Pathobiology of Human Germ Cell Neoplasia is a state-of-the-art compendium on a very recent branch of tumor biology. It offers an awareness and understanding of germ cell tumors: from the earliest stages to their va- rious differentiations. Original data for this volume was supplied by experts in the fields of pathology, developmental biology, genetics, molecular biology and other related fields. This compilation of knowledge provides information necessary to persons working in clinical and preclinical areas.

The production of a textbook of the pathology of bone work with isotopic markers to refine their classifica- tion. tumours is a hard task to embark upon, but Andre In this book, the author takes up a firm position Mazabraud has certainly succeeded. about the difference between osteoid osteoma and oste- It is the outcome of a very long experience, provided oblastoma, about "tumoral associations" and about the initially by his hospital training, then by his collabora- so-called malignant forms of disorders described as tion with Rutishauser at the Institut de Pathologie at benign. His personal stamp is evident throughout the Geneva and with Dahlin at the Mayo Clinic. The bonds various chapters. he forged then have never been loosened. Certainly, treatment in the area is rapidly changing Subsequently, his duties as head of the department and advancing, but this book does not risk obsoles- of pathology at the Institut Curie directed him finally cence since treatment is not its focus. The extent and towards tumour pathology. At the Institute, he was not nature of the author's experience explain the essentially satisfied with routine examinations but very soon linked anatomo-pathological orientation taken by this semi- up with the research team and worked especially on nal book. It also provides valuable clinical information Ewing's sarcoma and the problems of ultrastructure, and a good radiological study.

The International Life Sciences Institute (ILSI) was creat ed to promote cooperative efforts toward solving critical health and safety questions involving foods, drugs, cosmet ics, chemicals, and other aspects of the environment. The Officers and Trustees believe that questions regarding health and safety are best resolved when government and industry rely on scientific investigations, analyses, and reviews by independent experts. Further, the scientific aspects of an issue should be examined and discussed on an international basis, separate from the political concerns of individual companies. ILSI is pleased to sponsor this set of monographs on the pathology of laboratory animals. This project will be use ful in improving the scientific basis for the application of pathologic techniques to health and safety evaluation of substances in our environment. The world wide distribu tion of the authors, editors, and Editorial Board who are creating these monographs strengthens the expectation that international communication and cooperation will al so be strengthened."

The only book to attempt any perspective on methods of assessing cell proliferation is published to satisfy the growing interest amongst pathologists and clinicians in areas which have for more than three decades been the preserve of experimental biologists

Twenty years ago when Children's Cancer Association of Japan was born, the diagnosis of childhood leukemia amounted to a death sentence. Only 20% or so of children with leukemia survived more than 5 years. Since then, enormous improvements have been achieved regarding our understanding on the etiology, diagnosis, and the treatment of childhood leukemia. Now, 70% of children with leukemia survive and enter adult life. Even though the improved survival rate of children with leukemia represents a medical success story, we now face new problems. The first problem is the fact that we still lose 20-30% of patients with childhood leukemia. To address this problem, we need to understand the etiology, epidemiology, and biology of leukemia; to identify the patients at greater risk; and to develop adequate treatments. The second problem is the treatment itself. Even though efficacious, the modem treatment for leukemia is a grueling experience for children and their families. We should develop a total care system for families and children based on a deep understanding of their needs. The third problem is the aftereffects of the treatment and of cured leukemia. Extensive radiation and chemotherapy have an entirely different spectrum of long-term effects on children than on adults. These treatments in the early stage of life, when the mind and body are developing, create many physical and psychological problems. These are the present problems of childhood leukemia.

In this book, concerned with the spatial and structural repre- sentation of the cell and its particular specializations, the author hasdeviatedconsiderablyfrom the usual planfor other books related to this subject and has presented the illustrative material in the form of detailed and accurate drawings. The layout of the book provides the reader with a briefnarrative accountoftheparticularorganelleaccompanied byafull-plate illustration on the facing page. Most ofthe narrative accounts areaccompaniedbyashortbibliographyofgermanereferences in the event the reader desires to pursue the subject matter in greater depth. In my estimation there is no other presentation currentlyavailablewhich utilizes thisapproach to demonstrate the cellular components and their associated morphophysi- ology with such elegance. Thetextisclearlywrittenand,althoughtheindividualaccounts are brief, they are highly informative with all ofthe important details being provided. The accuracy ofthe textural presenta- tions and the continuity ofexpression provide strong evidence that the author has spent an enormous amount of time in preparing the text and in painstakingly drawing the illustra- tions. Certainly, an obvious strength ofthis volume is the high qualityoftheillustrativerenditions, allofwhichweredrawnby Dr. KRSTIC. These attest to the profound and comprehensive nature of the author's knowledge of the field of cellular and structural biology. This book is truly a work oflove and art by one who is gifted both didactically and artistically. Dr. KRSTIC should be con- gratulated for providing us with an extremely accurate and detailedaccountofthe 2-dimensional, andinmanycasesthe 3- dimensional, view of the cell and its component organelles. It has no equal.

These collected papers represent only a small part of the large amount of new work in the field of stereotaxy. The number of contributions to the Birmingham meeting was such that only selected papers, chosen as representative of advances in the field, could be printed. These papers present the most up to date accounts of major advances in stereotactic imaging and the renewed interest in the stereotactic treatment of movement disorders. Contents Section I. Stereotactic Imaging, Tumours and Haematomas Lipinski, H. G., Struppler, A., Birk, P.: Transformation Modes in Computerized Human Thalamic Brain Mapping . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 3 . . . Giunta, F., Marini, G., Bertossi, M.: Stereotactic Computer Graphic System with Brain Maps. . ., 7 Giorgi, c., Cerchiari, U., Broggi, G., Contardi, N., Birk, P., Struppler, A: An Intraoperative Interactive Method to Monitor Stereotactic Functional Procedures . . . . . . . . . . . . . ., . . . 10 Giorgi, c., Cerchiari, u., Broggi, G., Passerini, A.: 3-D Reconstruction of Cerebral Angiography in Stereotactic Neurosurgery . . . . . . . . . . . . . . . . . . . . . . .. . . . 13 . . Vandermeulen, D., Suetens, P., Gybels, J., Oosteriinck, A: Angiographic Localizer Ring for the BRW Stereotactic System . . . . . . . . . . . . . . . . . . . . . . . . . ., . . 15 . . . Uematsu, S., Rosenbaum, A. E., Erozan, Y. S., Gupta, P. K., Moses, H., Nauta, H. J., Rigsby, W. H., Wang, A, Weiderman, L., Kumar, A J.: Intraoperative CT Monitoring During Stereotactic Brain Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 18 . . .

Prior to the virtual atomic explosion of medical knowledge, at a time when communica tion was very much slower, a medical book, to be authoritative and believable, had to be written by a very knowledgable, and, per force, usually quite senior person. The choice of texts was limited and tended to be dominated by a few "classic" (a phrase not quite synonymous with dogma). Following the information explosion, the scenario is quite different. Not only is there a geometric progression in the quantity and speed of devel opment of new medical knowledge, but also this development is occurring at very dif ferent rates in different countries. This is particularly true in medical imaging. The result is that it is now virtually impossible to produce a "single author" book that can cover the field or even a subdivi sion of it. This absolute requirement for multiple authors has in turn created the need for a new type of editor/author who must be multinational in approach, have a uniquely informed appreciation of what is going on in medical imaging research throughout the entire world and possess the depth of personal knowledge and experience to judge cor rectly what work is the most rigorous and likely to have the greatest impact."

(North American) Blastomycosis is caused by the dimorphic fungus Blastomyces dermati- tidis, first described by Gilchrist andStokes in 1896. The perfect stage was grown by Mc- Donough and Lewis in 1967 and is known as Ajellomyces dermatitidis. In the body and on appropriate media at 37 C, the organism presents itself as a round, thick-walled budding yeast cell, characteristically with a broad porus between mother and daughter cells. The yeast cell is multinucleated. For many years, North America was assumed to be the only place where blastomycosis was found, but recent demonstration of indigenous African cases changed this impression (Emmons et al., 1964). Within the United States, more cases are seen in Kentucky, Ohio, the Carolinas, Illinois, Michigan, Wisconsin, Iowa, Tennessee, Arkansas, and the Virginias than in the remainder of the country (Chick, 1971). In Mexico, occasionally, and in the provinces of Canada adjacent to the endemic areas of the United States, endemic blasto- mycosis has been recognized. Soil has been long suspected as the habitat for the fungus, but recovery from soil has seldom been successful (Denton and Di Salvo, 1964). The primary infection is, as a rule, pulmonary with frequent secondary foci in skin, bone, male genital system, and, eventually, spares no organ in widely disseminated cases. The rare cases of primary cutaneous blastomycosis are consequences of accidental percutaneous laboratory infection. These can be clinically easily differentiated from the average case of secondary hematogenous spread to the skin (Landay and Schwarz, 1971).

Pathology of Multiple Pregnancy collates case material from over 500 autopsies (including embryos) and 1200 placentas from twins, triplets, and higher multiples with selected literature on human multiple reproduction. It emphasizes important new concepts of pathophysiology and interpretation of less than ideal outcomes of multiple conception based on over 30 years experience in the field. Aspects of perinatal pathology unique to twins and higher multiples are emphasized, with practical suggestions for the service pathologist, including items of potential medico-legal significance. Controversial topics, such as the value of studies of concordance for diseases or malformations, and the significance of inter-twin anastomoses, are addressed and suggestions made for further investigation. A close working relationship between pathologists and clinical colleagues is encouraged by discussion of clinico-pathological correlations. And, the most recent discussions on mechanisms of twinning and genetic versus environmental influences on the development of twins are presented.

Traditions are dangerous; doubly so in science. Traditions are unchanging; science is about change. This was the 4th International Colloquium on Carbohydrate Metabolism in Pregnancy and the Newborn to be held in Aberdeen, and by now the form is set. How much its content has changed is a matter of nice judgement and not under the control of the organizers. It is not within their power to bring news of revolution, if there has been no revolution. Certainly many of the speakers had kent faces from previous Aberdeen meetings, but so they would be at any meeting on diabetes anywhere in the world. The written proceedings of scientific conferences have purposes other than to record changes: sometimes they need to state a consensus. The 3rd Colloquium came to an agreement about the importance of prepregnancy recognition and control of abnormalities of carbohydrate metabolism. The 4th set out to examine what results it had achieved. Much of this book is taken up with follow-up studies of the applications of similar regimes in different parts of the world. Since the first Aberdeen meeting in 1973, progress in the manage ment of diabetic pregnancy has been slow and steady, but the change in the city and the society where the meetings took place has been fast.

Increasingly, pathologists are being confronted with the effects of a number of complex devices on the body. Cardiac pace-makers are becoming increasingly sophisticated, ventricular support systems for the heart are well established, and vascular and other protheses are being used in increasing numbers. New joint systems, contraceptive devices used as drug delivery systems, and the use of new cement materials all provide challenges in terms of their pathology. The articles in this text collectively form a body of information on these devices not available elsewhere and with an up-to-date bibliography.

The tumors of the brain similar to other pathological changes of that particular organ claim for a separate position in scientific medicine regarding biology, morphology, features of clinical manifestation, diagnostics and therapy. During the past years due to rapid progress in basic neurosciences and medical biotechnics the situation of the neuroclinician in front of brain tumors has been dramatically changed. The prerequisites for early and accurate diagnosis as well as for successful treatment also of malignant neoplasms have increased and remarkably improved. At the same time the information necessary for an appropriate pragmatic use of the available cognitive methods and therapeutic means increased along the same scale and is permanently being critically modified or changed due to fundamental new insights which come up in always shorter intervals. These facts necessitate the preparation of publications in which the state of the art is presented in possible completeness, systematic order and proper disposability for rational management and therapeutic strategies.

The Leitmotiv of the Second Convention of the Academia Eurasiana Neurochirurgica was "Cerebrum convalescit" - literally "the brain recovers." The focus of the meeting was on plasticity of the central nervous system, one of the most decisive factors in recovery and readaption after cerebral lesions. Distinguished experts from the fields of neurosurgery, neurology, neurophysiology, anatomy, pathology, oncology, and pharmacology discussed the following topics: - Molecular and cellular basis of plasticity - Regeneration and growth in the CNS - Self-organization of neuronal network - Brain oedema - a reparatory process? - Growth factors and carcinogenesis

This Atlas of Oral PathologV is intended primarily as a ances where appropriate and reproduce relevant radio graphs. Every pathologist who deals with bone specimens bench companion for the general diagnostic pathologist. especially the trainee. It has not been designed to cover will know the value of radiographs, and some indeed are the subject fully and in detail, nor does it enter into the reluctantto make a diagnosis in their absence. In addition, radiographs may give a good idea of the extent aFld other more theoretical aspects. Since the book is essentially an atlas the text has been features of a lesion that may be represented in the first kept to a minimum, but in it we have tried to adopt'a instance only by a small biopsy specimen. practical approach, with special regard to differential diag While many of the illustrations have been made from nosis. We have made some remarks about the clinical sections freshly cut and stained for the purpose, others features of the various conditions dealt with, since this have been prepared from stained sections already in our may help the pathologist to appreciate what is in the refer files and since, in addition, the material comes principally ring clinician's mind in an area with which the pathologist from two departments, as well as from outside sources, may not be particularly familiar."

Twenty-five years have passed since J. MILLER'S basic work on the central role of the thymus for the generation of immunological reactivi ty. During this time, the abundance of fascinating literature on the immunological and functional aspects of this organ has been in contrast to the paucity of reports on its role in pathology. The causal or formal pathogenesis even of many of the well-documented pathological fea tures is so far unexplained or at least uncertain. In spite of some concep tual progress related to the work of CASTLEMAN, LEVINE, and ROSAI, we regrettably have to say that in pathology the thymus remains almost as inconspicuous as 25 years ago. Only the new techniques developed in recent years have made it possible to look as closely into the complicated structural organization of the thymus as it appears to be necessary to observe and document abnormalities. Major steps have been taken with the advent of mono clonal antibody immune histochemistry and with detailed ultrastructur al studies in embryology. At this point, pathologists and researchers with a special interest in the thymus were asked to give overviews of their respective fields of interest in light of recent findings in immunology and basic insights into the structural-functional interrelationship of the human thymus. The results of this initiative have been brought together in this volume.

The patriarch of experimental pancreas research is REIGNIER DE GRAAF (1641-1673). He carried out the first experiments with dogs in order to ob tain fistular secretion (1664). But only few years later, the just arisen interest in the physiology of the pancreas was severely set back by remarks of CONRAD BRUNNER. In 1682, BRUNNER expressed his belief that on the basis of experi ments he had carried out the pancreas was a vitally unimportant organ. He overlooked that after ligation of the main duct (discovered in the turkey by HOFMAN in 1641 and in a human cadaver by WIRSUNG in 1642), in the dog an accessory duct (described by SANTORINI in 1724) usually maintains an adequate flow of secretion. EBERLE in his monograph (1834) confirmed the emulsifying capacity of the pancreatic juice which had already been suggested by SYLVIUS (FRAN CISCUS DE LE BOE, 1614-1672) and he dealt with the essential enzymatic functions of the pancreatic juice such as amylolysis, lipolysis and proteolysis. Since HEIDENHAIN (1875), we know that for example trypsin (largely isolated by KUHNE in 1867) is situated in the acinar epithelial cells as zymogen in inactive form; it is thought that the action of "acid" on the glandular tissue is needed for inducing the "enzymatic activity." According to what we know now about the central role of acidosis in the activation of zymogen this topic is, of course, of topical interest."

The International Life Sciences Institute (ILSI) was estab lished to stimulate and support scientific research and edu cational programs in nutrition, toxicology, and food safe ty; and to encourage cooperation in these programs among scientists from universities, industry, and government in order to facilitate the resolution of health and safety issues. The officers and trustees of ILSI believe that questions re garding health and safety are best resolved when govern ment and industry rely on scientific investigations, analy ses, and reviews by independent experts. This process is furthered by the examination and discussion of issues on an international basis. ILSI is pleased to sponsor this set of monographs on the pathology of laboratory animals. This project collectively brings together the most comprehensive information on non-neoplastic and neoplastic lesions that occur in com monly used laboratory animals. The international compo sition of the authors, editors, and editorial board who have contributed to these monographs strengthens our expecta tions that understanding and cooperation will be strength ened worldwide through this series."

Biopsy of the gastrointestinal tract has been revolution less busy) teaching hospital. These sort of techniques, which I confess interest me greatly because of the ized by the introduction of fibreoptics; the proximal additional information which they can yield when rightly reaches, as far as the second part of the duodenum, and chosen, are naturally linked with improved methods of the whole large bowel back to the caecum can now be tissue preservation in general, bearing in mind that the sampled under direct vision and multiple small biopsies need for special techniques often becomes apparent can be obtained. Only in the jejunum and ileum are there only when the biopsy has been conventionally still limitations on the sampling of localized as opposed to generalized conditions. The sheer volume of gastro processed and examined. However, I have firmly intestinal material passing through our own laboratories stabled this hobbyhorse and have included little that has risen steeply over the last years to form some 25% cannot be done in a district general hospital and nothing that I am not prepared to do myself. I have tried to of the total current work load and the rise continues; stress, particularly, common lesions which can cause nearly all of it is in biopsy form rather than as resected specimens."

Various textbooks on stereotactic neurosurgery have been published during the last few years (Riechert 1980, Schaltenbrand and Walker 1982, Spiegel 1982), all of them dealing with functional stereo tactics as the major subject in the field. Diagnostic and therapeutic stereotactic interventions are only briefly described, whereas localization techniques are not yet mentioned. Since 1980, however, an increasing number of reports has been published on CT guided and computer monitored stereotactic performances which enable the surgeon to combine diagnostic and therapeutic efforts in one session. With recent progress in scanning techniques, including high resolution CT, NMR, and PET imaging of the brain, it has become possible to study and localize any brain area of interest. With the concomitant advances in computer technology, 3-dimensional reconstruction of deep seated lesions in stereotactic space is possible and the way is open for combined surgery with stereotactic precision and computer guided open resection. This type of open surgery in stereotactic space is already being developed in some centers with the aid of microsurgical, fiberoptic, and laser beam instrumentation. With these advances stereotactic techniques will rapidly become in tegrated into clinical neurosurgery. Stereotactics has become a metho dology which enables the surgeon to attack deep seated and subcortical small tumors. Neurosurgeons may abandon therapeutic nihilism, still frequently seen in glioma treatment, in the near future when stereotactic resection will be feasible and remaining tumor cells may be killed by adjuvant treatment modalities still in development."

The purpose of this work is to review the current knowledge of laryngeal pathology in the light of my experience at the Institute of Laryngology and Otology, London. The role of histopathological investigations in the care of patients with diseases of the larynx is given special consideration. Radiologi cal study of the larynx has become more refined in recent years with the introduction of computerised tomography. Microlaryngoscopy with biopsy of the interior of the larynx is now a frequent procedure in the diagnosis of laryngeal disease. In the effort to interpret the findings resulting from these methods, the need for a monograph outlining the pathological basis of laryngeal disorders has arisen. To the best of my knowledge, such a work, devoted to the pathology of the larynx only, has never been written; a modern study in this field is certainly not available. I have aimed the text towards the practising pathologist in order to give it the broadest scope. It was necessary, therefore, to include an account of the basic anatomy of the larynx. For this purpose (and in subsequent descriptions throughout the book) I have not used the formal anatomical terminology for the two folds on either side of the ventricle of the larynx. There is some variation in the use of these terms, and they are not yet completely in general use."

One out of every two men over eigthy suffers from carcinoma of the prostate.It is discovered incidentally in many patients with an alleged benign prostatic hyperplasia. In treating patients, the authors make clear that primary radical prostatectomy is preferred over transurethral resection due to the lower complication rate.

Almost all known tumors and tumor-like conditions of the fe- male lower genital tract are classified in this complete mo- nograph on the subject. Clinical features, treatment and prognosis ar included, making this book a practical refe- rence for the busy clinician.

John R. Petersen and Amin A. Mohammad, along with a panel of leading basic and clinical investigators, review those CE methods that are now replacing many routine serum and blood tests in clinical and forensic laboratories. Major areas reviewed include the coating of columns; the analysis of serum, urine, and CSF proteins and paraproteins; abnormal hemoglobins and hemoglobin Alc; peptides, amino and organic acids; therapeutic drugs; drugs of abuse; viral load; and short tandem repeats (STR). The methods discussed include capillary zone, micellar, electrokinetic, capillary gel, and non-aqueous electrophoresis. Innovative and highly practical, Clinical and Forensic Applications of Capillary Electrophoresis demonstrates the power and versatility of CE-not only to develop new assays, but also to markedly simplify today's clinical and forensic laboratory methodology.

Larry L. Hench June Wilson OBJECTIVE Millions of people presently enjoy an improved quality of life due to prostheses which repair, augment or replace parts of their skeletal system: bones, joints, teeth, etc. However, all replacement parts have a finite probability of survival. The goal of this book is to compare the survivability data for various skeletal prosthesis systems. All data derive from previously published clinical studies. Where possible statistical comparisons are made and the reasons for failure are discussed. THE NEED FOR SKELETAL PROSTHESES We are an aging population with more than 100 million people in the U. S. and Europe over the age of 50 years. An unfortunate consequence of aging is a progressive deterioration of the quality of skeletal tissues. From the age of 30 years there is a decrease in bone mass for both men and women (Fig. 1. 1). However, for women it is much greater and between 40 and 60 years of age the rate of deterioration of long bones and vertebrae of women is especially severe due to hormonal changes. By the age of 70 most women will have lost from 35 to 60% of their bone mass. The loss of volume of cancellous or trabecular bone leads to a large decrease in mechanical compressive strength (Fig. 1. 2). The clinical consequence is an increasing incidence of vertebral collapse. Cortical bone decreases in tensile strength with age (Fig. 1.