Hamilton Bailey was a legendary figure during his lifetime. He is still perceived as a great surgeon, though his fame rests less upon his prowess in the operating theatre than on his qualities as a writer and teacher. His textbooks, although constantly rewritten and updated, still command worldwide sales. Of all those who have ever written about surgery, Bailey is without doubt by far the most widely read. A large, strong man, with an air of self-confidence and authority, he had no difficulty in dominating those around him, but this imposing physique concealed a troubled and fragile mind. There was a family background of mental illness, and an accumulation of stresses and tragedies finally broke him down. What followed represents one of the most remarkable case histories in twentieth-century psychiatry. Originally published in 1999, this biography tells the story of Bailey's extraordinary life, in the light of much fresh evidence and original research.

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."

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.

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."

The topicS in this book represent the presentations given at the Fifth Annual Meeting entitled "Cardiac Surgery: Current Issues" held at the Frenchman's Reef Beach Resort. St. Thomas. U.S. Virgin Islands. November 11-14. 1992. This symposium was sponsored by the Division of Cardiothoracic Sur gery. the School of Cardiovascular Perfusion and the Department of Nursing Education and QUality Assurance of Cooper Hospital/University Medical Center. the University of Medicine and Dentistry 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 cardiac surgery. The book is specifically tailored to the needs of cardiothoracic surgeons. cardiovascular perfusionists. allied health professionals and nursing personnel involved in all phases of caring for the cardiac surgical patient. Although intended as a reference source with emphasis on up-dated approaches applied in cardiac surgery. it is hoped that the discussion of these topics will compliment other texts and manuscripts. Obviously.';ibook of this length cannot cover the whole multidiSciplinary and complex field of cardiac surgery. However. co-editors are certain that the annual appearance of this text will highlight comprehensive. new and interesting approaches to the field of cardiac surgery."

A thorough review of the operative techniques as well as the indications, pitfalls, strategies and timing, complications, and long term results involved in the surgical treatment of ulcerative colitis and Crohn's Disease. As IBD is characterised by a high incidence of re-operations and complications, independent sections of the text are devoted entirely to surgical treatment of specific complications and the management of recurrent diseases. Exquisitely illustrated with over 200 line drawings, this book contains important information on medical treatment, endoscopic evaluation, pathology, radiology, and aetiology.

Currently blood is a volatile issue. The safety of blood and the quantification of transfusion risks have been dominant themes that have stimulated the development of alternative approaches in this rapidly developing area. In clinical medicine conventional blood and its components are used in supportive therapies dependent on the choice of apparent uncritical trigger factors. A compounding factor is depth of prospective clinical trials for evidence. Such trials in critical care areas would be of enormous value, not only in recording adverse effects and under-transfusion, but also indicating the value of decision analysis and cost-effectiveness in transfusion practice. Alternative approaches include the use of cytokines, growth factors, humanised monoclonal antibodies, recombinant plasma factors, and buffy coat derived natural human interferons. These are being increasingly implemented in the clinic. Solutions for oxygen transport are being developed and fibrinogen coated microcapsules are being investigated for thrombocytopenia. In surgical patients, various crystalloid and colloid combinations are explored as volume replacements. To avoid allogeneic transfusions, beneficial blood saving methods include various strategies, such as autologous deposits, normovolemic haemodilution and various agents including aprotinin, tranecamic acid, desmopressin and erythropoietin, but their use in hospital shows considerable variations. That umbilical cord blood could be a significant source of allogeneic stem cells in related and unrelated transplantation is illustrated by the increasing number of cord blood banks in Europe and elsewhere. Future blood resources are likely to face several challenges: immediate challenges relate to increased regulatory and political oversights; intermediate solutions would offer some improvements in public health and alleviate public fear but probably not address the economic challenges thrust upon the medical care system. As we approach the year 2000, the major concerns about transfusion medicine remain its logistics, safety and effectiveness. This theme is presented in the proceedings of the 22nd International Symposium on Blood Transfusion, developed in 21 up-to-date topics, collected and discussed in four sections. This book will be of timely value to students, professionals and all others interested or involved in the field of transfusion medicine, whether clinical or related.

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

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.

With the introduction of new post-graduate Medical training in the UK, virtually all doctors will be exposed to some form of surgical training prior to specialization. Many of these doctors will have little exposure to surgical emergencies in medical school. Thus, they may unnecessarily refer to a senior doctor when not needed, or catastrophically neglect a patient needing urgent surgical opinion. Surgical Emergencies in Clinical Practice is a compact resource which allows any clinician, without previous surgical knowledge, to be able to make an accurate diagnosis and have a treatment plan for the whole spectrum of surgical emergencies. The essential steps of initial management of all surgical emergencies is outlined in a manner that can be used on a day-to-day basis for clinical management. Written by experts in the field, Surgical Emergencies in Clinical Practice is a valuable tool for all junior doctors and medical students in the UK, Europe, Asia and North America. It will also be of interest to nurse practitioners, general practitioners and allied health professionals managing these patients.

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.

Xenotransplantation could have an impact on at least three aspects of medicine. The first is as a means of overcoming a severe shortage of human donor organs for the treatment of organ failure. The second aspect relates to the possibility that a xenogeneic organ would not be susceptible to infection by a "human" virus and thus the xenograft might resist injury caused by such viruses. The third and, as of yet, unexplored aspect relates to a means of delivering genes for therapeutic purposes thus overcoming some of the limitations of "conventional" gene therapy.

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.

It gives me particular pleasure to write the foreword to this book; this is largely due to the fact that I have devoted a substantial part of my life to the improve ment of the methods used in ophthalmic research. Rarely has one of my students taken the opportunity of dealing systematically with the possibilities of these methods. Dr. Eisner is, however, one of these exceptions. First, he has substantially improved the indentation contact glass; secondly, he has, with untiring enthusiasm, made a systematic collection of the normal and pathologic findings, which, with the help of the indentation contact glass and the slit lamp, can be observed in the outermost periphery of the fundus and the ciliary body. He has compared them to findings obtained with slight magnification in autopsy eyes and to histological sections. Owing to a fortunate circumstance, W. Hess, who is both an excellent draughts man and a master of the special examination technique, was able to reproduce the visual phenomena faithfully. The reader who tries to interpret these illustrations spatially will discover that this was often not easy. It is a process which requires a certain effort of imagi nation of space, but which is very rewarding. Dr. Eisner's monograph is an introduction to a little-known branch of biomicroscopy which broadens our means of diagnosis and promises further interesting aspects for the future. I wish him well-earned success.

The papers collected in this volume represent the formal proceedings of the Third European Symposium on Calcified Tissues which was held in Davos, Switzerland from 11th to 16th April 1965 under the sponsorship of the Laboratorium fur experi mentelle Chirurgie, Schweizerisches Forschungsinstitut Davos. This Symposium fol lowed the now established tradition of the previous Symposia held in Oxford in 1963 and in Liege in 1964. Participation was again strictly on a residential basis. This year the Schatz alp Hotel provided a scenic and secluded meeting place high on a mountain side overlooking Davos yet close to the Forschungsinstitut in which the opening session of the Symposium was held. The papers and communications published in the volume are arranged in order of presentation and are grouped under the five main themes selected for discussion by the Symposium, namely, "Cell function in the formation, maintenance and destruc tion of osseous tissue," "Response of calcified tissues to mechanical factors," "Mecha nisms of mineralization and diseases related to mineral deposition," "Hormones and bone" and "Fundamental structure of dental hard tissues." The programme consisted of a number of review lectures given by invited speakers and of short communications in relation to each of the above themes. No attempt was made to record the dis cussions to the papers as, being a residential meeting, the more valuable and interest ing interchanges took place informally in small discussion groups and not within the time schedule of the prearranged programme."