In this book, the recent developments in immunology and the impact on the treatment of infections in critical care and in surgery are presented, also describing how cellular immunology influences clinical treatment. This information helps in understanding the pathogenesis of infections in surgery and critical care. The impact of a standard treatment such as antibiotic therapy is evaluated and possible future therapy modalities outlined. This book will be of interest to clinicians and immunologists as scientists of both specialties have contributed to the book.

These eight volumes, which developed out of the international con gress "Update and Future Trends in Fibrin Sealing in Surgical and Nonsurgical Fields" held in November 1992, present the state of the art in fibrin sealing. Initially, fibrin sealant played an important role in surgery. During the past few years, it has been increasingly applied in nonsurgical applications and we can now say that it has become an integral component of medical treatment. The doubts which have been raised by nonusers about the efficacy of fibrin sealant are no longer valid. The correct indication and technique continue to be basic prerequisites for effective treatment. Even today - 20 years after fibrin sealant was first used - the three most prominent effects of fibrin sealant are still hemostasis, sealing of the wound, and support of wound healing. The problems posed by the transmission of viral infections have gained substantially in importance because of the potential transmission of AIDS via fibrin sealant. Fortunately, this is so unlikely today that it no longer represents a cause for concern, which does not mean, however, that research in this field can be discontinued.

"Advances in Neurosurgery 22" is devoted to three main topics, the first one being Cerebellar Infarcts. Following the introduction with the microsurgical anatomy and the neuropathology of cerebellar infarction, the indication for operative treatment and its results are then discussed. The neuroradiological treatment with local and antifibrinolytic therapy for vertebrobasilar occlusion completes this section. The management and surgical approaches to the various forms of midline lesions are then presented. Special interest is centred on minimal invasive endoscopic neurosurgery (MIEN), (intraventricular tumors, optic pathway gliomas, endoscopic brainstem tumors and vascular malformations). Furthermore the special equipment and fields of indications are extensively discussed.

These eight volumes, which developed out of the international con gress "Update and Future Trends in Fibrin Sealing in Surgical and Nonsurgical Fields" held in November 1992, attempt to present the state of the art concerning fibrin sealing. Initially fibrin sealant played an important role in surgery. During the past few years, however, it has been increasingly used in nonsurgical applications, and we can now say that it has become a component of medicine in general. The doubts about the efficacy of fibrin sealant, which had been raised by nonusers, are no longer valid. The correct indication and method ology continue to be basic prerequisites, and even today - after 20 years of fibrin sealant renaissance - the three most prominent effects of fibrin sealant still retain their validity: hemostasis, sealing and sup port of wound healing. The problems posed by the transmission of viral infections have gained substantially in importance because of the potential transmission of AIDS via fibrin sealant. Fortunately the transmission of AIDS via fi brin sealant is today so unlikely that it no longer poses a cause for con cern. This does not mean, however, that research in this field can be discontinued.

Das Buch richtet sich an Chirurgen, die in vertrauter Sprache und Form Antworten auf spezifische juristische Fragen und Probleme suchen. Die gemeinsame Erarbeitung durch einen Juristen und Chirurgen erlauben eine hohe Praxisrelevanz bei gleichzeitiger juristischer Genauigkeit. Typische Situationen und Probleme des chirurgischen Alltags in Klinik und Praxis werden juristisch durchleuchtet. Sofort umsetzbare Antworten werden erganzt durch Checklisten und Praxistipps. Zukunftige Entwicklungen wie der Einfluss des europaischen Rechts auf die tagliche Arbeit oder auch Netzstrukturen werden berucksichtigt. Ein detailliertes Stichwortverzeichnis erleichtert das Auffinden der entsprechenden Themen. Das Buch richtet sich an Chirurgen aber auch an Arzte in der chirurgischen Weiterbildung in Klinik, Praxis und Verwaltung, um insbesondere Unsicherheiten in Bezug auf juristische Fragen dieses Fachgebietes zu nehmen.

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Epidural opioids are widely used in the management of post- operative pain. On the basis of an extensive review of the literature the authors here present their own interpretation of current knowledge of how the distribution and effectiveness of epidurally administered opiods are fundamentally determined. They conclude that all opioids that are currently being used to treat postoperative epidural pain carry the potential risk of severe side effects if the dose regimens are not tailored to the patients individual analgesic need. This book will serve to stimulate new ideas among pain specialistst.

This book is the result of the 3rd Wiggers Bernard Conference. The Wiggers Bernard Conferences, named after two great physiologists of the past, are biannual gatherings of the leaders in the field of shock. The meetings focus on specific areas of interest, where a lot of new informations is available, but needs to be focused. There are informal presentations during which the seminarian can be intenupted in order to clarify a pat1icular point; formal discussions follow each presentation; these are followed by infOlmal gatherings in which these discussion continue in a very relaxed environment. The 1992 meeting took place in Obermayerhofen, a small but charming castle in the soft green hills of Eastern Styria in the South-Eastern part of Austria. The castle was built in 1130, restored and turned into a hotel in 1977. The renaissance court yard and the generous and exclusive decors make it one of the most beautiful castles in Austria. The frank beauty and hospitality of this area acted as a catalyst to crystalize the thoughts of this interdisciplinary group of scientists as they discussed new findings in the cytokine area.

Advances in Neurosurgery presents the experience and research results of modern neurosurgeons confronted with urgent diagnostic and therapeutic problems. The first topic here is spontaneous intracerebral hematomas, whose localization determines the form of treatment and usually its outcome. Newer therapeutic approaches such as stereotactic removal, endoscopy and fibrinolysis supplement the results of standard operative methods. Secondly, the hydrocephalus malresorptivus is covered, presenting experience with the diagnostic value of intrathecal infusion tests, CT-cisternography, evoked potentials, and MRI CSF-flow studies, as well as aspects of neurosurgical intensive care such as barbiturate treatment, respiratory problems in head injury patients, auto-regulation mechanisms, and hospital infection. The last section is devoted to peripheral nerve surgery, reports on experience with microsurgery and various forms of anastomosis in both traumatic and tumorous nerve lesions.

Cell transplantation to the brain and spinal cord is a well-established research tool for studies on cellular and molecular mechanisms, but can it be developed into a useful therapuetic approach in human neurological disorders? Clinical trials in patients with Parkinson's disease have provided encouraging evidence, however, no treatment based on transplantation is available yet. An overview of current research is given in this book. It summarizes the status of grafting in humans and discusses scientific problems that have to be solved before intracerebral transplantation can become a useful routine approach to treatment.

In this issue of Dental Clinics, guest editors Drs. Jack L. Ferracane, Luiz E. Bertassoni, and Carmem S. Pfeifer bring their considerable expertise to the topic of Dental Biomaterials. Dental biomaterials have received recent attention in terms of exhibiting excellent performance, as well as increased migration and proliferation of cells involved in the osseointegration of implants. This issue offers up-to-date, expert coverage of adhesives, cements, composites, ceramics, scaffold materials, and implants, as well as light curing and safety of dental materials. Contains 11 practice-oriented topics including dental adhesives: surface modifications of tooth structure for stable bonding; resin-based composites: materials for direct and indirect applications; new technologies for restorative dentistry; advances in ceramics for dental applications; cements and protocols for bonded dental ceramics; and more. Provides in-depth clinical reviews on dental biomaterials, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

The anastomotic technique plays a predominant role in gastrointestinal surgery. A feared complication is leakage due to the sutures. Such leakage cannot be detected early; consequently, infection spreads locally and systemically. An anastomotic method is generally evaluated according to its rate of leakage, related to the localization, bur real scientific comparisons, i.e., controlled studies, are almost totally lack ing. The criteria of evaluation include the type of suture, the localization, the auxiliary technical tools, practicability, the different forms of wound healing, angiogenesis, and vascularization, among others. The postoperative criteria are complications shortly after surgery, such as bleeding, ruptures, and stenoses of the anastomosis. A standard comparison is made difficult by the variety of cytophysiological and biochemical factors that influence wound healing. In the comparison of larger series one must always take into account differences of auxiliary tools, strategies, and inhomogeneity of patients. A change of one auxiliary tool or of one strategy implies the modification of various target criteria. Often enough, however, one does not sufficiently consider the surgeon's most. important role."

Complementary therapies can benefit many people with disabilities. This text gives disabled people, and those who care for them, the information required to make informed decisions about their health and health care. "Disability" is defined broadly, to include conditions causing long-term physical disabilities and potentially disabling conditions such as multiple sclerosis, stroke or arthritis.;Designed to be of use to a wide range of people, this book: offers practical advice on finding qualified and competent practitioners in complementary medicine; describes and analyzes each major complementary therapy; and uses clear, non-technical language.

Introducing this monograph by expressing our heartfeIt thanks to all those who have contributed to its success may seem no more than a rhetorical exercise. However, at the same time we feel duty bound to add our sincere apologies, for we know that many of the dis tinguished authors of the various chapters have been hard put to find any relevant information in the existing literature. The plain fact is that very little has been said and written about pancreatic fistulas compared with other aspects of pancreatic disease. Why is this? Essentially, we believe there may be two main reasons: one practical explanation may be their relative rarity, while the other reas on is, as it were, "psychological," i. e., pancreatic fistulas tend almost invariably to be regarded as complications of an imperfectly performed surgical procedure. However useful it might be if we were to do it more often, it goes against the grain to public1y admit one's own mistakes. Ever since I (P. P. ) started practising in medicine, it has been my destiny and privilege to work alongside Professor Dagradi, the pioneer ofpancreatic surgeryin Italy, and to assist him over the years in something like 2000 operations on the pancreatic gland. Clearly, then, any complication due or related to such surgery however rare, has become part and parcel of my practical day-to-day c1inical experience and scientific interests."

In this issue of Atlas of the Oral and Maxillofacial Surgery Clinics, guest editor Dr. Florencio Monje Gil brings his considerable expertise to the topic of Temporomandibular Joint Surgery. TMJ disorders affect 12% or more of the population in the U.S. alone, primarily women in their childbearing years. In this issue, top experts in the field provide comprehensive, current tutorials of every major TMJ surgery, including articles on pre- and postoperative treatment. Contains 14 practice-oriented topics including rules for surgical decision making in temporomandibular joint treatment; temporomandibular joint arthrocentesis; operative arthroscopy and electrocoagulation of the temporomandibular joint; open temporomandibular joint surgery: discectomy with or without interpositional reconstruction; temporomandibular joint surgery: open discopexy; and more. Provides in-depth clinical reviews on temporomandibular joint surgery, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Three topics of major interest for neursurgeons are covered in this volume of the Advances in Neurosurgery series, as the title suggests. First, neurosurgical standards of diagnosis and treatment are viewed from several points of view, including the legal one. Second, the many aspects of aneurysm surgery are dealt with: timing and grading, monitoring during the operation, postoperative vasospasm, Doppler sonography and new research in subarachnoid hemorrhage. Third, the diagnosis and treatment of malignant gliomas are discussed; there are preliminary reports on interstitial laser-assisted thermal therapy, immunotherapy and radiopharmaceutical substances as well as the standard forms of neurosurgical and radiation treatment.

In den Bereichen Laser/Optoelektronik/Mikrowellen werden Forschungsergebnisse in rasantem Tempo in technische Entwicklungen und Anwendungen umgesetzt. Der seit 1973 alle 2Jahre in M}nchen veranstaltete internationale Kongress gibt, in Verbindung mit der bedeutendsten internationalen Fachmesse der Optoelektronik, einen ]berblick }ber den aktuellen Stand in Forschung, Technik und Medizin. InFortsetzung dieser Tradition vermittelt der 10. Internationale Kongre~ LASER91 neue Erkenntnisse aus Grundlagenforschung, Entwicklung und praxisbezogener Anwendung. Zur Abdeckung des breiten Interessenspektrums von Forschern, Ingenieuren, [rzten und Anwendern wurde der Kongre~ in unterschiedliche Darbietungsebenen strukturiert. Die Vortr{ge, die sich mit medizinischen Anwendungen befassen, wurden in folgende Themengruppen gegliedert: Chirurgie/Surgery.-Urologie/Urology.-Photodynamische Therapie/Photodynamic Therapy.-Gyn{kologie/Gynecology.- Neurochirurgie/Neurosurgery.-Angioplastie/Angioplasty.- HNO/ENT.-Ophtalmologie/Ophtalmology.- Zahnmedizin/Dentistry. -Optische Methoden in der Diagnostik/Optical Methods in Dia- gnosis.-Dermatologie/Dermatology.-Photobiologie/Photobiolo- gy.- Laserstrahlenschutz in der klinischen Forschung und Routine/Laser Ray Protection in clinical research and practice.

Here is the ideal book for preparing for the new Part One of the FRCS exam. To conform to the recently introduced syllabus the questions used are now much more surgically relevant. Answers, many with explanations, are provided to make the use of the MCQs a more useful learning exercise. The book follows the format of the examination and is split into the following sections: Anatomy (including histology, embryology and medical imaging); Physiology and Biochemistry; Clinical Pharmacology; General and Systemic Pathology; Microbiology; Clinical Immunology; Haematology.

Advances in Surgery reviews the year's most important findings and updates within the field in order to provide surgeons with the current clinical information they need for everyday practice. A distinguished editorial board, led by Dr. John L. Cameron, identifies key areas of major progress and controversy and invites preeminent specialists to contribute original articles devoted to these topics. These insightful overviews in surgery inform and enhance clinical practice by bringing concepts to a clinical level and exploring their everyday impact on patient care. Contains 20 articles on such topics as failure to rescue after the Whipple; management of necrotizing pancreatitis; what surgeons need to know about gene therapy for cancer; and how can we decrease firearm deaths in the United States. Provides in-depth, clinical reviews in surgery, providing actionable insights for clinical practice. Presents the latest information in the field under the leadership of an experienced editorial team. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

A book that compiles symposia papers from the International Journal of Colorectal Disease on issues that are highly controversial and hotly debated.

This study sets out to describe all aspects of a congenital anomaly which has been described as "the epitome of modern surgery" and "the raison d'etre of pediatric surgery". The book is presented in eight sections, commencing with a summary of the historical events of significance, followed by epidemiology and genetics, embryology, anatomy and pathophysiology. The clinical aspects commence with chapters dealing with diagnosis, transport, anaesthesia and intensive care. This is followed by a section which addresses the surgical aspects of the specific variants of the anormaly.;A major problem in a baby with oesophageal atresia is the associated anomalies which are present in over 50% of the patients; therefore section 4 is devoted to the consideration of these anomalies with emphasis on the most important specific anomalies.;It also includes the overall care of the child and family and to complete the monograph by describing the management of specific problems and complications, and the longterm results of surgery.;This book is presented in the hope that it will be of help to all concerned with the care of the baby with oesophageal atresia and its family, recognizing that the field is wide, involving as it does representatives of many medical and paramedical disciplines.

The continued high mortality (up to 70 %) in patients with necro- tizing pancreatitis and diffuse peritonitis has led to the develop- ment of various surgical strategies within the past few decades. Up to the present decisions about the management of these disea- ses have been rather difficult because of the individual courses differ considerably, even being incomparable. Today, as a result of our in creased knowledge of the pathophysiology, the impro- ved imaging procedures, and the standaridized intensive care, the rend is moving toward delayed surgical intervention. The goals in the surgical treatment of necrotizing pancreatitis and diffuse peritonitis are still surgical removal of the focus of infection, elimination of endotoxins by lavage, and optimal drainage of the peritoneal cavity. Depending on the patient's general condition this cannot always be achieved in the first surgi- cal intervention. A number of surgical methods have therefore been developed, such as postoperative dorsoventral lavage, step- by-step lavage therapy, postoperative closed continuous perito- neal lavage, and open treatment (laparostomy). The last-mentioned method ist not new; it was first described by KOR'J;E in 1894 for the treatment of necrotizing pancreatitis. However, due to the progress in intensive care medicine (long- term respiratory therapy, hemofiltration, etc.) in the last few years this method of management has become successful and gai- ned in recognition.

The majority of amputations in the western world today are due to vascular disease. Despite the advances in surgical treatment of this disease, particularly by reconstruction, it is a sad fact that the number of amputations performed in these countries each year for vascular disease is increasing. Most of these amputees are elderly and their life expectancy is short, so it is important that the treatment and rehabilitation that they receive is informed, appropriate, efficient and swift to enable them to return successfully to life in the community for their remaining years. Management of this group of patients has proved to be successful only if a multidisciplinary team approach is adopted. Until recently in the UK, this approach sadly has only been implemented by a few centres. However, with the publication of the McColl report into the prosthetic and wheelchair service in 1986, interest in the care of the amputee is growing throughout the country. This book covers all aspects of amputation from disease and diagnosis to rehabilitation and community discharge with emphasis on the man agerneut of the largest group, the vascular lower limb amputee. A team approach is described and emphasized as being essential for good results and subsequent successful return into the community. The role of each of the important disciplines is described in relation to the appropriate part of the rehabilitation phase."

Interventional Radiology has as its main goal the performance of surgical techniques using a percutaneous approach to simplify patient care. Percutaneous cholecystostomy now has many advocates; still, it is practised in comparatively few centers. Over many years it was used as a last resort at failed transhepatic cholangiography to provide images of the bile ducts in biliary obstruction. Transhepatic cholecystostomy is reputed to be safer than transperito- neal puncture, since bile leaks do not enter the peritoneum. The advo- cates of percutaneous cholecystolithotomy, almost without exception, fa- vour subcostal cholecystostomy and puncture of the fundus of the gall- bladder. There is no evidence of bile peritonitis after successfully making a track to the gallbladder 18 F in diameter or larger for stone removal. After 1-7 days a postlithotomy drain is removed from the gallbladder and the patient is allowed home. Transhepatic cholecystostomy for gallstone lysis, in contrast, requires only a 5-F track to the hepatic surface of the gallbladder. Loss of the gallbladder is not as great a fear with this technique as it is during dilata- tion of a subcostal track for cholecystolithotomy. During the latter pro- cedure this may result in laparotomy to avoid bile peritonitis, while in the former, if the gallbladder is still visualised, the procedure may be re- commenced immediately. Catheter dislodgement is a fear when prolon- ged catheterisation is considered.

Augmented reality (AR) is transforming how we work, learn, play and connect with the world, and is now being introduced to the field of medicine, where it is revolutionising healthcare as pioneering virtual elements are being added to real images to provide a more compelling and intuitive view during procedures. This book, which had its beginnings at the AE-CAI: Augmented Environments for Computer-Assisted Interventions MICCAI Workshop in Munich in 2015, is the first to review the area of mixed and augmented reality in medicine. Covering a range of examples of the use of AR in medicine, it explores its relevance to minimally-invasive interventions, how it can improve the accuracy of a procedure and reduce procedure time, and how it may be employed to reduce radiation risks. It also discusses how AR can be an effective tool in the education of physicians, medical students, nurses and other health professionals. Features: An ideal practical guide for medical professionals and students looking to understand the implementation, applications, and future of AR Contains the latest developments and technologies in this innovative field Edited by highly respected pioneers in the field, who have been immersed in AR as well as virtual reality and image-guided surgery since their inception, with chapter contributions from subject area specialists working with AR