Rejection and Tolerance is the latest subject in the Continuing Education series, organized by Fondation Marcel Merieux and Universite Claude Bernard in Lyon. The annual subject is chosen to reflect the status of the topical issues of the year, as taught by leading international experts. The contribution of transplantation and clinical immunology to advanced medicine is considerable and promising. The annual volumes in this series keep the reader abreast of these developments. "

This book provides a concise, patient-directed approach to stone prevention. It defines who to evaluate and when to treat, and provides empiric guidelines for all stone formers. Specific treatment guidelines are also included, based on the kidney stone composition and the underlying metabolic abnormalities demonstrated by 24-hour urine stone risk profile. Written by experts in the field, Pocket Guide to Kidney Stone Prevention: Dietary and Medical Therapy serves as a valuable resource for a broad base of clinicians in primary and specialty care.

While patients with metastatic renal cell carcinoma (mRCC) are now living longer with improved quality of life, the success of novel therapies for mRCC has created challenges for practicing oncologists. Many patients who initially respond to targeted therapies ultimately develop progressive disease due to acquired resistance to these agents. Additionally, some patients do not respond at all to any of the currently approved targeted agents, underscoring the need for continued and concerted efforts to identify other relevant targets and pursue alternative therapeutic strategies. Part of the Oxford American Oncology Library, Renal Cell Carcinoma is a concise handbook that addresses the complex management of patients with mRCC. The book begins with a review of the epidemiology, pathology, and biology of renal cell carcinoma followed by chapters on specific targeted therapies and managing complications. The final chapters discuss supportive and integrative care and emerging therapies.

We present to our readers the proceedings of the Second International Workshop on Phosphate. A short account of the history of the effort led to the Phosphate Workshops is appro priate and can be of interest to the reader. The idea for Phosphate Workshops was born in the early days of November, 1974. One of us (S. G. M. ) suggested the thought to a group of scientists gathered for a luncheon in one of the attrac tive small restaurants in Weisbaden, Germany. The purpose of the workshop was to bring together interested scientists to discuss the newer developments and the recent advances in the field of phosphate metabolism and the other related minerals. An Organizing Committee made of Shaul G. Massry (USA), Louis V. Avioli (USA), Philippe Bordier (France), Herbert Fleisch (Switzerland), and Eduardo Slatopolsky (USA) was formed. The First Workshop was held in Paris during June 5-6, 1975 and was hosted by Dr. Philippe Bordier. Its proceeding was already published. The Second Workshop took place in Heidelberg during June 28-30, 1976 and was hosted by Dr. Eberhard Ritz. Both of these workshops were extremely successful scientific endeavors, and the need for them was demonstrated by the great interest they generated among the scientific community. The Or ganizing Committee, therefore, decided to continue with the tradi tion to hold additional Workshops annually or every other year."

This is the first textbook entirely dedicated to the endovascular treatment of complications related to arteriovenous accesses for hemodialysis (native fistulas and prosthetic grafts). The book addresses the anatomy of upper limb arteries and veins as well as the clinical presentation of patients and the way to perform and read a fistulogram. Many details and illustrations are provided, clarifying the subtleties in catheterization and the dilation of stenoses. From a strategic point of view, it is explained for the first time that many stenoses must either be ignored or deliberately underdilated. A wealth of images helps to understand the different stages of access recovery from thrombosis. As the number of incident dialysis patients is increasing by 5% every year, this is a field of growing interest. In testament to this there are several annual or bi-annual meetings held by numerous national and international societies (vascularaccesssociety.com, sfav.org, vasamd.org, dialysiscontroversies.org, asdin.org).

Biologics have revolutionised the treatment of many severe conditions, delivering exceptional clinical results but also producing exceptionally high prices. As patents expire, copies and price competition are expected throughout the world. However, due to the intrinsic heterogeneity and molecular complexity of biologic medicinal products, their copies cannot simply be authorized under the "generic rule" valid for small chemical entities. In response, a dedicated regulation was issued in the European Union. It is based on the concept of "biological medicinal products similar to a biological reference product", or "biosimilars". This book analyses the context of biotechnological production and addresses the European legal framework for biosimilar market approval. It highlights post-market authorisation issues, such as Risk Management Plans and substitution of products, and outlines some other issues, such as cost management and international nomenclature. This book is primarily intended for hospital-based physicians and pharmacists. It will also be a valuable resource for all actors from all countries who want to better understand the emergence of these new medicinal products within the European context.

WEGENER'S GRANULOMATOSIS & ANCA-ASSOCIATED DISEASES: THE STORY CONTINUES The disease now designated as Wegener's granulomatosis (WG) was first described in 1931 by Heinz Klinger, who considered it to be a special form of polyarteritis nodosa. Klinger's friend, Friedrich Wegener, expanded on the first observations and interpreted the pathological and clinical fmdings to represent a distinct disease entity (Wegener, 1939). He described this entity as a "peculiar rhinogenous granulomatosis with a unique participation of the arterial system and the kidneys". Later, Godman and Churg (1954) established the classical diagnostic criteria (the "WG triad"): granuloma, vasculitis, and glomerulonephritis. In 1958 Walton pointed out the poor prognosis of WG based on a small number of published cases (mean survival time: 5 months). In 1966 Carrington and Liebow reported "limited forms" of WG with a defmitely more favorable prognosis. Since then positive results have been reported with cyclophosphamide therapy. In addition, a retrospective study of combined low-dose cyclophosphamide and prednisolone in 85 WG patients over a period of 21 years found a similarly encouraging outcome. The*latter experience led to the current "standard" treatment protocol (FAUCI et al. , 1973 and 1983). More recently, strong evidence has emerged that some of the morbidity and mortality ofWG - and other types of systemic vasculitis - may be a consequence of this treatment (Hoffman et al. , 1992).

This volume was designed as a text for medical students, house officers, and even clinicians. It deals with the most common problems in nephrology, providing new insight into how to improve clinical skills. A comprehensive overview of renal physiology and electrolyte disorders lays the groundwork for a clear presentation of the pathophysiological principles that underlie these disorders and a step-by-step presentation of the mechanisms behind the signs and symptoms of kidney failure. The origins of this book can be traced to the teaching of a Renal Pathophysiology course at the Washington University School of Medicine, beginning in the mid-1960s. When changes in the medical school curriculum took place in the early 1970s, an effort was made to synthesize the minimum core curriculum for sophomore medical students, and the distillation of "essential material" to be covered in the area of renal pathophysiology led to the development of the first edition of a renal syllabus. This syllabus has been used in our department since 1974, and, following some of the recommendations and critiques of students and faculty, it has been entirely reworked many times to improve its effectiveness and value. This book is a direct extension of that syllabus, integrated with contri butions from faculty members in our Renal Division, and expanded to include a section on therapy in most chapters. It is our hope that this format will serve the needs of not only sophomore and senior medical students, but also house officers, nephrology fellows, and clinicians."

Diabetic nephropathy is a tragic illness. Its often insidious onset in the insulin dependent (type I) diabetic, typically a young adult, heralds the last act in the course of a disease that will increasingly become the dominant preoccupation in the patient's shortened life. For most type II diabetics, the beginning of clinical renal insufficiency is but a phase in a continuous deterioration that affects the integrity ofjob, marriage, and family. The nephropathic diabetic is hypertensive, has worsening retinopathy, and more often than not, is also plagued by peripheral vascular insufficiency, heart disease, gastrointestinal malfunction, and deepening depression. Until the 1980's, few type I diabetics who became uremic (because ofdiabetic nephropathy) lived for more than two years. Hardly any attained true rehabilitation. This dismal prognosis is changing substantially for the better. Research in diabetes has resulted in striking advances at both ends of the type I diabetic's natural history. In one exciting clinical trial now underway in London, Ontario, halfofchildhood diabetics treated with cyclosporine within six weeks of onset evince"permanent" disappearanceofhyperglycemia and the need for insulin. At the otherendofthe natural historyofdiabetes for the nephropathic patientwith worsening eye disease (renal-retinal syndrome), who receives a kidney transplant, patient and graft survival, two years after cadaveric kidney transplantation in type I diabetics is now equal to that of the nondiabetic."

Proceedings of the FEMS Symposium on Genes and Proteins Underlying Microbial Urinary Tract Virulence: Basic Aspects and Applications, held September 16-19, 1999, in Pecs, Hungary. Urinary tract infections are among the most frequent diseases caused by microbial pathogens. In this volume, researchers, clinical microbiologists and clinicians exchange the latest ideas covering four major aspects of this important topic: * Genetic information, synthesis and assembly of virulence factors in urinary pathogens; * Regulation of genes involved in the phenotypic appearance of virulence; * Host-parasite interactions determining the process and outcome of the infection; * Possible applications of the above aspects in diagnosis, therapy and prevention.

Extracorporeal shock wave lithotripsy (ESWL)" arrived in the United States in February of 1984 with explosive impact in the field of urology. The first ESWL treatment in the United States with the Dornier H~ device occurred at the Methodist Hospital of Indiana, and by the end of 1984, In spite of the rapidly the United StatesESWL study group had accrued over2,5()() ESWL treatments. accumulated experience at the six institutions involved in the FDA trial of the Dornier HM] device, other urologists in this country and around the world had little opportunity to gain knowledge about the utilization of this revolutionary technique. For this reason, the Methodist Hospital of Indiana organized the first symposium on shock wave lithotripsy in February of1985. Interest in this meeting was intense, as approval of the Dornier device had occurred only a few weeks earlier in December of 1984. Because of the success of this initial meeting, subsequent meetings have been held annually in Indianapolis. Following the third annual symposium on extracorporeal shock wave lithotripsy in March of 1987, a number of participants and attendees requested that the information presented at the meeting be made available. Therefore, plans were made to publish the proceedings of the next meeting which occurred March 5 and 6, 1988. The Methodist Hospi tal ofIndiana' s 4th Symposium on Shock Wave Lithotripsy: State of the Art was the best attended meeting to date with over 650 registrants from 36 states and 24 countries.

Stjarne: The present review puts the emphasis on two important developments: the discovery that individual postganglionic sympathetic neurons may secrete multiple transmitter substances from different classes of vesicles and by different mechanisms, and the introduction of new techniques which may permit for the first time direct impulse by impulse analysis of transmitter secretion in individual sympathetic nerve varicosities. Illes: Exogenous and endogen opioid peptides elicit a number of effects in the organism, usually by modifying the function of transmitter and hormone systems, for example, activation of multiple opioid receptors. The effects of opioids on transmitter and hormone release have frequently been reviewed. This review gives a detailed overview on the involvement of multiple opioid receptors in these processes. Rothstein: This article gives an overview of the exchange in acidification and transepithelial salt and water transfer in nonepithelial cells. Delineating the exchanger's most important, common features, and concentrating particularly on its role in cell pH and volume regulation.

Chronic Kidney Disease (CKD) is a recognized risk factor for cardiovascular events and death. The coexistence of CKD and heart failure is increasing in prevalence worldwide and requires a unique and subtle approach to patient management. The Kidney in Heart Failure focuses on the changes that occur in kidney physiology as a function of a failing heart. This comprehensive resource covers epidemiology, pathophysiology, management of kidney disorders and advances in nephropathy management. In addition, the latest therapies, common heart failure dilemmas and kidney disease markers are included. Each chapter is co-authored by a Nephrologist and Cardiologist, offering a unified perspective to these chronic conditions. This indispensible volume provides the reader with the depth-of-knowledge needed for assessing and treating the cardio renal patient.

The sum of clinical problems caused by diabetic renal disease has been steadily increasing since the first edition of this book was published in 1988. The years since have seen tremendous progress in research activities. Importantly, this also includes improvement in the treatment programs to prevent end-stage renal failure. It has become clear that the diabetic kidney is extremely pressure-sensitive, responding to effective antihypertensive treatment by retarded progression of disease. Some agents may be more beneficial in this respect than others, although effective blood pressure reduction per se is crucial throughout the stages of diabetic renal disease. However, the prime cause of diabetic renal disease is related to poor metabolic control and it is now documented beyond doubt that good metabolic control is able to postpone or perhaps even prevent the development of renal disease. However, in many individuals we are not able to provide such a quality of control that will prevent complications, and therefore non-glycaemic intervention remains important.Maybe in the future non-glycaemic intervention will become the most important research area in diabetic nephropathy. Much information is now available on the exact mechanisms behind poor metabolic control and development of renal disease. It is likely that a combination of genetic predisposition and metabolic and haemodynamic abnormalities explain the progression to renal disease, seen in about 30% of diabetic individuals. Much of this development probably relates to modifiable genetic factors, such as blood pressure elevation or haemodynamic aberrations. However, mechanisms related to the response to hyperglycaemia are also of clear importance, as is the possibility that these metabolic or haemodynamic pathways may be inhibited. This volume reviews older data as well as the progress seen within the research on diabetic nephropathy over the last five years and describes the state of the art of the development.

We have witnessed a rapid development within the field of the kidney and hypertension in diabetes mellitus. A significant amount of work within the traditional areas has been published, and several new dimensions are now being developed, mostly in the experimental setting. These dimensions are discussed in several chapters of this new edition, The Kidney and Hypertension in Diabetes Mellitus, Fourth Edition. This volume endeavors to cover all aspects of renal involvement in diabetes. It is written by colleagues who are themselves active in the many fields of medical research covered in this volume: epidemiology, physiology and pathophysiology, laboratory methodology and renal pathology.

The first sporadic observations describing renal abnormalities in diabetes were published late in the 19th century, but systematic studies of the kidney in diabetes started only half a century ago after the paper by Cambier in 1934 and the much more famous study by Kimmelstiel and Wilson in 1936. These authors described two distinct features of renal involvement in diabetes: early hyperfiltration and late nephropathy. Diabetic nephropathy is, despite half a century of studies, still a very pertinent problem, renal disease in diabetes now being a very common cause of end-stage renal failure in Europe and North America and probably throughout the world. It is a very important part of the generalized vascular disease found in long-term diabetes as described by Knud Lundbaek in his mono graph Long-term Diabetes in 1953, published by Munks gaard, Copenhagen. Surprisingly, there has not been a comprehensive volume describing all aspects of renal involvement in diabetes, and the time is now ripe for such a volume summarizing the very considerable research activity within this field during the last decade and especially during the last few years. This book attempts to cover practically all aspects of renal involvement in diabetes. It is written by colleagues who are themselves active in the many fields of medical research covered in this volume: epidemiology, physiology and pathophysiology, laboratory methodology, and renal pathology. New studies deal with the dia gnosis and treatment of both incipient and overt nephropathy by metabolie, antihypertensive, and dietary invention."

Renal sonography forms a basic part of routine diagnostic strategy. This textbook summarizes eighteen years of experience in diagnostic ultrasound. We want it to serve as a guide to both imagers and mere consumers of information. That is why we shall emphasize practical advice and diagnostic pitfalls; it is also why we shall often deal with the relations of sonography with other diagnostic procedures, which it may complement or replace, precede or follow, the purpose being to achieve efficiency at low cost. We shall limit our subject matter to the kidney itself and the neighboring retroperitoneal compartments, dealing only briefly with the lower urinary tract, which requires specialized procedures. We devoted considerable space to renal sonography in our book Clinical Atlas of Ultrasonic Radiography, published in 1973. Since then, nothing has changed and everything has changed. Nothing, because even then the differential diagnosis between a solid and a cystic mass, the etiologic diagnosis of a nonsecreting kidney, and the positive diagnosis of a traumatic juxtarenal hematoma were quite reliable, making possible drastic reductions in the indications for instrumental roentgenologic examinations. Everything, be cause improved resolution and grey scale imaging (already partially achieved in 1973, thanks to real time) have profoundly refined both anatomic and pathologic ultrasonic studies. And now high resolution real time imaging has revolutionized renal examination techniques, whereas Doppler is entering routine ultrasonic diagnosis."

There is a rapid increase in interest related to novel approaches in artificial kidneys, artificial liver, and detoxifi cation. Recent research has included the successful clinical appli cations of the principle of artificial cells for adsorbent hemo perfusion. Since it is 20 years ago at McGill that the first report on "Artificial Cells" was presented, I thought it might be useful to get together a small group of speakers and participants for a day before the ASAIO meeting to discuss some recent advances in the area of the clinical applications of artificial kidney, artificial liver and artificial cells with emphasis on adsorbent hemoperfusion. However, the enthusiastic supports of distinguished speakers, session chairmen and participants were such that the original pro jection of 100 participants had expanded to a preregistration total of 250, from Australia, Canada, England, France, Germany, Israel, Italy, Japan, The Netherlands, Scotland, Sweden and U. S. A. The program also expanded to include a review section on hemodialysis, dialysate regeneration, hemofiltration, resin hemoperfusion and oxystarch given by their respective originators. The remaining of the symposium emphasizes the status of the art on different encap sulated adsorbent hemoperfusion approaches. I would like to apolo gize to those who we could not accommodate beca se of space limita tions. It is hoped that this symposium volume may be useful for them and for others who are interested in this area. Special thanks are due to Ms Joanne Toms for her excellent secretarial assistance for the conference and Mrs."

The general populations are incidentally exposed to a wide variety of xenobiotics as a consequence of the pollution of the environment by industrial and agricultural chemicals. Xenobiotics entering the animal will undergo one or more of the following fate: (a) elimination unchanged, (b) metabolism by enzymes, (c) spontaneous chemical transformation and (d) remain unchanged in the body. The actions of xenobiotics on the body exhibit certain specificity depending upon the compound's chemical structure and reactivity. Since the processes of metabolism change these chemical properties ofaxenobiotic, bewildering number of reactions continue to pose new challenges to toxicologists and pharmacologists. It necessitates periodic and precise revision of the subject. This book contains invited contributions from learned colleagues that offer an excellent survey of and profound insight into the disposition and metabolism of a few environmentally and industrially significant xenobiotics. The topics range from an assessment of drug metabolising enzymes in the liver, DNA damage by reactive oxygen species generated by pesticides, role of NO in liver injury, hepatotrophicgrowth factor in liver regeneration, extracellular matrix in the liver, oncogene expression in liver injury, the hepatocarcinogenesis to oxidative stress and undifferentiated gene expression. Detailed analysis of the validity of liver function tests has been included. Last Chapter addresses the problem of apoptosis, which plays a key role in the signal transduction system of xenobiotics-induced liver injury. The reader should appreciate that overall exposure to this field is expanding at a rapid pace and selections had to be made.

It is increasingly recognized that various transporter proteins are expressed throughout the body and determine absorption, tissue distribution, biliary and renal elimination of endogenous compounds and drugs and drug effects. This book will give an overview on the transporter families which are most important for drug therapy. Most chapters will focus on one transporter family highlighting tissue expression, substrates, inhibitors, knock-out mouse models and clinical studies.

This book is intended as a practical bench manual phological abnormalities in renal diseases, and for the hospital pathologist who wishes to have where appropriate these have been illustrated. access to a simple informative account of renal Although the main emphasis is on the pathology, pathology, particularly for the interpretation of the relevant clinical aspects of the conditions cov percutaneous needle biopsy specimens. I n addition ered are included in recognition of the fact that we trust it will be valuable to physicians working renal disease is an area in which correlation of the in the field of renal disease, for whom the interpre clinical and histopathological findings is particularly tation of renal biopsy material is directly relevant to important in reaching an informed diagnosis. patient management. Whilst a comprehensive coverage more appro priate to a larger text has not been attempted, the Acknowledgements text has been planned to give an adequate account of the more important non-neoplastic disease pro We would like to thank the technical staff of the cesses and their pathological appearances in the Histopathology Laboratories of The London Hos kidney. Points of difficulty in interpretation and dif pital Medical College, The Hospital for Sick Chil ferential diagnosis are covered both in the text and in dren, Great Ormond Street, and Guy's Hospital the illustrations.

Infectious and non-infectious tubulointerstitial nephropathies are old subjects but there is enough confusion and disagreement on terminology and etiopathogenesis to warrant a new look at these problems. We were fortunate in having at the Pediatric Nephrology Seminar 6 and as contributors to this volume, the representative- or shall I say "originators"? - of each of the three most identifi- able positions: Dr. Renee Habib - congenital anomalies, Dr. John Hodson - reflux, and Dr. Robert Heptinstall - infection. Although some tend to hold onto one position and exclude others, in this case there was overlapping of perception. Dr. Habib accepts a role for infection in reflux and for infection in the presence of obstruc- tion; Dr. Hodson accepts infection and congenital anomalies as modi- fiers; and Dr. Heptinstall takes an overall position whicm encompas- ses the three. Thus the first part of the book emphasizes the complexity of something as seemingly simple as UTI and demonstrates awareness of disagreement even among the pros about meanings, interpretations, and treatment. Drs. Gustavo Gordillo, Jorge de la Cruz and their associates emphasize the importance of predisposing factors for UTI; Dr. Materson focuses on the workup of the patient, Dr. Zillerueloon bacteriological aspects, and Dr. Gorman on treatment approaches. Dr. Vaamonde reviews nephrotoxic agents. Finally, Drs. Andres and Noble review the immunological aspects of various tubulointer- stitial nephritides.

We are pleased to present to our readers the Proceedings of the Fifth International Workshop on Phosphate and Other Minerals which was held in New York City, New York, U.S.A during September 23-27,1981. It was hosted by Joseph M. Letteri, M.D., Professor of Medicine at the State University of New York at Stonybrook School of Medicine, and Chief, Division of Nephrology, Nassau County Medical Center. As in the previous Workshops, this meeting provided an oppor tunity for interested scientists from interrelated fields, including nephrology, endocrinology, physiology, biochemistry and nutrition, to get together and discuss the recent advances in the field of phosphate and mineral metabolism. There were 29 invited presenta tions by leading scientists and 40 oral and 90 poster presentations selected from over 250 abstracts submitted to the Organizing Committee. The Workshop was attended by 250 scientists from 14 countries including Austria, Australia, Canada, Denmark, England, France, Germany, Holland, Israel, Italy, Japan, Sweden, and the United States of America. The Sixth International Workshop on Phosphate and Other Minerals will be held during June 24-26, 1983 in Verona, Italy. It will be hosted by Professor Giuseppe Maschio, Director, Division of Nephrology, Istituti Ospitalieri, Verona, Italy. The theme of this coming Workshop will continue to focus on the pathophysiology of phosphate homeostasis and the metabolism of other minerals."

With a long practice of organ transplantation, retransplantation has become a major goal in patients with long-term failure of their first transplant (chronic rejection, exhaustion of the transplant, recurrence of the initial disease, etc. ). In addition, retransplantation can be necessary in the initial period, due to severe acute rejection, a non-functioning organ, or surgical complication. Immunological and non-immunological factors affecting the success of a second transplant are described in this volume, together with alternatives to retransplantation. It is hoped that in the future retransplants will be less frequent, as a result of improved prevention of transplant failure. J. L. Torrroine et a/. (ens. ), Retra isplantation, xvii. Q 1997 Kluwer Academic Pirblislters. P . iilted in Great Britain. List of contributors R. ARNOLD Y. W. CHO University of Pittsburgh UCLA School of Medicine Center for Medical Ethics Tissue Typing Laboratory Division of General Internal Medicine 950 Veteran Avenue 200 Lothrop Street - MUH, Suite W-919 Los Angeles, CA 90095-1652 Pittsburgh, PA 15213-2582 USA USA P. COCHAT M. A. BELGER Hopital Edouard Herriot UKTSSA Pavillon S Fox Den Road 5, Place d'Arsonva1 Stoke Gifford F-69437 Lyon Cedex 3 Bristol BS12 5RR France UK B. CUZIN F. BERTHOUX Hopital Edouard Herriot Service de Nephrologie et Pavillon V Transplantation Renale 5, Place d3Arsonval Hopital Nord F-69437 Lyon Cedex 3 F-42055 Saint Etienne Cedex 2 France France J. H. DAUBER C.

We are pleased to present to our readers the Proceedings of the Third International Workshop on Phosphate and Other Minerals which was held in Madrid, during July 15-18, 1977. It was hosted by Dr. Aurelio Rapado, Head of the Metabolic Unit at the Fundacion Jimenez Diaz. The Third International Workshop was organized in the tradition of the previous two Workshops. Scientists from 15 countries attended the meeting which provided a forum for formal presentations and informal discussions of topics of current interest in the field of phosphate metabolism, and that of the homeostasis of other minerals. One day of the Workshop was devoted to the subject of Phosphate Depletion. The latest information on the various aspects of the metabolic consequences of phosphate depletion were brought into focus. In the preface of the Proceedings of the Second International Workshop on Phosphate, we indicated that the enthusiasm with which these Workshops were received generated the idea for the creation of a Journal which will publish research endeavors related to mineral and electrolyte metabolism. These efforts were brought into fruition, and the first issue of the new Journal, M). . neJLai. . and E-te. c. ;tJr. o-ty-te. Me. -taboWm has already appeared in November, 1977. It is published by Karger of Basel, Switzerland under the Editorship of Dr. Shaul G. Massry of Los Angeles, with Dr. Louis V. Avioli of St. Louis and Dr. Eberhard Ritz of Heidelberg, serving as Associate Editors.