There is now increasing awareness by the general public in European countries that prostate cancer is a serious threat to health, and this has created higher expectations for improved and more effective methods for detecting and treating the disease. However, urologists are very conscious of the limitations of the diagnostic methods that are available and are even more concerned about the apparent lack of therapeutic advances made during the past 50 years since Huggins discovered the fundamental principles of endocrine treatment for is theo prostate cancer. Recent efforts to detect the disease when it retically "curable" have been successful, certainly in the USA, but this has highlighted our uncertainty about the best treatment for early stage prostate cancer, and there is no doubt that radical pro statectomy is sometimes carried out on men who may not be threa tened by their illness. While it is generally accepted that many men with prostate cancer will die of old age rather than this malignancy, it cannot be ignored that this disease kills many others in a process that is frequently lingering, miserable, and humiliating, not only for the victim but also his family. There are many important issues about prostate cancer that remain unclear at the present time, some of which are addressed by the reviews in this book. The debate about early detection and screening can arouse considerable heat in otherwise placid urological mee tings."

Written by world-renowned experts, this book addresses immunological and molecular methodologies of diagnosis as well as clinical aspects of diseases. It book discusses DNA and RNA amplification methods, explains ELISA approaches, and introduces rapid diagnosis techniques, biosensors, and flow cytometry. The book examines bacterial and parasitic infections, including M. tuberculosis, Borrelia burgdorferi, Streptococcus pyogenes, chlamydia and schistosomes, and describe viral infections such as hantaviruses, hepatitis C., cytomegalovirus, herpes virus, and HIV. It also covers syndromes with infections origins, including prions, chronic fatigue syndrome, and superantigens, and much more.

Alzheimers Disease (AD), the most frequent cause of mental decline in the elderly represents one of the major health problems facing modern society. Despite considerable progress in the clinical diagnosis, epidemiology, structural basis, biochemistry, molecular genetics, and pharmacological aspects of AD, its etiology, molecular backgrounds, and treatment challenges are still poorly understood. This volume based on the 2nd International Symposium of EBEWE Research Initiative in October 1993 in Salzburg, Austria, is conceived as a review of our current knowledge of morphology, diagnostic clinical and imaging techniques, methodological approaches of cognitive assessment, trial designs, outcome variables and possibilities of therapy of AD and other neurodegenerative disorders. The books coverage is broad and it should be of interest for investigators, clinicians, and researchers involved in the problems of AD."

M. K. Gospodarowicz, P. Hermanek, and D. E. Henson Attention to innovations in cancer treatment has tended to eclipse the importance of prognostic assessment. However, the recognition that prognostic factors often have a greater impact on outcome than available therapies and the proliferation of biochemical, molecular, and genetic markers have resulted in renewed interest in this field. The outcome in patients with cancer is determined by a combination of numerous factors. Presently, the most widely recognized are the extent of disease, histologic type of tumor, and treatment. It has been known for some time that additional factors also influence outcome. These include histologic grade, lymphatic or vascular invasion, mitotic index, performance status, symptoms, and most recently genetic and biochemical markers. It is the aim of this volume to compile those prognostic factors that have emerged as important determinants of outcome for tumors at various sites. This compilation represents the first phase of a more extensive process to integrate all prognostic factors in cancer to further enhance the prediction of outcome following treatment. Certain issues surround ing the assessment and reporting of prognostic factors are also considered. Importance of Prognostic Factors Prognostic factors in cancer often have an immense influence on outcome, while treatment often has a much weaker effect. For example, the influence of the presence of lymph node involvement on survival of patients with metastatic breast cancer is much greater than the effect of adjuvant treatment with tamoxifen in the same group of patients 5]."

7he a1m 0f EL15A: 7he0ry and Pract1ce t0 1ntr0duce the expe- menter t0 the techn0109y kn0wn the En2yme L1nked 1mmun050r6ent A55ay (EL15A). 7he 600k d1rected at w0rker5 w1th vary1n9 de9ree5 0f exper1ence, 6ut f0r th05e w1th0ut any prev10u5 c0ntact w1th the a55ay. 1mmun0a55ay5 f0rm the 6ack60ne 0f u5ed te5t5 the 5tudy 0f 1nf- d15ea5e5 t10u5 and end0cr1n0109y, and hence can 6e u5ed t01d- a9ent5 cau5at1ve t1fy 0f the extent and nature (ep1dem10109y) 0f d15ea5e, and mea5ure h0rm0ne5 at EL15A5 pr0v1de h19h1y and prec15e meth0d5 f0r the mat10n 0f parameter5, w1th the added advanta9e that they can hand1e 1ar9e num6er5 0f 5amp1e5 that may then 6e ana1y2ed rap1d1y. 7he5e a55ay5 are ver5at11e, hav1n9 6een app11ed t0 a w1de ran9e 0f e.9., v1ru5e5, 6acter1a, fun91, and pr0t020an and meta- 20an 51nce para51te5. 1971, when the effect1ve en2yme-1a6e1ed a55ay wa5 de5cr16ed (1), th0u5and5 0f have 6een pu6115hed de- w1th the 4uant1f1cat10n 0f ant19en5 and ant160d1e5 f0r re5earch and app11ed purp05e5. EL15A and re1ated a55ay5 1nv01v1n9 u5e 0f en2yme5 t0 06ta1n c010r1metr1c re5u1t5 have n0w rep1aced rad101mmun0a55ay (R1A) f0r m05t d1a9n05t1c purp05e5, 51nce the f0rmer 0ffer5 a p0tent1a1 w1th 1ncrea5ed ver5at111ty t0 a w1der 9r0up 0f Examp1e5 0f 5pec1f1c area5 t0 wh1ch EL15A5 have 6een app11ed re5earch and are: Detect10n and 0f wh01e 0r part5 0f a9ent5, e.9., typ1n9; 2. 0f a9ent5, e.9., 5u6typ1n9; d15ea5e D15cr1m1nat10n d15ea5e 1dent1f1cat10n 1. d1a9n0515 1n 5c1ent15t5.

This volume contains the proceedings of the thirteenth biennial International Conference on Information Processing in Medical Imaging (IPMI XIII), held on the campus of Northern Arizona University in Flagstaff, Arizona, in June 1993. This conference was the latest in a series of meetings where new developments in the acquisition, analysis and utilization of medical images are presented, discussed, dissected, and extended. Today IPMI is widely recognized as a preeminent international forum for presentation of cutting-edge research in medical imaging and imageanalysis. The volume contains the text of the papers presented orally atIPMI XIII. Over 100 manuscripts were submitted and critically reviewed, of which 35 were selected for presentation. In this volume they are arranged into nine categories: shape description with deformable models, abstractshape description, knowledge-based systems, neural networks, novel imaging methods, tomographic reconstruction, image sequences, statistical pattern recognition, and image quality.

When John Thompson and I first began talking about finding a way to measure and cost the output of hospitals in the 1960s. we really had no concept of the need for this kind of result. In fact. if we had listened to others in the health services research community. we would rrever have begun or persisted in the task. But it seemed important to us to begin to understand what up until then seemed unexplainable - the rather strange cost behavior of hospitals. We had the benefit of Professor Martin Feld stein's observation that case-mix was certainly an important factor. but we had literally no guidance on how to make some sense out of the very large number of illnesses that beset the human race. and the very large number of different processes that obtain in our hospitals as they attempt to cope with those illnesses. We were fortunate to find a small number of curious and capable graduate students to join us in this effort. for without them we would not have had a chance of success. While many contrib uted to the ultimate outcome. it is important to single out Ronald E. Mills. Richard F. Averill. Youngsoo Shin. and Jean L. Freeman for their efforts over many years. The diagnosis-related groups (DRGs) constitute a way of identifying the normal output of hospitals in a consistent and exhaustive manner."

Present and potential future applications of new diagnostic strategies basedon the direct or indirect detection of cancer genes are delineated in this volume. Among the methodological aspects covered are enzymatic target amplification by the polymerase chain reaction and related techniques, DNA fingerprinting, transfer of putative cancer genes in appropriate receipient cells, and recent developments inthe application of monoclonal antibodies in immunohistochemistry and immunoscintigraphy. The diagnostic and functional implications of mutations in cancer genes such as ras and p53 are described. The characterization of cancer genes and their products is correlated with growth control anddissemination of tumour cells by in vitro or clinical evidence. The contributions in the present volume uptdate the information available on established or newly described cancer genes, and may help manage the transition from basic research to clinical practice.

Biochemical monitoring of the fetus has been in the back of every perinatologist's mind. Technological advancements have been made in the last ten years but not to the expected level. A continued interest in the subject can only be maintained by symposiums of this nature where perinatologists from different countries can share their experience. Laserspectroscopy of the fetus is a valuable addition to this volume. The future of biochemical monitoring of the intrapartum fetus depends on the continued collection of scientific data and further technological advances. This successful symposium was held in October, 1990, in Albuquerque, New Mexico, USA. I would like to thank Hewlett Packard for their generous support without which this publication would not have been possible. My sincere thanks goes to my secretary, Nancy Whalen, who has done a tremendous job with the word processing, organization, and layout of the chapters. Molly S. Chatterjee, M. D. Associate Professor University of New Mexico Department of Obstetrics & Gynecology CLINICAL IMPORTANCE OF BIOCHEMICAL MONITORING OF THE FETUS DURING LABOR WITH DEMONSTRATION OF TYPICAL CASES E. SALING, J. BARTNICKI Institute of Perinatal Medicine, Free University of Berlin, Berlin, Germany The biochemical monitoring of the fetus during labor is historically the oldest part of prenatal medicine. The very first direct approach to the human fetus took place on June 21, 1960 when the first blood samples were taken from the fetal scalp in our labor room (3).

Early detection of cancer has been recognized as an important area of preventive medicine for quite some time. In a few sites, such as the cervix, the breast, and the skin, it has been shown beyond doubt that early detection and secondary prevention of cancer are realistic goals. However, the general success of this approach is limited and re- quires substantial additional effort in research and public health education. The present volume is based on an International Symposium on Cancer Diagnosis - Early Detection, which was organized by the Committee Coordinating Cancer Research in GroBforschungsein- richtungen of the Federal Republic of Germany. The meeting was held at the German Cancer Research Center in Heidelberg, June 3-15, 1991. I am grateful to all members of the Scientific Committee who gave valuable advice in preparing the program of the conference: Gunther Bastert (Heidelberg), John Collins (Braunschweig), Heinz Hofler (MunichINeuherberg), Ernst Jung (Mannheim), Gerhard van Kaick (Heidelberg), Stefan Meuer (Heidelberg), Michael Wannenmacher (Heidelberg), and Wolfgang Wilmanns (Munich/ Neuherberg). I am obliged to Volker Diehl (Cologne), Gunther Bastert (Heidelberg), Hans K. Miiller-Hermelink (Wiirzburg), Manfred Schwab (Heidelberg), and Georg Dhom (Homburg/Saar) for serving as chairmen of the sessions. I am also grateful to Horst Metzler and the administration of the German Cancer Research Center for all their efforts to guarantee a smooth running of the Conference.

The fourth edition of the landmark reference Child Maltreatment?now titled Chadwick's Child Maltreatment?offers a comprehensive view of the signs and aftermath of physical and sexual abuse, neglect, and psychological maltreatment. Formerly presented as a 2-volume clinical guide and photographic atlas, this cutting-edge series has been divided into 3 definitive volumes: Physical Abuse and Neglect, Sexual Abuse and Psychological Maltreatment, and Cultures at Risk and Role of Professionals. Each book is supplemented by an atlas of clinically valuable case studies and images to assist in the identification, interpretation, and investigation of child maltreatment. Chadwick's Child Maltreatment has been edited by some of the most prominent experts in the field, including child abuse specialist and pioneer Dr. David Chadwick. This newly revised series is specifically designed for professionals who are in positions to identify and respond to the plight of child maltreatment and its many adverse effects on children and families. Dr. Chadwick and his collaborators have expended great effort to present relevant, updated clinical text in the fourth edition, which includes 1950 pages and 1976 images. Key benefits and features of Chadwick's Child Maltreatment include: New! Over 350 new photographs to help practicing professionals identify various incidents of child maltreatment. New! Seven new chapters including: Volume 2, Chapter 5, Sexual Behaviors in Children; Volume 2, Chapter 6, Therapy Approaches in Sexually Abused Children; Volume 2, Chapter 7, Positive and Negative Findings and What They Mean; Volume 2, Chapter 9, Understanding Resilience; Volume 2, Chapter 10, Lifelong and Life-Limiting Effects of Child Maltreatment; Volume 3, Chapter 10, Prosecution of Child Maltreatment; and Volume 3, Chapter 23, Public Health. Volume 3, Chapter 2, Risk of the Internet, has been completely revised to reflect the fast-paced growth of the role of technology in our society. Combined clinical guide and photographic atlas in each book for easier access to information. Multidisciplinary focus to support collaboration among health care, law enforcement, social work, child protection, and court-related professionals. Volume Two: Sexual Abuse and Psychological Maltreatment Volume Two in the fourth edition of Chadwick's Child Maltreatment series provides a comprehensive review of the signs and effects of sexual abuse and psychological maltreatment toward children. The clinical text includes new and revised content on topics that are critical to the effective assessment and treatment of sexually and psychologically abused victims. More than 30 medical experts collaborated to provide the latest clinical data and research on topics including interviewing children, sexually transmitted infections, psychological assessment and treatment approaches, and developmental aspects of the young, among others. The clinical portion of the text is accompanied by a photographic atlas in the back of the book, which contains current cases studies and more than 300 images and illustrations that document instances of sexual abuse, equipment used by professionals for the documentation of cases, and concepts of psychological maltreatment and developmental health issues. Peer-reviewed by experts in the field, Sexual Abuse and Psychological Maltreatment is a comprehensive resource to support health care, law enforcement, social work, child protection, and court-related professionals in their ongoing efforts to identify and prevent sexual abuse and psychological maltreatment of innocent victims. Key Features and Benefits: New! Over 100 new photographs to help practicing professionals identify and treat various incidents of sexual abuse and psychological maltreatment. New! Five new chapters including: Chapter 5, Sexual Behaviors in Children; Chapter 6, Therapy Approaches in Sexually Abused Children; Chapter 7, Positive and Negative Findings and What They Mean; Chapter 9, Understanding Resilience; and Chapter 10, Lifelong and Life-Limiting Effects of Child Maltreatment. New! Combined clinical guide and photographic atlas for more convenience and easier access to information. Multidisciplinary focus to support collaboration among health care, law enforcement, social work, child protection, and court-related professionals.

Taking an interdisciplinary approach that emphasizes the adaptability of immunochemical and related bioanalytical methods to a variety of matrices, Immunoassay and Other Bioanalytical Techniques describes the strength and the versatility of these methods in a wide range of environmental and biological measurement applications. With contributions from leading authors drawn from varied disciplines in academia, industry, and government institutions, the book discusses the evolution of the technology and explores the wide spectrum of chemicalimmuno methods available, including multiplexed immunoassays. It presents standard and innovative applications of immunochemical and related methods, such as microarrays and sensors, examines quality assurance guidelines, and offers insight into recently developed products and procedures. Meeting the continuing and pressing need for economical analytical methods that can detect trace levels of hazardous compounds in complex environmental and biological media, this text reviews breakthrough research, including the impact of nanotechnology. It describes the strength and versatility of immunochemical and related bioanalytical methods while highlighting other areas of applied bioanalytical methods. The book provides both a basic understanding of the field and an update on important technological advances such as new platforms and detection systems. It demonstrates how significant time and cost savings can be achieved for studies requiring repetitive analysis or having high sample loads.

There is an urgent need to develop and integrate new statistical, mathematical, visualization, and computational models with the ability to analyze Big Data in order to retrieve useful information to aid clinicians in accurately diagnosing and treating patients. The main focus of this book is to review and summarize state-of-the-art big data and deep learning approaches to analyze and integrate multiple data types for the creation of a decision matrix to aid clinicians in the early diagnosis and identification of high risk patients for human diseases and disorders. Leading researchers will contribute original research book chapters analyzing efforts to solve these important problems.

In writing this book, I have attempted to provide information about the relative value of particular investigations in various neurological disorders. The book is divided into sections dealing with the methods of investigation, the investigation of particular symptoms, the investigation of specific neurological conditions and neurological emergencies. Finally, the assessment of certain disorders suggesting a particular anatomical localization, for example isolated optic atro phy, is considered. Following an appraisal of the literature, each section ends with a recommendation regarding appropriate investigation. In some in stances this is supported by an algorithm. Specific recommendations have been attempted despite the risk of producing over-dogmatic criteria for patient management. A small amount of illustrative material is included. I am grateful to colleagues at Charing Cross Hospital who have provided some of the illustrations. Figs 1. 4, 2. 1 and 10. 2 are reproduced from Atlas of Clinical Neurology, by G. D. Perkin eta/. , Gower Medical Publishing, 1986, courtesy of the publishers. Fig. 3, in Chapter 4, is reproduced from Brain, vol. 2 104, 753-78, 1981, courtesy of the editor and Dr. R. S. J. Frackowiak. Fig. 6, in the same chapter, is reproduced from Fig. 62 in the Atlas of Positron Emission Tomography, edited by E-D. Heiss et al. , Springer-Verlag, 1985, courtesy of the publishers and Dr. J. C. Maziotta. Fig. 3 in Chapter 6 is reproduced from Fig.

Apathy is characterized by loss of motivation, decreased initiative, and emotional blunting. It is highly prevalent in neurological, and psychiatric disorders like Alzheimer's disease, traumatic brain injury, schizophrenia, Parkinson's disease, Huntington's disease, cerebrovascular disorders, and mild behavioural impairment. It has negative outcomes including impairments in activities of daily living, caregiver burden, and higher rates of institutionalization and mortality. The definition of apathy has changed over the years alongside the development of diagnostic criteria and apathy scales and measurements. Apathy is emerging as a treatment target with interest in pharmacological, non-pharmacological, and neuromodulatory treatments for apathy. There is also an increased understanding of the neurobiology of apathy with functional and structural neuroimaging research studies. This book is a comprehensive, in-depth review from experts in neurology and psychiatry. It reviews the current state of apathy in these various disorders while also summarizing apathy diagnostic criteria, scales and measurements, neuropathology, and treatments.

This book is the fourth edition of a highly regarded text which was first published in 1988. It introduces the reader to the interpretation of routine laboratory biochemical test results and covers all aspects of interpretative chemical pathology (including reproductive endocrinology, which was not covered previously).

The approach is based on case material from the authors' laboratory and employs algorithms and similar aids for interpretation. The material is structured so that it is comprehensible to beginners as well as being useful for the more experienced practitioners. The envisaged audience is medical undergraduates, general practitioners, clinical biochemists and laboratory technicians.

Cholecystoses, as dealt with in this book by Dr J. H. J. Ruijs, radiologist, and DrS. G. Th. Hulst, internist, is an interesting clinical and pathologi- cal entity and is unique in that it was introduced into medicine by radiological examination. Soon after the discovery of a usable contrast medium for the gallbladder examination- 35 years ago - some features of cholecystoses have appeared in publications: Rokitansky-Aschoff sinuses and adeno- myomatosis. Jutras' display at the Congress in Montreal in 1962, informed the international radiological world of the common basis for the many different manifestations of cholecystoses. Every radiologist is now acquainted with cholecystoses, but as symptoms are sometimes extremely slight - radiological technique must be exact. The aim of this book is to inform the clinician and surgeon on this clinical and radiodiagnostic entity, and to correlate symptoms and signs with the possible need for surgery. Drs Ruijs and Hulst have succeeded in presenting all this information clearly and succinctly. C.B.A.J. Puijlaert, M.D.

"Diagnostic Electron Microscopy: A Practical Guide to Interpretation and Technique "summarises the current interpretational applications of TEM in diagnostic pathology. This concise and accessible volume provides a working guide to the main, or most useful, applications of the technique including practical topics of concern to laboratory scientists, brief guides to traditional tissue and microbiological preparation techniques, microwave processing, digital imaging and measurement uncertainty.

The text features both a screening and interpretational guide for TEM diagnostic applications and current TEM diagnostic tissue preparation methods pertinent to all clinical electron microscope units worldwide. Containing high-quality representative images, this up-to-date text includes detailed information on the most important diagnostic applications of transmission electron microscopy as well as instructions for specific tissues and current basic preparative techniques.The book is relevant to trainee pathologists and practising pathologists who are expected to understand and evaluate/screen tissues by TEM. In addition, technical and scientific staff involved in tissue preparation and diagnostic tissue evaluation/screening by TEM will find this text useful.

This pioneering book investigates how biographical evidence has been variously used, misused, or not used at all, by clinicians entirely reliant on biographical evidence for the influential posthumous diagnoses they have produced of Winston Churchill as a manic-depressive. Attention is paid, also, to the distinct question of Churchill and "nerves," otherwise known as neurasthenia. This question has a place alongside the manic-depression issue because, by ensuring there is a marked contrast between two lines of biographical inquiry, it facilitates a significant move in the direction of a more rounded, a more securely founded, understanding of how Churchill functioned psychologically, and how he did not. That goal of a more rounded understanding is important, and the contribution Diagnosing Churchill makes towards its achievement is worthwhile, because accuracy in the depiction of key elements in the functioning of a major historical figure, one of the heroes of Western democratic civilization, is enjoined by a principle Churchill expressed thus: "the meanest historian owes something to the truth."

This scenario-based text provides answers to urgent and emergent questions in acute, emergency, and critical care situations focusing on the electrocardiogram in patient care management. The text is arranged in traditional topics areas such as ACS, dysrhythmia, etc yet each chapter is essentially a question with several cases illustrating the clinical dilemma - the chapter itself is a specific answer to the question.

This is a unique format among textbooks with an ECG focus. The clinical scenarios cover the issues involved in detecting and managing major cardiovascular conditions. Focused, structured discussion then solves these problems in a clinically relevant, rapid, and easy to read fashion.

This novel approach to ECG instruction is ideal for practicing critical care and emergency physicians, specialist nurses, cardiologists, as well as students and trainees with a special interest in the ECG.

1. Would a better understanding of the anatomy and improvement of the method make it possible to reduce the percentage of failures sufficiently to earn selective arteriography of bronchial and intercostal arteries a place among the accepted methods of selective arteriographic investigation? 2. Can indications for such selective arteriographical investigations be formulated? The answers to these questions were considered to offer a basis for the evaluation of the clinical contribution to be expected of this method. In designing this research project, we started by making a detailed study of the radiological and anatomical literature. I I LITERATURE 11.1. PART I -RADIOLOGY Wide bronchial arteries can be demonstrated by conventional radiological methods. CAMPBELL AND GARDNER (1950), CSAKANY (1964) and KIEFFER ET AL. (1965) described characteristic pictures seen on normal X-ray's and RICHTER (1965) those seen on tomograms of the thorax. TAUSSIG (1947) and SEGERS AND BROMBART (1953) established typical impressions in the esophagus. Some of these authors, including CAMPBELL AND GARDNER (1950) and GARUSI (1961), saw wide bronchial arteries on venous angiocardiograms, but direct study of the bronchial arteries can only be done by arteriography, which still has a rather brief history. Research has been done in dogs and in man; only the latter will be discussed.

Differential Diagnosis of Autism Spectrum Disorder provides a framework for clinical considerations and best practices related to diagnosing children with autism spectrum disorder (ASD) versus commonly co-occurring conditions. Differential diagnosis is a complex process, and it is common for clinicians to observe symptom overlap between conditions. In this comprehensive text, the authors focus on the similarities and differences between ASD and a second diagnosis. Leading experts provide practical guidance in the diagnostic process for ASD versus a second condition, such as anxiety or attention deficit/hyperactivity disorder. Each chapter includes clinical case studies to provide real-world examples of how clinicians make diagnostic decisions. Ample illustrations and 'decision trees' provide a visual representation of clinical decision-making.