outflow obstruction reveal that about 20% -30% of patients treated with transurethral resection or open prostatectomy are actually not obstructed. This means that these patients do not receive the most effective therapy. Finally, various new treatment been developed, including medical treat modalities have ment directed at endocrine pathways in the prostatic cells, balloon dilatation, spirals, temporary or permanent stents, C). nd the application of heat in hyperthermia or thermo therapy. The contributions to this volume were selected from a symposium on the diagnosis and treatment of BPH. They are intended to provide a comprehensive review of the state of the art in treating BPH. Aachen, Liege, Maastricht, September 1992 The Editors Contents Development of Benign Prostatic Hyperplasia 1 J. E. Altwein and H. Baur Bladder Outflow Obstruction: Definition, Clinical Application, and Grading in Benign Prostatic Hyperplasia. . . . . . ."

Medical Applications of Microcomputers deals with microcomputer applications in a wide area of clinical medicine. Recent developments are discussed in several clinical specialties including medicine, surgery, urology, anaesthesia and oncology. Topics include the storage of analysis of clinical audit data, the display of processing of data from direct physiological measurements and computers in control of therapy. The authors draw on their practical experience and knowledge of specific areas to which they have applied modern microcomputer techniques and give detailed descriptions of the means by which the problems that may be encountered may be overcome. Those wishing to implement their own computer systems will find this book a useful further source of ideas and techniques which add to those described in the earlier volume "Microcomputers in Medicine" by the same editors.

This book covers the molecular and cellular aspects of cancer metastasis, and discusses the clinical aspect of micro- and macro-metastases, which result in the death of the majority of patients with cancer. The current edition attempts to examine the current status of the basic scientific and clinical research in the area, and is a very useful reference for clinicians, oncologists, and biologists. It is intended for undergraduates as well as postgraduates in the area of medicine, oncology, and cancer biology.

The events of September 11,2001 in the United States will always be r~membered with horror and sadness but also admiration for those who risked, and often lost, their lives attempting to save others. When the Fifth International Germ Cell Tumour Conference began, the US air space was closed and our American friends were unable to join us. We were faced with a programme that now had many gaps. What happened next was an illustration of the sense of community that prevails at the Germ Cell Tumour Conferences. Some of those who could not be there in person, such as Richard Foster and Craig Nichols, sent their slides by email, and we were indebted to those, such as Michael Jewett, Ben Mead and Malcolm Mason, who stepped into the breach to present them. Others gave impromptu, and often thought provoking, talks. The discussion periods were lively and it will come as no surprise to those who regularly attend the meeting that Tim Oliver won the prize for "Most Questions Asked", managing even to ask questions following his own presentations. The quality of the talks was outstanding. There was closer integration of the adult and paediatric sessions than in previous meetings. As a result, the differences and similarities between adult male, female and paediatric germ cell tumours became more apparent. This cross-fertilization of ideas from different groups will no doubt lead to further advances. As a result of all these efforts, the conference was a great success.

In 1986, the Committee of Experts on Blood Transfusion and Immunohae- tology of the Council of Europe chose for their Programme of Co-ordinated Research "An investigation of the procurement and sharing of transplantable organs for potential recipients who are highly sensitized to HLA-antigens." This topic was of common concern to all centres practising renal transplan- tion. The terms of reference of the study were: To estimate the number of patients who are virtually "untransplantable" because of high sensitization in each European country. To study the nature of immunization in terms of the type and specificity of antibodies present in the blood and techniques used for their detection. To investigate possible practical solutions - both current and future, invo- ing cross-matching procedures, the circulation of reference material from patients, and the willingness of the national organizations to share resources. 4. To explore other methods of resolving this problem. Although the study did not offer the prospect of a brilliant new insight into the problem of high sensitization, it was unique in several ways: for the first time we saw all European organizations collaborating in a common project to provide information on their activities, their problems and the methods to resolve them; it introduced, for this subject, relatively novel statistical methods to investigate susceptibility to sensitization and factors affecting transplant outcome; it enabled a large database of transplanted highly sensitized patients and matched controls to be assembled, that would have been unavailable as a research resource at any single centre.

Examining the complex dynamics of medical treatment options and the variable character of surgical technologies, this volume broadens and transcends the notion of technological innovation. Surgery is an ideal field for examining the processes of technological change in medicine. The contributors to this book go beyond the concept of innovation, with its focus on a single technology and its sharp dichotomy of acceptance versus rejection. Instead they explore the historical contexts of change in surgery, looking at the complex dynamics of the various treatment options available -- old and new, surgical and nonsurgical -- as well as the variable character of the new technologies themselves, thus broadening and transcending the notion of technological innovation. CONTRIBUTORS: Christopher Crenner, Sally Frampton, Delia Gavrus, Lisa Haushofer, David S. Jones, Beth Linker, Shelley McKellar, Thomas Schlich Thomas Schlich is the James McGill Professor of the History of Medicine at the Department of Social Studies of Medicine at McGill University. Christopher Crenner is the RalphMajor and Robert Hudson Professor and chair of the Department of History and Philosophy of Medicine at the University of Kansas Medical Center.

This book covers the clinical approach to managing head and neck pathology as it presents to the otolaryngology department. Including cervical lymphadenopathy, salivary gland disease, oral, oropharyngeal, laryngeal and hypopharyngeal lesions as well as thyroid and parathyroid diseases. Each chapter presents an evidence-based, practical, and user-friendly approach to assessing, investigating and managing these patients A practical, clinically applicable guide to managing head and neck pathology An evidence-based approach to the clear guidance provided in the book. Colour images and flow charts for quick reference Clear, concise and comprehensive, Head, Neck & Thyroid Surgery: An introduction and practical guide will be useful to trainees and clinicians in otolaryngology, maxillo-facial and plastic surgery.

From the foreword: "Microsurgery of Retinal Detachment is an important contribution to the practice of vitreoretinal surgery. In this comprehensive volume, Dr. Bonnet shares her extensive experience in the management of conditions ranging from retinal tears and primary retinal detachment to giant retinal breaks and vitreoretinal surgery. The field of microsurgery has continued to evolve over the last twenty years, both for the anterior segment surgeon and, since 1970, for the vitreoretinal surgeon. Although there have been extensive descriptions of vitrectomy techniques, little has been written about microsurgical techniques for scleral buckling operations. This subject is well covered in the present edition, which consequently will be a valuable resource to the majority of retinal surgeons who do not as a rule employ microsurgery in the repair of retinal detachments."

Contents: The Use of Immunohistochemistry: Present and Future - The Expression of Vimentin in Epithelial Neoplasms - Morphologic Manifestations of Malignant Lymphomas in the Spleen. A Histologic and Immunohistochemical Study of 500 Biopsy Cases - Demonstration of Epstein-Barr Viral Genomes in Routine Paraffin Sections of Lymphoproliferative and Epithelial Lesions by in Situ Hybridization - Carcinoma of the Lung;Changing Sex Distribution and Histopathologic Cell Types - Pulmonary Pathology in Lung Transplant Patients - Bronchiolitis Obliterans with Organizing Pneumonia and Constrictive Bronchiolitis: Comparative Analysis ofTwo Distinct Entities - Lymphoid Interstitial Pneunomia in HIV Infected Individuals. Long-Term Clinicopathologic Observations in 52 Patients and Pathogenesis - Genital Human Papillomavirus (HPV) Infections and Their Associations with Squamous Cell Cancer: Reappraisal of the Morphologic, Epidemiologic and DNA Data - Central and Peripheral Bronchial Carcinoids Possess Distinct Peptide Immunostaining Patterns - Diagnosis of Rhabdomyosarcomas with Particular Reference to Immunohistochemical Markers - Borderline Lesionsof the Gastric Epithelium: New Indicators of Cancer Risk and Clinical Implications - The Pathology of Secondary Human Yolk Sac in Spontaneous Abortion: Findings in 103 Cases

Vascular pathology is essentially based on a transverse, the main basic lesions, this book provides precise multi-organ approach to pathology. It has been the descriptions in all of the main areas : atherosclerotic, subject of only a few reference works as it tends to be inflammatory, dysplastic, and traumatic diseases, etc. ignored by organ specialists. However, the vascular Throughout this book, the lesions are precisely system is widely distributed in all tissues ; it is modelled described with identification of the various recognized very early during organogenesis by haemodynamic syndromes and discussion of the main established factors, it possesses a remarkable reactivity and pathophysiological interpretations, together with a plasticity, and it is involved in a large number of complete bibliography. pathological processes. General pathologists are often poorly equipped to interpret morphological features We hope this book, based on the authors' medical and encountered during histological examination and to scientific knowledge, has the success it deserves. We integrate these findings into a rational approach. would like to thank them for giving us a very well documented book, which will be useful to both This book by Doctor Phat N. VUONG and Professor students and experienced pathologists.

This book advocates a new approach to the clinical management of the musculoskeletal system in children with cerebral palsy based on the concept of intervention to a complex adaptive system with the aim of improving the lived experience of the child with cerebral palsy. Provides a critical review of the current understanding and management of musculoskeletal deformity in children with CP, in the context of the available evidence base and models of clinical practice. Transfers current understanding of muscle and bone physiology and impairment, from the realms of research into mainstream clinical thinking Discusses an alternative clinical model of assessment and intervention, focusing on impairment of muscle growth and function Considers the musculoskeletal system in a child with cerebral palsy as a linked system of interactive processes and subsystems, extending from individual molecules to the child and their environment. The concepts discussed regarding clinical knowledge, evidence, causation, and complex adaptive systems are relevant to the clinician, child, and family, and the possibility of new models and new therapeutic approaches offer exciting future opportunities to improve the child's interaction with, and experience of, the world of which they are a part.

In the past ten years, full-scale simulation training has become dramatically more evident in undergraduate and graduate medical education. This increase has been due pri marily to two factors: the development of new computer-driven technology and an interest in simulation-specific training techniques. Technologically, simulators have evolved from simple anatomical reproductions to full-scale accurate reproductions of anatomy and physiology powered by multiple computers. High-technology simulation centers run by teams of faculty are emerging as integral tools in fulfilling medical centers' educational missions. In addition, educational techniques specific to simulation, which have been de veloped and used by other industries for over half a century, are being applied to medical training. Aviation and aerospace have used sophisticated simulation since the 1950s to train pilots and astronauts. Extrapolating these methods for use in the medical world has been a natural course of events, particularly in specialties that require some of the same basic thought processes and interactions required of the pilot or astronaut. It is not surprising, then, that anesthesiology would be the medical specialty to take the lead in adding simula tion training to its educational programs. The anesthesiologist's job in the operating room is similar to that of a pilot in a cockpit, not in the specific tasks, but in decision making, technological and human interfaces, and crisis management."

Comprehensive Tracheostomy Care is a resource developed by the UK National Tracheostomy Safety Project (NTSP) to help promote and facilitate the safe management of tracheostomies and laryngectomies. The scope includes hospital in-patient specialist areas such as critical care, head & neck units and specialist wards, but it is also applicable to more general wards, outpatient and community settings. The majority of the content is for adult patients, complemented by a dedicated paediatric chapter developed with colleagues from Great Ormond Street Hospital. The manual is a one stop shop covering all aspects of tracheostomy and laryngectomy management. It includes multidisciplinary resources from surgical, anaesthetic, nursing, intensive care and allied health backgrounds, along with guidance from key UK stakeholder organisations. Emergency guidance has been reviewed and endorsed by relevant Royal Colleges, national organisations and patient groups. It takes into account many national and international guidelines, policies and resources. It has been developed by consulting as widely as possible, across traditional professional boundaries using expertise and existing guidance from around the world, including the Global Tracheostomy Collaborative (www.globaltrach.org). Relevant existing resources are brought together coherently, with new resources presented in easy-to-follow text, illustrations, photographs and innovative linked e-learning and interactive resources.

All around us, in this age of consumerism, are expressions of public expectations regarding the quality of medical care. Among the responses of the medical profession to this growing public demand has been a cre scendo of interest in continuing education. Continuing education is not a new concern for the physician. Most major professional organizations were founded to increase the exchange of information among members. But something new is in the wind. Both inside and outside the profes sion, the question is becoming more and more insistent: What does at tendance at meetings or exposure to other types of prepared materials have to do with the quality of care that is provided? Recertification, reexamination, and peer review of outcomes of practice-subjects only recently unmentionable-have become common issues before specialty boards, legislatures, hospital boards, insurance carriers, and even medical societies. As of October of 1979, all 22 of the member boards of the American Board of Medical Specialties had made commitments to the principle of periodic recertification of their members. Most boards have explicitly acknowledged that the cognitive skills measured in the objective examination do not assure clinical competence. An assumption behind information-assessing recertification efforts is that, though mastery of the current knowledge upon which clinical decisions should be made does not guarantee competent practice, the lack of it probably impairs competent practice.

Focuses primarily on aortic and mitral valve disease. Special attention devoted to optimal timing and the role of echocardiography to assess prosthetic valve function and dysfunction. Discusses techniques for aortic valve surgery and choosing valve replacement devices. Part of the series: Developments in Cardiovascular Medicine

This reference book is for anyone involved in generating surgical training scenarios, as well as in VR-based training in general. It examines the main components required to define a scenario, in the context of surgical scene generation: Generation of the scene geometry; modelling of organ appearance; definition of biomechanical parameters. The book is the ideal reference for any reader involved in generating training scenarios, as well as in VR-based training in general.

Reactive oxygen species (ROS) which include free radicals, peroxides, singlet oxygen, ozone, and nitrogen monoxide and dioxide free radicals, is an area of intense research. This volume covers (1) the destruction of cellular function by ROS resulting in pathological states; (2) the protection by ROS of an organism against invading organisms that cause infections; and (3) the role of ROS in normal physiological processes. Designed for beginning graduate students, this book gives a concise overview of the field.

TH. BERCHEM ince its foundation 400 years ago, Wurzburg University has 1 S followed its purpose of safeguarding tradition and acting as a meeting point for scientists from horne and abroad; in short, it is a forum for national and international exchange, in accordance with its memorandum of establishment. The historie role of Wur- zburg University has been accentuated by its faculty of medicine, surgery in particular. One name, indeed, illuminates its excellent scientific reputation, a name representing a whole dynasty of scholars: Siebold. This year we celebrate the 200th anniversary of Philipp Franz von Siebold's birth. He is one of Wurzburg's most famous scholars. However, we should remember that his grandfa- ther, Carl Caspar, originally contributed to a considerable en- hancement of this university's reputation: he was the founder and first head of surgery. CI like the idea that he came from my hometown of Nideggen in the Eifel region, but this is only of mar- ginal interest. ) When Carl Caspar came to Wurzburg in 1760, the medical faculty consisted of five students. Since then, the total number has grown to 20,000. In 1760 Wurzburg University was much dif- ferent from nowadays. Medicine at Wurzburg during the eight- eenth century meant the Juliusspital, a very famous hospital at that time and which still exists today. The garden pavilion of that hospital was Germany's first institution for anatomy.

Traditional methods of medical education and training are changing rapidly. This volume integrates the printed text--as provided by leading experts in science and medicine--with multimedia applications using desktop conferencing and the Internet in the delivery of instruction. The Department of Biochemistry and Molecular Biology at The George Washington University Medical Center, with the support of an unrestricted educational grant from the Healthcare Education Department of Glaxo Welcome, Inc. , has created a distance-learning lecture series on the Internet for continuing medical education. In this lecture series, leading scientists and physicians discussed the most current as well as future projected treatments of prominent afflictions of mankind. These chosen speakers, who are at the forefront of research and treatment in the field of biomedicine, build a structural framework for the audience in their field of expertise, and from there looked into their crystal ball and discussed their view of the future. The lectures, approximately one hour in length, were broadcast live from The George Washington University Medical Center in Washington, D. C. as part of the Department of Medicine Grand Rounds. These lectures will be available on the Internet until 2001. In partnership with Medical Consumer Media, the lectures were simultaneously broadcast live around the world via the Internet with real-time audio streaming and digitized 35mm slide presentation. The lecture format was designed to foster questions which went beyond basic science and current treatments.

The New Contract which came into force on April 1st 1990 includes proposals for the provision of minor surgery services by the General Practitioner. The aim of this book is to assist those doctors undertaking minor surgery in their Practices. It is intended to present a practical, clear and concise text. This is accompanied by easy to follow illustrations. The contents of the book are governed by two considerations. Firstly, it covers only those procedures which are safe for the patient. Secondly, it only includes minor surgery which it is possible for the ordinary General Practitioner in a busy practice to undertake. Vll Chapter One The Advantages of Minor Surgery in General Practice Minor Surgery:- Despite this descriptive term, no surgery can be considered "minor" no matter where it is carried out! It requires a knowledge of anatomy and basic surgical principles. There must be an understanding of the procedures and technical skills required. Careful planning is needed at all stages. Arrangements must also be made to deal with any complications and disasters which may occur. Having stated these provisos, however, surgical procedures can and should be an important part of general practice within the British National Health Service (NHS). There are many advantages to be gained, both for patient and doctor, when minor surgery is undertaken by the general practitioner.

Proceedings of the Second International Workshop on Epidemiology and Prevention of Gallstone Disease, held in Rome, December 4-5, 1989

Despite numerous reports of cerebral damage in cardiac surgery, the subject has not been given the attention it requires. This book, with a preface by Torkel Aberg, will remedy that situation. The causes and incidence of pre- and post-operative cerebral damage are considered in the first section. Cardiac surgery patients frequently have preoperative cerebral impairment, not suprising when one considers the impaired circulation from a damaged heart and the brain's prodigious need for blood. Moreover, several perioperative aspects of surgical procedures have been considered as possible causes of cerebral dysfunction, for example: microbubbles, toxic by-products, non-pulsatile blood flow. The second section describes how imaging techniques (CT scan, MRI, regional cerebral blood flow imaging), and functional assessment techniques. (PET scan, EEG, BEAM and evoked potentials) can be used to measure cerebral damage. In the third section, psychometric and neuropsychological techniques are used to assess impaired mental abilities (abstract thinking, language, memory, visuo-spatial ability, mental flexibility, attention and concentration). The final section explores the relationship between cerebral dysfunction and psychopathology (several types of depression, anxiety, and aspects of organic brain syndrome, delirium and dementia).

'Roger Kneebone is a legend' Mark Miodownik, author of Stuff Matters 'Fascinating and inspiring' Financial Times 'The pandemic has made the necessity of relying on experts evident to all . . . this is a rich exploration of lifelong learning' Guardian What could a lacemaker have in common with vascular surgeons? A Savile Row tailor with molecular scientists? A fighter pilot with jazz musicians? At first glance, very little. But Roger Kneebone is the expert on experts, having spent a lifetime finding the connections. In Expert, he combines his own experiences as a doctor with insights from extraordinary people and cutting-edge research to map out the path we're all following - from 'doing time' as an Apprentice, to developing your 'voice' and taking on responsibility as a Journeyman, to finally becoming a Master and passing on your skills. As Kneebone shows, although each outcome is different, the journey is always the same. Whether you're developing a new career, studying a language, learning a musical instrument or simply becoming the person you want to be, this ground-breaking book reveals the path to mastery.