Medical imaging has been transformed over the past 30 years by the advent of computerized tomography (CT), magnetic resonance imaging (MRI), and various advances in x-ray and ultrasonic techniques. An enabling force behind this progress has been the (so far) exponentially increasing power of computers, which has made it practical to explore fundamentally new approaches. In particular, what our group terms "model-based" modalities-which produce tissue property images from data using nonlinear, iterative numerical modeling techniques-have become increasingly feasible.

Alternative Breast Imaging: Four Model-Based Approaches explores our research on four such modalities, particularly with regard to imaging of the breast: (1) MR elastography (MRE), (2) electrical impedance spectroscopy (EIS), (3) microwave imaging spectroscopy (MIS), and (4) near infrared spectroscopic imaging (NIS). Chapter 1 introduces the present state of breast imaging and discusses how our alternative modalities can contribute to the field. Chapter 2 looks at the computational common ground shared by all four modalities. Chapters 2 through 10 are devoted to the four modalities, with each modality being discussed first in a theory chapter and then in an implementation-and-results chapter. The eleventh and final chapter discusses statistical methods for image analysis in the context of these four alternative imaging modalities.

Imaging for the detection of breast cancer is a particularly interesting and relevant application of the four imaging modalities discussed in this book. Breast cancer is an extremely common health problem for women; the National Cancer Institute estimates that one in eight US women will develop breast cancer at least once in her lifetime. Yet the efficacy of the standard (and notoriously uncomfortable) early-detection test, the x-ray mammogram, has been disputed of late, especially for younger women. Conditions are thus ripe for the development of affordable techniques that replace or complement mammography. The breast is both anatomically accessible and small enough that the computing power required to model it, is affordable.

The Interfaces of Perinatal Addiction Ira J ChasnofT In the last few years, problems associated with drug use in pregnancy have become endemic. As cocaine has become the drug of choice for millions of Americans, including pregnant women, as AIDS has become more commonly recognized in women and infants, and as legal cases have begun to raise the question of fetal abuse, no professional group has come forward to serve as advocate for this special population of substance abusers. Meanwhile, however, physicians, nurses, social service agencies and public health officials have all been faced with increasing numbers of infants showing the detrimental effects of their mothers' drug use. Although problems of substance abuse in pregnancy have received increasing attention in the medical literature since the early 1970s, there has recently been a very rapid increase in the number of articles published related to this field. The reasons for this new interest are easily understood when current statistics from the National Institute on Drug Abuse are reviewed 1. Although patterns of abuse of alcohol, marijuana, heroin and other substances by women of childbearing age have changed very little over the last ten years, the incidence of cocaine use in this special population has been rising rapidly, a reflection of cocaine's increasing popularity among the general population of the United States.

In June 1998 the Fourth International Workshop on Digital Mammography was held in Nijmegen, The Netherlands, where it was hosted by the department of Radiology of the University Hospital Nijmegen. This series of meetings was initiated at the 1993 SPIE Biomedical Image Processing Conference in San Jose, USA, where a number of sessions were entirely devoted to mammographic image analysis. At very successful subsequent workshops held in York, UK (1994) and Chicago, USA (1996), the scope of the conference was broadened, establishing a platform for presentation and discussion of new developments in digital mammog raphy. Topics that are addressed at these meetings are computer-aided diagnosis, image processing, detector development, system design, observer performance and clinical evaluation. The goal is to bring researchers from universities, breast cancer experts, and engineers together, to exchange information and present new scientific developments in this rapidly evolving field. This book contains all the scientific papers and posters presented at the work shop in Nijmegen. Contributions came from as many as 20 different countries and 190 participants attended the meeting. At a technical exhibit companies demon strated new products and work in progress. Abstracts of all papers were reviewed by members of the scientific committee. Many of the accepted papers had excellent quality, but due to limited space not all of them could be included as full papers in these proceedings. Papers that were rated high by the reviewers are included as long or short papers, others appear as extended abstracts in the last chapter."

This book presenting the latest thinking on Reproductive Endocrinology and Infertility is truly international as the authors hail from no less than four different continents (North America, Europe, Australia and Asia). The idea for this book was conceived during the XII World Congress On Fertility and Sterility where the unique confluence of our distinguished authors occurred in Singapore in October 1986. The authors were involved in the Pre And Post Congress Scientific Programmes which we organised. The overwhelming success of the Congress and the Pre And Post Congress Scientific Programmes prompted this book so that those unable to attend the meeting will still be able to benefit from the vast range of topics covered. This book will be a valuable addition to the knowledge in Reproductive Endocrinology and Infertility and will be useful reading for those wishing to pursue this subspecialty. The authors are indebted to Lee Foundation (Singapore) for help in the publication of this book. We would also like to thank Miss Jam Siew Fong and Miss Tang May Mey for their excellent secretarial assistance. Singapore, January 1988 Charles SANg F H Maurine Tsakok S LTan K H Chan ix 1 Hypothalamic and Pituitary Disorders in Reproduction ROGER J PEPPERELL 1 HYPOTHALAMIC AND PrruITARY DISORDERS Disorders of ovulation are present in 15 to 25% of couples with infertility.

Recent years have seen important advances in the technology and techniques available to surgeons performing gynecologic surgery as well as reconstructive of clinical pelvic procedures. These developments took place in a wide variety settings from regional teaching centers to private clinical facilities. In 1996, the leading investigators from around the world gathered to discuss the present status of pelvic surgery and adhesion prevention with a look toward the future of patient care. This volume contains the proceedings of that meeting: the Third Interna tional Congress on Pelvic Surgery and Adhesion Prevention. Each chapter in cludes the material presented at the congress as well as a timely update of the authors' latest research and clinical thinking. Presentation integrating basic and clinical science provide the basis for con sidering peritoneal repair after surgery including the interaction of growth factors and other biochemical messengers. Research has increased the understanding of mesothelial reepithelialization and has led to new surgical technologies to reduce adhesion fonnation. A state-of-the-art review of emerging surgical adjuvants for adhesion prevention is provided, including discussion of barriers, gels, and poly mers as well as "designer" drugs effective at modifying the peritoneal response to injury. Assessment of clinical outcome in a wide variety of gynecologic surgical procedures brings into focus the benefits available as a result of these new tech nologies."

Handbook of Obesity in Obstetrics and Gynecology addresses all aspects of general obstetrics and gynecology in obese patients, providing evidence-based guidance for the treatment and management of gynecological problems and pregnancy-related care in obese women. The book is a valuable resource for junior doctors, residents and obstetricians and gynecologists looking for a comprehensive guide that addresses the most relevant aspects of obstetric and gynecologic care that are impacted by obesity, an increasingly prevalent condition. The rising prevalence of global obesity is of public health concern, hence obese women suffer from a higher incidence of menstrual disorders, polycystic ovaries, infertility issues, and more. In pregnancy, obesity is associated with an increased risk of early pregnancy loss, recurrent pregnancy loss, fetal developmental abnormalities, thrombo-embolic disease, gestational diabetes, dysfunctional labor, post-partum hemorrhage and difficult operative deliveries.

Oncofertility integrates the two previously distinct fields of cancer treatment and fertility research and aims to explore and expand the reproductive future of cancer survivors. In order to achieve the goal of fertility preservation, the Oncofertility community must focus on communication and the way data is provided and received. Concomitant with the rapidly changing technology of Oncofertility, there have been radical shifts and advances in the way health educators and clinicians can produce and share information.As success rates of reproductive techniques such as egg freezing and banking continue to rise, providing increasing opportunities for young cancer patients to preserve their fertility prior to the onset of cancer treatments, communication among professionals in oncology, reproductive medicine, and psychosocial work, among others, becomes crucial, and clinical demand for Oncofertility information is expected to rise considerably.

"Oncofertility Communication" describes and addresses the myriad channels through which the multiple audiences involved in Oncofertility can be served with appropriate and accurate information about cancer-related fertility issues. The text answers frequently asked questions and provides invaluable insights to scientific and health care professionals about communication among the diverse Oncofertility audiences. It incorporates timely discussions about traditional and emerging electronic communication tools and discusses the impact of health care policy changes on the Oncofertility field. "

This book is a practical guide to latest procedures and diagnostic guidelines for use of sonography in gynaecology. Beginning with an introduction to the role of ultrasound and patient preparation, the following chapters cover common pathologies, uterocervical abnormalities, colour flow mapping, and duplex Doppler. All the latest advances have been included to ensure clinicians are fully up to date in their field. The book features nearly 500 2D, 3D and 4D ultrasound images, with a corresponding image for most of the pathologies described in the text. Key Points Practical guide to latest procedures and diagnostic guidelines for gynaecologic sonography Provides overview of role of ultrasound and patient preparation Covers common pathologies, abnormalities, and different types of ultrasound Includes nearly 500 2D, 3D and 4D ultrasound images

Prenatal testing for genetic abnormalities has transformed pregnancy and motherhood. Using sociological research, this book analyzes the social-psychological and ethical implications of invasive prenatal testing, particularly CVS and amniocentesis. Among the issues covered are changes in the genetic counseling profession and in client demographics; the challenge of nondirective genetic counseling; decisions on testing and on which test to have; the timing and risks of the procedures; abortion and grief; the ethics of sex selection; potential uses and abuses of genetic knowledge; and policy and ethical implications.

No single area of medicine promises more acrimonious and intense debate in the coming decades than the implications of new medical technologies on the maternal-fetal relationships. This is the only book to combine comprehensive coverage of the legal and social issues raised as a result of both emerging technologies for fetal intervention and increasing knowledge of fetal development. It examines such issues as the effects of maternal behavior on the fetus's health, hazards in the workplace, teenage pregnancy, and the use of therapeutic and diagnostic techniques. The volume also summarizes the legal/political context of policies regarding the mother's responsibility for the welfare of the fetus and describes the current status of these issues in public law. The work opens with a framework for examining rights and, in chapter 2, gives an in-depth description of knowledge about the impact of maternal actions on fetal development. Attention then turns to current trends in case law, as Chapter 3 traces the growing acceptance of causes of legal action for prenatal injury or death of the fetus. Chapter 4 extends this analysis to look at the changing legal context for defining standards of care for pregnant women. Chapter 5 examines three disparate but critical topics illustrating the pressures women face in the 1990s: workplace hazards, teenage pregnancy, and surrogate motherhood. The final chapter integrates the technological, legal, social, and political dimensions surrounding the maternal-fetal relationship into a context for creating an effective public policy.

Vulval diseases are managed by dermatologists and by ObGyns and while expert referral centres do exist, the majority of patients are treated by non-specialists. These conditions are relatively common (approximately 15% of a gynaecologist's caseload) and can be difficult to diagnose. Gynecologic Dermatology is a practical, highly illustrated guide written with the needs of the general dermatologist or gynaecologist in mind. The book begins with chapters on normal anatomy; history taking and examination of the vulva; biopsy taking and general management options. Next, symptom-based chapters describe presenting problems such as pruritus, broken skin and scarring, using flowcharts to help the physician work through to a diagnosis. Finally, chapters devoted to key conditions (lichen sclerosus, lichen planus, etc) describe the pathogenesis, clinical presentation, differential diagnosis and management of the disease in question. Abundantly illustrated and written in a practical, clinically oriented style, Gynecologic Dermatology is an indispensable reference for non-specialists that bridges the gap between dermatology and gynaecology. Symptom-based section reflects how patients present in real life and provides algorithms/flowcharts to help with diagnosis Includes second-line treatment options to help physician when standard treatment is unsuccessful Lavishly illustrated with over 500 photos, diagrams, tables and boxes

A comprehensive, cutting-edge review of the complex interactions between maternal and fetal-placental tissues that control the establishment and maintenance of pregnancy, the proper development of the fetus, the birth process, and the behavioral aspects of bonding between mother and newborn. Expert researchers review the endocrine and physiological events that culminate in the delivery of offspring, and provide a solid base of comparative information on the menstrual cycle of primates, including humans. They also discuss the sources and functions of both steroid and protein hormones from the placenta and the details of their effects on uterine function, placental development, fetal growth and well-being, and maternal responses to pregnancy. This book will become the standard reference source not only for reproductive scientists, but also for those clinicians who want better to understand the complex factors that affect pregnancy-and their pregnant patients.

Polycystic ovary syndrome (PCOS) is a classic female infertility condition affecting an estimated 6-10% of all women, many of whom are unaware of the problem. A disease that affects women from adolescence to menopause, PCOS is the single most common endrocrinologic abnormality affecting women. This book is an edited collection of writings that comprehensively covers the disease, from diagnosis and epidemiology of PCOS to clinical evaluation.

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

Advances in technology now offer promising solutions to deal with the chronological aging of the cell, tissue or organ to synchronize its existence and its use. This book covers the developments in and benefits of the latest vitrification technology and its extensive applications in reproductive medicine. Protocols of gametes (oocyte and sperm), embryos, blastocysts and ovarian tissue cryopreservation have been reviewed by leaders in the field. In order to address the escalation in cross-border reproductive tourism entailing the transfer of reproductive cells and tissues rather than the patient, the challenges, caution and emerging possibilities of nitrogen vapor shipment of vitrified cells have been discussed. Current perspectives on oocyte banking present the reader with options and solutions to effectively utilize these gametes despite the physiological deterrents.The versatile applications and potential of vitrification of human embryonic stem cells, discussed in the concluding chapter, is an exciting reality offered by vitrification to help overcome numerous stumbling blocks in the management of various disorders.

This stimulating volume addresses vital questions about gene/environment interactions as they affect cell health from the prenatal period through later life. Beginning with a tour of epigenetic processes in the human body, the book assembles current theoretical and empirical developments across the discipline, among them transgenerational epigenetic inheritance, the effects of maternal nutrition on epigenetic change, and possible links between epigenetics and childhood obesity. Public health and policy aspects of the field are discussed in depth, with the understanding that much can be done to improve our epigenetic health as a species. And in this vein, contributors consider future possibilities, such as the reprogramming of genes to reverse cancer and other diseases. Included in the coverage: The role of environmental epigenetics in perinatal and neonatal development The epigenetic biomarker H2AX: from bench science to clinical trials What's the risk? Dental amalgam, mercury exposure, and human health risks throughout the lifespan Post-traumatic stress disorder: neurological, genetic, and epigenetic bases Children's exposure to alcohol, tobacco, and drugs: long-term outcomes Ethical implications of epigenetics Epigenetics, the Environment, and Children's Health Across Lifespans brings real-world knowledge and applications of this increasingly important field to public health practitioners, maternal and child health researchers, and environmental health experts.

The editor of this volume takes on the challenging task of presenting an encompassing view of childbirth in America from an anthropological perspective. The book is indeed comprehensive. . . . Collectively the chapters in Childbirth in America lay out a representative sketch of research problems of interest to sociocultural anthropologists and other social scientists working in the area of reproductive health. A distinct accomplishment is the acknowledgement in some of the chapters that not all American women want the same kind of childbirth care or have the same values and attitudes about pregnancy, birth, and parenting, and that this variation needs addressing in both childbirth policy and practice. American Journal of Physical Anthropology A comprehensive and critical examination of the experience of childbirth in America today, from pregnancy to early postpartum. This book covers many controversial issues in the context of diverse cultural, social, and economic backgrounds, which have arisen as a result of the new technologies and ideologies surrounding pregnancy and birth. Most useful as a text for courses in childbirth education, anthropology of women's health, and anthropology of medicine.

Key Clinical Topics in Obstetrics and Gynaecology offers an indispensable and practical guide for exam revision and clinical practice. Written and edited by specialists with a wealth of experience, this book provides rapid access to the core topics in obstetrics and gynaecology. Each topic is written in a concise and easy-to-digest format, making this book an essential resource for exam revision and quick reference at the point of care. Over 100 topics presented in alpha order, from abnormality of the genital tract, to venous thromboembolism Effective exam revision for MRCOG Part 2 candidates Succinct coverage of clinical features, diagnosis and patient management Includes clinical photos and diagrams to improve understanding of concepts Contributions from experienced specialists to ensure authoritative, accurate content