Up until two decades ago, clinical interest in the etiopathogenetic interpretation of lumbo-radicular syndromes was prevalently concentrated on the pathology of the inter vertebral disc. This vision gradually changed and grew as a result of the affirmation of the concept of pathological narrowing of the osteoligamentous vertebral canal as a cause of compression of the lumbar nervous structures. Finally, in the last ten years, lumbar stenosis has become more and more a subject of current interest not only as a result of problems related to nosography, diagnosis, and therapy, but also as a result of the increasing frequency with which vertebral canal or nerve root canal stenosis syndromes are recognized and treated. At the same time there was a tendency to include in stenotic pathology other pathological conditions responsible for lumbo-radicular syndromes. This led to dilation of the concept of stenosis, which perhaps no longer responded to reality, and which was not useful from a practical point of view. The need to define stenotic pathology and to correctly locate it within the vast field of lumbar pathology inspired the writing of this volume. This monograph gathers many diagnostic and therapeutic concepts matured at our In stitution over the years. Some of these concepts have already been defined in scientific meet ings or in publications."

Spontaneous intracerebral haemorrhages are the most dangerous complication of cerebral vascular disease. Because of their frequency and the fact that they lead to serious injuries, prolonged disabilities and, often, death, they have acquired an enormous significance, both medically and socially. Their precise diagnosis, location, wide extent and accomp ying manifestations were for a very long time uncertain and, in small and deeply situated haematomas, these factors were impossible to determine. Diagnosis was confirmed by the clinical picture, by angiography and sometimes by ventriculography and included, in the main, both lobar and more extensive haematomas. The results of operative treatment following the first attempt of H. Cushing in 1903 were poor and remained unsatisfactory in spite of the endeavours of numerous authors (Guillaume et al. 1956; Lazorthes 1956; McKissock et al. 1959; Luessenhop 1967 and many others). Especially for the most frequent and typically hypertensive haematomas in the region of the internal, capsule, the opinion was often expressed that operative treatment was useless.

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 fust 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 KrayenbUhl. 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 fust part of each volume."

In nearly all areas of technology our generation is experiencing the phenomena of fast paced innovation and great bursts in development. Besides the completely new techniques, the "experienced user" is astonished when obviously good and appar ently matured technology such as the next to last generation of CT equipment undergoes further development, such as is the case with the spiral CT technique. The enormous potential of spiral CT suddenly became apparent, stimulating and giving rise to a wide range of research on its clinical application. Yet again we can see in the field of imaging how great advances in one method competitively affect the range of application in another. Hence it is extremely valuable and necessary to appraise the current situation now. Both physicians - who use the equipment - and the health system and with this the patient - which finances it - have the obligation and the right to permanent optimization of the application strategies of diagnostic procedures. Not least, this symposium also meant to fit the new voice of spiral CT harmo niously into the symphonic score of diagnostic procedures. The large radiodiagno stic department ofthe university clinics which has been established at the Neues All gemeines Krankenhaus in Vienna, Austria, is proud to have jointly arranged this user symposium with Siemens."

Pediatric body CT began in earnest in 1976 when for the first time a body CT machine was installed in a pediatric institution, the Hospital for Sick Children in Toronto. The first images were received with great enthusiasm. More recently, newer equipment with faster scan times and better resolution has enabled us to delineate disease processes with even greater accuracy. In the past 9 years we have performed more than 5000 body scans in children. With this experience our examination techniques have changed and the indications for CT in children have been modified. CT has come to occupy an important and specific place in the management of pediatric patients. The performance of body CT studies in children is not always easy. Excellent diagnostic studies can be obtained only with a special understanding of the problems of pediatric patients and pediatric pathology. The information contained herein is a review of our experience with pediatric body CT, how we use body CT in children, and its relationship to other modalities in this department.

Medical Image Databases covers the new technologies of biomedical imaging databases and their applications in clinical services, education, and research. Authors were selected because they are doing cutting-edge basic or technology work in relevant areas. This was done to infuse each chapter with ideas from people actively investigating and developing medical image databases rather than simply review the existing literature. The authors have analyzed the literature and have expanded on their own research. They have also addressed several common threads within their generic topics. These include system architecture, standards, information retrieval, data modeling, image visualizations, query languages, telematics, data mining, and decision supports. The new ideas and results reported in this volume suggest new and better ways to develop imaging databases and possibly lead us to the next information infrastructure in biomedicine. Medical Image Databases is suitable as a textbook for a graduate-level course on biomedical imaging or medical image databases, and as a reference for researchers and practitioners in industry.

This volume of Documenta Ophthalmologica Proceedings Series collects the scientific papers presented at the 2nd International Symposium on Retinal Pigment Epithelium and the 4th Meeting of the European Macula Group held in Genoa, May 29-June 1, 1996. The Symposium on Retinal Pigment Epithelium was promoted by the University Eye Clinic of Genoa as the natural continuation of the first Symposium held with great success in Genoa in 1988. The previous Meetings of the European Macula Group were held in Coimbra (1988), Crete (1989) and Athens (1994). I was greatly pleased and honoured to host the fourth congress of this distinguished Society and I am grateful to Gabriel Coscas, Jose Cunha-Vaz and George Theodossiadis, found ers of the Society, for selecting Genoa on this occasion. The two meetings integrated well in an unicuum and brought together an exceptional number of outstanding retinal specialists coming from all over the world. All the aspects of the current research concerning retinal pigment epithelial and macular diseases were covered. Several interesting presentations regarded new techniques of retinal and choroidal imaging. A full session was dedicated to the latest advances in culture and transplantation of retinal pigment epithelial cells. Age-related macular degeneration was a major subject for discussion, including new approaches to treatment. This topic was high lighted by a mini-symposium on drusen, including a series of superb lectures on classification, clinicopathological studies, indocyanine green imaging, and laser treatment for prevention of choroidal neovascularization.

It is with pleasure that I write this foreword for the book "Magnetic Resonance Imaging in Coronary Artery Disease", edited by Dr. van der Wall and Dr. de Roos. I am pleased for two reasons. Firstly, as chairman of the Scientific Board of the Interuniversity Cardiology Institute of the Netherlands (ICIN), because ever since the technique became available for use in medicine and biology our Institute has tried and succeeded to promote the introduction and dev- opment of magnetic resonance imaging in cardiology in the Netherlands. ICIN was the first cardiological institute on the European continent to purchase its own nuclear magnetic resonance spectroscope for the study of myocardial metabolism. Secondly, because I have always been infatuated with this noninvasive technique that can produce cardiac images without ionic radiation and at the same time allows for the study of myocardial metabolism as well. And even more so because nuclear magnetic resonance imaging in medicine is one of the shining examples of medical progress as a result of breakthrough discoveries in physics and chemistry.

In the last few years, increasing effort has been devoted to better define the characteristics of tissue damage occurring outside MRI-visible lesions in patients with multiple sclerosis (MS) and, as a consequence, to improve our understanding of the disease pathobiology and of the mechanisms leading to the accumulation of irreversible disability. This book provides an updated review of the results obtained by leading research groups in this field. The potential clinical applications of what has been shown so far, as well as the areas for future research in the study of normal-appearing white and gray matter damage in MS are extensively discussed, making this book a valuable tool for clinical neurologists who are involved in the daily-life care of MS patients and for neuroscientists involved in MS research.

..". I would recommend this book for an in-depth analysis of the lumbar spine and its degenerative states ... extremely beneficial for the resident early in trainings as he or she attempts to correlate the complex anatomy of the lumbosacral region with associated pathological states ... Journal of Neurosurgery"

Contents: Intracranial Pressure and Mass Displacements of the Intracranial Contents. - Special Neuropathology - Morphology and Biology of the Space-Occupying and Atrophic Processes with Their Related Neuroradiological Changes of Diagnostic Significance. - Cerebral Angiography. - Pneumoencephalography. - Myelography. - Spinal Angiography. - Discography. - Ossovenography and Epidural Venography. - References. - Subject Index.

For the first time four crucial aspects of gastrointestinal endoscopy are combined in a single text. Drugs for sedation and monitoring of the patient are addressed with particular reference to safety issues and comfort and acceptability for the patient. Resource management and health economic techniques are applied to endoscopy to determine quality and outcome. Problems of negligence and informed consent form the basis of a medico-legal examination of endoscopic practices.

Isolated Cells and Perfused Organs 1. O. Kaplan, P.C.M. van Zijl, J.S. Cohen, Washington, DC/USA NMR Studies of Metabolism of Cells and Perfused Organs Individual Nuclei 2. S.R. Williams, London, UK In Vivo Proton Spectroscopy: Experimental Asoects and Potential 3. N. Beckmann, Basel, Switzerland In Vivo 13C Spectroscopy in Humans 4. M.J.W. Prior, R.J. Maxwell, J.R. Griffiths, London, UK Fluorine - 19F NMR Spectroscopy and Imaging In Vivo 5. J.S. Ingwall, Boston, MA/USA Measuring Cation Movements Across the Cell Wall Using NMR Spectroscopy: Sodium Movements in Striated Muscle 6. M. Rudin, A. Sauter, Basel, Switzerland In Vivo Phosphorus-31 NMR: Potential and Limitations

The eighth annual multidisciplinary symposium on clinical oncol ogy organised by the Royal College of Radiologists discussed the subject of investigational techniques in oncology. It was held in London in February 1986. This volume collects together the edited texts of the papers which were presented at the meeting, together with the George Edelstyn memorial lecture given by Professor J. Einhorn. Clinicians rely very heavily on pathologists and radiologists to help with the diagnosis and staging of patients who present with malignant tumours. The conventional techniques to which we have become accustomed are fast being supplemented by exciting new approaches. These have moved very rapidly from being purely experimental techniques to being a part of routine clinical practice. Some of these new approaches have been highlighted in this symposium. Recent advances in molecular biology have produced various specific techniques for looking at phenotypic changes in cells as detected by immunohistochemical probes. Visualisation of genes and their transcripts in human biopsies has become a real possibility using a wide and increasing range of molecular probes. Some of the advantages of these techniques and their potential for the future are presented here."

Der hier vorgelegte Atlas der Positronen-Emis- This atlas of positron emISSIOn tomography sions-Tomographie (PET) des Gehirns solI an- (PET) of the brain, with its many illustrations, hand von Bildbeispielen einen Uberblick tiber die is designed to give an overall impression of the Leistungsfahigkeit dieser aufwendigen Technik efficiency of this method in demonstrating physi- ologic and pathologic changes in the central ner- bei der Darstellung von physiologischen und vous system. In view of the rapid and multifa- pathologischen Veranderungen im Zentralner- vensystem vermitteln. Wegen der raschen und ceted development of PET, it seemed unrealistic vielseitigen Entwicklung der PET muBte von to attempt a comprehensive review of all the ap- vornherein auf Vollstandigkeit der Darstellung plications still in developmental or even in experi- aller in Entwicklung oder erster Erprobung be- mental stages. Attention has therefore been fo- findlicher Anwendungen verzichtet werden. Es cused on those methods which are already in rela- wurde daher ein Schwerpunkt auf die Methoden tively widespread clinical use and which are pro- gesetzt, die schon breiter klinisch angewandt wer- viding relevant findings on the pathogenesis and den und relevante Befunde tiber Pathogenese und development of diseases of the brain. Investiga- 15 Verlauf von Erkrankungen des Gehirns liefern.

Since the small bowel except the duodenum and (1961), Pygott et al. (1960), Gianturco (1967) terminal ileum is largely inaccessible during en- and Bilbao et al. (1967). doscopic examination, radiology of the small Sellink, however, was really responsible for bowel attains special significance as a diagnostic the widespread recognition of enteroclysis method. Owing to the length and position of (1971, 1974, 1976). In spite of the increasing this organ, good images are difficult to obtain. popularity of this method, the necessity for sub- Furthermore, the considerable variation oftran- stituting this apparently viable method for the sit time, unpredictable response of the contrast peroral examination is still equivocal (Rabe medium, and superimposition with the filled etal. 1981; Fried etal. 1981; Maglinte etal. loops make small bowel radiology difficult. As 1982; Ott et al. 1985). Comparisons of both methods, however, (Fleckenstein and Pedersen a result, few radiologists specialize in this field. With the exception of Crohn's disease, disorders 1975; Sanders and Ho 1976; Ekberg 1977; Val- lance 1980) have confirmed the superiority of of the small bowel are relatively rare. Thus, not many clinicians and radiologists are interested enteroclysis. It achieves a high accuracy (Antes in the small intestine. and Lissner 1983).

The purpose of this book is to provide some basic information regarding the fundamentals of magnetic resonance (MR) for all those who are less familiar with the technique and interested in MR spectroscopy and its possible applications in research and clinical practice. It will stimulate the reader to look more closely at the various topics covered by the contributors to this volume: tumor cell metabolism, kidney function, organ viability. Finally, several applications of high-field spectroscopy and imaging are illustrated. The book focusses on proven and possible clinical applications of MR in nephrourology: renal cell carcinoma, metabolic investigation of the kidney and pretransplant assessment of organ viability. The examples are thoroughly discussed and abundantly illustrated. The reader will benefit from this book by receiving a review of research and clinical aspects of MR simultaneously.

The series "Medical Radiology - Diagnostic Imaging and Radiation Oncology" is the successor to the well known "Encyclopedia of Medical RadiologyjHandbuch der medizinischen Radiologie." This international handbook with its unique compila tion of data in more than fifty volumes lags behind the fast developing knowledge in radiology today. "Medical Radiology" brings the state of the art on special topics in a timely fashion. The first volume of the series was "Lung cancer," edited by Scarantino. This volume "Innovation in Radiation Oncology," edited by H.R. Withers and L.J. Peters, presents data on the development of new therapeutic strategies in different oncologic diseases. 57 authors wrote 32 chapters covering a broad range of topics. The innovations are at various levels of development, but were all chosen with the practicing radiation oncologist in mind. Perhaps not all of the innovations will survive the test of time, others have now become well established standard procedure in some centers. Also discussed is the assessment of the effectiveness of standard treat ment and how it effects the quality of a patient's survival. The contributions have been grouped into 9 broad sections as outlined in the table of contents. We think the second volume, as the whole series, will provide valuable reading for the general community of radiation oncologists."

Historically the search for the neural bases of behavior goes back a long way. Neuroethology, which is concerned with the experimental analysis ofthe releasing and control mech anisms of behavior, is a young discipline. Results from this multidisciplinary branch of research, which uses physical, chemical, and mathematical methods, have not yet been extensively treated in textbooks of neurophysiology and ethology. This book is intended as a first attempt to pose major questions of neuroethology and to demonstrate, by means of selected research examples, some of the ways by which these questions are being approached. Inevitably this cannot be a complete and in depth detailed treatment of all of the neurobiology examples, and I realize that such a selection is of a subjective nature. The overall goal ofthe book is to present an introduction. After outlining some of the very basic neurophysiological and ethological concepts (Chaps. 2 and 3), neuroethological questions and methods are demonstrated extensively by means of a particular example (Chap. 4). There are two reasons to choose the visually guided prey-catching and avoidance behavior of the Common Toad: (1) it is a system which I have inves tigated for about fifteen years and therefore know best, (2) the toad story is one of the most comprehensive neuro ethological approaches so far. Thus, it is possible here to outline the major concepts of neuroethology and to pose the basic questions."

Advanced Renal Cell Carcinoma (RCC) cannot be cured by surgery alone. Its resillience to irradiation and chemotherapy demands a new approach to the management of this disease. This book provides an overview of the scientific and clinical developments of RCC, and clarifies the fields ofimmunotherapy and immunobiology. The book contains a compilation of approaches that will enhance the effectiveness of the management of advancedRCC, even in the absence of definitive pre-clinical data. These require additional study and will stimulate the reassessment of preliminary results.Furthermore, preliminary results of already implemented clinical trials withbiological modifiers are presented. Of special interest are the current achievements in the field of immunotherapy using topically and subcutaneously low dosage combinations of cytokines. This concise volume will benefit those seeking a thorough review of the research and the clinical aspects of RCC simultaneously.

Localization 1. C.S. Bosch, J.J.H. Ackerman, St. Louis, MO/USA SurfaceCoil Spectroscopy 2. P. Styles, Oxford, UK Rotating Frame Spectroscopyand Spectroscopic Imaging 3. P.A. Bottomley, Schenectady, NY/USA DepthResolved Surface Coil Spectroscopy (Dress) 4. R.J. Ordidge, J.A. Helpern, Detroit, MI/USA Image Guided Volume Selective Spectroscopy: A Comparison of Techniques for In-Vivo 31P NMR Spectroscopy of Human Brain 5. M. Decorps, D. Bourgeois, Grenoble, France Localized Spectroscopy Using Static Magnetic Field Gradients: Comparison of Techniques 6. J.A. den Hollander, P.R. Luyten, Ad J.H. Marien, Best, The Netherlands 1H NMR Spectroscopy and Spectroscopic Imaging of the Human Brain Spectral Editing and Kinetic Measurements 7. H.P. Hetherington, Birmingham, AL/USA Homo- and Heteronuclear Editing in Proton Spectroscopy 8. D. Freeman, R. Hurd, Fremont, CA/USA Metabolite Specific Methods Using Double Quantum Coherence Transfer Spectroscopy 9. B.A. Berkowitz, Research Triangle Park, NC/USA Two-Dimensional Correlated Spectroscopy In-Vivo 10. G. Navon, Tel Aviv, Israel; T. Kushnir, Tel Hashomer, Israel; N. Askenasy, O. Kaplan, Tel Aviv, Israel Two-Dimensional 31P-1H Correlation Spectroscopy in Intact Organs and Their Extracts 11. M. Rudin, A. Sauter, Basel, Switzerland Measurement of Reaction Rates In Vivo Using Magnetization Transfer Techniques

Imaging of Gastrointestinal Tract Tumors describes current imaging practice for the most commonly encountered benign and malignant digestive tract tumors and gives a review of the literature for less frequent tumors. General features (anatomic data, frequency, clinical and biologic signs, treatment) are discussed for all pathologies prior to description of imaging techniques, which include barium studies, ultrasonography and angiography, and above all CT. MRI appears particularly indicated for esophageal carcinoma and pelvic recurrences of colorectal cancers. The book is divided into three main section - benign tumors, malignant tumors, and tumors with an indeterminate prognosis - reflecting the value of different imaging strategies as a function of a tumor's natural history. The thorough analysis of literature for both frequent and less common tumors allows global evaluation of the diagnostic possibilities of imaging techniques, making Imaging of Gastrointestinal Tract Tumors a reference work for all specialists concerned with digestive tract pathologies.

'Morphological imaging' and 'functional imaging' are current mainstays for the diagnosis, successful treatment and accurate follow-up of patients with endocrine disorders. Functional and Morphological Imaging of the Endocrine System provides the reader with comprehensive but concise insights in the application of cutting edge imaging techniques and updated imaging protocols for the diagnosis and treatment of hypersecretory hormonal syndromes and functional endocrine masses.

Agreed standards and guidelines are the heart and soul of improving the differing training systems and to harmonize neurosurgical training in the European countries. Such standards and guidelines have been laid down in the European Training Charter of the European Union of Medical Specialists and recently novellated. This book, written by experienced neurosurgeons, offers all those concerned with neurosurgical training - trainers and trainees - practical advice to implement the above mentioned standards and recommendations. It has been written as a manual: "How to do it." It describes the tasks of a chairman (programme director), the tasks of the teaching staff, the organisation of a training curriculum, a rotation plan or a morbidity and mortality conference, the periodic progress evaluation, the course of an external audit and many more important topics. It contains a lot of practical tips, check lists and useful examples. Well educated young colleagues offer "safe neurosurgery" to our patients.