Anesthesiology: A Comprehensive Review for the Written Boards and Recertification is a high-yield, streamlined study aid. It contains more than 1000 updated, realistic multiple-choice questions tailored to the question content of recent American Board of Anesthesiology (ABA) exams. To maximize reading efficiency, key messages are repeated and highlighted in the bullets. While focusing on most-frequently tested keywords by the ABA, this book also covers new "emerging" topics such as patient safety, statistics, and ethics. Well-chosen illustrations and graphs are used to enhance the learning experience. Also novel is a high-yield summary of the 60 most frequently tested topics and concepts to be reviewed just before taking the boards. With this book as guidance, readers will be able to efficiently prepare for the written primary certification or recertification anesthesiology board exam.

Brain resuscitation is the therapeutic intervention for critically ill patients with severe brain damage, particularly the types caused by ischemia and hypoxia. The The objective of the International Symposium on Brain Resuscitation held in Ube, Yamaguchi Japan October 31 to November 2 1988, and sponsored by Yamaguchi University and the Japanese Ministry of Education, was to review our recent progress in brain resuscitation and to discuss controversies both basic and clinical. To my knowledge, this symposium was the first held in Japan. Our understanding of neuronal dysfunction due to ischemic/hypoxic insults at organ, cellular, and molecular levels has advanced significantly in the last two decades. We had therefore intended that this international symposium should broadly cover the topics which are of interest to both basic researchers and clinicians. Three hundred and twenty-five attendants, including twenty scientists from eight different countries, actively participated in discussion and exchange of new ideas and thoughts concerning brain resuscitation. This book comprises the re ports presented during the symposium which consisted of two main parts: basic and clinical. Although one single meeting can never be expected to solve any problems, meetings often highlight areas of ignorance and problems which are ripe for solving. It has been hard to review all the papers because of the multi plicity of the discussed topics, but the overview on brain resuscitation by Profes sor Bo K. Siesjo and the summary by Professor J."

The past few years have seen the publication of a large number of articles and not a few books on the subject of relief of intractable pain. New ideas have been put forward on pain mechanisms, new methods of treatment have been reported and improved results c1aimed, and a growing catalogue of complications oftreatment has been recorded. The vast and expanding literature on the subject poses for the reader the dual problems of surveil lance and of assessment. The object of the present book is to provide a critical and constructive review of current writings and ideas on a wide range of aspects of the nature of intractable pain, particularly of present day practice and new ideas on treatment. Each chapter is written by an acknowledged authority and the approach throughout is practical rather than academic. In editing the individual chapters an effort was made to achieve a contemporary approach and to eliminate material which was unduly historicalor retrospective in content. At the same time the individ ual style of the authors was retained as far as possible. For decades chronic pain has been a therapeutic 'no man's land'. For the surgeon pain was an unfortunate complication wh ich not infrequently followed surgery; for the physician it was a distressing symptom in a number of disease syndromes; to the psychiatrist it was one of a number of features in many cases of mental illness."

Neurophysiological recording is the major neuromonitoring technique employed in ICU. In addition, continuous recording of intracranial pressure has proved to provide infomation useful for critical care of the patient with severe brain damage. It is, however, difficult to assess neurochemical and/or metabolic environments of the brain with these conventional neuromoni toring techniques. Information regarding these changes, if available on a real-time basis, is undoubtedly useful for patient care. Many important developments in bedside techniques to monitor these changes have been achieved during the last few years. It was the consensus of the editors that a symposium to exchange knowledge concerning recent advances in such techniques would be valuable. With this background, the First International Symposium of Neuro chemical Monitoring in ICU held May 20-21, 1994, in Tokyo, Japan. It was not the intention of the organizers that this symposium should survey the whole field of neuromonitoring in ICU. The symposium was thus focused on clinical application of microdialysis, jugular venous oximetry, and near infrared spectroscopy, which currently appear to be the most promising techniques for monitoring neurochemical and metabolic changes in the brain in a clinical setting. We termed these techniques collectively as neuro chemical monitoring, contrasting them with neurophysiological monitoring in ICU. The concept that has motivated this symposium was to provide an opportunity to exchange up-to-date summaries on issues currently debated for these techniques. This volume is based on the papers presented at the symposium."

This aim of this book is to focus on a very common situation seen in medical practice, the acute catabolic state. This pathophysiological sit uation is rarely discussed as a separate entity, possibly because it is seen in all specialties of medicine and results from a great diversity of agents, insults, and diseases. It thus seemed to be high time to gather the most important and up-to-date knowledge on this entity, and the primary aim of the book is to offer a collection of updated information on the acute catabolic state. Another objective of the book is to make clear that, apart from the general response of the whole organism during the acute catabolic state, a series of organ-specific responses will also take place, which must also be considered during treatment. It has become very clear of these organ-spe from working on this book that current knowledge cific responses is very sparse and in some areas almost nonexistent; this book thus also focuses on the responses and changes which take place in different organs during the acute catabolic state and the inter action between these organs and their responses.

B. Raymond Fink Sheldon Roth and Keith Miller have asked me to record that the Third Conference on Molecular and Cellular Mechanisms of Anesthesia was held in Calgary last May "in my honor. " Such was my dear friends' gracious way of continuing a series that began at the University of Washington, where I hosted two, four, or five previous ones, 1,3-6 depending 2 on how far back one wishes to count. At that, Seattle took up where Paris left off in 1951. These occasions create their own unforgettable memories. This book captures the fine, invigorating ambience of the University of Calgary and the exciting explorations and com panionship of a gathering in a frontier territory of neuroscience. So, floreant symposia. They have progressively refined the quarry, from pathway to synapse to lipoprotein membrane to receptor and single channel, in heuristic convergences of neuronal physiology, biochemistry, and pharmacology. Nevertheless, the anesthesiologist in me senses a certain disquiet, a certain claustrophobia provoked by the narrow confines of micropipettes. How much more tubular must tunnel vision become before the desired broad view emerges? At present, the advances in molecular neurobiology seem continually to increase the apparent complexity of the total problem and the conceptual distance between the reductionists in the laboratories and the holists in the operating rooms. Happily, what is also growing is the excitement in trying to bridge the gap. Perhaps it would be timely to regard general anesthesia not as a state but as a syndrome."

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

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

One of the easiest things an anesthesiologist can do is to administer an anesthetic, and therein lies one of the major dangers of anesthesia. Like in flying and diving, if the rules are followed, mishaps should be very rare. The Art of Anesthesiology so often depends on anticipation of the unexpected, knowing the patient and doing something intelligent when the Science does not give a clear cut answer to a problem. The risks to our patients can, therefore, be markedly reduced, if we have a good grasp of the difficulties and dilemmas that they are prone to, before they are anesthetized. Herein lies the great value of preanesthetic assessment. Preanesthetic Assessment has now reached its third volume in the space of five years. Twenty-four new areas are covered with more than enough detailed information to satisfy the careful practitioner and the Board Examiner. Dr. Elizabeth Frost is to be congratulated on presenting a breadth of material that contains something useful and informative for everyone in training or practice. Subjects vary from the demands of the athlete to those of the Jehovah 's Witness, congenital disorders to pediatric and obstetrical quandaries. Other problem areas include drug abuse, endocrinology, the patient undergoing neuroradiology and a mixed bag of diseases that provide the unprepared anesthesiologist with problems.

Anesthetics produce a reversible state of unconsciousness accompanied by ante- grade amnesia. This remarkable phenomenon brings great relief to surgical patients and wonder to clinicians and scientists. To date, we do not fully understand the mechanisms by which anesthetics ablate conscious sensation and memory. We are, however, making progress. This book presents original results as well as overviews of the current state of knowledge of the problem. It is authored by investigators who know the ?eld well; their research at a number of levels has contributed substantially to our c- rent understanding of anesthetic modulation of memory and consciousness. Most of the contributors were presenters at two workshops organized by Dr. Pearce and Dr. Hudetz at the 40th Annual Winter Conference on Brain Research, held at Snowmass Village, Colorado, from January 27 through February 2, 2007. One workshop focused on anesthetic modulation of consciousness and another on an- thetic modulation of memory. Seven of the chapters are based on material presented at these symposia - appropriately updated with new relevant ?ndings. This infor- tion is supplemented by chapters on anesthesia and sleep, computational analysis of the state of anesthesia, and the clinical phenomenon of "anesthesia awareness," a topic that has recently received much public attention. With these three additional contributions, the book thus includes 10 chapters.

The first international symposium on brain edema was held in Vienna/ Austria in 1965 followed by altogether eight meetings since. The most recent was organized in Y okohama by the Department of Neurosurgery of the Musashino Red Cross Hospital, Tokyo. The continuing interest of both, clinicians and experimental scientists alike may be attributable to the fact that brain edema is a common denominator of many cerebral disorders, which under acute conditions threatens life and weIl-being of afflicted patients. Although progress in understanding as weIl as treatment can be recognized since 1965 many problems remain, particularly concerning the control of brain edema under acute conditions, as in trauma or ischemia. A quantum leap was the distinction of the cytotoxic and vasogenic brain edema prototypes as advanced by Igor Klatzo, providing for transition from a morphological to functional understanding now. The recent brain edema meetings were certainly benefiting from developments of both, molecular neurobiology on the one hand side and functional brain imaging at an ever-increasing resolution on the other, such as magnetic resonance imaging orpositron emission tomography. The international symposium in San Diego 1996 may witness further breakthroughs, hopefully also of effective treatment modalities. The symposium in Y okohama was dedicated to the "Legacy of 28 Years of Brain Edema Research" as a reminder of accomplishments as weIl as remaining challenges.

Ischemic brain damage represents a major source of morbidity and mortality in westernized society and poses a significant financial burden on the health care system. To date, few effective therapies have been realized. Recent evidence, however, suggests that channels, pumps, and ionic exchangers are involved in CNS ischemia and ischemic stroke, but the potential contribution of these channels for curing stroke is far less understood than for many other normal and pathological conditions. New Strategies in Stroke Intervention: Ionic Channels, Pumps, and Transporters, analyzes the roles played by targets in stroke development and the potential action of drugs modulating these proteins. This book provides a groundbreaking review of these ionic channels, pumps, and transporters as regulators of neuronal ionic homeostasis, providing a better understanding of ischemic brain disorders and the new pharmacological avenues for a cure.

Until recently, monitoring of cerebral blood flow and metabolism was an unattained goal. Determination of cerebral blood flow was limited to intermittent measurements and particularly difficult to perform in critically ill patients. Meanwhile there are techniques available, however, to monitor cerebral blood flow and cerebral oxygenation, both globally and regionally. Therefore we thought it worthwhile to discuss these new continuous techniques and to compare them with well-known techniques which discontinuously measure CBF. For that purpose, an international workshop with some leading experts in the field was held in October 1992 in Berlin. The workshop consisted of about 20 lectures, either reviews on a special topic, or latest results. These contributions were given by invitation and were extensively discussed. Unfortunately it is impossible to reproduce the discussions. On the other hand, all speakers delivered a manuscript promptly after the meeting so that we were able to edit them within a short time. Since monitoring of cerebral blood flow in intensive care is a rapidly growing and changing topic, the written contributions should be quickly available. Authors, editors and publishers have tried to come close to this ideal. As editors we would like to thank the authors and the publishers who enabled us to come out with this volume of the proceedings as early as possible.

25 years have passed since a small group met for the First International Symposia on Brain Edema in Vienna. Subsequent Symposia were held in Mainz, Montreal, Berlin, Groningen, Tokyo and Baltimore. During this time we have witnessed a virtual explosion of the number of publications in this field and our basic and clinical understanding of this disease process has increased tremendously. Our meetings have always been a landmark to take stock of our experience so far and to provide perspectives toward future developments. In addition, it always was a good opportunity to renew old friendship and to make new friends. This volume is a compilation of papers presented at the Eighth International Symposium on Brain Edema held on June 17-20, 1990 in Bern, Switzerland. During this Symposium 158 papers were presented as oral or poster presentations. This considerable number of papers was chosen from more than 230 abstracts that were received. The organizers wish to thank the Advisory Committee for the work done in paper selection and focus on the Symposium. Appreciation is also given to all persons, who have contributed to the success of this meeting, the Chairmen, the participants and last but not least all the staff who worked behind the scene.

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

Great progress has been made in the understanding and prevention of secondary brain damage from acute cerebral disorders, such as trauma and ischemia. Advances may be concerned in particular with better organization and logistics of preclinical emergency care, including rapid arrival of well-trained medical staff on the scene of an accident and of transportation to a competent hospital. Nevertheless, it is a safe assumption that development of secondary brain damage from both intra- and extracranial causes still represents a major factor for the final outcome in severe head injury. Thus, exchanges of experiences and information between various disciplines involved with this important clinical problem - trauma still assumes the number one position as a cause of morbidity and mortality up to an age of 45 years - may provide a basis for in-depth analysis of remaining problems as well as of methods of their solution. This exactly is the purpose of the present publication on concepts and findings pertinent for the general subject of secondary brain damage from various experimental as well as clinical viewpoints. An internationally high-ranking group of experts has been contributing to this collection of reviews on cerebral trauma and ischemia and its adverse sequelae, including cerebral exploration by most modern technologies, such as NMR spectroscopy or PET scanning, among others.

by E.K. ZSIGMOND, M.D. Department of Anesthesiology University of Illinois Chicago U.S.A. It is, indeed, a distinct honor and privilege to be invited by the authors to write a preface to this monumental monograph, Regional Opioid Analgesia. Regional Opioid Analgesia is a colossal undertaking by Drs. De Castro, Meynadier and Zenz shortly after the introduction of this revolutionary approach to pain relief which opened a new epoch in analgesiology. This is, indeed, the first authentic and comprehensive textbook encompassing the current knowl edge on this novel approach to pain relief. We are indebted to the authors for introducing the new opioids to regional analgesia with the scientists, who de veloped the potent short and ultrashort acting opioids with high therapeutic indices, which many researchers dreamt about but never before materialized. The side effect liabilities of these new opioids are minute as compared to morphine and meperidine. Regional Opioid Analgesia could not have been more authentically written than by Drs. De Castro, Zenz and Meynadier, who have conducted daily clinical investigations on all known opioids for regional analgesia as well as for neurolept analgesia. Therein lies the great value of this monograph: it is the most authentic work on this topic."

Over the last 10 years the syndrome of severe acute renal failure has progressively changed in its epidemiology. It is now most frequently seen in critically ill patients, typically in the context of sepsis and multiorgan failure. This epidemiologic change has meant that intensive care physicians and nephrologists must now work in close cooperation at all times and must take many com plex issues of prevention, pathogenesis, and management into account that they did not previously have to tackle. Simultaneously, the last 10 years have seen the development of major technical and conceptual changes in the field of renal replacement therapy. There are now previously unavailable therapeutic options that provide physicians with a flexible and rapidly evolving armamentarium. The nutrition of these patients, previously limited by the par tial efficacy of renal replacement therapies, has also become more aggressive and more in tune with the needs of critically ill patients. Increased understanding of the pathogenesis of the multi organ failure syndrome has focused on the role of many soluble "mediators of injury" (cytokines, leukotrienes, prostanoids etc.). These molecules are likely to participate in the pathogenesis of acute renal failure. Their generation and disposal is also affected by different techniques of artificial renal support."

This book reviews the most recent developments in the patho- physiology and therapy of ventilatory failure. It contains contributions by twenty-five internationally recognized aut- horities on respiratory muscle function and investigators actively contributing to our knowledge of the cause, diagno- sis and therapy of ventilatory failure. Of particular inter- estare the descriptions of new modalities of partial and complete ventilatory assistance as well as new knowledge re- garding ventilatory control and fatigue during stressful breathing. The reader will find here a state-of-the-art re- view of the latest research and practical applications in this most critical area of intensive care medicine.

The publication of the Vth International Symposium 1995 on "Mechanisms of Secondary Brain Damage" in Mauls/ltaly is a collection of focused reviews reaching from novel molecular- and cell biological findings to aspects of clinical management in head injury and cerebral ischemia. A specific purpose of these series of meetings introduced in 1984 is for an exchange on problems of mutual interest by international high ranking experts from the basic sciences and related clinical disciplines, such as intensive care medicine, neurology, or neurosurgery. The present volume covers three major areas: (a) Molecular and cell biological mechanisms including inflammation (b) Novel findings on mechanisms and treatment in cerebral ischemia (c) Secondary processes in head injury, regeneration and treatment Molecular-and cell biology is currently attracting attention towards activation of genomic processes associated with the demise of cells referred to as "programmed cell death" and "apoptosis" which, actually, might be distinguished from each other. Thus, the phenomenon of delayed neuronal death in selectively vulnerable brain areas following brief interruption of blood flow is scrutinized as to the contribution of the activation of suicide genes. The physiological role of such a response, among others, is removal of surplus neurons during ontogenesis of the brain. Yet, evidence is accumulating that similar mechanisms playa role in cerebral ischemia, probably also trauma, where nerve-and other cells demonstrate features of apoptosis. Observations on protection of neurons by administration of protein synthesis inhibitors in cerebral ischemia provide more direct support.

This book deals with the methods and scientific basis of inhalation toxicology. It describes devices and facilities needed to expose animals to inhaled particles and gases as well as approaches to estimating or measuring the fraction of the inhaled material that is retained in the respiratory tract. The book then reviews the evergrowing repertoire of techniques that can be used to measure the responses elicited by the exposure. Quantitative and qualitative anatomical, physiological, and biochemical strategies are discussed in detail. We believe that the toxicology of inhaled materials is an important and timely topic for several'reasons. During the past decade, morbidity and mortality attributable to cardiovascular disease have significantly decreased. Progress in combatting cancer, the second most important cause of death, has been slower, and lung cancer actually became the leading cause of death in men and the second leading cause of cancer death in women. In addition, the incidence of non-neo plastic respiratory diseases such as emphysema, fibrosis, and chronic bronchitis has increased the past decade. In the United States, the National Institutes of Health (NIH) has recently reported that chronic obstructive pulmonary disease affects nearly 10 miliion persons and accounts for 59,000 deaths yearly; indeed, it ranks as the fifth leading cause of death. Because the incidence is increasing, the NIH estimates that it may become the nation's fourth or even third leading cause of death by the year 2000."

Every so often a gathering of minds and experience occurs that results in an all encompassing overview in depth of such a vast subject as Cerebro-Vascular Malformations, as occurred in Verona in June 1992 and which warrants publication. Professors Da Pian and Pasqualin deserve high compliment and it is a measure of the respect in which they are held that virtually all those most knowledgeable around the world attended, presented their work and thoughts and contributed to intense discussion. Ljunggren's opening historical survey set the stage and must be the most comprehensive yet published. Subarachnoid hemorrhage from aneurysm rupture still constitutes, I dare say, the most difficult problem for neurosurgeons, in relief of the brain injury and arterial reaction and the technical perfection of aneurysm obliteration, even for small, as well as large and giant sacs. Very large high flow A VMs can be as demanding too. The bulk of the conference was devoted to subarachnoid hemorrhage, aneurysms and A VMs which were discussed under about 14 headings each. But vein of Galen malformations, dural A VMs, cavernous angiomas and venous angiomas (renamed developmental venous anomalies) came under scrutiny, not always with consensus. Trends are perceptible such as fibrinolysis of subarachnoid clot, non surgery for Galenic and dural malforma tions, the benignity of venous angioma, but there is still much variation in approach, pharmacologically, technically and with such as the evolving endovascular and radiosurgical stories, used alone or in conjunction."

Sepsis is still the leading cause of death in surgical and general intensive care units. Although our knowledge of this complex syndrome has increased in recent years, it is still far from com- plete. New therapeutic approaches have been developed. Some did not fullfill the high expectations for their use in clinical prac- tice; others are still under clinical evaluation. is the aim of this monograph to offer basic information on the It etiology, definition, pathophysiology, prevention and therapy of sepsis and septic shock to both the clinician and the scientist. We believe that it presents an extensive overview that may help the clinician to better understand and treat sepsis and septic shock. We also hope that this work will give some directions for future research both in the clinical field as well as the laboratory. Jena, Berlin, Jerusalem, K.Reinhart February 1994 K.Eyrich C.Sprung TableofContents I.Definition/Prognosis Sepsis and Septic Shock: Update on Definitions (Jo-L.Vincent) 0 0 0 0 0 0 0 0 0 0 0 0 ******** 3 Clinical Manifestations and Prognostic Indicators in Sepsis (R.C.Bone) ...0 * * * * * * * * * * * * * * * * * * * 16 What Determines Prognosis in Sepsis? Evidence for a Comprehensive Individual Patient Risk Assessment Approach to the Design and Analysis of Clinical Trials (W.A.Knaus, D.P.Wagner, F.E.Harrell, Jr.

This book concentrates on problems generated by acute care in severely traumatized patients during the first 24 hours after injury. During this hectic period, highly complicated problems have to be solved at the site of the accident, during transport to hospital, and in hospital. Multiple medical and paramedical disciplines are involved in providing care to the severely injured. This book endeavors to present a problem-oriented approach to the diagnostic, therapeutic, and organizational aspects that may be encountered.

Nitric Oxide (NO) is a free radical, a gas, and a pluripotent product of mammalian cells. Only a few years ago, scientific discussions of NO were largely held in the context of the chemistry of air pollution. Now, however, the great significance of NO as a signalling and cytotoxic molecule has captured the attention of the biomedical community. This book provides a very up-to-date review of the role of NO in sepsis and ARDS. Consideration is given to NO both as a pathophysiologic mediator as well as a therapeutic agent. An internationally recognized group of scientists and clinicians have contributed chapters dealing with cutting-edge science and practical clinical strategies. Numerous tables and charts have been included to aid the reader in understanding this fascinating and important subject.