There are two important reasons for commencing this new series of publi cations entitled "Advances and Technical Standards in Neurosurgery" 1. the lack of any organized common European postgraduate training system for young neurosurgeons and 2. the language barriers, which impede the exchange of neuro surgical findings in Europe more than in other parts of the world. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore the Editors have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publi cation of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions will be written by specialists in the given fields and will constitute the first part of each volume."

Diagnostic ultrasound is changing dramatically because of the development of a variety of high resolution real-time scanning instruments. Until recently the standard instrument was the articulated arm contact scanner. Real-time scanners were viewed as adjunct instruments for specific and limited pur poses. The roles are reversing with real-time instruments more frequently accepted as the primary diagnostic tool and the contact scanner becoming the ancillary instrument for use mainly for viewing a large field that cannot be scanned with real-time instruments. Two recent editorials stated that real-time instruments were used as the sole diagnostic instrument for between 80% [Cooperberg (2)] and 98% [Bartrum and Crow (1)] of their abdominal examinations. This book introduces the reader to the field of real-time scanning in the abdomen. It presupposes an understanding of basic physical concepts of ultrasound, the appearance of both normal and pathologic conditions as produced by static articulated arm contact scanning, and a familiarity with the techniques of contact scanning. It is designed to acquaint the reader with the spectrum of real-time instrumentation, provide a basic understanding of the physics of ultrasound as related to these instruments, emphasize the special skills required in the use of this equipment, and describe applications of real-time scanning for various parts of the abdomen. While numerous illustrations of both normal and pathologic anatomy are shown, the book is an all-inclusive study of abdominal pathology as demonstrated by real-time imaging.

This atlas is a selection of roentgenograms of patients who visited the radiology departments at the University Hospital in Leiden between 1970 and 1978, the Free University Hospital in Amsterdam in 1979, and the radiology department at the Indiana University Medical School in Indianapolis in 1977. The most common radiological abnormalities of the small intestine are illustrated clearly, unhindered by flocculation or segmentation of the contrast fluid. The authors believe this book is a definite contribution to the goal of precise early small bowel diagnosis. However, the key to good diagnosis is not only a superb examination technique, but also the knowledge, the character, and the personal perfectionism of the physician. If these factors are optimal, then the best possible roentgenographic series will be obtained - at least as far as the technique is concerned. All patients illustrated here were examined by using the enteroclysis technique. With this method of small bowel examination, the contrast fluid is administered via an infusion directly into the duodenum instead of orally. The infusion method has added a new dimension to the usual radiological examination of the small intestine. This method is also especially suited for the comparative evaluation of motility, and the study of disturbed motility. Throughout the course of the examination, the technique can be adapted to special situations at any given moment and can be modified to produce precise diagnostic roentgenograms and diagnosis.

The purpose of this book is to explain the current state of the art in radiological examination, interpretation, and understanding of colonic disease. The radiologic aspects of colon disease are combined here with clinical information to serve both beginners and advanced students. Major emphasis has been placed on technique for those radiologists, residents, and technologists first undertaking modern gastrointestinal radiographic techniques. The essentials of technique are stressed so that the reader obtains a clear understanding of colon disease based on sound practical information. We believe this book is a thorough and practical text of particular interest to clinical radiologists and gastroenterologists in their everyday practice, and also for teachers, residents and medical students. Digital examination and sigmoidoscopy are the first procedures in examination of the colon. Then, the radiologic examination is the next most important procedure. Endoscopy and biopsy play a compli mentary role to the radiological examination. The barium enema reveals quickly and early the overall status of the colon and it can then guide endoscopy and biopsy together with subsequent treatment. Surely, if the lesion is not detected our clinical, radiologic, endoscopic, and therapeutic skills are of no use."

There have been significant advances in the treatment of sarcomas in the past several years. Further, different clini cal treatment programs are being advocated in different areas including surgery alone, surgery with preoperative or post operative chemotherapy, surgery with different radiotherapy modalities, with each investigator espousing his own treat ment program. On the other side, there is the question of whether these treatment programs are offering better results or whether the natural history of sarcomas has changed. The International Symposium on Sarcomas was held at Innisbrook Resort, Tarpon Springs, Florida, October 8-10, 1987. This was the first international symposium to date involving all of the disciplines treating sarcomas including pathologists, orthopaedic surgeons, general surgeons, medical oncologists, pediatric oncologists, and radiation oncol ogists. The Symposium brought together a number of special ists working in the clinical field of sarcomas for a presen tation of their specific treatment programs and their results. The presentations were followed by panel discussions to stimulate educational debate as to the different forms of treatment for sarcomas and to formulate some conformity in control of disease, control of spread, and ultimate function for the patient. James R. Ryan, M.D."

It Itis is 1984, 1984, a a year year immortalized immortalizedby by George GeorgeOrwell Orwell some some35 35 year year ago. ago. In In 1949, 1949, he he prophesized prophesized a a world worlddominated dominated by by television television images images and andelectronic electronic communica communica tions. Orwell's vision of an incredible technologic revolution is the reality of the tions. Orwell'svisionofanincredibletechnologicrevolutionistherealityofthe 1980's. 1980's. Over Over the the past past three threedecades, decades, this this technical technicalexplosion explosion has has impacted impacted on on all all levels levelsof of society, society, including including the the practice practice of ofMedicine. Medicine. In 1949, the cardiologist had available to him only his stethoscope, the chest In1949, thecardiologisthadavailabletohimonlyhisstethoscope, thechest roentgenogram, roentgenogram, the theelectrocardiogram, electrocardiogram, and and his hisclinical clinical astuteness. astuteness. In In 1984, 1984, the the cardiologist still requires great clinical skills, but also has available to him echo cardiologiststillrequiresgreatclinicalskills, butalsohasavailabletohimecho cardiography, cardiography, radionuclide radionuclideperfusion perfusion and and functional functional tests, tests, digital digital radiography, radiography, computed computed tomography, tomography, positron positronemission emission tomography, tomography, and and nuclear nuclearmagnetic magnetic resonance resonanceimaging. imaging. These These imaging imagingmodalities modalities are are the theresult result of ofthe the development developmentof of the the digital digitalcomputer, computer, and and the theexplosive explosive advances advances in in microelectronics. microelectronics. Cardiac Cardiac imaging imaginghas has rapidly rapidlyevolved evolved into intoa a specialized specialized area area of of interest interestshared shared by by cardiolo cardiolo gists, radiologists, engineers, physicists, and statisticians. Our book, Digital gists, radiologists, engineers, physicists, andstatisticians."

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series devoted to Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publication of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume. In the second part of each volume, we publish detailed descriptions of standard operative procedures, furnished by experienced clinicians; in these articles the authors describe the techniques they employ and explain the advantages, difficulties and risks involved in the various procedures. This part is intended primarily to assist young neurosurgeons in their post graduate training. However, we are convinced that it will also be useful to experienced, fully trained neurosurgeons."

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series of Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. This series was first discussed in 1972 at a combined meeting of the Italian and German Neurosurgical Societies in Taormina, the founding fathers of the series being Jean Brihaye, Bernard Pertuiset, Fritz Loew and Hugo Krayenbiihl. Thus were established the principles of European co operation which have been born from the European spirit, flourished in the European Association, and have throughout been associated with this series. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publication of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by spe cialists in the given fields and constitute the first part of each volume."

The advances in neuroimaging are occurring at a we wish to accomplish by bringing out a series of dizzying pace. It is difficult for trainees in radiology volumes, each dealing with a single theme. The first and others in neurosciences-related disciplines to one is in your hands. keep abreast of the new developments. It is especially We wish to express our deepest gratitude to the important to design neuroimaging protocols to distinguished contributors, who have done an out evaluate various neurological diseases. It therefore standing job. We equally thank our publisher. seems highly desirable that review articles be readily Comments are welcome. available that comb through the plethora of literature and provide state-of-the-art information on neuro MS imaging of neurological diseases. It is this goal that SB Xl IMAGING OF NON-TRAUMATIC ISCHEMIC AND HEMORRHAGIC DISORDERS OF THE CENTRAL NERVOUS SYSTEM 1. MAGNETIC RESONANCE IMAGING OF INTRACRANIAL HEMORRHAGE Robert D. Zimmerman Historical Background is inferior scanners with MR units. If, however, MR The advent of magnetic resonance imaging led to to CT in the detection of hemorrhage, hospitals attempts to define the appearance of hemorrhage would still be required to maintain CT scanners, using this new technique. Early reports focused on since the demonstration of hemorrhage is of para hematomas studied with T1-weighted (Tl W) inver mount diagnostic and therapeutic importance in a sion recovery (IR) Scans performed on resistive MR patient with acute neurologic ictus. imagers."

Interest in bone densitometry methods has recently experienced a resurgence within the medical community. Physicians have become more interested than ever before in the diagnosis and treatment of degenerative diseases of bone such as osteoporosis. The public perception of osteoporosis and its prevention has been recently heightened. Because osteoporosis is widespread, especially in women, and leads to an increase in fractures in our population, many re searchers and clinicians are strongly motivated in their search for more sensi tive and accurate methods of diagnosis. This book was written for physicians, scientists, engineers, medical phy sicists, and others desiring an introduction or further understanding of this exciting field. Beginning with the early development of x-ray film methods for assessing bone status, the field has steadily grown throughout the years. Novel and interesting devices have been designed for the measurement of bone mass, bone density, cortical thickness, and other parameters of bone changes. Both qualitative and quantitative bone methods are described. The techniques include imaging devices such as CT and radiography as well as fixed point methods in which bone characteristics of a region of interest are analyzed."

In this issue of Radiologic Clinics, guest editor Dr. Loren Ketai brings his considerable expertise to the topic of Imaging of Thoracic Infections. Top experts in the field cover key topics such as infections in lung and other solid organ transplants, endemic fungal infections, viral pneumonias, non-tuberculous mycobacteria, and more. Contains 12 relevant, practice-oriented topics including coronavirus pneumonias; endemic thoracic infections in Central and South America; endemic thoracic infections in East Asia; endemic thoracic infections in sub-Saharan Africa; and more. Provides in-depth clinical reviews on imaging of thoracic infections, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

During the past decade Positron Emission Tomography (PET) has turned from a highly sophisticated tool developed for basic research in neurology and cardiology into an advanced nuclear medicine imaging technique ready for routine use. Along with remarkable technical improvements, an overwhelming number of PET studies has been published covering not only scientific but also relevant clinical problems. Due to this rapid development, comprehensive information about the current status of 'clinical' PET is lacking. In this book the applications of PET in neurology, cardiology and oncology are discussed in separate sections. In each section, following an introduction reviewing the present clinical demands, special diagnostic problems and their possible solution by PET are addressed. Results of conventional scintigraphic techniques are also mentioned, and compared with PET. In the last section, technical aspects (e.g. instrumentation, software) are presented, including statements of representatives of leading manufacturers in the field. Clinical PET provides a critical overview of relevant applications of PET for all those who are starting to run a PET facility or are planning to do so. The book is also dedicated to interested clinicians who are willing to utilize the diagnostic potential of PET.

The idea for this treatise on the radiological anatomy of superficial and deep spinal cord vasculature evolved from daily routine neuroradiological work. This was also the reason for subdividing the monograph into a postmortem anatomical and a clinical part. The actual importance of a clear conception of radio anatomic fundamentals was made clear by many clinical conferences with neurologists, neurosurgeons and orthopedists, where a lack of knowledge about medullary syndromes of suspected vascular origin became evident. Also among neuroradiologists there is still widespread uncertainty in the interpretation of myelograms and angiographies in such cases. A study of the spinal cord's angioarchitecture is all the more justified and necessary considering the vast number of descriptions of cerebro vascular anatomy and pathology. The clinical challenge posed by patients suffering from partial or complete transverse spinal lesions has grown due to new diagnostic and therapeutic approaches. Myelography using water-soluble contrast media, X-ray computed tomography, magnetic resonance imaging and spinal angiography today allow and require both earlier and topographically and pathogenetically more exact classification of diseases of the spinal cord and its surrounding structures. Due to progress in microneurosurgery and interventional neuroradiology, even intramedullary lesions have become more and more accessible and treatable. Therefore this monograph mainly addresses those concerned with invasive therapeutic techniques and who are familiar with the interpretation of radio anatomic findings. A comprehensive description of medullary vascular syndromes would be beyond the scope of this treatise."

For the fourth English edition, this highly popular book has been thoroughly revised and updated to include such new sections as endoscopic digestive US and abnormalities related to AIDS. It is the only work available covering the diagnostic US of the whole abdomen, and its superb treatment of elementary symptoms enables beginners to become familiar with more complicated features. After an extensive technical introduction, the book covers the sonoanatomy and ultrasonic symptomatology of the diseases of the digestive system and the abdominal vessels. Numerous tips on avoiding pitfalls, as well as indications for other procedures, and backed by some 1000 illustrations, this is well on its way to becoming a standard text for practitioners and clinicians in the field.

Intracranial Pressure is a linking keyword, uniting various aspects of diagnostics and treatment of hydrocephalus, head injury, subarachnoid haemorrhage, and brain ischaemia. This volume contains selected papers presented at the XIth International Symposium on Intracranial Pressure and Brain Biochemical Monitoring, held in Cambridge, UK, in July 2000. Various clinical and experimental methodologies are discussed including multiparameter brain biochemical monitoring (including brain oxygenation, microdialysis and novel imaging techniques), assessment of cerebral autoregulation, measurement of brain compliance, etc. This state-of-the-art volume introduces neuroscientists into a world of new techniques, models, monitoring modalities but also theories and new concepts, which highlight directions for the further research and future clinical practice.

Bone and joint tuberculosis is common in developing countries, and surgeons in these countries are often faced with the dual problem of diagnosing and treating this disease. However, bone and joint tuberculosis has not yet completely disappeared from industrialized countries, either. Therefore, this book is also intended for orthopedic surgeons in industrialized countries, who, faced with the rare but characteristic problems posed by bone and joint tuberculosis, are searching for reliable solutions. The last comprehensive textbook on this subject appeared more than 20 years ago, and that was a third edition of a pre-war work. Advances in chemotherapy had made this edition out-of-date even before it was published. The need for a definite up-to-date textbook has therefore been acute. The present book has been written to fill that need, and is based not only upon 20 years' experience with 700 cases, but also upon the results of clinical, bacteriologic, pathologic, and therapeutic research.

Endovascular Interventional Neuroradiology is comprised of selected papers from the prestigious "Stonwin Medical" "Conference," which each summer invites a group of internationally prominent neuroscientists, bioengineers, neurosurgeons, and radiologists to explore and discuss selected topics of neurosurgical investigation. This volume addresses recent advances in endovascular approaches to cerebral circulation, including: Surgical exposure of the superior ophthalmic vein in the management of carotid cavernous fistulas at Johns Hopkins; Current and future perspectives in interventional neuroradiology at New York University; Interventional neuroradiology; Principles of endovascular neurosurgery: N.N. Burdenko Neurosurgical Institute; Intravascular embolization of craniocerebral vascular diseases: Beijing Neurosurgical Institute; and more.

Over the past decade, techniques have been developed and implemented to observe metabolism noninvasively in localized regions of intact, living experimental animals and humans through the use of magnetic resonance spectroscopy (MRS). At the same time, magnetic resonance imaging (MRI) techniques developed in the 1970s and refined in this decade have been increasingly applied as a powerful clinical tool to probe human anatomy. Because of the unusual metabolic and physiologic characteristics of malignant tissues, oncology has been one of the primary focuses of the application of both MRS and MRI. Although considerable progress has been made in oncologic applications of magnetic resonance (MR), further research is needed to realize the full potential of MR in this area. Consequently, the 21st Annual Detroit Cancer Symposium entitled "Magnetic Resonance in Experimental and Clin ical Oncology" was organized to provide a forum for researchers in the field to report the state of the art of MRS and MRI in oncol ogy, to discuss future goals for MRS and MRI in oncology, and to define the research needed to meet those goals. The major emphasis of the symposium was on MRS due to both the recent widespread availability of clinical MRS instrumentation and the extensive amount of animal MRS research performed over the past half decade.

ThisbookcomprisesthescientificproceedingsoftheInternationalWorkshop onDigitalMammography(IWDM),heldinBremen,Germany,fromJune22 toJune25,2002. Sinceitsinceptionin1992,IWDMhasgrownintotheIn- ternationalForumonDigitalMammography. TheuniquenessofIWDMisits attractivenesstoresearchers,medicalpractitioners,andindustrialdevelopers. F6rmerworkshopswereheldinSanJose,USA(1992),York,UK(1994), Chicago,USA(1996),Nijmegen,NL(1998),andToronto,Canada(2000). Each ofthesescientificeventshasbeencombinedwithverysuccessfulandfocused industrialandresearchexhibits,whichdemonstratedthemilestonesofdigital mammographyhard-andsoftware. Now,thatdigitalmammographyisenteringroutineclinicaluse,wewitness itsstrongimpactonscreeninganddiagnosticmammography,computeraided detection,minimallyinvasiveprocedures,andthedevelopmentofsystemicand integrateddisease-orientedbreastcare. Inviewofthis,the2002workshoppro- videdawindowtogiveusaglanceatthefuture,andtheworkwhichwas presentedintalks,postersandexhibitshasdemonstratedthatIWDM2002will takeaspecialplaceintheverysuccessfulsequenceofIWDMevents. Finally,asconferencechair,Iwouldliketothankallwhohavehelpedtopre- pareandrunIWDM2002:theScientificAdvisoryBoardforitsexcellentworkin guaranteeingscientificsignificance,theOrganizationalBoardforitshardworkto accomplishanappropriateframeworkfortheevent,andtheindustrialexhibitors andsponsorsfortheirgeneroussupport. Bremen,January2003 Heinz-Otto Peitgen ConferenceChair ProfessorofMathematicsand BiomedicalSciences VI Scientific Committee SusanAstley UniversityofManchester,UK UlrichBick CharitBerlin,Germany/UniversityofChicago,USA MichaelBrady OxfordUniversity,UK HiroshiFujita GifuUniversity,Japan MaryellenGiger UniversityofChicago,USA NicoKarssemeijer UniversityHospitalNijmegen,TheNetherlands Heinz-OttoPeitgenUniversityofBremen,Germany EttaD. Pisano UniversityofNorthCarolina,USA MartinYaffe UniversityofToronto,Canada IWDM 2002 was supported by (MeViS SIEMENS BreastCare medical I' General Electric ARC-0 Fllmle. . Perfection for DI I JMammography Table of Contents Imaging Systems and Detectors...1 DigitalMammographicApplicationofaSinglePhotonCountingPixel Detector...3 Amendolia SR, Bisogni MG, Delogu P, Fantacci ME, Novelli M, Quattrocchi M, Rosso V, Stefanini A, Zucca S BreastCancerScreeningUsingaDedicatedBreastCTScanner:A FeasibilityStudy...6 Boone JM, Lindfors KK, Seibert JA, Nelson TR PhysicalEvaluationofaPrototypefortheSectraMicrodose MammographySystem...12 Lundqvist M, Bergstrom D, Cederstrom B, Chmill V, Chuntonov A, Danielsson M, Aslund M DoseMeasurementsonaScanningMulti-slitDigitalMammography System...17 Hansson B, Cederstrom B, Danielsson M, Aslund M DigitalMammographyvs. toScreen-FilmMammography:aPhantom Study...20 Heid P, PagliuchiC, Seradour B, Motte N, Langlois L, Kurkdjian S, Piana L MammographyTaxonomyforImprovementofLesionDetectionRates...27 Howard D, Roberts SC, Tabar L AHighResolution(25 p. m)HybridSelenium/CCDSlotScanDetector forDigitalMammography...33 Hunter DM, De CrescenzoG, Mainprize JG, Mawdsley GE, SmithC, Kasap SO, Rowlands JAR, Tumer T, Yin S, Yaffe MJ Co-registeredBreastImagingwith3DX-Raysand3DUltrasound...38 Kapur A, Eberhard JW, Abdalmajeid AM, Thomenius K ImagingCharacteristicsofaDirectConversionFull-FieldDigital MammographyDetectorusingSelenium...4 3 Lee DL, Yorker lG, ling Z, leromin LS SimultaneousAcquisitionofDiffraction,ScatteringandPhase-Contrast ImagesbyMeansofaMulti-LayerEdge-OnMicrostripDetector 48 Olivo A, Arfelli P, Bergamaschi A, Dreossi D, Longo R, Menk RH, Montanari F, Pani S, Poropat P, Rigon L, Vallazza E, Castelli E VIII FullFieldDigitalMammographywithaCCDBasedSlot-Scanned Detector. PhysicalCharacteristicsMeasurements...

Where do you begin to look for a recent, authoritative article on the diagnosis or management of a particular malignancy? The few general oncology text books are generally out of date. Single papers in specialized journals are informative but seldom comprehensive; these are more often preliminary reports on a very limited number of patients. Certain general journals frequently publish good in-depth reviews of cancer topics, and published symposium lectures are often the best overviews available. Unfortunately, these reviews and supplements appear sporadically, and the reader can never be sure when a topic of special interest will be covered. Cancer Treatment and Research is a series of authoritative volumes that aim to meet this need. It is an attempt to establish a critical mass of oncology literature covering virtually all oncology topics, revised frequently to keep the coverage up to date, and easily available on a single library shelf or by a single personal subscription. We have approached the problem in the following fashion: first, by dividing the oncology literature into specific subdivisions such as lung cancer, genitourinary cancer, pediatric oncology, etc.; and second, by asking eminent authorities in each of these areas to edit a volume on the specific topic on an annual or biannual basis. Each topic and tumor type is covered in a volume appearing frequently and predictably, discussing current diagnosis, staging, markers, all forms of treatment modalities, basic biology, and more."

"Progress in Medical Imaging" contains a collection of interdisciplinary reviews of subtopics in medical imaging written by internationally known experts. Topics contained in the book include automatic recognition of cells and tissue types in light microscopy, computerized manipulation and assembly of two-dimensional scans of an organ into images of the three-dimensional organ which can be rotated in space, techniques for reducing the image degradation produced by scattering radiation in chest radiography, recent advances in instrumentation, and principles of positron-emission tomography. The final chapters of this book describe the advantages of pseudo-random codes as transmitted signals for ultrasonic flow measurement, imaging, and medium characterization. The primary audience for "Progress in Medical Imaging" includes engineers, physicists, and students engaged in research, development, or applications of medical imaging.

This book shows how the various paradigms of computational intelligence, employed either singly or in combination, can produce an effective structure for obtaining often vital information from ECG signals. The text is self-contained, addressing concepts, methodology, algorithms, and case studies and applications, providing the reader with the necessary background augmented with step-by-step explanation of the more advanced concepts. It is structured in three parts: Part I covers the fundamental ideas of computational intelligence together with the relevant principles of data acquisition, morphology and use in diagnosis; Part II deals with techniques and models of computational intelligence that are suitable for signal processing; and, Part III details ECG system-diagnostic interpretation and knowledge acquisition architectures. Illustrative material includes: brief numerical experiments; and, detailed schemes, exercises and more advanced problems.

Radiophannaceutical research has recently undergone a major change in direction. In past years it has been concerned mainly with the development of perfusion tracers, the biodistribution of which reflect the regional blood flow to areas of major organs such as the heart and brain. However, a major new direction of interest now lies in the development of receptor-binding radio-tracers which can be used to perform in-vivo characterisation of diseased tissues and it is likely that much of the future research in this field will follow this direction. The difficulties in developing such tracers are considerable. The researcher must first identify a promising target for radiopharmaceutical development. High specific activity radioactive molecules must be designed and synthesised which will both bind to the target receptor with high affinity, and also have the physicochemical characteristics which will allow them to reach the target site in sufficient quantity while at the same time showing minimal uptake in non-target tissues. Thus the knowledge base required for radiophannaceutical development has now expanded beyond the limits of radiopharmaceutical chemistry to include aspects of biochemistry, molecular biology and conventional drug design. The portfolio of basic knowledge required to support current radiopharmaceutical development is changing and scientists working in this arena need to be trained in this regard. At the same time, the very latest developments in the field need to be communicated to the scientific community in order to stimulate the advancement of this exciting new direction of research.

Today, coronary artery disease is one of the major causes of mortality and morbidity in the Western World. In the last decade many major diagnostic and therapeutic advances have been made, considerably furthering our potential in the management of coronary artery disease. At the same time, a new generation of cardiac tools has appeared. The field which has, perhaps, undergone the most important technological innovations is echocardiography. Nowadays, in fact, the world of ultrasounds ofters the cardiologist a wide range of technical applicatons: two-dimensional real-time imaging, intra-and extra-cardiac Doppler flow measurements, real-time imaging of cardiac struc ture and flow by 2D color Doppler, high resolution cardiac imaging by transesophageal echocardiography, tissue characterization by analysis of ultrasound wave characteristics, information on myocardial perfusion by con trast echocardiography, etc. Thanks to these technical improvements and to its consequent increased potentiality, echocardiography now plays an impor tant and irreplaceable role in the management of all cardiac diseases. In the field of coronary artery disease, echocardiography can reliably be used not only in the acute phases of the disease to derive useful functional and prog nostic information but also as a stress diagnostic procedure (thanks to new stress modalities and the continuing improvement of reviewing digital sys tems) for the diagnosis of coronary artery disease and for the evaluation of various therapeutic interventions. Furthermore, other promising applications of ultrasounds in this disease are currently being investigated: tissue charac coronary artery anatomy terization, myocardial contrast echocardiography, and flow evaluation by specially-designed ultrasound catheters."

In 1992 the Editors published the first volume of Minimally Invasive Neurosurgery (MIN I) which described the current state of the art in this rapidly developing field of neurosurgery and reported first clinical experiences with these new technologies. The subject of MIN II is limited to endoscopic anatomy, technical devices and surgical management of disorders suitable for endoscopic procedures. The indications and approaches in different diseases are still highly preliminary and longterm results are not yet available. The clinical value and the benefit to the patients treated with these new techniques must still be proven against the well established standards of microsurgery. This volume presents a critical update of neuroendoscopy.