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.

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.

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.

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.

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.

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

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.

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."

Surgical Education: Theorising an Emerging Domain delineates surgical (as opposed to medical) education as a new and emerging field of academic enquiry. This reflects profound changes in healthcare training and practice on an international basis. As such, this book introduces, examines and explores the contribution of selected concepts and theories to surgical learning and practice. The first four chapters consider core facets of surgical education, such as simulation, while subsequent chapters take a key idea, often well known in another field, and examine its relevance to surgical education.

Of course, performing invasive procedures is no longer the exclusive preserve of traditional surgeons. Boundaries between surgery and the interventional specialties (radiology, cardiology, intensive care) are becoming increasingly blurred, especially as technology continues to expand. Changing work patterns and explosive technological development mark this out as a major growth area. New educational approaches (e.g. the use of simulation) are emerging. And all clinical practice is a team activity, where clinicians from many specialties (medicine, nursing, allied professions) come together with shared goals. For all the above groups, and their patients, education (teaching, training, learning and assessment) is of crucial importance.

Yet the unique characteristics of surgical education have not previously been addressed from an educational perspective, nor have its possibilities as a new research domain been mapped. The domain needs to be theorised and its epistemological foundations established. There is thus both a need and a market for a definitive work in this area, aimed at surgeons, other clinicians, non-clinicians, educators, and others interested in this new domain."

Trauma surgery has increasingly become a specialized field inspired by different principles and philosophy. A good trauma surgeon is a surgeon who knows how to perform abdominal, vascular, thoracic, urologic, gynecologic, and orthopaedic procedures and is able to repair multiple traumatic injuries in the best sequence possible. In this second volume the focus is exclusively on thoracic and abdominal trauma, with coverage of injuries to all regions. The surgical techniques employed in managing such trauma are carefully described with the aid of high-quality illustrations. Exploratory surgery (via either laparotomy or laparoscopy), damage control surgery, and definitive surgery are all fully covered, and attention is drawn to important technical tips and tricks. The volume will be a handy pocket guide for trainee surgeons who are beginning to deal with severe multiple trauma patients, as well as for all general or specialty surgeons and professionals (including scrub nurses and theatre staff) who are involved in trauma care and wish to keep abreast of developments in this complex field. Also available: Trauma Surgery Vol. 1: Trauma Management, Trauma Critical Care, Orthopaedic Trauma and Neuro-Trauma

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).

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.

The 20th century has finished, the century when surgery took huge steps forward thanks to progress in technology. Now we have entered the "century of biotechnologies", which will not only generate progress in surgery, but also lead to a real "cultural revolution" that will completely change approaches to solving different problems in medicine. The aim of this book is to bring surgeons closer to biotechnologies and to overcome the cultural gap dividing them from these new approaches. Biotechnologies are already proposed and used at different levels in surgical practice: in diagnostic technique, enabling practitioners to identify diseases at an early stage and follow their molecular modification over time; and in tissue engineering, where the use of "smart scaffolds" offers a possible answer to increasing demand for biocompatible tissues and organs in transplantation surgery. This volume focuses on the emerging field of stem cells, analyzing both their role as possible players in originating and perpetuating cancer - "cancer stem cells" - and, conversely, their extraordinary therapeutical potential. An additional section is dedicated to the evaluation and application of derived molecular factors that can enhance the physiological processes that are fundamentally important in surgery, such as hemostasis and wound healing. Surgeons have always been technologists, in the sense that since surgery began they have always needed technology, beginning with a scalpel and surgical instruments. They have always cooperated with technologists. However, in the new century, the first one of the millennium, a rapid increase in knowledge that is outside the realm of the surgeon's traditional technological training is imposing itself - hence the aim of this book. It is now urgent to encourage surgeons to embrace this knowledge (biotechnology) with confidence. By its very nature, biotechnology is completely different from the technologies used so far, because it escapes the senses of sight and touch, which up to now have been the essence of the surgeon's work. The cellular and molecular dimensions of biotechnologies are still far removed from most of the recent advances in modern surgical techniques. A common language between surgeons and biotechnologists will create further, revolutionary, progress in surgical sciences in the twenty-first century.

Despite recent advances in the diagnosis and treatment of various cardiac illnesses, including ischemic, valvular and cardiomyopathic disease, the most cost-effective means of employing laboratory testing and treatment modalities remains an issue in most practice settings. With the advent of managed care and vigilant third-party payer evaluation of the use of diagnostic tests and hospital length of stay, the most effective medical and economic method of managing everyday cardiac illness is a question that arises daily in practice. To this end, we have selected well-known and widely published experts in cardiac diagnosis and therapy to develop practical and informative approaches outlining the most cost-effective methods of patient management. The topics include the entire range of cardiac diseases and emphasize the economic impact on decision-making. We develop guidelines and present general strategies for the practicing cardiologist and general internist. Additionally, the editors, who have 10 years of experience in this area, discuss the methods necessary to bring critical pathways and practice guidelines into clinical use. Both hospital and out-patient phases of illness are considered. Special concerns of hospital, private practice managed care and group practice settings are specifically addressed.

Recent Developments in Graves' Ophthalmopathy offers an overview of the pathogenesis, assessment and management of patients with thyroid-associated eye disease. Each chapter is written by an expert and truly represents the current state of the art on the particular topic. This book can therefore almost be considered a textbook on this enigmatic disorder. Recent Developments in Graves' Ophthalmopathy is designed for all those interested in this disease, including basic scientists, clinical endocrinologists, ophthalmologists, radiotherapists, and orbital surgeons. The book gives a comprehensive overview of all aspects of Graves' ophthalmopathy. Subjects covered include the pathology of Graves' eye disease and the controversial views on its autoimmune pathogenesis; assessment of the eye changes using reliable measurements; medical management of Graves' eye disease with an overview of the many treatment options available to the clinician, including orbital radiotherapy and other immunosuppressive treatments; management of the thyroid disease; and finally, the techniques for performing various surgical procedures, which are explained and illustrated.

A description of the latest methods of oncological and hematological diagnostics, such as immunological, molecular genetic and histological essays. All methods are described in principle in their different variations and compared with regard to their effectiveness and cost. Written for scientists, clinicians and personnel in research, specialised and routine diagnostic laboratories in hospitals, this book satisfies the increased demand for information on new methods in hematology and oncology.

Strain Measurement in Biomechanics will provide a valuable reference source for all research workers in biomechanics and biomaterials as well as orthopaedic manufacturers and orthopaedic surgeons.

This monograph is intended to compile the lectures presented at the 4th Annual Symposium "Cardiac Surgery:1992" held at the Frenchman's Reef Beach Resort, St. Thomas, US Virgin Islands, November 7-10, 1991. This symposium was organized by the Division of Cardiothoracic Surgery and the School of Cardiovascular Perfusion, Cooper Hospital/University Medical Center, Camden, New Jersey and sponsored by the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Philadelphia Academy of Cardiovascular Perfusion and the American Society of Extracorporeal Technology -Region II. The symposium was devoted to cardiothoracic surgeons, cardiologists, cardiovascular perfusionists, and nurses involved in the management of the cardiac surgical patient. Therefore, the context of the book represents the multidisciplinary nature of cardiac surgery at its present level of development. The contributors to this book have critically examined their experience and discussed controversial issues regarding cardiac pathophysiology, surgical indications, operative techniques, and long term care and outcome. The co-editors wish to express their gratitude for the contributors' efforts in the production of this manuscript. We would also like to thank the members of the Organizing Committee, Jane V. Stewart MSN, RN, CCRN, Roger A. Vertrees BA, CCP, Rosemary Volosin, MSN, RN, Rosemary Morrone and Paul R. Cappola BS, CCP, who have greatly contributed to the success of the symposium."

The aim of this symposium was to provide basic and clinical investigators with the latest information on the biology of wound healing and tissue repair. Written and edited by eminent experts in the field, the papers cover the general concepts of wound healing; the role of nutrients; endogenous growth factors; clinical applications of growth hormone and IGF-1 therapy; and clinical applications of peptide growth factors.

The topics in this book represent the presentations given at the First and Second Annual Meetings entitled "Critical Issues in Surgery" held at the Frenchman's Reef Beach Resort, st. Thomas, U.S. Virgin Islands, November 1992 and 1993. This symposium was sponsored by the Department of Surgery, and the Department of Nursing Education and Quality Assurance of Cooper Hospital/University Medical Center, the University of Medicine and Den tistry of New Jersey, Robert Wood Johnson Medical School, Camden, New Jersey, as well as the Academy of Medicine of New Jersey. Chapter authors were charged with the task of writing brief overviews of major issues related to the field of general surgery and critical care medicine. The book is specifically tailored to the needs of general surgeons, allied health professionals and nursing personnel involved in all phases of caring for the surgical patient. Although intended as a reference source with emphasis on up-dated approaches applied in general surgery, it is hoped that the discussion of these topics will compliment other texts and manuscripts. Obviously, a book of this length cannot cover the whole multidiSCiplinary and complex field of surgery. However, the co-editors are certain that the annual appearance of this text will highlight comprehensive, new and interesting approaches to the field of surgery."

Lung cancer is the most common cause of cancer-related death in the world. Recently, better understanding of the biology of lung cancer has led to the development of newer targeted therapies for specific subpopulations of lung cancer patients. While this has led to multiple exciting advances that promise to improve outcomes in the future, there has also been a significant increase in the complexity of care of the lung cancer patient. Part of the Oxford American Oncology Library, this concise handbook identifies best-practice guidelines, as well as differences of opinion in the field. It presents the most current procedures for the diagnosis and management of lung cancer in a succinct and easy-to-read manner. Chapters focus on topics such as the biology, pathology, and staging of lung cancer, special populations, and supportive care. Lung Cancer is a must-have tool for busy oncologists.