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.

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."

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.

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.

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."

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.

As recently as 20 years ago, ceramics were widely ignored as potential biomaterials. Interest in bioceramics has increased dramatically over the past decade to the point where it is anticipated they will be the materials of choice for many orthopedic, otologic, maxillofacial and dental applications during the decade of the '90s. Alumina ceramics are being used extensively as articulating comJ1onents in total joint prostheses because of Ithe materials low coefficient of friction and excellent wear resistances. Alumina ceramics are also being used in dental and maxillofacial applica tions because of the materials excellent biocompatibility. Because of its ability to chemically bond to bone, hydroxyapatite is rapidly becoming the material of choice for many dental and maxillofacial applications. For the past decade, one of the most widely researched topics in the field of orthopedics has been the clinical evaluation of joint prostheses based upon stabili zation via tissue ingrowth. It appears that the next generation of joint prostheses will be based upon direct chemically bonding to bone using hydroxyapatite, surface-active glass or surface-active glass ceramics coatings. Resorbable bioceramics are limited to temporary bone space fillers, periodontal pockets treatment and resorbable pharma ceutical delivery systems. Bioceramics is a comprehensive reference textbook covering the history of bio ceramics, present status of bioceramics, and prediction for future use of bioceramics. This book will serve as a major reference for students, as well as experienced bio material researchers. The book presents the state-of-the-art of bioceramics as of 1991."

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

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.

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."

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."

Dermatosurgery cannot readily be therefore be to impart the knowledge assigned to anyone branch of medical that gives the dermatologist this free- science, and as with any borderline dom of choice. This involves the teach- case, this assignation is a matter of con- ing not only of the basic principles of troversy. Since the end of the last cen- dermatosurgery but also of the ability tury, the place of the subject in the field to discriminate according to the most of dermatology has been firmly estab- varied criteria. In this field, technical lished. This is hardly surprising, since knowledge, motivation, and enthusi- a number of specialists in dermatology asm are not enough; talent is also re- spent the first part of their professional quired. C. Moncorps was engaged in work life as surgeons: for example, E. Lang of Vienna, famous for his treatment of on a monograph on dermatosurgery lupus by plastic surgery; and K. Linser (unfortunately nowhere near comple- of Tiibingen, one of the originators of tion) at the time of his death. As a for- varicose-vein stripping. H. T. Schreus mer pupil and long-standing colleague and C. Moncorps were distinguished of his, it is particularly gratifying to me to see colleagues past and present con- members of a later generation of sur- gery-oriented dermatologists; the der- tinuing a tradition in their work.

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 18-20, 1993. This symposium was sponsored by the Division of Cardiothoracic Surgery, 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 perfusion ists, 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, a book 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."

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 volatile anesthetics continue to be one of the most mysterious yet commonly used class of drugs in medical practice today. A prominent and troublesome side effect of volatile anesthetics is their ability to alter hemodynamics. This arises from two diverse but interrelated phenomena, depression of cardiac contractility and dilation of the vasculature. These effects of volatile anesthetics on cardiac and smooth muscle plus the action of volatile anesthetics on skeletal muscle in the malignant hyperthermic syndrome have led to concern about the interaction of volatile anesthetics (and other anesthetic agents) with calcium metabolism in the muscle cell. Many of the phenomena caused by anesthetics appear to have common mechanisms in all of the muscle types; however, the differences among skeletal, cardiac and smooth muscle also lead to distinct effects of the anesthetics in each. Given the diverse research disciplines which have been brought to hear on the mechanism of anesthetic alteration of contractility, the symposium from which this book originates was convened for the purpose of gathering those with common interests in anesthetic agents and their cellular and subcellular actions in muscle. The recent symposium had its origins in a small but exciting meeting that took place at the University of Texas at Houston in 1984. At that time, Robert Merin and Jacques Chelly convened a group of people who had interest in cardiac muscle and calcium antagonists.

In spite of today's increasing body of knowledge in regard to central nervous func tion and/or the mode of action of centrally active compounds, little is done to monitor those patients which are at risk of cerebral lesions either in the OR or in the ICU. Due to the inconsistency of reports regarding the application and the benefits computerized EEG and/or evoked potential monitoring will bring to the clinician, physicians still are reluctant to get involved with a technique, which they think, will have little or no effect on the outcome of a patients well being. However, due to the development in computer technology, data acquisition and comprehension, it now is possible to monitor such a viable organ as the Central Nervous System (CNS) on a routine base without being a specialist in neurology or electroencephalography. Thus, the book is intended to guide the clinician to use BEG and evoked potential monitoring in a day to day situation, without going too deep into technical details. As an improvement of cerebral care is needed, various representative cases underline the interpretation of EEG power spectra and evoked potential changes in regard to the underlying clinical situation. It is hoped that this book will serve as a guide to anyone who considers cerebral monitoring a necessity in today's patient care. This may be the anesthesiologist, the intensive care therapist, the nurse anesthetist as well as the medical personnel in the lCU setting."

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.

Endocrine conditions requiring surgical intervention in the pediatric age group are uncommon. When diagnosed, they are the source of great in terest and, often, considerable debate. This is understandable, since few centers and even fewer individual surgeons can draw on vast experience of this subject. The great divergence of opinion regarding management is also understandable in that pediatric endocrine lesions often differ considerably from their adult counterparts in histology, natural history and response to treatment. Pediatric endocrine lesions are also, as a rule, less frequently malignant. In addition to the great strides made in surgical and anesthetic technique and operative monitoring, progress in four areas has substantially advanced the management of endocrine dis orders in the pediatric age group in the last decade: imaging, pathology, pharmacology and genetics. The new imaging tools, ultrasonography, computed tomography and magnetic resonance imaging, have added great diagnostic possibilities. More recent developments, such as radio nuclide imaging for the adrenal gland and the possibility of using tagged antibodies, promise to expand our imaging horizons even further. In the field of pathology, the develop ment of immunocytochemical markers (e. g. , monoclonal antibodies), the refinement in special stains and the continuous perfection of fine needle aspiration biopsies offer great new diagnostic as well as research capabil ities. Newer pharmacological agents, such as the alpha and beta blockers, the calcium channel blockers and thyroxine analogs, add a whole new level of safety to the management of the potentially lethal pheochromocytoma.

Starting in 1986, the European School of Oncology has expanded its activities in postgraduate teaching, which consisted mainly of traditional disease-orientated courses, by promoting new educational initiatives. One of these is the cloister seminars, short meetings intended for highly qualified oncologists and dealing with specific, controversial aspects of clinical practice and research. Another is the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on developments and treatment in specific fields of oncology. This series of ESO Monographs was designed with the specific purpose of disseminating the results of the most interesting of the seminars and study groups, and providing concise and updated reviews of the subjects discussed. It wa& decided to keep the layout very simple in order to keep costs to a minimum and make the monographs available in the shortest possible time, thus overcoming a common problem in medical literature: that of the material being outdated even before publication.

Despite recent advances in adjuvant therapies of cancer, the regi mens of postoperative adjuvant chemotherapy treatment which are presently available fail to cure the majority of cancer patients. Pre operative (neoadjuvant) chemotherapy represents a new approach in drug scheduling, based on sound theoretical, pharmacokinetic, and experimental principles. The preoperative timing of chemotherapy before definitive sur gery is not a minor change in the therapy of cancer. To be successful, large numbers of practitioners and their patients must participate. Substantial alterations of many aspects of the present management of cancer will have to follow. Therefore, before such therapy can be fully and routinely implemented, results of the novel treatment and its rationale have to be carefully evaluated. In preoperative treatment, other features will likely gain impor tance. For the first time, clinicians have a chance to follow the in vivo response of the tumor exposed to preoperative chemotherapy. The subsequent histological assessment of the tumor sample may likely become an important prognostic guide, permitting more re fined individual approaches to the planning of postoperative adju vant treatment. The value of such a treatment strategy can already be appreciated in the clinical setting, as seen from the therapy of osteosarcoma. Furthermore, preoperative chemotherapy might render previously inoperable tumors operable and hence resectable with a curative intention. The preoperative reduction of tumor bulk may also effectively decrease the need for more radical operations, permitting a more uniform adoption of conservative surgery."

What is the best way to plan surgical research? What problems are most often encountered in clinical research? How should a research report be presented at a scientific meeting? These questions and more are all answered in Principles and Practice of Research.The second edition has added new sections on animal research models, the molecular and cellular dimension of surgical research, and practical guidelines for obtaining government and third-party funding. Other improvements include a friendlier discussion of statistics and updated material about on-line computer literature searches. This book provides every clinical researcher with a roadmap around the pitfalls of poorly designed studies, through the jungle of incomprehensible statistics, and over the hurdles of research reporting to a successful study from start to finish. From the reviews of the first edition: "For me, it is a bible and a "must" for every Ph.D. or M.D. involved in clinical research, especially in the field of surgery. It should be on the table - not on the book shelf - of both the young as well as the experienced investigator as a readily accessible source of information to avoid the trial-and-error approach to problems in surgical research." #"World Journal of Surgery"#1 ..".a carefully conceived, concise blend of factual theory and principles, practical guidelines, and philosophical perspective... ...I have found it hard to identify any omission (even a selected bibliography on laboratory animals, their care, handling, and anatomy is included) and impossible to single out any individual contribution: each is a treasure - well written, concise, and complete." #"The " "Lancet"#2 "The feature of the book is that, despite attention to detail, it maintains a clear and practical approach to the whole field, beginning with the reasons for carrying out research, the types of research, and above all the reporting of research... ...Almost all aspects of research are covered, from small retrospective studies to departmental, institutional, national and international projects... ...The chapter on writing for publication should be compulsory reading for all budding authors." #"Journal of Bone and Joint" "Surgery"#3

Severe, protracted pain defying control is being seen with in creasing frequency as a symptom of chronic disease. It accompanies many, mostly serious, disorders in various organs and parts of the human body, making the sufferer's life increasingly intolerable. It no longer fulfillR its mission of warning signal of disease present, protecting health, but on the contrary arises as an important factor in systematically reducing and preparing the final collapse of the defensive forces of the body, both in the somatic and psychic spheres. It can surprise nobody that patients tormented and plagued by severe pain do not wish to live under conditions primarily caused by incurable disease, and are looking forward longingly to their release by deat. h, if no help is forthcoming. Attempts to control such pain are, therefore entirely justified, necessary and logical. The treatment of intractable pain is without exception sympto matic in character. Efforts to control it by drugs are, even at present and despite the striking progress in pharmacology, unsatisfactory and inadequate. So far we know of no drug capable of effectively and systematically alleviating such pain without concurrently inter fering with the other sensitive-sensory components. In addition to the direct changes and dist. urbances of consciousness and personal ity, protracted conservative therapy results in addiction to narcot ics."

Immunology is a rapidly developing subject. The contributors in this book present some components of immunological knowledge which relate to the present and the possible future practice of surgery. Aspects of cellular and humoral immunity necessary for understanding are described and considera tion given to the mechanisms underlying immunological diseases. Whilst the original interest in immune response was related to microbial resistance, the recent impetus to surgical immunology has been the resurgence of organ grafting. Separate sections of the book deal with clinical organ transplanta tion, the allograft reaction, graft rejection and immunogenetics. A pre-requi site of successful organ grafting is suppressive control of immune responses. Approaches to conventional immunosuppression and specific non-reactivity are therefore considered. One method of cancer therapy is strengthening of the host's immune responses. Both experimental and clinical immunotherapy are discussed and components of tumour immunology necessary for their rational understand ing are dealt with separately. Successful immunotherapy requires monitoring of immune responses but another method for improving results of cancer treatment is earlier diagnosis by immunological methods. The book is aimed at practising surgeons who want to know the relevance of immunology to clinical surgery and laboratory scientists needing to understand the applications of their basic concepts. I am very grateful both to the authors for their contributions and the editorial staff of MTP Press Limited, for their considerable help."