An unprecedented glimpse into the multidimensional learning processes that take place when novice professionals develop the necessary communication skills for effective task accomplishment. This analysis of authentic patient consultations by pharmacy interns is a significant contribution to research on health communication training.

The International Life Sciences Institute (ILSI), a nonprofit, public foundation, was established in 1978 to advance the sciences of nutrition, toxicology, and food safety. ILSI promotes the resolution of health and safety issues in these areas by sponsoring research, conferences, publications, and educational programs. Through ILSI's programs, scientists from government, academia, and industry unite their efforts to resolve issues of critical importance to the public. As part of its commitment to understanding and resolving health and safety issues, ILSI is pleased to sponsor this series of monographs that consolidates new scientific knowledge, defines research needs, and provides a background for the effective application of scientific advances in toxicology and food safety. Alex Malaspina President International Life Sciences Institute Contents Series Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . xiii . . . . . . . . . . . . . Part I. Integrative Approach to Assessing Human Health Risk: Two Contemporary Problems Chapter 1. Integrating Diverse Data Sets to Assess the Risks of Airborne Pollutants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 R.o. McClellan, R.G. Cuddihy, w.e. Griffith, and J. L. Mauderly Chapter 2. Risk Assessment for Radon Inhalation Based on Animal Exposure Data and Human Epidemiology . . . . . . . 23 . F. Steinhausler Part II. Types of Evidence: General Strengths and Weaknesses Section 1. Epidemiological Chapter 3. Inhalation Hazards: The Interpretation of Epidemiologic Evidence. . . . . . . . . . . . . . . . . . . . 39 . . . . . . . J.e. Bailar Chapter 4. Problems in Interpreting Epidemiological Data 49 P.N. Lee Section 2. Animal Chapter 5. Rodent Carcinogenicity Studies: Their Value and Limitations. . . . . . . . . . . . . . . . . . . . . . . . . . 61 . . . . . . . . . .

Plants are a major source of medicines, flavors, fragrances, and various pharmaceutical and industrial products. Biotechnology is being put to the service for mass clonal propagation of plants, and to produce impor- tant secondary products in cell cultures. In some cases cell cultures ac- cumulate higher amounts of products than the intact plant cells in situ, and such cultures can be stored through immobilization and cryopreser- vation. An in vitro-produced anti-inflammatory drug, shikonin, has been commercialized, and the recent observations on the increased pro- duction of atropine and hyoscyamine by Agrobacterium rhizogenes- mediated transformed "hairy roots" have encouraged the acceptance of such biotechnologies by the pharmaceutical industry. In an earlier volume, Medicinal and Aromatic Plants I, various aspects of in-vitro culture of cells, bioreactors, micropropagation, im- mobilization, and cryopreservation were discussed. The present volume concerns the application of these biotechnologies to 29 genera of medicinal and aromatic plants. It deals with the distribution, economic importance, conventional propagation, micro propagation, review of tissue culture studies, and the in-vitro production of important medicinal and pharmaceutical compounds in various species of Angelica, Anisodus, Basel/a, Bupleurum, Camellia, Co ix, Coptis, Cryp- tomeria, Datura, Dioscorea, Foeniculum, Gardenia, Geigeria, Heimia, Humulus, Hyoscyamus, Jasminum, Macleaya, Mucuna, Nicotiana, Pimpinel/a, Rauwolfia, Ruta, Salvia, So/anum, Saponaria, Stevia, Tabernaemontana, and Zingiber. The potential role of biotechnology for industrial production is discussed. Biotechnology enables the production and isolation of products of higher purity and also opens the possibility of making desired molecular alterations in products.

Ten years have elapsed since the publication in 1978 of Vol. 49 of the Handbook of Experimental Pharmacology [41], a toOO-page survey of the data then available on Ergot Alkaloids and Related Compounds. A booklet published in 1979 presented the in formation on one of these compounds, namely co-dergocrine (Hydergine@), as extracted from the Handbook and updated to take the latest developments into account [42]. Co-dergocrine had at the time been on the market for 30 years and had given rise to over 2000 papers, so that one might have felt justified in thinking that its scientific history had virtually come to an end. It has now become obvious that such a view would have been wide of the mark. Research on the pharmacology and clinical pharmacology of co-dergocrine has remained as active as ever. The resulting obsolescence of the 1979 booklet made necessary the preparation of the present version. Like its predecessor, it is intended as an inventory of findings and facts rather than a work dealing with their interpretation.

I have been privileged to witness and participate in the great growth of knowledge on chemical carcinogenesis and mutagenesis since 1939 when I entered graduate school in biochemistry at the University of Wisconsin Madison. I immediately started to work with the carcinogenic aminoazo dyes un der the direction of Professor CARL BAUMANN. In 1942 I joined a fellow graduate student, ELIZABETH CA VERT, in marriage and we soon commenced a joyous part nership in research on chemical carcinogenesis at the McArdle Laboratory for Cancer Research in the University of Wisconsin Medical School in Madison. This collaboration lasted 45 years. I am very grateful that this volume is dedi cated to the memory of Elizabeth. The important and varied topics that are reviewed here attest to the continued growth of the fields of chemical car cinogenesis and mutagenesis, including their recent and fruitful union with viral oncology. I feel very optimistic about the application of knowledge in these fields to the eventual solution of numerous problems, including the detection and estimation of the risks to humans of environmental chemical carcinogens and re lated factors.

This publication comprises the reports presented at the Symposium on the Treatmenr of Burns, held in Prague on September 13-15, 1973 by the Czech Society of Plastic Surgeons under the auspices of the ISBI on the occasion of the 20th anniversary of the foundation of the Prague Burns Unit. The program of the symposium was confined to four topics which under the present state of burn treatment represent the basic range of clinical problems. They are: surgery of the burn wound, anaesthesiology and resuscitation, septicaemia and complications of the burn illness. Most of the reports presented at the Symposium are printed in this book in full, as they were submitted by the authors. Only in some cases were the editors obliged to make minor formal adjustments in the interest of the earliest possible publication of the book. We hope that, after careful study, this publication will arouse the interest of further specialists in such an intricate field as is the treatment of burns and that it will stimulate all those concerned to further work. We should like to thank all those who facilitated the publication of this book by their participation in the Symposium and by their co-operation. The Editors Welcoming Address of the President of the Symposium On behalf of the organizing committee I would like to welcome all participants in this symposium."

Volume 47 of "Progress in Drug Research" contains eight reviews and the various indexes which facilitate its use and establish the connection with the previous volumes. The articles in this volume deal with inotropic steroids, with chemokines and their involvement in a wide range of inflam matory diseases, with the subclassification and nomenclature of ul- and Uz-adrenoceptors, with Chinese traditional medicine, with drug targets in the molecular pathogenesis of asthma, with cytokines and their therapeutic application in immunosuppression and immunostimulation, with alter native medicine and with the potential use of calcium blockers in psy chiatry. These reviews and the quotations of original articles provide the reader with valuable information on several new developments in the world-wide search for new and better medicines. In 1959, when the Editor started this series of monographs, it was his intention to help disseminate informa tion on the vast and fast growing domain of drug research. Already at that time, it was not possible to follow the major individual publications in this field, and the reader was thereby provided with a tool to keep abreast of the latest developments and trends. This goal remained unchanged over the last 37 years, and I believe that the reviews in PDR are useful to the non-specialist who can obtain an overview of a particular field of drug research in a relatively short time."

This volume places more emphasis on endogenous mediators of gut motility than on drugs used to treat patients with deranged motility. In this respect it resembles most other books on gastroenterology, for while only a relatively small number of drugs are really useful for a rational therapy, a tremendous amount of data is available on neural and hormonal factors regulating the motility of the alimentary canal. Moreover, it must be considered that some of the drugs which can routinely be employed to modify deranged motility of the digestive system are represented by pure or slightly modified endogenous compounds (e. g. , cholecystokinin, its C terminal octapeptide and caerulein), and it is easy to foresee that their number is destined to increase in the near future. Other drugs are simply antagonists of physiological substances acting on specific receptors (e. g. , histamine H -blockers 2 and opioid compounds). The real explosion of research in this field and the extreme specialization often connected with the use of very sophisticated techniques and methodologies would probably have required a larger number of experts to cover some very specific fields from both an anatomical (lower esophageal sphincter, stomach, pylorus, small and large intestine) and a biochemical (hormones, candidate hormones, locally active substances, neurotransmitters etc. ) point of view.

Traditional Chinese medicine has been used for thousands of years by a large population. It is currently still serving many of the health needs of the Chinese people; and still enjoying their confi dence it is practised in China in parallel with modern Western medical treatment. In addition to scientific organisations dedi cated to modern Western medicine, e. g. the Chinese Academy of Medical Sciences and various medical schools, a series of parallel institutions have been established in China to promote traditional Chinese medicine, such as the Academy of Traditional Chinese Medicine and training institutions. Almost all hospitals in China have a department of traditional medicine. Furthermore, a large number of scientific journals are dedicated to traditional Chinese medicine, covering both experimental and clinical investigations. Medicinal materials constitute a key topic in the treatment of disease according to traditional Chinese medicine. The Chinese Pharmacopoeia (1985 edition) is therefore divided into two sepa rate volumes, Volume I containing traditional Chinese medicinal materials and preparations and Volume II containing pharmaceu tics of Western medicine. The oldest Chinese review of medicinal materials, Shennong Bencao Jing (100-200 A. D. ), covered 365 herbal drugs. The clas sic compilation in this field, Bencao Gangmu (Compendium of Materia Medica), was published in 1578 by Li Shi-zhen and recorded as many as 1898 crude drugs of plant, animal and min eral origin."

Die Entdeckung bzw. Wiederentdeckung der blutzuckersenkenden Wirkung von Sulfonylharnstoffen im Jahre 1955 durch FRANKE und FUCHS hat die For- schung sowohl uber die Physiologie der Langerhansschen Inseln als auch uber den Kohlenhydratstoffwechsel sehr angeregt. Nachdem es wahrscheinlich wurde, dass Substanzen aus der Gruppe der Sulfonylharnstoffe die Sekretion von Insulin stimulieren, wurden verschiedene Methoden zur Bestimmung von Insulin im Blut entwickelt, die wegweisend fur empfindliche Methoden zur Bestimmung anderer Peptidhormone waren, und die elektronenmikroskopischen Beobachtungen der Vorgange bei der Sekretion von Insulin aus den B-Zellen wurden zum Modell fur die Vorstellungen uber die Funktion anderer Drusen. Es gibt viele Substanzen, die die Insulin-Sekretion aus den B-Zellen beeinflus- sen, die Zucker Glucose und Mannose, die Aminosauren Arginin und Leucin, ver- schiedene kurzkettige Fettsauren, verschiedene Metaboliten des intermediaren Stoffwechsels und Hormone, wie Glucagon, Corticotropin, Secretin, Gastrin, Pankreozym und verschiedene andere. In diesem Band sollten die therapeutisch interessanten Pharmaka abgehandelt werden, zu denen vor allem die Gruppen der Sulfonylharnstoffe bzw. Sulfonamide und der Biguanide gehoren. Auf die Geschichte der Verwendung von Biguaniden zur Behandlung von Diabetikern geht BECKMANN in seinem Artikel ausfuhrlich ein, so dass sich eine Darstellung hier erubrigt. Die blutzuckersenkenden Sulfonylharnstoffe wurden 1955 sozusagen durch eine klinische Zufallsbeobachtung mit Carbutamid wieder entdeckt und fur die Therapie zuganglich gemacht, nachdem LOUBATIERES sich mit der Wirkung ahnlicher Substanzen auf den Blutzucker und auf die Langerhans'schen Inseln bereits seit Anfang der 40er Jahre ausfuhrlich experimentell beschaftigt und bereits prinzipielle Aussagen uber den Wirkungsmechanismus gemacht hatte, die auch heute noch weitgehend akzeptiert werden.

The landmark description by Delay and Deniker in 1952 of chlorpromazine's effect in psychosis suddenly eclipsed all other progress in psychopharmacology over the previous centuries. Since this report 35 years ago, a vast amount of research has contributed to the major advances in treatment that have improved the lives of millions of patients who would otherwise be incapacitated by their psychiatric disorders. This research has also led to valuable new insights into the causes of mental illnesses and the mechanisms of action of therapeutic drugs. However, there is much more work to be done. Thus, it is of great value periodically to assess the present state of knowledge as a first step to charting future directions. This symposium held in Denmark in 1987 covered many critical issues in psychopharmacology. The etiology, pathogenetic mechanisms, clinical aspects, and future directions of research in schizophrenia, affective disorders, anxiety, and dementia are addressed. Several of the problems with current therapeutic agents, such as side effects and limited efficacy, are also reviewed. Preclinical strategies with existing and new animal and computer models are discussed to point the way for developing better psychopharmacologic treatments of all psychiatric disorders.

Understanding the molecular basis of complex biological processes has been a major goal of biological chemistry from early on. Inflammation is one such entity, and recent years have seen exciting progress in the under- standing of molecular interactions; there has been a long way from dolor, rubor, calor, and tumor as a fundamental description of the phenomenon to current knowledge, e.g., on the control of the respiratory burst of the granulocyte, the atomic details of protease regulation, or the interaction of cytokines. We were glad to have been given the opportunity by the Gesellschaft fUr Biologische Chemie to call upon experts in this bustling field of research for this Colloquium. The sessions were organized in the order of increasing complexity, starting with the key phenomena of the inflamma- tory response and its modulation by cytokines to intravascular events and shock and sepsis; thus, the current attempts to apply basic knowledge on mediators of inflammation to the clinical situation were also considered. In-depth chapters presenting the state of the art in these areas are collected in this book, and we thank the authors for their efforts. We also thank the Chairmen of the sessions, Profs. C. Sorg (Munster), D. Roos (Amsterdam), S. Bhakdi (Mainz), H. J. Muller-Eberhard (Hamburg), H. G. Schwick (Marburg), K. Resch (Hannover), W. Schaper (Bad Nauheim), D. Keppler (Heidelberg), and O. Trentz (Zurich) for their input, and it is a great pleasure to acknowledge the support by Drs.

Roots of the theory and practice of ocular pharmacology may be traced to the ancient Mesopotamian code of Hammurabi and then to several papyri reflecting the clinical interests of the Egyptians. The evolution of its art and science was irregularly paced until the nineteenth century when Kohler, in 1884, proved the anesthetic effect of cocaine on the cornea, and when Fraser, Laquer, Schmiedeberg, Meyer, and others studied the pharmacology of the autonomic nervous system by way of observations of the pupil. Advances in the past few decades have been nothing short of explosive. How can the student, physician, or basic research scientist stay in touch with these electrifying studies? To help with the answer to this question, the authors set as their goal the development of increased understanding so that the student, research scientist, and ophthalmologist can cope with the latest discoveries. The authors want to narrow what appears to be an ever-increasing gap between basic science and ophthalmology. The basic aspects of pharmacology have been presented in light of the natural physiology. In this regard, while distinctions among endogenous mechanisms, drug effects, and the pathogenesis of disease are to be separately recognized, appreciation must be given to the concept that both the desirable and unwanted manifestations or functions caused by either disease or drugs must very often represent a quantitative change in normal metabolic pathways.

The major cause of death in the Western world is some form of vascular disease; and principal among these forms is atherosclerotic heart disease (ASHD). Although much is known about the etiology and treatment of ASHD, there is, as yet, no specific means of prognosis of an impending coronary episode. There are, however, several indications of susceptibility to coronary disease, generally known as risk factors, the foremost of which is hyperlipidemia. Hyperlipidemia is more commonly designated as hypercholesteremia or triglyceridemia, depending upon which moiety is elevated, but since lipids are transported in the blood as members of a lipoprotein complex, the most descriptive general term would be hyperlipoproteinemia. This volume represents an effort to elucidate the origins and metabolic behavior of lipoproteins and their components, to describe aspects of the morphology, biochemistry and experimental induction of ASHD, and to describe modalities of treatment. The contributions to this book include descriptions of cholesterol synthesis and metabolism, as well as the metabolism of bile acids, the principal products of cholesterol metabolism. There are also chapters on the mechanisms of hyperlipidemia and on lipoprotein metabolism. The induction of experimental atherosclerosis and the aortic structural changes caused by this disease are discussed.

Autoimmune diseases are common and often associated with considerable morbidity or - in diseases such as IDDM, myasthenia gravis and multiple sclerosis - mortality. In this volume, experts of international stature in basic science and clinical medicine with a common interest in understanding the normal and aberrant immune response present their experiences. It was their intention to fur- ther the understanding of potential clinical application of scientific observations and to help to comprehend the huge amount of results in autoimmunity research.

This work is the first monograph devoted solely to "Bombax ceiba," popularly known as the Red Silk Cotton Tree. Consisting of seven chapters, it covers all relevant aspects of this plant, from its historical and spiritual importance, to its botanical characterization, pharmacognostical details and ethnobiological uses, to its scientific validation in various animal and human studies. Each part of the tree is of medicinal value and possesses many novel chemical constituents such as shamimicin, bombasin, bombamalone, bombamaloside etc. along with other bioactive secondary metabolites. The book presents the chemical structures of the most important constituents and highlights various pharmacological activities, predominantly antioxidant, anti-inflammatory, anti-mutagenic, hypoglycemic, hypotensive, hepatoprotective and fibrinolytic, which may prove to be a source for the development of a novel phyto-pharmaceutical agent to treat diabetes, heart disease and cancer. In addition, separate chapters deal with the commercial and ecological significance of "B. ceiba," as well as a case study on its conservation. Numerous color illustrations are included to identify the plant and to justify its nickname, the Little Bird s Cafeteria . "

Natural product chemistry has undergone an explosive growth during the latter half of the current century. This has been brought about by a number of factors. One of these has been the growing number of sub stances from natural sources which display interesting pharmacological activities. These include antibiotics, anti-tumor agents, immunostimu lants, drugs affecting the cardiovascular and central nervous systems, analgesics etc. Another factor has been the improvements made in the technology of isolation processes which includes the development of such techniques as high pressure liquid chromatography which has al lowed the rapid isolation of substances which were previously diffi cult to obtain by classical procedures. The most important factor has been the development of new spectrosopic techniques which have opened up whole new vistas in this exciting field. Prominent in these advan ces has been the advent of powerful superconducting magnets with very stable magnetic fields, and pulse NMR in which the duration, direction and phases of pulses can be accurately controlled by means of mini computers. These have heralded the advent of two-dimensional NMR spec troscopy which has now come to be routinely employed in unravelling complex structures. No less important, though somewhat less dramatic, have been the advances made in the field of mass spectroscopy where new ionization techniques such as positive and negative fast atom bom bardment, field desorption, chemical ionization etc. have allowed the mass spectra of larger non-volatile substances to be recorded. The field of organic synthesis has seen equally rapid advances."

Calcium Entry Blockers (CEBs) are a new class of drugs which have been pushing back the frontiers of science and medicine for almost two decades. This report reviews some of the wealth of chemical, biological and clinical data describing the discovery and development of these compounds. The scientific importance, therapeutic benefit and marketing potential of these compounds have caused an explosion of scientific literature describing their effects in many preclinical and clinical settings. The definitional characteristics of these compounds suggest a certain predictability of their biological profile but their therapeutic usefulness varies widely dependent upon their physical properties, net hemodynamic effects, duration of action and incidence of side effects. CEBs appear uniquely suited to the treatment of the underlying complexity of cardiovascular disease. The CEBs of the future may live up to the expectations of pathophysiologically based therapeutics and allow the heart and blood vessels to outlive the cells which they support. The development of CEBs is an evolving story of epic proportions and represents the cooperative efforts of individuals in all areas of science.

More than a year ago the three editors sat down at a table and worked out a set of six chapter headings which they believed might serve, in turn, for each of the three sections of this handbook. (The reader will note a similarity in order of presentation and in emphasis.) However, as our editorial plans progressed it became apparent that for each element and for the element group, there were one or two special topics appropiate for that section alone. Accordingly, in the section on uranium the common pattern holds for Chaps. 1 through 6 which include: an introduction (Chap. 1), a discussion of the physical and chemical properties (Chap. 2), experimental data on animals (Chap. 3), ex perimental data on man (Chap. 4), the rationale and development of air con centration limits to control industrial worker exposure (Chap. 5), and the prac tical problems of applying such limits in the uranium industry (Chap. 6). Chap. 7 entitled "Uranium Mining Hazards" is the subject category which is special for uranium; the chapter brings up to date the account of an important occupational hazard which was first noted by GEORGIUS AGRICOLA (1490-1555)."

Cyclic nucleotides are intimately involved in the consequences of either stimulation or blockade of receptors; therefore, an understanding of the biochemistry of cyclic nucleotides ought to be important for pharmacologists. Pharmacology is a science that among other things investigates chemical compounds that affect the physiology of cells, tissues and organs. Frequently pharmacologists account for the effect of low concentrations of a drug upon a tissue by invoking the presence of a receptor upon the surface of the cell. Traditional pharmacologists excelled at identifying and classifying the properties of receptors. A. J. CLARK'S monograph in the earlier series of the Handbook of Experimental Pharmacology (CLARK 1937) summarized the mathematics underlying the traditional pharmacological approach towards receptors. By its nature, however, classic pharmacology provided little useful information about the intracellular events occurring as a consequence of occupying a receptor; for example, ALQUIST (1948) identified the beta-adrenocep tor, but he did not provide any insight into how stimulation of the receptor produces tissue-specific physiological responses. The discovery of cyclic AMP by RALL and SUTHERLAND (see RALL, Vol. I) led to biochemical investigations of many different receptors (including ALQUIST'S beta-adrenoceptor) that share a cyclic nucleotide as a common factor in the biochemical mechanisms that translate the occupancy of receptors into physiological effects. Ten years ago, in the introduction to their monograph on cyclic nucleotides, ROBISON et al. (1971) commented on the rapid growth of interest in cyclic nucleotides over the preceding years."

Beta-Rezeptorenblocker sind aus dem therapeutischen Arsenal zur Be- hand lung zahlreicher Erkrankungen nicht mehr wegzudenken. Die Be- miihung urn eine prazisere differentialtherapeutische Anwendung dieser Pharmaka-Gruppe, einschlie13lich der Erarbeitung von Dosierungsvor- schlagen und der Erkennung von therapeutischen Alternativen im Hin- blick auf Nebenwirkungen und Kontraindikationen, fUhrte eine Viel- zahl von Referenten aus dem In- und Ausland (U.S.A., England, Schweiz, Schweden) zu einem Symposion im November 1980 zusam- men. Mit dem Ziel, die praktische Anwendung von Beta-Rezeptorenblok- kern verstandlicher zu mach en und die therapeutische Sicherheit zu erh6hen, wurden zunachst pharmakologische Grundlagen und klinisch- pharmakologische Untersuchungsbefunde er6rtert. Ein wei teres wichti- ges Anliegen war es, M6glichkeiten und Grenzen, Nutzen und Risiko einer Therapie mit diesen Substanzen bei einzelnen Krankheiten aufzu- zeigen. Die Autoren der einzelnen Beitrage haben sich dankenswerterweise der Miihe unterzogen, ihre Manuskripte fUr die Publikation zu iiber- arbeiten und Anregungen und Erganzungen aus der Diskussion einzube- ziehen. Zusatzliche wichtige Gesichtspunkte aus der Diskussion wurden von den Herausgebern zusammengefaBt und sind am SchluB des Buches dargestellt. Dank und Anerkennung gebiihrt allen Mitarbeitern dieses Buches. Ferner danken wir den Damen und Herren des Springer-Verlages, ins- besondere Herrn Dr. Wieczorek und Herrn H. lakobi, fUr die ausge- zeichnete Zusammenarbeit.

Volume 43 of "Progress in Drug Research" contains five reviews and the various indexes which facilitate its use and establish the connection with the previous volumes. The articles in this volume deal with high cholesterol blood levels and other dyslipidemias; search of ideal antihypertensive drugs; the natural PQlyamines and the immune system; biologically active quinazolones and with production and action of interferons. In the 35 years the PDR has existed, the Editor has enjoyed the valuable help and advice of many colleagues. Readers, the authors of the reviews, and last but not least, the reviewers have all contributed greatly to the success of this series. Although the comments received so far have generally been favorable, it is nevertheless necessary to analyze and to reassess the current position and the future direction of such a review series. So far, it has been the Editors intention to help disseminate information on the vast domain of drug research, and to provide the reader with a tool with which to keep abreast of the latest developments and trends. The reviews in PDR are useful to the non-specialist, who can obtain an overview of a particular field of drug research in a relatively short time. The specialist readers of PDR will appreciate the reviews' comprehensive bibliographies, and, in addition, they may even get fresh impulses for their own research. Finally, the readers can use the 43 volumes of PDR as an encyclopedic source of information.

Percutaneous and coronary interventions, used to treat narrow arteries of the heart caused by/found in those with coronary heart disease. This book is a detailed guide for performing percutaneous procedures and it covers in-depth the procedures that cardiologists and interested specialists must be aware of in order to use the devices proficiently

Disturbances of haemostasis and thromboembolic disorders still constitute a great problem in clinical practice. Increasing insight into the mechanism of blood coagula tion has led to more effective therapy and prophylaxis. Particularly, the understand ing of the biochemistry of fibrinolysis has provided possibilities for the pharma cological interference of these processes, which has resulted in effective haemostatic agents and useful antithrombotic ones. The development of antifibrinolytics for interfering with pathological fibrinolytic processes is nearly complete and has led to the development of drugs essential to the therapy of hyperfibrinolytic bleeding. The search for fibrinolytics for dissolving intravascular thrombi has led to highly effective compounds. This development is still under way and promising results are hoped. Spontaneous dissolution of blood clots is a phenomenon which was described a century ago. First investigations of this process assured that there is in the organism a system capable of removing the fibrin which is formed during blood coagulation after it has fulfilled its physiological function. This fibrinolytic system is specifically adapted to the degradation of insoluble fibrin into soluble degradation products. In the past 30 years, thorough investigation of this system has clarified the fibrinolytic process, its physiological role and its meaning as a pathogenetic principle. A good knowledge of these processes is required for an understanding of the effects and side effects of fibrinolytics and antifibrinolytics, which comprise the basis of methods for the detection of fibrinolytic processes in the organism and of the control of therapy with these drugs."

According to most studies, allergic reactions represent 35%-50% of all untoward reactions to drugs, yet the pharmacological literature concerning the clinical aspects, diagnosis, and pathophysiological mechanisms of drug allergy is markedly less extensive than reports dealing with the toxicological or pharmacological effects of drugs. The main reasons for this state of affairs may be on the one hand that until a few years ago the pathophysiological mechanisms of the various types of allergic reactions were not well understood, and on the other hand that objective diagnosis of a drug allergy is still fraught with serious difficulties. Drug allergy is still an unpopular topic for most allergologists and pharmacologists; this is reflected by the fact that despite their frequency, allergic reactions to drugs still occupy a relatively small proportion of space in most pharmacology handbooks and in classical books devoted to the side effects of drugs. There has recently been considerable progress in research into the immunologi cal and pathophysiological events occurring in allergic reactions, and on that basis investigations of various drug allergies have also yield d new objective findings. Consequently, it was natural to attempt a review of the most frequent and important drug allergies in the form of a handbook. We originally intended to present a comprehensive review of all drug allergies, but the realization of this goal soon became more difficult than we had at first imagined."