by CDs, but we continue to utilize the same general format of morning didactics and afternoon glass slide review and small group interactions. One of our biggest successes was in the ever-expanding set of didactic lecture notes and radiologic, gross, microscopic, ultrastructural, and other images that course participants received, so it wasn't much of a surprise when we were approached by the publisher to consider creating an updated compilation of some of the best talks and packaging them in a monograph available to a broader population of physicians and scientists. With the extraordinary attention to detail that he is known for, my co-editor David Chhieng has been both the brains and the brawn of this project, resulting in the bringing together of such a collection while trying to be sensitive and representative of the various branches of pathology reflected in the actual course. From surgical pathology, chapters cover select topics in endocrine, gynecologic, GU, and GI pathology with contributions from Walter Bell, Michael Conner, Katrin Klemm, and Audrey Lazenby, respectively. Tom Winokur has begun to prepare us for the near future with a treatise on molecular markers in breast cancer. The interactive nature of cytopathology and surgical pathology are brought together by Claudia Castro [now at the U. T. Medical Branch at Galveston] and David Chhieng in three chapters covering mediastinal, pleural, and pulmonary pathology.

The annual research conference for 1996 of the American Institute for Cancer Re search was again held at the Loews L'Enfant Plaza Hotel in Washington, DC, August 29 and 30. The topic for this, the seventh in the series, was "Dietary Fat and Cancer: Genetic and Molecular Mechanisms. " Two separate presentations were given as the conference overview. "Fat and Cancer: The Epidemiologic Evidence in Perspective" noted that die tary fat can be saturated, largely from animal or dairy sources, or mono- or polyunsatu rated, mostly from plant sources. Unlike animal fats, fish contain relatively high levels of protective omega-3 fatty acids. Although the hypothesis that dietary fat is associated with cancer is plausible, the mechanisms involved are reasonable, and many animal studies support the hypothesis, there are many obstacles in any direct extrapolation to humans, in cluding imprecise measures of dietary fat intake, variability in individual diets, and spe cies variations. Despite these limitations, there is a weak positive correlation between colon cancer and dietary fat intake, but with substantial differences for various ethnic groups. In the case of breast cancer, there is substantial variation among countries and eth nic groups, but the overall evidence indicated an association with fat in the diet. Epidemiologic studies of dietary fat and prostate cancer are more consistent and most show a positive relationship. However, it was not clear which types of dietary fat were im plicated in the effect."

Essentials of Autopsy Practice updates the modern pathologist on issues related to the autopsy. This volume contains topical chapters on the pathology of shock, religious attitudes to death, incised wounds, radiological investigations, metabolic disorders in childhood, maternal deaths, body alterations and piercings which are comprehensive, unique and educational. It brings the literature together into a modern, up-to-date review of the subject, each authored by experts in their field. It comprises the most recent developments in current autopsy practice making the book unique and exceptional - a valuable aid for the bench top, autopsy suite, laboratory or library. A hands-on reference book, Essentials of Autopsy Practice is of interest to both trainees and consultants in all sub-branches of pathology including forensic pathology. It can also be used by non-medical staff involved in the dead, such as nurses, police, lawyers and bereavement officers.

Decoding the significance of proteinuria as an indicator of severity or prognosis in kidney disease is a stimulating challenge to students and practitioners of nephrology. Sir Richard Bright in 1827 associated pro with the disease that bears his name. In the subsequent more teinuria than a century and a half, however, the meaning of the linkage between proteinuria and renal disease remains elusive. Proteinuria is discovered on routine urinalysis in about 10 million Americans, most of whom express no symptoms of kidney disease, each year. From the studies of Robinson (updated in these pages), we know that proteinuria, per se, can be present for 20 years without change in re nal function, as described in orthostatic proteinuria. By contrast, pro teinuria may be the harbinger of swift kidney destruction, rarely cul minating in clinical collapse, a syndrome typifying "malignant proteinuria" as detailed herein by Avram. Although proteinuria is ubiquitous, an orderly management strategy for rational handling of proteinuria of less than nephrotic range is lack ing. Separation of tubular proteinuria and transient proteinuria of fever is now possible routinely. This book provides a record of the contribu tions of investigators and clinicians whose work forms the substrate for production of understanding and, ultimately, marching orders for prac titioners seeking optimized management for their proteinuric patients."

Over the last few decades new data on the distribution, pathogenicity, diagnosis, treatment and control of trematode infections and diseases in man and animals, including zoonotic trematodiasis, have emerged from various geographical regions. These new data are compiled in this book together with existing information to fulfil the present need. Seven major trematode-induced disease groups, namely, schistosomiasis, paragonimiasis, fascioliasis and fasciolopsiasis, dicrocoeliasis and eurytremiasis, clonorchiasis and opisthorchiasis, paramphistomiasis, and diseases due to intestinal trematode infections are dealt with in this book. These diseases still rank as a major cause of morbidity and mortality - both in man and in livestock - mainly in the tropics, and contribute to the socio-economic problems. Many of these diseases are also zoonoses, some major and others potential. The intended readership of this treatise include postgraduate students of medical and veterinary parasitology, research workers as well as medical practitioners, veterinarians, tropical diseases specialists, veterinary public health specialists and teachers concerned with trematode infections and trematodiasis of man and animals.

Dr. Peter S. Conti is a Professor of Radiology and the Director of the PET Imaging Science Center at the University of Southern California, and is a Fellow of both the American College of Radiology and American College of Nuclear Physicians. He is a pioneer in the development of the clinical applications of PET and more recently PET-CT. He and one of his fellows, Dr. Daniel Cham, have published this groundbreaking PET-CT case-based book, which reveals how PET-CT can be applied in routine clinical scenarios. Leading authorities in the field examine a wealth of heavily-illustrated original PET-CT cases that showcase both common and uncommon cancers, and the latest PET-CT applications for neurological and cardiovascular disorders. Correlative three-dimensional cross-sectional PET and CT images highlight pathological findings. Each of the clinical applications is accompanied by a concise explanation of the patient history and interpretation of the PET-CT study. Insightful discussions and "pearls and pitfalls" are included to assist in a better understanding of pathology, diagnosis, and imaging approaches. Readers also find important coverage of pathophysiology and technical artifacts. This unique book is ideal for nuclear medicine practitioners, radiologists, and residents, as well as referring clinicians interested in learning more about how this new medical imaging technology can be applied in their patient populations.This unique book is ideal for nuclear medicine practitioners, nuclear medicine residents, and clinicians interested in medical imaging for tumor patients.

Many pathologists have little acquaintance with ear, nose concomitant biopsy have become commonplace in the and throat pathology. Some receive few specimens from management of throat disorders. It is hoped that. by ENT tissues; others are deterred from deeper study of the publication of this Atlas, pathologists receiving only material that emanates from regions the normal anatomy occasional specimens will be guided in their provision of of which is so forbidding in its complexity and holds no a report helpful to the clinician and those who are involved familiarity through autopsy investigation, for, apart from with a larger ENT service may be providec with a guide the larynx, there is usually no compelling indication for to the deeper understanding of the subject. examination of the ear, nose or throat at postmortem. Yet. The modern tendency in publication of ristopatholog equally with biopsy specimens from other parts of the ical microphotographs is to omit any statement of their body, the pathologist's report is consequential for the magnification, since it will usually be clear to the reader efficient handling of ear, nose and throat illnesses and what order of enlargement is involved. I n this Atlas, sometimes even for the patient's survival."

In "Inflammation in the Pathogenesis of Chronic Diseases: The COX-2 Controversy," a worldwide panel of leading experts discusses the role of inflammation in the pathogenesis of major chronic diseases and the current controversy regarding risk versus benefit of selective cyclooxygenase-2 (COX-2) inhibitors. This volume is intended for scientists in medicine, epidemiology, pharmacology, molecular biology, and related fields. The authors provide exciting and enlightening perspectives on COX-2 and related molecular targets in the future of medicine, including historical perspectives on the discovery and development of aspirin, ibuprofen, and compounds that selectively inhibit COX-2, and the potential for development of new compounds with better efficacy and safety in the 21st century. Specfic chapters illuminate the role of inflammatory mechanisms in the pathogenesis of arthritis, cardiovascular disease, cancer, neurodegenerative disease, diabetes mellitus, obesity, and other life-threatening and debilitating conditions. Experts in cardiovascular medicine explore the "COX-2 controversy" regarding adverse effects of some (not all) selective COX-2 inhibitors on the cardiovasculature. Recent findings suggest that cardiovascular risk associated with some COX-2 inhibitors may not be due to a class effect, but rather depends upon the molecular structure of specific compounds. Important findings are documented in cancer research showing that selective COX-2 inhibitors have powerful antineoplastic effects against major forms of cancer. A special section explores the current evidence supporting the role of COX-2 and inflammation in the development of Alzheimer s disease and other neurodegenerative conditions and the potential benefit of compounds that modulate COX-2 and other inflammatory cytokines. The final section addresses nutritional modulation of inflammation and the chemopreventive value of anti-inflammatory nutraceutical agents. "

With the growing global fear of a major pandemic, avian influenza (AI) virus research has greatly increased in importance. In Avian Influenza Virus, an expert team of researchers and diagnosticians examine the fundamental, yet essential, virological methods for AI virus research and diagnostics as well as some of the newest molecular procedures currently used for basic and applied research. They present exciting, cutting-edge new methods that focus both on studying the virus itself and on work with avian hosts, an area greatly lacking in research.

In this new volume of the globally recognized Forensic Pathology Reviews, Dr. Michael Tsokos has gathered chapters from the top experts in the field to reveal both the applied and scientific areas of expertise along the broad spectrum of forensics studies. Volume 5 piques the mind as leading forensic pathologists from the United States and around the world offer advanced insight into death caused environmental conditions, trauma, neuropathology, natural causes, and ballistics. The authors of this volume further their exploration as they impart research related to identification, serial murder, histopathology, and age estimation. While unveiling unsurpassed and cutting-edge knowledge, Forensic Pathology Reviews, Volume 5 will also inspire emerging forensic scientists to immerse themselves in innovative research.

In recent years, a series of excellent textbooks have been published dealing with pathology of the thyroid gland. The present volume of CURRENT TOPICS IN PATHOLOGY provides further information for both pathologists and clinicians interested in the thyroid gland. The contributions deal with surgical pathology of the thyroid as well as with basic aspects of thyroid metabolism, hormone transport, and growth factors in thyroid cells. The topics covered in this book should mainly be considered as adjuncts to common textbooks on thyroid pathology. The contributions should help pathologists in their routine diagnosis and should stimulate further thyroid research.

Definition of the barrier The interstitial fluid (rSF) of the brain is separated from the blood by the blood-brain barrier (BBB). This barrier must not be thought of as a single entity or as an absolute restriction to all molecules, but as a multiple structure located at several sites within the brain. The first of these interfaces is located at the endothelium of the brain capillaries. Secondly there is a potential site for interchange on the outer linings of the brain between the dura and the arachnoid membranes. Thirdly, there are the choroid plexuses and the cerebrospinal fluid (CSF) which is in contact with the very permeable internal ependymal lining of the brain (Figure 1. 1). Finally there are areas of the brain which lack a blood-brain barrier. These areas constitute the circumventricu lar organs and have leaky capillaries with a barrier at the ependyma which limits the spread of molecules from those regions (Figure 1. 2). Each of these BBB sites has its own characteristic permeability and transport functions. We will now consider the properties of each of these barrier sites between the blood and the brain. THE CEREBRAL CAPILLARY ENDOTHELIUM Morphology This interface has both the largest surface area and the shortest path length between the blood and the brain rSF. The cerebral capillaries, which at first sight seem little different from the rest of the systemic circulation, are in fact unique to the brain."

Seymour Glagov The last meeting, devoted exclusively to an examination of the atherosclerotic plaque, took place in Chicago 25 years ago under the joint auspices of the Council on Arteriosclerosis of the American Heart Association and the Chicago Heart Association. The proceedings were published subsequently in a volume entitled "Evolution of the Atherosclerotic Plaque", edited by Richard J. Jones (1). Both experimental and human lesions were considered and several provocative new approaches to the disorder were discussed. The electron microscope was being applied systematically to the study of blood vessels at that time, so that details of the infrastructure and cellular composition of the artery wall and of atherosclerotic lesions were presented in some detail. There was, as one result of these explorations, considerable discussion of morphologic evidence suggesting that the principal cell involved in the atherogenic process was neither the fibroblast nor the macrophage, as had been supposed, but the smooth muscle cell. In particular, the findings indicated that this cell could incorporate lipid and become a foam cell.

It is hoped that this book may serve two purposes. felt that the resulting increase in size and expense of First it is intended for use at the bench. to help solve the book would not be justified. some of the problems of cell identification which The material was collected over many years and puzzle not only beginners. but even experienced we cannot individually acknowledge the great contri observers in the field of cytological diagnosis. Sec bution made by technical staff of the clinical cytology ondly we have reviewed the most significant previous laboratories who assisted the two authors to prepare publications. particularly those of the past 20 years. and stain the sl ides. Most of the electron micrographs so as to provide a source of reference. were made by or with the assistance of the late Denis Cytological diagnosis should not be isolated from W. Jerrome. and we are also grateful to Dr David histopathology. and many readers will regret the lack Ferguson for further help and advice with these. All of the immunocytochemical stains were done by Dr of cyto-histological correlation in our choice of photographs. Cells centrifuged out of suspension in Anna Ghosh. and Drs David Mason and Kevin Gatter pathological fluids bear very little resemblance to kindly commented on that part of the manuscript. their counterparts in tissue sections."

on the theories of Planck and Einstein. Rather, until The concept that human disease is a specialized branch of biology is universally accepted today, but in the mid-20th century, the accretion of individual historical perspective, is actually of recent origin. At examples of the biological nature of disease processes provided the framework for an evolutionary change in one time, the heliocentric theories of astronomy and the metallurgic transmutations of alchemy had their thinking. The new psychological and philosophical milieu provided the basis for an unprecedented accel counterparts in magical and vitalistic approaches to eration in the pace of biomedical research. It is clear human disease. Any relation between disease of humans and that of animals was not only unacceptable that the biological revolution of the last 35 years was made possible not only by technological advances and intellectually, but abhorrent theologically. Humans (and their diseases) were unique, and biology was the innovative analytical methods, but also by an intellec domain of those who studied animals and plants. tual emphasis on the unity of biological processes. The unification of biology and the study of human High school students are now aware that there is much disease, though begun some centuries ago, was con to be learned about the human condition by studying spicuously stimulated by the work of Darwin, and bacterial DNA, the chloroplasts of green leaves, or the reached its full flower in this century. For example, kinetics of enzymes in vitro."

It is difficult to imagine anyone who has not heard of cancer. This disease can affect families, friends or any one of us at any time in our lives. Every year nearly 3 million Europeans are diagnosed with cancer, leading to around 800,000 deaths per year. These deaths occur not only in aging populations, but also in children and adults who are in the most active period of their lives. This represents a tremendous problem that cannot be ignored by politicians or citizens. Fortunately, there is a constantly growing awareness that although cancer is a problem to be dealt with by clinicians, it should also be the concern of everyone. This volume contains the lectures held at the International Symposium on Cancer "New Trends in Cancer for the 21st Century." Fundamental researchers, politicians and representatives from patient coalitions share here their knowledge and interests as well as their concerns and experiences. Not only do these papers provide state-of-the-art information on cancer, they are also an opportunity to look at the problem from different points of view. It can be encouraging to realise that we are not alone in this fight.

Diagnosis of tumors is among the most commonly performed tasks in pulmonary pathology, and the chapters on tumors in Dail and Hammar: Pulmonary Pathology have been singled out for special praise for their authoritative discussions and comprehensive lists of references. In reviewing the first edition, "Diagnostic Cytopathology" said: "the chapter on common lung neoplasms is like a book within a book." In revising the chapter on uncommon lung tumors, Dr. Dail "added" nearly 500 new references and 100 new illustrations.
The present proposal is to make the chapters on tumors from the second edition of Pulmonary Pathology available to the broad range of pathology residents and clinicians who will not buy Pulmonary Pathology, 2nd ed. for their personal libraries because of its size and cost.

We are currently experiencing a fundamental shift in the way in which we approach the characterization of cancer. Never before has the make up of cancer tissues and individual cells been so exhaustively researched and char- terized. We are now capable of producing molecular "fingerprints" that ch- acterize the expression of all known and unknown genes within tumors and their surrounding tissues. More than 30,000 different genes may be measured in each patient's tumor in a single experiment. Simultaneously, novel therapies that exploit the molecular roadmap have been developed and are now being offered to patients. These novel agents, such as Glivec, Herceptin, Iressa, and others, specifically target individual genes within tumors and can produce d- matic responses in some patients. These drugs are only the forerunners of a coming tidal wave of novel therapeutics that individually target specific m- ecules within cancer cells-more than 300 such agents are currently in phase I or II clinical trials. This is an exciting time for cancer specialists and patients alike. However, if we have learned anything from the past 50 or more years of research into cancer, it is that Lord Beaverbrook, in founding the British national health service in the 1950s, was frighteningly prescient when he defined the primary goal of health care to be "Diagnosis, Diagnosis, Diag- sis. " Now, more than ever, it is essential that appropriate diagnostic methods and approaches are applied to the selection of patients for treatment.

The era of molecular pathology has arrived. From its promising beg- nings in research laboratories, the field has grown, and continues to grow, to become a vital part of the care of an ever-increasing number of patients. Because of its recent emergence from the research taboratory, many molecuIar pathology protocols we still to be found in the primary litcramre, and have not appeared in a text. MO~PCU~Q~ Padhoiogy Protocob contains la- ratory protocoIs that have been developed by many of the authors for use in clinical molecular pathology laboratories and describe in detail Row to perform these assays. This book is therefore intended for clinical laboratory use by medical technologists and pathologists. It will dso be of interest to research workers who are performing these assays. In its broadest meaning, pathology is the study of disease, and therefore it follows that any disease for which the molecular basis is understood would be suitable as a topic for inclusion in this work. When seiecting protocols, it was necessary to place limits on the number of chapters that could be feasibly presented in a single work. Those protoculs that were selected are performed more frequently, or have achieved recognition as having important diagnostic utility in contemporary practice. A decision was made to exclude inherited genetic diseases with certain exceptions, such as those diseases that are associated with thrombotic states and are part of the traditional dumain of pathology.

The accurate and reliable diagnosis of transmissible diseases is the most powerful weapon available to ensure their control, and in some cases eradication. The detection of parasites in clinical cases, companion and farm animals, and in the environment is relatively easy since many of them are visible to the naked eye, and those that are not are readily detected by light microscopy. Fungal infections can similarly be determined. Bacteria are somewhat harder to detect. Although their presence can frequently be detected by light microscopy, differential diagnosis, beyond their gross morphology, is almost always impossible. However, most bacterial pathogens can be cultured in the laboratory and can be accurately identified by combinations of a series of simple tests such as morphology, staining, antibiotic sensitivity, biochemical analyses, nutrient dependence, and phage sensitivity. Viruses, however, have proved much more difficult; their size and absolute dependence of the host cell for propagation have rendered useless the methods traditionally used for other microorganisms. Until the development of tissue culture in the middle of this century, diagnosis was entirely dependent on the skill and experience of the clinician. But this was an unreliable process since many of the common virus infections exhibit similar clinical symptoms, such as coryza, exanthema, vomiting, diarrhea, neuralgia, and lethargy. Indeed many viral infections display clinical signs that are indistinguishable from bacterial or parasitic infections.

The pancreas is about the size and shape of the hand; the tail points to the spleen, and the head is nestled in a loop of the duodenum. Loss of the exocrine (digestive) func tions commonly leads to severe gastrointestinal disturbances, malabsorption, a cata bolic state, and weight loss in the face of an adequate diet. Loss of endocrine pancreatic function leads to a large spectrum of disorders associated with the loss of hormone secretions; the most common and most severe is diabetes mellitus. Loss of the entire pancreas owing to trauma, surgery, atherosclerosis, or other medical problems leaves the patient in a digestive and metabolic crisis. The correct diagnosis of pancreatic disorders remains a challenge given the multi faceted function of the pancreas. The clinical laboratory plays an important role, and other tools such as CAT scans, ultrasound, radiographs, biopsies, and even surgery are used to make a diagnosis. The emphasis of Clinical Pathology of Pancreatic Disorders is on the clinical laboratory definition of pancreatic pathology. Disorders of the endocrine pancreas can be highly complex, and sophisticated tests are needed to determine the nature of the disease, its prognosis, and its optimal treat ment. Diabetes is the most common of the endocrine diseases; it presents in many ways, and has varied etiologies. We now know that the diabetes of childhood is usually an autoimmune disease, and this has a major effect on the treatment of these individuals."

Pathology of the Stomach and Duodenum comprehensively surveys gastric and duodenal disease, including clinical findings, pathophysiology, and epidemiology, and emphasizing diagnostic gross and microscopic pathology. Topics discussed include anomalies, gastritis, peptic ulceration, hyperplasias and benign epithelial tumors, carcinoma of the stomach and duodenum, carcinoid tumors, reactive and neoplastic lymphoid lesions, gastric smooth muscle and nerve sheath tumors, and miscellaneous lesions and rare conditions reflecting gastroduodenal participation in systemic disease.

Mohs surgery is a highly effective treatment for certain cutaneous and oral pharyngeal cancers. The procedure allows for the precise and complete removal of cancers while preserving significant amounts of normal tissue. Through the presentation and orientation of the specimens' complete surgical margin on pathology slides, the location of tumor foci and other relevant findings can be correlated with their locations on the surgical wound. The ability to create perfect slides for histological examination lies at the core of effective Mohs surgery. These procedures have a 99 per cent cure rate for certain cancers when implemented correctly. This book describes the methods the dermatologist, pathologist, or technician can use to optimize the Mohs technique and produce the highest-quality slides and highest cure rates possible.

Hemodynamics makes it possible to characterize in a quantitative way, the function of the heart and arterial system, thereby producing information about what genetic and molecular processes are of importance for cardiovascular function.

Snapshots of Hemodynamics: An Aid for Clinical Research and Graduate Education by Nico Westerhof, Nikos Stergiopulos and Mark I. M. Noble is a quick reference guide designed to help basic and clinical researchers as well as graduate students to understand hemodynamics. The layout of the book provides short and independent chapters that provide teaching diagrams as well as clear descriptions of the essentials of basic and applied principles of hemodynamics. References are provided at the end of each chapter for further reading and reference.

Modern cardiovascular science has produced a revolutionary new idea: the heart acts not merely as a pump, but as a "gland," that is as a regulator of circulatory homeostasis and salt-water balance. This book combines the classical heamodynamic view with the new neuro-hormonal paradigm, in all its potential clinical implications. The book will interest physiologists and clinicians involved in the study of the cardiovascular system and care of heart patients.