Radiation Toxicity: A Practical Guide provides insight into the management of day-to-day aspects of radiotherapy. Most radiation oncologists and radiation oncology nurses spend a large percentage of their time dealing with the effects of radiotherapy. This book describes the biology behind each sites acute and long-term responses to radiotherapy, including the best current knowledge regarding radiation tolerance, and fills a needed void in the literature that is available on radiation oncology.

AsanadditiontotheEuropeanpostgraduatetrainingsystemforyoung neurosurgeons, we began to publish in 1974 this series of Advancesand Technical Standards in Neurosurgery which was later sponsored by the EuropeanAssociationofNeurosurgicalSocieties. This series was ?rst discussed in 1972 at a combined meeting of the Italian and German Neurosurgical Societies in Taormina, the founding fathersoftheseriesbeingJeanBrihaye,BernardPertuiset,FritzLoewand HugoKrayenbuhl. ThuswereestablishedtheprinciplesofEuropean- operationwhich havebeenbornfromthe Europeanspirit,?ourishedin theEuropeanAssociation,andhavebeenassociatedthroughoutwiththis series. ThefactthattheEnglishlanguageisnowtheinternationalmediumfor communicationatEuropeanscienti?cconferencesisagreatassetinterms ofmutualunderstanding. Thereforewehavedecidedtopublishallcont- butionsinEnglish,regardlessofthenativelanguageoftheauthors. All contributions are submitted to the entire editorial board before publicationofanyvolumeforscrutinyandsuggestionsforrevision. Ourseriesisnotintendedtocompetewiththepublicationsoforiginal scienti?cpapersinotherneurosurgicaljournals. Ourintentionis,rather,to present?eldsofneurosurgeryandrelatedareasinwhichimportantrecent advanceshavebeenmade. Thecontributionsarewrittenbyspecialistsin thegiven?eldsandconstitutethe?rstpartofeachvolume. Inthesecondpartofeachvolume,wepublishdetaileddescriptionsof standardoperativeproceduresandindepthreviewsofestablishedkno- edge in all aspects of neurosurgery, furnished by experienced clinicians. This part is intended primarily to assist young neurosurgeons in their postgraduatetraining. However,weareconvincedthatitwillalsobeu- fultoexperienced,fullytrainedneurosurgeons. We hope therefore that surgeons not only in Europe, but also throughouttheworld,willpro?tbythisseriesofAdvancesandTechnical StandardsinNeurosurgery. TheEditors Contents ListofContributors...XIII Advances .. Gene Technology Based Therapies in the Brain. T. Wirth1,4 and S. Yla- Herttuala1,2,3, 1A. I. Virtanen Institute,University of Kuopio, Kuopio,F- land, 2DepartmentofMedicine,UniversityofKuopioandGeneTherapyUnit, Kuopio, Finland, 3Gene Therapy Unit, Kuopio University Hospital, Kuopio, Finland,4ArkTherapeuticsOy,Kuopio,Finland Abstract...3 IntroductiontoGeneTherapy:ThePast,PresentandFuture...4 PotentialAreasforGeneTherapyintheBrain...6 GeneTherapyforParkinson'sDisease...7 GeneTherapyforAlzheimer'sDisease...8 GeneTherapyforVascularBrainDiseases...9 GeneTherapyforBrainTumours...11 ChallengesofGeneTherapyintheBrain...12 GeneTransferVectors...15 ViralGeneTransferVectors...17 Retroviruses...17 HerpesSimplexVirus-1(HSV-1)...17 Adenoviruses...18 Adeno-AssociatedVirus(AAV's)...18 Non-ViralVectors...19 Ethics...20 ConcludingRemarks...21 Acknowledgement...21 References...21 VIII Contents TechnicalStandards AnatomyoftheOrbitanditsSurgicalApproach. G. Hayek,Ph. Mercier,and H. D. Fournier, Laboratory of Anatomy, Faculty of Medicine, University of Angers,Angers,France Abstract...35 Introduction...36 AnatomyoftheOrbit...36 TheOrbitalCavity...36 TheOrbitalFasciaorPeriorbita...38 OrbitalContents...39 OrbitalMuscles...40 TheArteriesoftheOrbit...42 VeinsoftheOrbit...47 NervesoftheOrbit...48 LacrymalGland...55 ApproachRoutestotheOrbit...56 Incision...56 TheLateralApproachRoute...57 OsteoplasticTechniques...58 Non-OsteoplasticTechniques...58 TheSuperiorApproachRoute...60 TheHybridLateral/SuperiorRoute...63 Discussion...

The most salient feature of the infor last four chapters of the book evaluate the mation provided by nuclear medicine is its information from an analytical and pathophysiological and functional charac statistical point of view. This approach is ter. For adequate experimental or clinical required for correct decision-making. interpretation, such information should This book is therefore the result of necessarily be interpreted alongside the accumulated experience in nuclear cardiology views of the clinical cardiologist, who is with the invaluable cooperation of medical able to apply it to the individual patient. statisticians. It is directed to physicians This approach, which is routine in every with an interest in nuclear cardiology, to day clinical practice, reaches its plenitude nuclear medicine specialists wishing to when the whole process is completed and learn the uses and limitations of these an intimate cooperation is established procedures in everyday clinical cardiology, between the nuclear medicine specialist and to cardiologists who feel the need to and the clinical cardiologist. In such understand the rationale and methodology instances, each one of these professionals of the studies which benefit their patients. understands the needs, limits and possi We understand that the ultimate reason bilities of the other. for any scientific book is the transmission The present book is the fruit of such of knowledge, and we are fully conscious cooperation. In our hospital, an efficient of the enthusiasm of the authors of the nuclear cardiology team has been made up present text to achieve that aim.

For more than a century, microscopy has been a centerpiece of extraordinary discoveries in biology. Along the way, remarkable imaging tools have been developed allowing scientists to dissect the complexity of cellular processes at the nano length molecular scales. Nanoimaging: Methods and Protocols presents a diverse collection of microscopy techniques and methodologies that provides guidance to successfully image cellular molecular complexes at nanometer spatial resolution. The book's four parts cover: (1) light microscopy techniques with a special emphasis on methods that go beyond the classic diffraction-limited imaging; (2) electron microscopy techniques for high-resolution imaging of molecules, cells and tissues, in both two and three dimensions; (3) scanning probe microscopy techniques for imaging and probing macromolecular complexes and membrane surface topography; and (4) complementary techniques on correlative microscopy, soft x-ray tomography and secondary ion mass spectrometry imaging. Written in the successful format of the Methods in Molecular Biology (TM) series, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step protocols, and notes on troubleshooting and avoiding known pitfalls. Authoritative and accessible, Nanoimaging: Methods and Protocols highlights many of the most exciting possibilities in microscopy for the investigation of biological structures at the nano length molecular scales.

The book introduces the fundamental aspects of digital imaging and covers four main themes: Ultrasound techniques and imaging applications, Magnetic resonance and MPJ in hospital, Digital imaging with X-rays, Emission tomography (PET and SPECT). Each of these topics is developed by analysing the underlying physics principles and their implementation, quality and safety aspects, clinical performance and recent advancements in the field. Some issues specific to the individual techniques are also treated, e.g. choice of radioisotopes or contrast agents, optimisation of data acquisition and storage, readout electronics, modelling and computer algorithms for imaging and measurement in ultrasounds and tomography applications.

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 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 are written by specialists in the given fields and constitute the first part of each volume.

This volume provides a comprehensive review of resistance induced by photodynamic therapy (PDT) in tumor cells. Understanding the underlying mechanisms in this process leads to the improvement of therapeutic modality, in combination with chemotherapy, immunotherapy, and radiotherapy. Photodynamic therapy is a minimally invasive therapeutic procedure that can exert a selective or preferential cytotoxic activity toward malignant cells. The procedure involves administration of an intrinsically non-toxic photosensitizing agent (PS) followed by irradiation at a wavelength corresponding to a visible absorption band of the sensitizer. In the presence of oxygen, a series of events lead to direct tumor cell death, damage to the microvasculature, and induction of a local inflammatory reaction. Studies reveal that PDT can be curative, particularly in early stage tumors and this volume explores the potential of PDT, but also reveals strategic approaches to overcome resistance in tumor cells.

AMI E. ISKANDRIAN & ERNST E. VAN DER WALL The first edition of this book was published in 1994. Since then important advances have occurred in the field of myocardial viability. This, coupled with increasing interest by the scientific community in the broader issues of its relevance to patient care, suggested to us the need to write the second edition. We are most fortunate to have the help of a distinguished group of experts who have helped shape the field; we appreciate their commitments and contributions. Almost all chapters have been radically modified. Chapter 1 deals with pathophysiology of myocardial hibernation and stunning; Chapter 2 with apoptosis; Chapter 3 with the role of positron emission tomography; Chapters 4 and 5 with the role of single photon emission computed tomography with thallium-201 and technetium agents, respectively; Chapter 6 with the role of SPECT fatty acid imaging; Chapter 7 with the role of SPECT FDG imaging; Chapter 8 with the role of cardiac catheterization angiography; Chapter 9 with the role of echocardiography; Chapter 10 with the role of magnetic resonance imaging; and Chapter 11 with clinical applications. Finally, Chapter 12 provides a short summary.

This book offers a review of the normal histopathological anatomy, imaging techniques and diagnostic findings for a broad spectrum of clinical problems. It includes a classification of inflammatory syndromes previously described under several different terms. It is the first textbook to describe the imaging of all anterior chest wall disorders.

Final FRCR Viva: 100 Cases and Revision Notes provides an invaluable collection of high quality cases to enable radiological trainees to fully prepare for the FRCR Part B Viva exam. Focussing solely on providing the knowledge necessary to pass one of the toughest exam components, 100 common viva topics are presented, each one accompanied by model answers and tips on how to discuss the case in question. Contains 100 typical exam cases, with accompanying scripts (model answers) and relevant key points Model answers enhanced with concise revision notes Highly illustrated with images and diagrams to aid understanding of differential diagnoses Authors include experienced consultant radiologists involved in FRCR training

Some 25 years ago, the coronary care unit concentrated high technology and the acutely ill patients who might benefit from it in a single, recognizable space. Since then, that space and its technical equipment have changed, as has part of its population. Acute ischemia, silent and manifest, occurs within and outside of the coronary care unit as pain, arrhythmia, or pump failure. Its detection and treatment require the utilization of many diagnostic techniques and skills, not the least of which is two-dimensional Doppler echocardio graphy, which is gaining importance. Future developments, in tandem with computer technology, may add to this importance by enabling tissue identification, spatial representation, and Doppler flow mapping. This book describes the state of the art for the practicing clinician using Doppler echocardi?graphy at the bedside of patients with acute ischemic manifestations of coronary heart disease. The first requirement is to move from the echo laboratory to the coronary care unit, emergency department, operating room, or catheterization laboratory, using equipment suited for that purpose. The second, more trying imperative is to secure good cooper Ition between those treating the acutely ill patient and the investigator who interferes with his probes. If successful ceeding in both, rewarding results can be obtained, since echocardiography is a very sensitive and specific tool for recognizing and quantifying early ischemia.

A comprehensive description of macroscopic, microscopic, and radiological methods for the diagnosis of bone diseases. The book presents all the procedures involved in diagnosis, using not only radiological and histological techniques, but also modern immunohistochemical and scintigraphic methods. Succinct and well-structured therapeutic recommendations are provided for an array of bone diseases, making this a practice-oriented reference work for pathologists, radiologists, rheumatologists, and orthopedists.

Quantitative coronary angiography has become an invaluable tool for the interventional cardiologist, providing objective and reproducible measurements of coronary artery dimensions, which can be used to study progression or regression of coronary atherosclerosis, as well as the immediate and long term effects of percutaneous interventions. Until recently, this powerful imaging technology was confined to a small number of so-called high level institutions. Fortunately, with the development of digital cardiac imaging equipment and adaptation of cine-angiographically based computer software for on-line use in the catheterization room, quantitative coronary angiography is now available to all interventionalists. This book is a timely guide for the impending QCA user, providing practical as well as theoretical and scientific information. A comprehensive evaluation of the clinical usefulness of QCA is covered, from the fundamental principles through experimental validation studies, application to clinical trials of a wide range of pharmacological and interventional therapies in the full spectrum of clinical presentation of coronary disease syndromes, evaluation of the therapeutic efficacy of various new devices for coronary intervention, together with extensive presentation of its physiological, functional and anatomical correlations, by comparison with other intracoronary measurement and imaging techniques. In addition, evolving theories and concepts in the ever topical restenosis phenomenon' after percutaneous intervention, based on serial QCA studies, are presented and discussed and a potentially unifying methodological approach to further study of this ubiquitous problem is offered. Thisbook, thanks to the collaboration of many experts in the field of intracoronary imaging and measurement, provides stimulating, interesting and practical information, both for the academic scientist and practising clinician.

The advances in neuroimaging technologies have led to substantial progress in understanding the neural mechanisms of cognitive functions. Thinking and reasoning have only recently been addressed by using neuroimaging techniques. The present book comprehensively explores current approaches and contributions to understanding the neural mechanisms of thinking in a concise and readable manner. It provides an insight into the state of the art and the potentials, but also the limitations of current neuroimaging methods for studying cognitive functions. The book will be a valuable companion for everyone interested in one of the most fascinating topics of cognitive neuroscience.

This book provides an up-to-date comprehensive overview of the exciting new developments shaping the current and future practice of radiation oncology. Advances in treatment planning and delivery, in biological targeted therapies combined with radiation and in functional and molecular imaging are all covered in a single volume. All of these advances are discussed by leading experts in the field and with a critical evaluation of their clinical relevance throughout.

Magnetic Resonance Image Reconstruction: Theory, Methods and Applications presents the fundamental concepts of MR image reconstruction, including its formulation as an inverse problem, as well as the most common models and optimization methods for reconstructing MR images. The book discusses approaches for specific applications such as non-Cartesian imaging, under sampled reconstruction, motion correction, dynamic imaging and quantitative MRI. This unique resource is suitable for physicists, engineers, technologists and clinicians with an interest in medical image reconstruction and MRI.

A widely used, classroom-tested text, Applied Medical Image Processing: A Basic Course delivers an ideal introduction to image processing in medicine, emphasizing the clinical relevance and special requirements of the field. Avoiding excessive mathematical formalisms, the book presents key principles by implementing algorithms from scratch and using simple MATLAB (R)/Octave scripts with image data and illustrations on downloadable resources or companion website. Organized as a complete textbook, it provides an overview of the physics of medical image processing and discusses image formats and data storage, intensity transforms, filtering of images and applications of the Fourier transform, three-dimensional spatial transforms, volume rendering, image registration, and tomographic reconstruction. This Second Edition of the bestseller: Contains two brand-new chapters on clinical applications and image-guided therapy Devotes more attention to the subject of color space Includes additional examples from radiology, internal medicine, surgery, and radiation therapy Incorporates freely available programs in the public domain (e.g., GIMP, 3DSlicer, and ImageJ) when applicable Beneficial to students of medical physics, biomedical engineering, computer science, applied mathematics, and related fields, as well as medical physicists, radiographers, radiologists, and other professionals, Applied Medical Image Processing: A Basic Course, Second Edition is fully updated and expanded to ensure a perfect blend of theory and practice.

A practical guide to radiation safety

Many health and scientific professionals require a basic understanding of radiological safety principles, even and especially if they are not specialists in radiological health. Principles of Radiological Health and Safety is designed for this purpose as well as a resource for safety personnel who also handle radiation safety duties. It is a text of basic concepts needed in broad-based protection programs, with real-world examples and practice problems to demonstrate principles and hone skills.

Resource data for practical problems in radiation protection are provided along with illustrative examples of their use. For example, modes and energies of radioactive transformation, radiation attenuation and absorption, dose coefficients, and environmental transport parameters are included for many of the common circumstances encountered in laboratory and industrial settings. these are cross referenced to standard compendiums for straightforward use when more in-depth listings need to be consulted. Other topics include:

• Atom structure and radioactivity
• Radiation protection standards and programs
• Radiation interactions and dose
• Environmental radiological assessment
• Radiation shielding
• Radon
• Internal radiation dosimetry
• Radioactive waste

Safety professionals as well as students and teachers will find Principles of Radiological Health and Safety to be an invaluable addition to their professional and academic libraries.

Photodynamic Therapy: From Theory to Application brings attention to an exceptional treatment strategy, which until now has not achieved the recognition and breadth of applications it deserves. The authors, all experts and pioneers in their field, discuss the history and basic principles of PDT, as well as the fundamentals of the theory, methods, and instrumentation of clinical diagnosis and treatment of cancer. Non-oncological applications such as the use of PDT in control of parasites and noxious insects are also discussed. This book serves as a standard reference for researchers and students at all levels, clinical specialists interested in the topic and those in industry exploring new areas for development. A comprehensive exposition of both the theory and application of PDT, this book fills the gaps in the current literature by bringing together both basic understanding of the process of PDT and an expanded vision of its applications.

This atlas comprises a complete and extensive exposure of the spatial and temporal aspects of human cardiac development as seen with scanning electron microscopy. Apart from serving as a unique overview on cardiac development in the human embryo, this atlas gives an updated morphological reference of cardiac embryology for topographic correlation and enables the projection of experimental results in animals to the human situation.

The spectrum of occupational and environmental diseases has changed markedly in recent years. New industrial processes have led to the production and use of a wide range of chemicals, metals, and alloys, an increasing number of which have been reported to cause interstitial lung disease in exposed workers. Thus, while the workforce in coal mining and asbestos handling has decreased, new groups of workers are at risk of exposure to agents potentially responsible for pneumoconiosis. This well-illustrated book, written by internationally acclaimed experts, provides a comprehensive approach to modern imaging of environmental and occupational diseases of the chest. The first part of the book addresses the basic knowledge required to understand imaging in this context, while the second focuses on the imaging results achieved in a variety of specific disorders. There is particular emphasis on thin-section computed tomography since this technique facilitates the detection of early subclinical abnormalities.

"Decision Making in Radiation Oncology" is a reference book designed to enable radiation oncologists, including those in training, to make diagnostic and treatment decisions effectively and efficiently. The design is based on the belief that a picture is worth a thousand words. Knowledge is conveyed through an illustrative approach using algorithms, schemas, graphics, and tables. Detailed guidelines are provided for multidisciplinary cancer management and radiation therapy techniques. In addition to the attention-riveting algorithms for diagnosis and treatment, strategies for the management of disease at individual stages are detailed for all the commonly diagnosed malignancies. Clinical trials that have yielded gold standard treatment and their results are documented in the schemas. Moreover, radiation techniques, including treatment planning and delivery, are presented in an illustrative way. This groundbreaking publication is an essential tool for physicians in their daily clinical practice."

The first edition of this definitive text ran to 24 chapters. The second edition, reflecting the explosive growth of interest in echo-enhancement, contains 44. The first section deals with some of the most important emerging issues and technologies and covers harmonic imaging, the use of echo-enhancers to provide quantitative information, and the application of enhanced power Doppler to tissue imaging. The second, on contrast echocardiography, explores the use of echo-enhancement during transesophageal imaging. One chapter describes the use of contrast-enhancement transesophageal imaging to determine coronary flow reserve and another gives a detailed account of the application of the technique to the evaluation of left ventricular function. Other authors describe the intraoperative use of contrast echocardiography and discuss the potential of myocardial contrast echocardiography to replace thallium scintigraphy. Another chapter covers the emerging technique of transient response imaging and its role in the assessment of myocardial perfusion, and two chapters are devoted to three-dimensional contrast echocardiographic assessment of myocardial perfusion. Use of echo-enhancement in the evaluation of peripheral circulation is discussed in chapters on carotid and peripheral arterial flow imaging and others that describe renal and hepatic vascular imaging. The newer applications of echo-enhancement outside the cardiovascular system are described in three chapters devoted to the visualization of tumour vasculature. The final chapters look to the future and cover the imaging of intramyocardial vasculature, the development of site-specific agents and the emergence of the new acoustically active agents.

This third edition is a simulator for your clinical mind and exclusively designed to give you the final edge over intense competition. The book is a compilation of all the possible clinical scenarios which have been asked in various examinations and may be repeated in the future. This book provides a comprehensive and easy-to-grasp insight into the world of image-based questions. The new pattern of examination has loads of image-based MCQs, creating an unpredictable atmosphere and doubts in even the best of brains. This compilation is dedicated to all those young inquisitive minds, who have endured all the long study hours, feeling of despair and finally, relief when the results are out.