This book examines the interaction between nano tools and nano materials. It explains the use of appropriate tools in surgery for a variety of applications and provides a complete description of clinical procedures accompanied by photographs. Coverage also presents the latest developments in surface coatings technology such as chemical vapor deposition for use on complex cutting tools for biomedical applications.

Biomaterials for Surgical Operation offers a review of the latest advances made in developing bioabsorbable devices for surgical operations which include surgical adhesives (sealants), barriers for the prevention of tissue adhesion, polymers for fractured bone fixation, growth factors for the promotion of wound healing, and sutures. Over the years, many descriptions of biomaterials have appeared in academic journals and books, but most of them have been devoted to limited clinical areas. This is in marked contrast with this volume which covers a wide range of bioabsorbable devices used in surgery from a practical point of view. The currently applied polymeric devices are critical in surgery, but all involve serious problems due to their poor performance. For instance, fibrin glue, the most widely used surgical sealant, can produce only a weak gel with low adhesive strength to tissues, accentuating the limited effectiveness of current treatment options. Likewise, the currently available barrier membranes cannot fully prevent tissue adhesion at the acceptable level and are, moreover, not easy to handle with endoscopes due to their poor mechanical properties. Biomaterials for Surgical Operation is aimed at those who are interested in expanding their knowledge of how the problems associated with the currently used devices for surgical operation can be solved. It primarily focuses on the absorbable biomaterials which are the main components of these medical devices.

Perioperative Addiction addresses an issue that every anesthesiologist will encounter many times during the course of his or her career: the patient who arrives for operative care under the influence of legal or illegal drugs. The editors and contributors provide expert guidance on how to identify and manage the addicted patient, approaching the subject from the vantage points of the specific drug and of special patient populations. Features: * Guidance for spotting and managing addicted patients * All common and important drugs of addiction, from opioids, cocaine, club drugs, and alcohol, to tobacco, marijuana, nitrous oxide, inhalants, and propofol * Special populations, including pregnant women, pain patients, adolescents, older patients, and healthcare professionals * Fascinating overview of the long history of addiction * Genetic basis of addiction, and the range of pharmacological treatments for addiction

This new, up-to-date, concise revision guide for the MRCS Part B examination equips candidates with the essential knowledge and armamentarium required to tackle the exam. Written in a model question-and-answer format to aid the breakdown of information, candidates can practise some of the most common exam questions they can expect to face. Including subdivisions on applied surgical science and critical care, anatomy and surgical pathology, surgical skills and patient safety and a section on clinical examinations of the limbs and spine, this guide will increase candidates' confidence in both exam technique and key concepts. MRCS Revision Guide: Limbs and Spine is a concise, handy pocket book; a 'must have' quick reference guide for busy surgical trainees studying for the MRCS examination.

Biomaterials associated infection (BAI) is one of the most common complications associated with implantation of any biomaterial regardless of form or function. These infections usually involve bacterial colonization and biofilm formation on the biomaterial itself, rendering the infection impervious to antimicrobials and host defenses. In addition, it is becoming increasingly clear that infection of the surrounding tissues also plays an important role in BAI, and that the infection may be influenced by the composition and design of the implanted biomaterial. In this book, worldwide leaders in the field address this critical problem in the translation of biomaterials research into clinical practice. The book begins with an emphasis on the latest research in the pathogenesis of BAI from microbiological, immunological, and materials science perspectives. The current state of the art in antimicrobial activation of biomaterials through surface modification and the incorporation of antimicrobial agents is then discussed. In the concluding chapters, successful translation of a selection of antimicrobial technologies from preclinical research into clinical use is described alongside a discussion of the utility of these devices and perspectives for future development. This book is essential reading for researchers and clinicians who are interested in understanding the fundamentals of BAI, the latest in antimicrobial materials research, and the state of the art in clinically available antimicrobial containing medical devices.

New technologies in 3D printing offer innovative capabilities in surgery, from planning complex operations through to educational purposes and providing alternatives to traditional training with more cost-effective outcomes. This hot topic title synthesizes the most up-to-date information on 3D printing and its application into surgical specialties including, hebatobilliary and pancreatic surgery, vascular surgery, orthopedic surgery, obstetrics and gynecology, cardiovascular and thoracic surgery, and more. Discusses challenges and opportunities of 3D printing across surgical sub-specialties. Covers 3D printing and its application in major surgical specialties, as well as dentistry, transplantation, global surgery, and diagnostic and interventional radiology. Consolidates today's available information on this burgeoning topic into a single convenient resource.

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.

Twenty Things to Know About Deep Brain Stimulation is an extensive and in-depth critical analysis of the field of Deep Brain Stimulation (DBS) from what many may consider a revolutionary perspective. This book demonstrates the unique nature and incredible promise of DBS and shows how it is unparalleled as a therapeutic intervention. Dr. Montgomery provides an epistemic analysis of the presuppositions, assumptions and fallacies underlying current clinical understanding of DBS as well as the physiology and pathophysiology affected by DBS. Reviews of the safety and efficacy for a number of conditions, patient selections and issues in the post-operative management are also included. Given the revolutionary potential and the complexity of DBS in an ever changing healthcare delivery context, the ethics of DBS are discussed in detail.

This first reference to comprehensively address both the medical and surgical management of diseases affecting the colon, this source spans the wide array of colorectal disorders including rectal prolapse, irritable bowel syndrome, benign and malignant colonic tumors, fissures and ulcers, and Crohn's colitis, among other ailments. With chapters by world leaders in the field, this guide analyzes diagnostic and imaging techniques for disease evaluation and management including advances in colonoscopy, radiology, and surgery.

The recent rapid advances in our knowledge of immunological and virological mechanisms involved in the pathogenesis of viral heart disease makes it difficult for everybody working in this field to keep up with the latest developments. How ever, much of what we know is still circumstantial and only vaguely substained. Interdisciplinary understanding and cooperation thus seems necessary to get a better insight into the mechanisms by which viruses may initiate immunological organ-specific tissue injury and disease! This volume evolved out of an international symposium by the same title held on May 25. -28. , 1988 in Tegernsee, near Munich, of which a wide spectrum ofim munological, virological, diagnostical and clinical problems was covered. Both review articles and new experimental and clinical data are included in this volume to give the reader an up-to-date information about current concepts and future aspects. Chapter I serves as an excellent introduction to the epidemiology and natural history of dilated cardiomyopathy / viral heart disease. Although a definite viral etiology in myocarditis and dilated cardiomyopathy is often difficult to establish, epidemiological and serological data incriminate a viral etiology underlying many cases of "dilated cardiomyopathy". Chapters II and III describe the current think ing on virological and immunological mechanisms involved in the pathogenesis of viral heart disease. Among others virus topism, virus persistance, possible mecha nisms and genetic basis of post-infection autoimmunity, and the virus-interaction with the immune system are discussed.

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.

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.

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.

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.

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. . . . . . ."

Are you looking for concise, practical answers to those questions that are often left unanswered by traditional texts and references in oculoplastics? Are you seeking brief, evidence-based advice for common clinical dilemmas or complications? Curbside Consultation in Oculoplastics: 49 Clinical Questions provides quick and direct answers to the thorny questions most commonly posed during a "curbside consultation" between experienced clinicians. Dr. Robert C. Kersten and Dr. Timothy J. McCulley, have designed this unique reference in which oculoplastic specialists offer expert advice, preferences, and opinions on tough clinical questions commonly associated with oculoplastics. The unique Q&A format provides quick access to current information related to oculoplastics with the simplicity of a conversation between two colleagues. Images, diagrams, and references are included to enhance the text and to illustrate common clinical dilemmas. Curbside Consultation in Oculoplastics: 49 Clinical Questions provides information basic enough for residents while also incorporating expert pearls that even high-volume ophthalmologists will appreciate. Residents, fellows, and practicing physicians alike will benefit from the user-friendly and casual format and the expert advice contained within. Some of the questions that are answered:What do I do when a patient on anti-coagulants needs surgery? When does an eyelid lesion need to be biopsied? What are the general treatment guidelines for Graves' ophthalmopathy? How should I treat bacterial orbital cellulitis? How do you distinguish an orbital infection from sterile inflammation? When should I be concerned about systemic disease in a patient with blepharoptosis? What are the oculoplastic uses of botulinum toxin? How do I know when to order an MRI or a CT?

Key Features: 1. Addresses the necessary gap in the literature with a concise yet comprehensive approach. 2. Overhauls and updates the content to provide an exam-oriented text for students of oral and maxillofacial surgery, and professionals.

Key Features: 1. Addresses the necessary gap in the literature with a concise yet comprehensive approach. 2. Overhauls and updates the content to provide an exam-oriented text for students of oral and maxillofacial surgery, and professionals.

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.

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

Squamous cell carcinoma of the esophagus has a lower incidence than other gastrointestinal tract cancer; however, there are many difficult issued related to the choice of appropriate therapy for these patients. In recent years, the use of multimodal treatment has greatly improved the prognosis of patients affected by this disease but several aspects of the oncological and surgical management are still controversial. This book aims to give a homogeneous approach to esophageal cancer treatment, based on the author's lifetime experience in conjunction with exhaustive review of recent literature. In each chapter surgeons and oncologists will find appropriate tools for correct management of the diagnosis and therapy of this difficult disease. The book analyzes all the aspects of staging and treatment, such as modern diagnostic and staging techniques (MRI or PET-CT), endoscopic treatment of early cancer, new minimally invasive and open surgical techniques, and combined treatment. In addition, there are chapters dedicated to the postoperative course of these patients, as well as their quality of life, with indications for the correct follow-up and treatment of relapses.

Professor Edwards is a pioneer of much of the research in applied human embryology, making a significant and invaluable contribution to knowledge in this field. In this 1992 book, he brought together the research experience of prominent scientists and clinicians. The most advanced scientific and clinical developments and techniques were presented, including both the transplantation of fetal tissue into mature recipients and the grafting of donor cells into fetuses known to be carrying a genetic disease. The successes and failures of these techniques as a clinical treatment and therapeutic tool are discussed. The book begins with an overview of embryologic devlopment: from fertilization to differentiation of cell lines and organogenesis. The transplantation of specific cell lines and tissue types is then considered. Transplantation techniques, donor host interactions and immunology, cell and tissue storage are all discussed, as are the ethical issues and the legal implications.

This book is designed to provide the busy ophthal inftammation, lacrimal gland tumors and inftamma mologist with a practieal guide to the management tion, lacrimal sac tumors and inftammation, and of lid and ocular adnexal disease. The book encom lid tumors and inftammations. passes more than tumors simply because other in This book provides the ophthalmologist with a ftammatory conditions may mimic tumors in their step-by-step approach to patients with lid and orbital presentation and vice versa. It is not meant to be tumors and inftammations. an encyclopedie, definitive work on a single subject, organized around individual disease entities; instead Acknowledgments it approaches the patient much as clinician does. It concentrates on the patient and considers various disease processes logieally. Work -up, differential We wish to thank all the referring doctors who diagnosis, and initial treatment are discussed. have allowed us to treat their patients with orbital When any patient presents with an orbital or an and ocular adnexal disease and without whom a ocular adnexal mass, the question that needs to be book of this type would have been impossible. We answered is whether the process is due to inftamma also would like to give special thanks to our teachers, Dr. Lorenz E. Zimmerman and Dr. Byron Smith."

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.

A decade has passed since systematic studies were initiated in the USA in an attempt at establishing the experimental basis for a surgical technique which was to prove an effective tool in combatting one of the most common diseases, i.e. cerebrovascular accidents. The development of such intricate vasculosurgical techniques as are required for extra intracranial arterial bypass operations would not have been possible without the aid of the surgical microscope, which had been designed some years earlier. In the past few years increasing emphasis has been placed on establishing clear-cut indications for the bypass operation, because satisfactory long-term results are unlikely to be obtained without them. Needless to say that this requires a close cooperation of the neurosurgeon with a team composed of neurologists, internists, radiologists, and pathologists. Fortunately enough, cooperation between the services of the University of Vienna Medical School proved to be exemplary. While there has been no lack of efforts by major medical centers both in Europe and the overseas countries to perfect bypass operations for cerebrovascular accidents, a comprehensive monograph reviewing all medical and operative problems involved in microvascular surgery for strokes was badly missed by many.