Having received the invitation from Springer-Verlag to produce a volume on drug-induced birth defects for the Handbook of Experimental Pharmacology, we asked ourselves what new approach could we offer that would capture the state of the science and bring a new synthesis of the information on this topic to the world's literature. We chose a three-pronged approach, centered around those particular drugs for which we have a relatively well established basis for understanding how they exert their unwanted effects on the human embryo. We then supplemented this information with a series of reviews of critical biological processes involved in the established normal developmental patterns, with emphasis on what happens to the embryo when the processes are perturbed by experimental means. Knowing that the search for mechanisms in teratology has often been inhibited by the lack of understanding of how normal development proceeds, we also included chapters describing the amazing new discoveries related to the molecular control of normal morphogenesis for several organ systems in the hope that experimental toxicologists and molecular biologists will begin to better appreciate each others questions and progress. Several times during the last two years of developing outlines, issuing invitations, reviewing chapters, and cajoling belated contributors, we have wondered whether we made the correct decision to undertake this effort.

Lipids and Women's Health is an up-to-date critical review of pertinent scientific and clinical issues connected with lipid disorders in women. Topics discussed include the public health significance of cardiovascular disease in women, lipoprotein and lipid metabolism, effects of estrogens and progestins on lipid metabolism, metabolic changes of menopause, and the paradox of obesity, a curable disease that is rarely cured, as well as those conceptual advances in our understanding of diabetes mellitus that have clarified diagnosis and may have improved treatment. The relationship of diet and lipid intake to the development of breast and uterine cancer; dietary and drug treatment of lipid disorders; effects of exercise, smoking, and stress; and repercussions of lipid disorders on the family are explored. The volume should prove of use to gynecologists, internists, family practitioners, and pediatricians, as well as to all other professionals with a major concern for the health of female patients.

A central concept in the evolutionary theory of senescence is the idea that ageing results from life-history trade-offs. In particular, the disposable soma theory suggests that longevity is determined through the setting of longevity assurance mechanisms so as to provide an optimal compromise between investments in somatic maintenance (including stress resistance) and in reproduction. Comparative studies among mammalian species confirm that cells from long-lived species appear to have a greater intrinsic capacity to withstand stresses than cells from short-lived species. Childbearing at older ages has become increasingly common in modern societies because of demographic changes, medical progress and personal choice. While the detrimental effects of late reproduction on infant mortality and genetic diseases have been well documented, little is known about the possible postponed detrimental effects of late parenting.

The traditional concept of a neuroendocrine mechanism for regulation of growth hormone (GH) secretion is based in large part on the work of Roger Guillemin. The work of Dr. Guillemin, who was awarded the 1977 Nobel Prize in Physiology and Medicine, supported the view that quantita tive change in GH secretion was the net result of pituitary stimulation and inhibition by the hypothalamic neurohormones, GH releasing hormone (GHRH), and somatostatin (somatotropin release inhibiting factor; SRIF), respectively. During the 1970s, another endocrine research pioneer, Dr. Cyril Bowers, discovered that structural modification of enkephalin re sulted in a family of peptides with GH releasing properties. These com pounds, simply called GH releasing peptide (GHRP), were originally thought to mimic GHRH. However, upon subsequent investigation they were found to supplement the activity of the natural hormone through a different mechanism. Nearly two decades after their discovery, the differ ences between GHRP and GHRH have been described by many different laboratories throughout the world. The complementary GH secretagogues have different binding sites, second messengers, and effects on gene expres sion. Based on these differences, it has been suggested that expansion of the original two hormone mechanisms for GH regulation to include a third molecule may be appropriate, even though the naturally occurring ana logue of GHRP has not yet been identified. Despite our lack of knowledge concerning the natural product mimicked by GHRP, clinical development of the new family of GH secretagogues for diagnostic and therapeutic purposes has begun in earnest."

The VIIIth Annual International Spring Symposium on Health Sciences held at the George Washington University School of Medicine in Washington, D.C., attracted over three hun dred fifty scientists from twenty-five countries. The leading scientific experts in the field reported on recent biomedical advances in aging. They provided an up-to-date account of the molecular, genetic, nutritional, and immunological mechanisms associated with the aging process and approaches to intervention and treatment of the major disorders associated with the aging process, including Alzheimer's disease. A unique aspect of this meeting was a concurrent one-day hearing of the U.S. Senate Sub-Committee on Aging, organized by the Alliance for Aging Research. The theme for the hearing was "Advances in Aging Research." Seven scientists attending our aging sym posium were asked to testify. They were Drs. Carl Cotman (University of California-Irvine), Trudy Bush (Johns Hopkins University), Takashi Makinodan (University of California-Los Angeles), William Ershler (University of Wisconsin-Madison), Gino Doria (ENEA, Rome), Mr. Dan Perry (Director of the Alliance for Aging Research), and myself."

Ovarian carcinoma continues to be responsible for more deaths than all other gynecologic malignancies combined, due to a continued inability to achieve detection of early (rather than advanced) stage disease and the lack of effective tumor-specific therapeutics.

Ovarian carcinogenesis, invasion, and metastatic dissemination require a complex cascade of interrelated genetic, molecular, and biochemical events that regulate the neoplastic transition of normal ovarian surface epithelium.

This updated second edition includes exciting new advances in ovarian cancer detection and treatment and provides an analysis of current research into aspects of malignant transformation, growth control, and metastasis. A more detailed understanding of these processes may ultimately translate into the development of novel approaches for the detection and control of ovarian cancer.

This RRCR-conference-volume marks "number six" in a 20-year evolution of international conferences on the adjuvant therapy of primary breast cancer. Starting in 1978, a handful of some 80 en thusiastic breast cancer surgeons and oncologists, met in a se cluded mountain resort near st. Gallen in Eastern Switzerland, to exchange their early data of some pioneer trials on adjuvant sys temic therapy of early breast cancer, and to correlate their future research efforts to overcome the frustrating prognostic stagna tion of this dominant neoplastic disease in Western females dur ing the past decades. Repeated every 3-4 years, these St. Gallen International Conferences on Adjuvant Therapy of Primary Breast Cancer have continuously grown in numbers of partici pants and in normative, therapeutic influence by being published in major oncology journals 1-3], the last (6th) conference hav ing taken place from February 25-28, 1998 with more than 1800 attendees from over 50 countries worldwide. What is the fascination of adjuvant therapy in primary (early) breast cancer, and what has changed, during the last 3 years since March 1995, to justify another international gathering of this size, and of the world's leading experts in the field? There is no question, that providing even more effective care and designing appropriate recommendations for the multitudes of patients with so-called early breast cancer or at high risk of developing the disease, remain highly important public health goals."

The frontispiece, Leonardo da Vinci's drawing of the embryo in the womb, was chosen as a starting point for this book. It was Leonardo who in his notebooks and drawings combined artistic composition and accurate recording of the anatomy of the human body. Leonardo studied human anatomy in order to execute artistic drawings. His aim was to clarify form and function of human organs including reproductive organs. He followed up his extensive research with graphic representa tion and thereby initiated record keeping as a basis of scientific investigation. His records, accurate three-dimensional drawings, allowed others to reproduce his find ings and to test for correctness. Results could be updated and refined. Only after these steps can abnormalities be ascertained and defined as pathology. Though Leonardo was both artist and scientist, it is assumed that his anatomic drawings were used to improve his art, and thus scientific endeavor was at the service of his art. Anatomy, the offspring of science and art, is an integration of the two and became an accepted branch of the natural sciences. Although art and science continued to interact throughout the Renaissance, art was often placed in the service of science. In the course of history that followed, art and science in creasingly followed separate ways."

"Fertility Preservation in Males: Emerging Technologies and Clinical Applications" contains a selection of the valuable chapters and protocols of Seli and Agarwal s previously published hardcover text "Fertility Preservation: Emerging Technologies and Clinical Applications." Newly available in this convenient and affordable softcover format, this practical reference guide provides an update on options for fertility preservation in men, while also discussing important related epidemiologic, ethical, medico-legal, psychological, and social aspects. Using a format that combines concise scientific background with practical methodological information and easy-to-grasp algorithms, the chapters all conform to a uniform structure, including step by step protocol of laboratory procedures, key issues in commentary and a list of references. The result is a unique resource for reproductive endocrinologists, urologists, embryologists, reproductive scientists, and oncologists."

A growing majority of women in the western hemisphere have been delaying initiation of childbearing to later in life. Consequently, more than ever before, women in their late 30s to early 40s are attempting their first pregnancy. Since the incidence of most cancers increases with age, delayed childbearing results in more female cancer survivors interested in fertility preservation." Fertility Preservation in Females: Emerging Technologies and Clinical Applications" contains a selection of the valuable chapters and protocols of Seli and Agarwal s previously published hardcover text "Fertility Preservation: Emerging Technologies and Clinical Applications." Newly available in this convenient and affordable softcover format, this unique and practical reference guide for reproductive endocrinologists, gynecologists, embryologists, reproductive scientists, and oncologists provides strategies for fertility preservation in women, using a format that combines concise scientific background with practical methodological information and easy-to-grasp algorithms."

This book is based on presentations by some of the world's leading experts at the Sixth International Conference on Clinical Cancer Prevention, held in St. Gallen, Switzerland, during March 2010. The main themes are the latest advances in the prevention of breast and prostate cancer and the role of infection in the development of liver and gastric cancer. Special emphasis is given to perspectives on the chemoprevention of breast cancer, as the conference included an international consensus meeting on this subject. New research findings are presented and potentially more effective cancer prevention strategies are discussed, with careful consideration of controversies. The expertise of the contributors encompasses genetics and microbiology, epidemiology, and health economics, as well as clinical cancer prevention. This book will be of interest to all who wish to learn about the most recent progress in combating the development of cancer.

Pelvic Inflammatory Disease is an in-depth, thorough guide for the clinician on the most common complication of sexually transmitted pathogens. Edited and written by the preeminent experts in the field, this volume presents the etiology, treatment, and diagnosis of PID, as well as chapters on risk factors, epidemiology, and prevention. In addition, the myriad clinical complications and challenges are discussed in chapters on tuboovarian abscess, PID and HIV infection, sequelae of PID, PID in adolescence, and PID in pregnancy. This is a must-have resource for obstetrician-gynecologists, primary care physicians, and all clinicians who provide health care to women of all ages.

Hemorrhage and thrombosis are major hazards for pregnant women and their newborn infants. This book is concerned with the developmental mechanisms, the diagnosis and treatment, as well as the prevention of these hemorrhagic and thrombotic disorders. The topics discussed in this volume, (1) perinatal hemorrhage in mothers and their offspring; (2) coagulation disorders complicating pregnancy; (3) neonatal intracranial hemorrhage; and, (4) vitamin K deficiency in the neonate, will help bridge the gap between basic scientists and clinicians and between the pediatri- cian and the obstetrician. Hopefully, all those concerned with preventing these disorders will be stimulated by the information and questions raised in the fol- lowing presentations. Acknowledgements We wish to thank Professors Takeshi Abe (Vice President, Teikyo University), Nobuyoshi Shinagawa (Hirosaki University), Hiroaki Soma (Tokyo Medical College), Tamotsu Miyazaki and Keisuke Sakurada (Hokkaido University) for their helpful advice. SHIGENORI SUZUKI WILLIAM E. HATHAWAY JOHN BONNAR ANTON H. SUTOR SHIGENORI SUZUKI. * 1936 in Sapporo, Japan. M.D., Uni- 'versity of Hokkaido, 1963. Lecturer, Hokkaido Univer- sity, 1974. Alexander Humboldt-Foundation Scholarship, Free University of Berlin. University of Munich, 1974- 1976. Foriner President, Japanese Society of Obstetrical, Gynecological, and Neonatal Hematology. President of International Symposium on Perinatal Thrombosis and Hemostasis (1989 Sapporo). Professor, College of Medi- cal Technology affiliated with Hokkaido University since 1983. WILLIAM E. HATHAWAY. * 1929 in Oklahoma, USA.

Pituitary adenomas account for 10-15% of all intracranial tumors and they frequently impair fertility. The development of medical and surgical therapy for such tumors has turned pregnancy into a reality for women harboring pituitary adenomas. However, gestation risks for both mother and fetus are still of concern for endocrinologists, gynecologists and pediatricians. This book intends to update knowledge on this topic, mainly regarding fertility restoration as well as gestational and post gestational management of patients with pituitary tumors.

The practice of clinical reproductive medicine has practice in the era of managed care and coordinat gradually moved from its initial 1980-90 hospital ing ancillary offsite medical personnel. base to its present (circa 2001) office site of oper The objective of this text is to assist in this ongo ation. With this transition have been improvements ing endeavor by presenting in a clear, concise man in efficiency of practice often in response to ner many of the topics relevant to contemporary increased pressure to provide the most patient sat office-based infertility practice. The initial half of isfaction. An added challenge of office-based prac this text addresses topics which focus upon general tice has been taking on many of the responsibili concepts of infertility evaluation and practice. The ties of what had been traditionally the hospital's latter half is a practical approach to the execution domain. Some of these new responsibilities have of specific office-based infertility procedures. We included the ordering of operative supplies and hope this book will assist all medical personnel who equipment, the establishment of quality control dedicate their clinical effort in achieving what is programs, construction and maintenance of special most coveted by our patients, the birth of a healthy laboratory spaces, redesigning efficient methods of newborn. DAVID B. SEIFER, M. D. UMDNJ-Robert Wood Johnson Medical School ROBERT L. COLLINS, M. D. The Reproductive Center, Youngstown, Ohio October 2001 vii Contents Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii . . . . . . . . . . . . . . . . . Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi . . . . . . . . . . . . . . . . . 1 Evaluation of the Female for Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Bryan D."

The recognition of normal and abnormal patterns in the breast by mammography is a skill that must be acquired through training and experience in the same way the radiologist learns to recognize the normal or abnormal skull, gastrointestinal tract, chest, spine, and other anatomy. To disseminate information on the breasts to radiologists on a large scale, the most effective method - person-to-person teaching - is obviously impractical. Even postgraduate courses in mammography can reach but a few fellow radiologists. Therefore we have felt for some time that a teaching Atlas of "1lalJlJJJography would serve a useful purpose, within the limita tions of the method, by bringing to the attention of radiologists and physicians in general the salient features of the X-ray appearance of the normal and the abnormal breast. In mammography as in no other area of roentgenologic study, technique is of crucial importance. Accurate diagnosis is abso lutely dependent upon demonstration of very fine detail, some times as delicate as a linear strand or two, or minute specks of calcium. To some extent the pictorial representation embraced by an atlas defeats the teaching objective, for much fine detail is often lost in reproducing radiographs. Every effort has been made to obtain the best possible reproductions of mammo grams in this Atlas) but some illustrations must of necessity remain unconvincing to the reader. Some of the details describ ed will be appreciated only when viewing a good quality original radiograph."

Sexology as a discipline has had to fight for full-fledged recognition in the scientific community. Yet special knowledge of normal and disturbed sexual behavior is expected of medical professionals, psychologists and educators alike. Based on the papers given at the 8th World Congress for Sexology in 1987, this volume gives an up-to-date discussion of the most interesting and controversial topics, such as AIDS, in the field. Contributions have been grouped under the main headings: Family Planning, Sterility and Sexuality, Erectile Dysfunction, Sexuality in the Elderly and in Marriage, Transsexualism, Sexual Therapy, and Sexuality and Illness, and include items of historical interest as well as transcultural comparisons.

Pelvic pain in the female patient is common in gynaecological practice, but the specialties of general surgery, urology and orthopaedics provide a significant number of patients and problems. These patients may suffer a multitude of symptoms, and only careful analysis and investigation of each individual problem by the doctor concerned will lead to correct diagnosis and management. The subject matter of this book lies in the practice of many specialties, and all are combined here in a coherent whole. This emphasises the close collaboration necessary between family practitioners, junior hospital staff and consultants. The authors are consultants who work together in a busy district general hospital, and their experience and collaboration is evident in the approach to the diagnosis and management of pelvic pain in the female. Emphasis is laid on the careful evaluation of history and examination and the correct interpretation of diagnostic investigations. Full details of radiology, ultrasound scanning, endoscopy, peritoneoscopy and bacteriological investigation are given. Full consultation between members of staff who have special experience in these investigative procedures is of paramount importance. Details of treatment for relief of pain are important to all doctors concerned with this aspect of clinical management. and this section will be of particular value. The blending of these specialties allows full consideration of the problems affecting the patients. Careful management leads to better treatment for the patient and better satisfaction for the doctor.

Breast Cancer, the second volume in the MD Anderson Solid Tumor Oncology series, this book provides the general surgeon, surgical oncologist, and medical oncologist with the state-of-the art multimodality care for breast cancer. Divided into five sections, the text brings the field's recognized esperts addressing the current status of breast imaging, breast pathology, the role of breast surgery including management of in situ and early stage carcinoma, prophylatic mastectomy, axillary node dissection, sentinel node and lymphatic mapping, and outpatient mastectomy, as well as coverage of special selected topics featuring breast cancer in pregnancy, inflammatory breast cancer and breast sarcoma. An important section on future research reviews on-going studies for the use of in situ laser ablation, cryosurgery, and translational research to bring the busy practitioner up-to-date on state-of-the art advances. This book is a must-have resource on the full specturm of current and prospective treatment options for this challenging disease.

The Organon Symposia have actually become a tradition, keeping up with exciting developments in reproductive medicine. The purpose of this symposium on "Fertiliza tion of the Human Egg in Vitro" was to bring together the stilllimited number of elinical specialists in the field and to stimulate another group of basic research people to exchange their experiences and knowledge, hopefully promoting elose cooperation between the two groups. It was a kind of scientific "first" that all research teams so far successful in achieving the birth of a healthy baby, fertilized in vitro came together at a workshop conference without a large audience of spectators and reporters, but with a small number of highly critical colleagues from the fields of basic reproductive physiology and comparative developmental biology. This atmosphere allowed for the elose exchange of results, hypotheses, diagnostic and therapeutic procedures, criticism, and respect, and created very productive discussions, all of which furthered the aim of the method: To help more childless couples to have their own babies by the ultima ratio procedure of in vitro fertilization and embryo replacement. The book that has emerged from this symposium will help to disseminate the great amount of information and experience gathered among the scientifically and clinically interested colleagues of many other hospitals and universities who could not be invited to the meeting. At the same time, it will prove that there is much more work to be done in the basic and clinical sciences of human embryology and reproductive biology."

This book aims to bring together clinical information on the biology, diagnosis, therapy and management of patients with inflammatory breast cancer. Authored by experts from the Instituto Nacional de Cancerologia in Mexico, this book will provide the reader with the state-of-the art treatment of this rare but pernicious disease.

Honourable Chairman, distinguished speakers, ladies and gentlemen, May & Baker, Singapore is proud to play a part in organizing and hosting this symposium. I hope that it is not necessary for me to intro duce myself, as Singapore doctors have received my letter of invitation and overseas delegates have received my letter of welcome. It is my very pleasant duty to introduce our Director of Research, Dr J. A. McFadzean, who has come specially to grace this occasion. Dr McFadzean, Sir, may I invite you to say a few words to this gathering of distinguished participants. TanJoo Hock VUl Welcome It is my privilege on behalf of May & Baker to welcome you here today. We have representatives from nine countries - Singapore, Malaysia, Thailand, Hong Kong, Indonesia, Japan, Norway, Sweden and UK. It is appropriate that this Symposium on Cervagem be held in South-east Asia where so much excellent development work was done with this product. Cervagem has resulted from many years of collaborative research and development between May & Baker and the Ono Pharmaceutical Company of Japan. It has been a most happy collaboration from the time the active ingredient ONO-802 was synthesized by the Ono Company. You will hear today of the stage we have reached with the R&D work."

The authors of this book have a goal-to describe the management of infertility from the perspective of physiology and anatomy gone awry. To accomplish this goal, the chapters devoted to the causes of infertil ity begin with a description of the normal structure and function of the organ or system causing the infertility. We believe that under standing the normal will result in rational and effective diagnosis and treatment of infertility. Our intent is that this book be a useful re source for those who care for infertile couples. For an infertile couple, success is the delivery of a normal and healthy infant. Chapters that describe the causes and treatment of habitual abortion and the reproductive performance of previously infertile couples emphasize the hazards that exist between conception and birth. Our environment is one of these hazards, one that may also affect reproduction before conception. A chapter is devoted to a de scription of environmental agents that affect reproduction, the mech anisms of their effect, and methods to predict those present and future environmental agents which might also affect reproduction."

The many advances in breast cancer research, as well as the large quantity of published material, make it very difficult to gain insight into the global aspects of cancer management. To follow and understand all the new developments is becoming a major challenge. For this reason, the editors decided to bring together a group of top researchers in breast cancer to provide a comprehensive, yet readable conceptual review of the state of the art of breast cancer diagnosis and therapy. The proposal to focus the review on the quantitative assessment of the risk at diagnosis, the determination of which may permit selective therapies for individual patients, was met with enthusiastic approval, resulting in the present volume with contributions by the leading investigators in the field. While the volume relating to diagnosis, published re cently, focused on efforts leading to refinement at diagnosis of risk criteria sensitive enough to reliably distinguish the low- and high-risk categories, the second volume, by provid ing a review of the main problems and results of therapy given to high-risk patients, can be considered as a continua tion of the first book. A refined risk assessment at diagnosis and the application of the most suitable treatments to well selected individuals are the most important steps towards avoiding the present worrisome reality of overtreating the low risk and undertreating the high-risk patients. The first few chapters of the present volume offer an insight into the general management of early breast cancer.

This volume will explore the latest findings in research into the genetics of breast and reproductive cancers, covering the epidemiological aspects of these cancers, their etiology, the effect of environment on genes and cancer etiology, and how research in this area can lead to development of preventative measures and treatments.