Atrophy of gonadotrophin producing cells Exogenously LH synthesis administered androgens and release or anabolic steroids are decreased Prostate Testes Normal function. Testosterone synthesis in The deficit of endogenously Leydig cells is decreased. The synthesized testosterone is exogenously administered compensated for by the steroid is not able to exogenously administered compensate for the deficit of steroid endogenously synthesized testosterone Figure 2 Intratesticular and serum testosterone concentrations after treatment with andro gens or anabolic steroids in order to substitute for the peripheral androgen deficiency and to achieve azoospermia. Because this steroid is alkylated in position 17, toxic effects on liver function can not be excluded. Danazol offers no advantages as compared with other anabolic steroids; rather, disadvantages. Numerous experiments of this type have been performed during the last 40 or 50 years. The outcome in each case was more or less identical: with a certain dose of an androgen or anabolic steroid it is possible to inhibit spermatogenesis without interfering with other androgen-dependent func tions, including libido (potentia coeundi) and accessory sexual glands. On the basis of this pharmacological-endocrinological background, androgens and anabolic steroids can be used for male fertility control, and several clinical trials have been performed during the last 10-15 years. Some of 1 these studies 2-23 are mentioned in Table 2."

The use of human in vitro fertilization in the management of infertility is the outgrowth of years of laboratory observations on in vitro sperm-egg interaction. "The editors of this work have themselves contributed significantly to basic knowledge of the mammalian fertilization process. The observations of Don Wolf on sperm penetration, the block to polyspermy and, most recently, sperm hyperactivation in the monkey and human, Gregory Kopf's elucidation of the mechanisms of sperm activation during penetration and the reciprocal dialogue between sperm and egg, and Barry Bavister's definition of culture conditions and requirements necessary for in vitro oocyte maturation, fertilization and development in model mammalian systems including nonhuman primates have contributed greatly to our understanding of the mammalian fertilization process. Wolf, Kopf and Gerrity have enjoyed substantial interaction with clinicians in Departments of Obstetrics and Gynecology and have been directly involved with successful IVF programs. Both Wolf and Kopf have served as research scientists in the Division of Reproductive Biology at the University of Pennsylvania, which, for more than 22 years, has fostered co-mingling of clinically oriented and basic science faculty. It is through such interaction, which clearly exists at many institutions including the University of Wisconsin, that the process of technology transfer is best served. Without an exquisitely coordinated laboratory, there can be no consistent success in human in vitro fertilization. Quality control is pivotal, but close collaboration between the laboratory and the clinic is also essential as information is shared and correlated.

A little over 12 years ago I wrote a small volume entitled Infertility. It seemed to me at that time that significant advances in the field called for the publication of such a volume. The following is from the preface to that volume: During the past 15 years considerable progress has been made in the field of infertility diagnosis and management. It is perhaps a paradox that much of this increased knowledge has come about because of Western medicine's preoccupation with the search for a means to control reproduction. As a result, we have achieved new insights into the physiologic mechanisms involved in reproduction, and we have found better methods for measuring physiologic changes in reproductive health and disease. To these advances can be added improvements in the utilization of endoscopic and surgical techniques, in the diagnosis and treatment of infections and endometriosis, and in the treatment of hormonal disorders. During this period, too, through workshops and conferences and in journals and texts, these latest advances have been made available to physi cians, an outstanding example being the two volumes of Progress in Infer tility, edited by Drs. Jan Behrman and Robert Kistner. As necessary as these publications are, they do not offer an overall view of infertility diag nosis and management."

In the middle of the 17th century, the great French philosopher Rene Descartes wrote (L'Homme, J. Le Gras, Paris, 1669) that a suitable stimulation of the brain results in two types of "movements": exterior movements, designed to seek desirable ends and to avoid undesirable or harmful ones and interior movements or "passions" which through the release of "animal spirits" regulate the heart, the liver, and other organs. When it appears appropriate to meet a threat with force, the passion of rage causes the release of strong spirits, whereas when avoidance appears to be the better choice, the passion of fear causes the brain to release weak spirits. We do not know what influence, if any, Descartes had on the thinking of Walter B. Cannon (Bodily Changes in Pain, Hunger, Fear and Rage, Appleton and Co. , New York, 1920), of Hans Selye (The Story of the Adaptation Syndrome, Acta, Inc. , Montreal, 1952), ofG. W. Harris or of R. Guillemin (Hypothalamic-Hypophysial Interrelationships. A Sym posium. c. c. Thomas, Springfield, 1956), but it is interesting to reflect upon the durable value of great ideas which constantly resurface even if modified by other ideas and by new techniques, as if propelled by a preordained intellectual imperative.

Due to the introduction of molecular and cellular biology approaches, our understanding of ovarian physiology has reached a new level during the last few years. The present volume provides a new perspective on the ovary from molecular and cellular to whole organ levels, from non-mammalian and rodent to human levels and from paracrine, neuroendocrine and endocrine levels as well. These papers represent the proceedings of the Ninth Ovarian Workshop sponsored by Serono Symposia, USA, July 9-11, 1992 in Chapel Hill, North Carolina.

Bernard (Barney) Berelson had a major influence in the application of social science concepts and methods to population policy during the period from 1962 to 1980. This was the period when concern with population problems spread from a relatively small group of scholars and population activists to a much larger, diverse, international group of political and intellectual leaders and to the general public as well. There was an exponential growth in the number of scholars and service personnel in vari ous population and family specialities in this period. Barney came into the field with his appointment as Director of the Com munication Research Program of The Population Council in 1962. He had no previous training or experience in demography. Frank Notestein, Presi dent of The Population Council at the time, had the wisdom to appreciate the value and relevance of Barney's itTIpressive background in communica tion research and other social science areas, as well as his creative mind and leadership qualities. His influence on the Council's rapidly expanding program was so immediate and impressive that within a year, he was named Vice President. When Frank Notestein retired in 1968, Barney became President, a post he held for 6 very productive years."

Ovulation Induction gives an integrated view of basic ovarian physiology, pathophysiology, and the clinical management of ovulatory disorders. It provides core information upon which specialists can base clinical decisions. The most important feature is the inclusion of newer agents now available for ovulation induction. Newer clinical applications for older medications as well as various treatment combinations (including GnRH analogs) are thoroughly discussed. There is a frank discussion of risks, side effects, and the expense related to ovulation inducing agents. Many of the results in this book have never before been published in book form. Topics examined include the neuroendocrine regulation of the menstrual cycle, ovarian physiology and in vitro fertilization, the diagnosis of ovulation and the role of ultrasound in monitoring the follicular response, the use of clomiphene citrate for ovulation induction, and the role of bromocriptine and related compounds for ovulation induction in hyperprolactinemia.

Neuroendocrine Perspectives, Volume 7, is part of an international book series designed to keep clinicians and researchers appraised of important trends and new data in basic and clinical neuroendocrinology. It focuses on four very rapidly evolving major topics: - the role of dopaminergic regulation of the intermediate pituitary lobe in elucidating intracellular signal transaction pathways and other regulatory mechanisms involved in transsynaptic regulation of peptide biosynthesis, post-translational processing, and hormone secretion; - the physiological and clinical implications of corticotropin releasing factor for such areas as diagnosing Cushing's syndrome, defining the hypothalamic and pituitary origins of secondary adrenal insufficiency, and distinguishing Cushing's syndrome from psychiatric states associated with hypercortisolism; - the large number of neurotrophic factors that affect CNS neurons and of neurite promoting factors that modulate neuronal performance, with emphasis on their mechanisms of action and their possible therapeutic applications to peripheral neuropathies and central diseases; - and the many factors that regulate changes in female reproductive cycles during middle age, with careful distinction between neuroendocrine and ovarian components and special attention to the possible cause-and-effect relationship within the cascade of events resulting in acyclicity and infertility.

Progress in biomedical science has called for an international discussion of the medical, ethical, and legal problems that confront physicians, medical researchers, infertile couples, pregnant women, and parents of premature or disabled infants. In addition, the unprecedented technological developments in obstetrical, perinatal, and neonatal medicine in recent years have indicated a need for an international forum for interdisciplinary dialogue regarding the definition of early human life, the neurological development of early human life, the value of early human life, the obligations for its protection and prolongation, and the limits to these obligations.

Early Life Origins of Health and Disease is a new book which presents and discusses the many factors that may have impact on normal development. In a concise and readable manner, the authors consider both the proven and suggestive evidence that the high prevalence of hypertension, diabetes, obesity and, in some populations, kidney disease, may not be all due to genetics or adult environment alone. There is good evidence that stress and more subtle dietary deficiencies, as well as placental malfunction, may increase the risk that the offspring will develop these problems in later life. Finally, new and emerging evidence for other areas of human health and disease such a motor control and mental health is critically reviewed for the first time. The book is a 'must' for all scientists interested in researching these areas, as there is a critical evaluation of the methodology used and suggestions for the 'optimal' way in which to investigate these phenomena.

It is a genuine honor and a privilege of distinction to provide the foreword for the proceedings that follow. This marvelous symposium reflects the unique qualities of its two principal sponsors. Whenever the Oregon Regional Primate Research Center is involved in matters of science, we see a consistent record of exceptional quality in both the work is unequaled and the people who do it. Likewise, Serono Symposia, USA in assuring a world-class speakers' forum, utterly without taint of commercial influence. The proceedings published herein are a remarkable testimony, not only to the contributors, but to Drs. Brenner, Wolf, Stouffer, and Burnett, who have shepherded its conception, presentation, and publication. Readers will notice immediately one of the universal strengths of this total composition; that is, the diversity of investigational interests among attendees. Presentations on the core topic of primate in vitro fertilization and embryo transfer were joined by specialist presentations in related areas, including human-assisted reproductive technologies, reproductive physiology of the great apes, sperm biology, implantation mechanisms, cryobiology, coculture systems for embryogenesis, micromanipulation technologies, and genetic diagnosis of heritable diseases in the pre embryo. Even though pro-fertility issues understandably dominated this forum, there was significant attention given to fertility-control research, especially the role of primates in this endeavor (more on this subject below)."

For the third time, specialists from all over the world met to present their most recent scientific results and to update their knowledge in the expand ing field of nutrition and, osteoporosis. Major nutrition-al factors, such as calcium and vitamin D, were reexamined, with special attention on the ef fects of calcium, given either as a supplement or in dairy products in chil dren and adolescents, and to vitamin D supplementation in the elderly. The RDA for calcium was questioned, and the calcium requirement was rede fined. Special attention was paid to proteins and their growth promoting action via IGF-l, as well as to the profound effects on calcium and bone metabolism of vegetarian diets or diets rich in acidic or alkaline foods. Although considered an environmental factor influencing the pathogenesis of osteoporosis, nutrition was discussed in relation to genetic conditions, because certain genetic conditions modifY patients' responses to nutritional deficiencies and to supplementary interventions. These proceedings report the wide spectrum of research currently being undertaken and the new perspectives this presents and emphasize the sig nificant and important impact of nutrition on bone health and disease."

Interest in bone densitometry methods has recently experienced a resurgence within the medical community. Physicians have become more interested than ever before in the diagnosis and treatment of degenerative diseases of bone such as osteoporosis. The public perception of osteoporosis and its prevention has been recently heightened. Because osteoporosis is widespread, especially in women, and leads to an increase in fractures in our population, many re searchers and clinicians are strongly motivated in their search for more sensi tive and accurate methods of diagnosis. This book was written for physicians, scientists, engineers, medical phy sicists, and others desiring an introduction or further understanding of this exciting field. Beginning with the early development of x-ray film methods for assessing bone status, the field has steadily grown throughout the years. Novel and interesting devices have been designed for the measurement of bone mass, bone density, cortical thickness, and other parameters of bone changes. Both qualitative and quantitative bone methods are described. The techniques include imaging devices such as CT and radiography as well as fixed point methods in which bone characteristics of a region of interest are analyzed."

Cancer and Pregnancy covers the clinical challenges to diagnosing and treating malignancies in the pregnant patient; however, the book also shows how an understanding of the common features of both processes (rapid cell proliferation) may lead to novel anti-cancer treatment options. The book should be read by obstetricians and gynaecologists, clinical oncologists, reproduction specialists, and those involved in investigation of development, biology, toxicology, immunology, as well as cancer research.

ThisbookcomprisesthescientificproceedingsoftheInternationalWorkshop onDigitalMammography(IWDM),heldinBremen,Germany,fromJune22 toJune25,2002. Sinceitsinceptionin1992,IWDMhasgrownintotheIn- ternationalForumonDigitalMammography. TheuniquenessofIWDMisits attractivenesstoresearchers,medicalpractitioners,andindustrialdevelopers. F6rmerworkshopswereheldinSanJose,USA(1992),York,UK(1994), Chicago,USA(1996),Nijmegen,NL(1998),andToronto,Canada(2000). Each ofthesescientificeventshasbeencombinedwithverysuccessfulandfocused industrialandresearchexhibits,whichdemonstratedthemilestonesofdigital mammographyhard-andsoftware. Now,thatdigitalmammographyisenteringroutineclinicaluse,wewitness itsstrongimpactonscreeninganddiagnosticmammography,computeraided detection,minimallyinvasiveprocedures,andthedevelopmentofsystemicand integrateddisease-orientedbreastcare. Inviewofthis,the2002workshoppro- videdawindowtogiveusaglanceatthefuture,andtheworkwhichwas presentedintalks,postersandexhibitshasdemonstratedthatIWDM2002will takeaspecialplaceintheverysuccessfulsequenceofIWDMevents. Finally,asconferencechair,Iwouldliketothankallwhohavehelpedtopre- pareandrunIWDM2002:theScientificAdvisoryBoardforitsexcellentworkin guaranteeingscientificsignificance,theOrganizationalBoardforitshardworkto accomplishanappropriateframeworkfortheevent,andtheindustrialexhibitors andsponsorsfortheirgeneroussupport. Bremen,January2003 Heinz-Otto Peitgen ConferenceChair ProfessorofMathematicsand BiomedicalSciences VI Scientific Committee SusanAstley UniversityofManchester,UK UlrichBick CharitBerlin,Germany/UniversityofChicago,USA MichaelBrady OxfordUniversity,UK HiroshiFujita GifuUniversity,Japan MaryellenGiger UniversityofChicago,USA NicoKarssemeijer UniversityHospitalNijmegen,TheNetherlands Heinz-OttoPeitgenUniversityofBremen,Germany EttaD. Pisano UniversityofNorthCarolina,USA MartinYaffe UniversityofToronto,Canada IWDM 2002 was supported by (MeViS SIEMENS BreastCare medical I' General Electric ARC-0 Fllmle. . Perfection for DI I JMammography Table of Contents Imaging Systems and Detectors...1 DigitalMammographicApplicationofaSinglePhotonCountingPixel Detector...3 Amendolia SR, Bisogni MG, Delogu P, Fantacci ME, Novelli M, Quattrocchi M, Rosso V, Stefanini A, Zucca S BreastCancerScreeningUsingaDedicatedBreastCTScanner:A FeasibilityStudy...6 Boone JM, Lindfors KK, Seibert JA, Nelson TR PhysicalEvaluationofaPrototypefortheSectraMicrodose MammographySystem...12 Lundqvist M, Bergstrom D, Cederstrom B, Chmill V, Chuntonov A, Danielsson M, Aslund M DoseMeasurementsonaScanningMulti-slitDigitalMammography System...17 Hansson B, Cederstrom B, Danielsson M, Aslund M DigitalMammographyvs. toScreen-FilmMammography:aPhantom Study...20 Heid P, PagliuchiC, Seradour B, Motte N, Langlois L, Kurkdjian S, Piana L MammographyTaxonomyforImprovementofLesionDetectionRates...27 Howard D, Roberts SC, Tabar L AHighResolution(25 p. m)HybridSelenium/CCDSlotScanDetector forDigitalMammography...33 Hunter DM, De CrescenzoG, Mainprize JG, Mawdsley GE, SmithC, Kasap SO, Rowlands JAR, Tumer T, Yin S, Yaffe MJ Co-registeredBreastImagingwith3DX-Raysand3DUltrasound...38 Kapur A, Eberhard JW, Abdalmajeid AM, Thomenius K ImagingCharacteristicsofaDirectConversionFull-FieldDigital MammographyDetectorusingSelenium...4 3 Lee DL, Yorker lG, ling Z, leromin LS SimultaneousAcquisitionofDiffraction,ScatteringandPhase-Contrast ImagesbyMeansofaMulti-LayerEdge-OnMicrostripDetector 48 Olivo A, Arfelli P, Bergamaschi A, Dreossi D, Longo R, Menk RH, Montanari F, Pani S, Poropat P, Rigon L, Vallazza E, Castelli E VIII FullFieldDigitalMammographywithaCCDBasedSlot-Scanned Detector. PhysicalCharacteristicsMeasurements...

Yury Verlinskyand Anver Kuliev Reproductive Genetics Institute, Illinois Masonic Medical Center, 836 W. Wellington chicago, IL 60657 Although introduction of a first trimester prenatal diagnosis by chorionic viIIus sampling (CVS) has considerably improved the possibility for prevention of genetic diseases, it requires a selective abortion in case of an affected fetus. Following the direction of an earlier prenatal diagnosis and to avoid the need for abortion, preimplantation genetic diagnosis has been initiated based on polar body removal and pre-embryo biopsy. The First International symposium on Preimplantation Genetics, Chicago, September 17-19, 1990, was organized to explore these important developments, to review the state of knowledge in the field, and to address existing problems to be solved for developing and improving current approaches for preimplantation diagnosis of genetic disorders. A growing interest in the subject was obvious from the wide attendance of the meeting: over 250 scientists from 19 countries participated. This was the first attempt to put together the advances in different areas of basic and applied research relevant to Preimplantation Genetic Diagnosis, with the multidisciplinary scientific program including the sessions on embryology, micromanipulation and biopsy, genetic analysis of gametes and pre-embryos, IVF, gene expression and gene therapy, and ethical and legal issues. The deliberations of the Symposium presented in the above mentioned sessions, which comprise the contents of correspond ing sections of the Proceedings, open a newarea in medical research based on the interaction of IVF and New Genetics."

This volume includes the latest diagnostic criteria for PCOS and comprises the most up-to-date information about the genetic features and pathogenesis of PCOS. It critically reviews the methodological approaches and the evidence for various PCOS susceptibility genes. The book also discusses additional familial phenotypes of PCOS and their potential genetic basis. All four editors of this title are extremely prominent in the field of PCOS.

Gonadotropin-releasing hormone (GnRH) cells are the key regulators of reproductive function in all vertebrate organisms. The GnRH molecule is synthesized in a small number of neurons in rostral hypothalamic regions of the brain. In mammals, these neurons release the GnRH decapeptide into the portal capillary system leading to the anterior pituitary gland. There, GnRH causes the release of the gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn act upon the gonads to stimulate their maturation, and to cause synthesis of sex steroid hormones, estrogen, progesterone and testosterone. Although each of the levels of the hypothalamic-pituitary-gonadal axis is critical for reproductive function, GnRH neurons play the primary role in the control of reproductive maturation and adult reproductive function, and may even play a role in reproductive senescence.

Since its discovery in 1970, there has been intense interest in GnRH-producing neurons, with more than 8000 papers and chapters in the last decade alone. Despite this activity of research in basic and clinical science, there has never been a book written specifically on GnRH neurons. GnRH: The Master Molecule of Reproduction aims to bring together the large and diverse literature of both laboratory and applied research that focuses on these unique cells.

This book will provide basic background into reproductive neuroendocrinology, as well as specifics regarding the role of GnRH neurons in the control of reproduction. Students studying endocrinology, reproduction, neuroendocrinology or molecular endocrinology will benefit from this book. In addition, this book will take a multi-species approach which will be useful both to basic researchers as well as clinicians. Whenever possible, species differences and similarities will be presented, and if possible, studies on humans, or the clinical relevance of basic research findings to humans will be discussed (such as the treatment of reproductive disorders such as abnormalities in pubertal development, or infertility).

There can never be enough material in the public domain about cancers, and particularly breast cancer. This book adds much to the literature. It provides general information on breast cancer management and considers all new methods of diagnosis and therapy. It focuses on nuclear medicine modalities by comparing their results with other diagnostic and therapeutic approaches. The coverage provides readers with up-to-date knowledge on breast cancer as well as information on the advances in the field of diagnosis. It also details data on the development of some new modalities and provides a general overview of the available tools for breast cancer treatment.

- With a dramatic increase in knowledge of anorectal physiology and imaging over the last five years, this book provides a comprehensive study of anorectal assessment.

- Explores all the lastest techniques and treatments in the field

- Organized into two, easy to manage, sections

- First book to pull a diverse area together and includes 3-D ultrasound, transperineal ultrasonography and dynamic MRI not found in other texts on anorectal disorders

The only book to deal specifically with constipation for specialists has been updated to include all the new advances since the first edition (1995). These advances include biofeedback, surgery for constipation, sacral nerve stimulation, the use of laparoscopy for rectal prolapse, treament and our understanding of some of the psychological problems of these patients. Innovations also include Professor Norman Williams Malone Procedure and the newer pharmacologic treatments such as nitric oxide and botulinum toxin injections.

Risk management is a relatively new process that can sometimes evoke feelings of suspicion among clinicians. However, when used proactively, it offers the opportunity to act at the root cause of an incident to expose de? ?ci- cies in the system rather than in individuals. This process encourages a s- portive approach to patients, relatives, and staff. The overall aim should be to learn lessons rather than to attribute blame. References 1. Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: a p- liminary retrospective record review. Br Med J. 2001;322:517-519. 2. Neale G, Woloshynowych M, Vincent C. Exploring the causes of adverse events in NHS hospital practice. J R Soc Med. 2001;94:322-330. 3. Walshe K. The development of clinical risk management. In: Vincent C, ed. Clinical Risk Management. London: BMJ Publishing Group; 2001, p. 45-60. 4. Department of Health. An Organization with a Memory. London: HMSO; 2000. 5. National Patient Safety Agency. Reporting incidents. Available at: http: //www.npsa. nhs.uk/health/reporting. Assessed June 25, 2007. 6. National Con? ? dential Enquiry into Perioperative Deaths. Changing the way we operate. The 2001 Report of the National Con? ? dential Enquiry into Perioperative Deaths. London: National Con? ?dential Enquiry into Perioperative Deaths; 2001. Available at: http: //www.ncepod.org.uk. Assessed June 25, 2007. 7. General Medical Council. Good Medical Practice. London: General Medical Council; 2006. Available at: http: //www.gmc-uk.org/guidance/good_medical_practice/index. a

This is the first book to specifically deal with hidradenitis suppurativa, a common but overlooked disease that regularly causes significant problems for both patients and doctors. The first section of this book presents the best current knowledge about diagnosis, pathogenesis and complications. The second section offers comprehensive guidelines on diagnosis and therapy. The book will assist doctors in providing a broader range of treatments for their patients. To increase the practical usefulness of the book, a description of the patients' perspective and patient information is included.

In this thorough and state-of-the-art book, top experts provide cutting edge techniques which greatly expand the depth and scope of classical invasive prenatal diagnosis. The book features a totally unique focus on novel non-invasive approaches for prenatal diagnosis. Following the Methods in Molecular Biology series format, the chapters feature step-by-step laboratory protocols, lists of the necessary materials, and tips on troubleshooting and avoiding known pitfalls.