Fast neutron therapy was introduced in London in 1970. The book gives an overview of the developments of the past 28 years, assesses the results of fast neutron treatment, and reviews the compiled clinical data worldwide. The authors describe the radiobiological profile of the neutron beams and evaluate the neutron RBE for secondary cancer induction, they introduce heavy-ion therapy, which combines high physical selectivity with the biological advantages of high-LET radiation for some tumor types, and finally they describe the very recent developments in Boron Neutron Capture Therapy (BNCT).

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.

Throughout the twentieth century, interest in sport has evidenced a major increase worldwide and a new field of sports medicine has emerged. Sport spectators hip has been stimulated in part by the increased ease of international travel and the intro duction of new means of communication. Interest in professional sports and in such events as the World Cup and the Olympic Garnes has never been higher and the general popularity of sports has drawn increasingly greater numbers of young people to sports participation. Interest in sports participation has been strength ened both by the provision of numerous sports facilities to populations throughout the world and the accumulating information base that relates regular participation in programs of sport and exercise to health enhancement. Along with in creases in interest and participation has corne a need for a better understanding of the physiological changes accompanying muscular activity and of the trauma that can result from both competitive sport and recreational exercise.

The biennial symposium 'Radiology Today' continues its original mission to bring together European and American radiologists to discuss advances in the field. This volume presents material by well-known experts in cardiovascular and skeletal radiology. Its aim is to provide an overview of each major topic, trends in clinical development, and current interests in research. The future holds much promise for cardiovascular and skeletal radiology, primarily because of new techniques and procedures, but also because of the development of imaginative approaches to clinical problems. Ideas are born on both sides of the Atlantic, and we believe that it is important to ensure a rapid exchange of new information and to determine how it fits into today's medical care, keeping in mind the quality of patients' care, their safety and comfort, as well as cost. The traditional role of radiologists as consultants has increased greatly over time, with new responsibilities being continuously added. We radiologists are challenged to determine the diagnostic pathway appropriate to each patient. To arrive at the diagnosis quickly, safely, and at the lowest possible cost is as important as our participation in determining the patient's management. Some therapeutic procedures are even carried out by diagnostic radiol ogists themselves, employing ultrasound, computed tomography, or fluoroscopy and intracavitary catheters. Abscesses can be drained, and blood vessels dilated or blocked. In diagnosis and therapy, events are moving quickly, and advances are made at a rapid pace."

We are in the midst of major advances in medical imaging, converting static pre sentation of anatomic information into near real-time interactive imaging and displays capable of depicting both structure and function. This will have pro found impact on diagnosis and image-guided therapies. These advances have been most notable in the modalities of computed tomog raphy and magnetic resonance. These technologies have become capable of ac quiring volumetric images in short periods of time. Speed gains in MRI were very significant in the early 1990s with the development of clinically usable pulse se quences for gradient-recalled and echo-planar imaging. It appears that further speed gains in MRI will be difficult to achieve. The development of spiral CT has ushered in an era in which major speed gains in CT are also possible. This has enabled creation of new types of applica tions such as CT angiography, which has already come to replace catheter angio graphy at many medical centers throughout the world. We are very pleased that the results from industrial and academic laboratories have been transferred to the bedside to improve patient care at a speed that may be faster than in any other area of medicine. Concurrent with advances in CT technology there have been dramatic strides in the performance characteristics and costs of computer hardware and software.

Percutaneous lumbar discectomy is a new surgical method for treating lumbar disc diseases. The goal of the procedure is decompression of the spinal nerve root by percutaneous removal of the nucleus pulposus under local anesthesia. Probably 20 % of all patients requiring lumbar disc surgery can be successfully treated by this method. During the past two years, percutaneous discectomy has spread rapidly, and it is now performed in most clinical departments engaged in spinal surgery. The first International Symposium on Percutaneous Lumbar Discectomy, held in Berlin in August 1988, covered all current procedures known as "percutaneous discectomy" and the entire range of percutaneous techniques, both clinical and experimental. Its publication is important because of the recency of this new surgical procedure, the outstanding experience of the speakers - including the Japanese, American, and European "pioneers" of the technique - and last but not least the gaps in the knowledge of physicians concerning this topic. This procedure opens up new perspectives in the surgical treatment of degenerative diseases of the lumbar spine.

A comprehensive review of current endovascular techniques for the treatment of cerebral aneurysms, this is a practical manual for those practicing, or intending to practice, this rapidly expanding branch of minimally invasive surgery. The authors provide descriptions based on an extensive combined experience of clinical management, technical problems, complications and recent results, and discuss the limitations and role of combined extravasular/endovascular techniques.

This book deals with all aspects of surgery of the pancreas. The leading authorities from all over the world have contributed to this volume. Surgery of acute pancreatitis, chronic pancreatitis and pancreatic malignancies is demonstrated. This book defines standards for pancreaticand general surgeons. In addition all aspects of diagnostics, pathophysiology and basic scientific data with regard to pancreatic disease are presented.

The decision of Harvey Cushing to leave general surgery and concentrate on the infant field of central nervous system surgery was in retrospect a landmark in the history of neurosurgery. His concentrated work, and also that of his colleague Walter Dandy, originated with the desires of both pioneers to understand surgical anatomy and neurophysiology. The fundamental knowledge and surgical techni ques that they provided became the standard of excellence for several generations of neurosurgeons; so much so that the general belief was that the surgical techniques could not be improved upon. Twenty-five to thirty years ago microtechniques began to appear in a few surgical research centers, they were then gradually applied to clinical neurosurgery and have contributed to a new level of understanding in surgical anatomy and neurophysiology. We are now fortunate to have a new standard of morbidity and mortality in the surgical treatment of intrathecal aneurysms, angiomas, and tumors. It has been said that microneurosurgery was reaching its limits, especially when treating lesions in and around the cavernous sinus and skull base; those lesions notorious for involvement of the dural and extradural compartments, with a tendency to infiltrate adjacent nerves and blood vessels. The dangers of uncontrollable hemorrhage from the basal sinuses and post-operative CSF rhinorrhea appeared unsurmountable. The lateral aspects of the petro-clival region have been of interest to a few pioneering ENT surgeons and neurosurgeons but the cavernous sinus in most respects has remained the final unconquered summit."

In 1932 there appeared the work of SCHMORL and JUNGHANNS, Die gesunde und kranke Wirbelsiiule im Rontgenbild, which laid the foundations of diagnostic radiology of the spine. Since that time the discipline has been extended and refined in a systematic manner and our knowledge has been greatly enriched by the large number of monographs in which leading experts have assembled additional data. An encyclopedic treatment of all that is currently known requires not only that reference be made to all work published since 1932 in order to reveal the problems that remain but also that a serious attempt be made to contribute to the solution of such problems. For this reason, Professor TONDURY and Professor THEILER of Zurich, who know more than anyone else about the ontogeny of the spine, have been invited to display their erudition in this field. Should contra dictions or divergent opinions on certain points be revealed through this confrontation with radiologically obtained findings, so much the better; the effect of this could only be to spur workers in both disciplines on to more advanced research. We have only to recall how in Goethe's time the premaxilla was still the subject of controversy, yet this great man pursuing his studies in comparative anatomy and anthropology was able to prove its existence beyond all doubt. Mainz, May 1974 L. DIETHELM Inhaltsverzeichnis - Contents A. Die normale Wirbelsliule . . . . . . . . . . . . . . . . . . . . 1 1 I. Phylogenetische Entwicklung des Achsenskelets. Von K. THEILER 1 1. Die Bogenelemente. . . . . . . . . . . . . . . 2. Die Chorda dorsalis . . . . . . . . . . . . . ."

Significant development made in the Siemens CT scanner SOMATOM PLUS have opened new possibilities for diagnostic imaging in computed tomography. Spiral CT with a continously rotating X-ray tube and synchronous table increments for up to 60 cm in less than half a minute make radiological diagnosis more accurate. Blind gaps are no longer a major problem, and all structures, especially in the lungs, can be identified and diagnosed. The practical experience of an expert groupof clinical researchers and physicists is now made available in this book.

In the past, CT was the first choice among diagnostic measures for neurological diseases, and MRI was con- sidered to be a supplementary test. However, with the introduction of an ever increasing number of devices, MRI is being used routinely, and it is possible that eventually CT will become supplementary to MRI. This guide to the practical use of MRI has been compiled bearing these considerations in mind. Minimal working knowledge of the simple operations - that does not require details about the technical production of television images - is all that is required in order to obtain information from the views. Thus, even if a clinician is not thoroughly familiar with the theories of MRI, he can use it as efficiently as he does the CT scan. In this book, the theoretical aspects of the principles of MRI are deliberately simplified and the text can be used solely as an atlas. In the introduction, useful general features of MRI interpretation are described and itemized, and major diseases of the central nervous system are presented.

This book is a supplement to Volume V/I in the present series, Diag- nostie Radiology, published in 1962. Despite the relatively long period of time whieh has elapsed sinee its publieation, that eomprehensive vol- urne is still essentially valid, even though further developments have of course oeeurred in eertain fields. In reeent years the developments in nuclear medieine and ultrasonie teehniques have led to a number of new methods of medieal investigation, whieh, in different ways, eomplement diagnostie radiology. Funetional disorders of the urinary traet ean often be detected by means of radioiso- topes. Sinee morphologie ehanges are almost always preeeeded by fune- tional disturbanees, radionuclide teehniques in many instanees produee an earlier diagnosis than radiography. Disturbances of renal blood flow, slight ureterie obstruetion, and ureterie reflux are examples of pathologie states whieh ean be deteeted early by the y scintillation eamera. Bone seans, Le., imaging of the skeletal system using a radionuclide, are used extensively to diagnose bone metastases now that it has been demonstrated that such metastatie growths are identified both earlier and with greater aeeuraey by scintigraphy than by radiographie teeh- niques.

Radiosurgery is a rapidly developing form of minimally invasive neurosurgery. Selected papers from the first meeting of the International Stereotactic Radiosurgery Society in Stockholm, June 1993, reflect current multidisciplinary approaches to difficult intracranial neurosurgical problems. Neurosurgeons, radiotherapists, oncologists, radiobiologists, physicists and representatives of several other clinical disciplines inform about the state-of-the-art of radiosurgical treatment of a multitude of intracranial problems such as arteriovenous malformations, pituitary and pineal tumors, vestibular schwannomas as well as metastatic brain tumors and gliomas.

In this age when we are witnessing a veritable explosion in new modalities in diagnos tic imaging we continue to have a great need for detailed studies of the vascularity of the brain in patients who have all types of cerebral vascular disease. Much of the understanding of cerebral vascular occlusive lesions which we developed in the last two decades was based on our ability to demonstrate the vessels that were affected. Much experimental work in animals had been done where major cerebral vessels were obstructed and the effects of these obstructions on the brain observed pathologically. However, it was not until cerebral angiography could be performed with the detail that became possible in the decades of the '60 's and subsequently that we could begin to understand the relationship of the obstructed vessels observed angiographically to the clinical findings. In addition, much physiologic information was obtained. For instance, the concept ofluxury perfusion which is used to describe non-nutritional flow through the tissues was observed first angiographically although the term was not used until LASSEN described it as a pathophysiological phenomenon observed during cerebral blood flow studies with radioactive isotopes. The concept of embolic occlusions of the cerebral vessels as against thrombosis was clarified and the relative frequency of thrombosis versus embolism was better understood. The concept of collateral circulation of the brain through so-called meningeal end-to end arterial anastomoses was vastly better understood when serial angiography in obstructive cerebral vascular disease was carried out with increasing frequency."

This book reflects the views of an international faculty and provides an authoritative appraisal of modern radiology. It represents the sec ond volume in a planned series of competent overviews, and is mod eled on the successful first volume, Radiology Today, which was enthu siastically received by an international readership. We were encour aged by the comments we received to continue blending the latest ad vances in radiology with comprehensive teaching material concerning modern radiological practice. The Radiology Today 1982 meeting again brought together outstanding radiologists from Europe and North America for the purpose of sharing their experiences and their viewpoints of the current position and opportunities of imaging in medicine. Updating his/her knowledge of advances in medical imaging has be come an integral part of continuing medical education for every radiol ogist. Because all imaging modalities are continuously being refined, new clinical applications develop and frequently replace more com plex or more invasive procedures. Also, the relationship of imaging procedures to each other changes constantly, and with it the configura tion of critical diagnostic pathways for investigation of clinical signs and symptoms. To recognize this trend is important, because it is ex panding the role of the radiologist: our involvement in active guidance to the point of the patient's diagnostic workup has increased signifi cantly where it has become strategic."

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."

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."

The esophagus, ostensibly a simple tubular structure whose functional role often is minimized and even ignored, is, in re- ality, a highly complex viscus. The problems associated with disorders of the esophagus are not only related to the usual en- tities which may be anticipated in any portion of the gastroin- testinal tract, but include in a major fashion the functional mechanisms indigenous to the pharyngoesophageal and eso- phagogastric junctions. A number of disorders, representative of the classical cate- gories of disease, affect the esophagus. These include the various congenital and developmental abnormalities, of which some are complex. Trauma to the esophagus is not un- common, and infective and inflammatory lesions of this struc- ture are encountered relatively frequently. The different types of neoplasms of the esophagus are relatively few in number, but are commonly observed-the most serious, from the point of view of survival, being carcinoma. The collagen disorders, particularly scleroderma and dermatomyositis, affect the eso- phagus all too often. A miscellaneous group includes such en- tities as achalasia and varices, occurring in varying degrees of frequency. Functional abnormalities of the oropharynx, hypo- pharynx and esophagus, particularly relating to swallowing and the frequently encountered instances of spasm of the pharyngoesophageal and the esophagogastric junctions, consti- tute an important and common source of difficulty in the pa- tient population at large. In this regard, anatomic, radiologic, and physiologic studies of these structures have provided through the years vital data which has proved of considerable VII ...

Due to the ever increasing interest in the use of non-invasive ultrasonic methods in medical diagnostics on the one hand and the specific effects of ultrasound in medical therapy on the other, the questions of safety and optimal applications are topical and of great importance. For this reason the symposium "Ultrasound Interaction in Biology and Medicine," initiated and supported by the "International Organization of Medical Physics," took place. The organizers were the Institute of Applied Biophysics of the Martin-Luther-University, Halle (Saale), German Democratic Republic, in association with the Society for Physical and Mathematical Biology of the GDR along with other scientific organizations. Renowned and internationally noted specialists in the field of ultrasonics reported on the latest findings regarding the biological interaction of ultrasound, which promised future improvements in the methods of ultrasonic diagnostics and gave and up-to-date insight into the biological effectiveness of ultrasound. We are pleased to be able to publish selected contributions to this symposium collected in one volume. The methods of investigation, theoretical considerations and results concerning the interaction of ultrasound on molecular, cellular and system levels contained herein will remain up-to-date for a long time to come, providing thought provoking material for further inter-disciplinary basic research and medical application.

Benefits: - Leblancs new investigative technique allows the rapid visualisation of the most vulnerable points of the cranial nerves - the course of each nerve is studied radiologically and anatomically, using dissections, injections, serial macroscopic sections, and x-rays - each cranial nerve is depicted from its origin to the muscle with its intracranial, extracranial, and intracranial pathways - the start of each chapter features an illustration of the cranial nerve as a whole, allowing the reader to quickly memorize the cranial anatomy - unique full-colour illustrations make the atlas a reference of outstanding value to clinicians, researchers and students

The rapid growth of fibre-optic endoscopy in recent than 7,500 examinations has been accumulated. years has had two consequences for the radiology of In part I of this study the theoretical background the stomach and the duocienum. and the technique of examination proper are de- scribed. The basic principles of interpretation of DC 1. Radiology has lost its previously rather auton- studies are stated. omous position in this field. Part II deals with the results. Chapter 5 consists of 2. As a result of the constant feed-back from the general remarks on the results, and on the comple- endoscopist, which the radiologist can and should mentary role of radiological examination and endos- have, he is in an excellent position to re-evaluate copy. Chapter 6 deals with a quantative study of and improve his own technique of examination. standard biphasic-contrast examinations in patients The author believes that the radiological exam- over a period of 3 years. This study was restricted to ination retains its value as a screening technique and malignant lesions, because it is only in this group a complementary method to gastroscopy and biop- that the definite criterion, a histological diagnosis, is sy. Only a sophisticated radiological technique will obtained. The natural history of malignant lesions fulfil these requirements. In 1973 the author devel- also makes follow-up studies possible. Results of the oped a standard examination that was called "bi- diagnosis of Early Gastric Cancer (EGC) are phasic", because it combines the advantages of included.

Chest Imaging Cases thoroughly encompasses the field of thoracic radiology through 137 cases covering common and challenging radiologic and clinical issues. The cases are divided into categories important for board examinations and clinical practice: diagnoses that should be made on radiography, trachea, esophagus, chest wall, thoracic outlet, congenital lesions, mediastinal lesions, pleura, diaphragm, pulmonary masses, diffuse lung disease, pulmonary vascular disease, thoracic trauma, and post-surgical complications. Using a problem and solution format, each case features high-quality images, practical differential diagnoses, approaches to daily practice, management pearls and suggested readings. Concise discussions keep cases brief and informative, allowing for efficient learning and interpretation. Chest Imaging Cases is the essential resource for honing diagnostic skills in thoracic radiology for students, physicians-in-training and practitioners. Features: * Features over 500 images and 137 cases covering common and challenging clinical issues. * Each case includes high-quality images, practical differential diagnoses, approaches to daily practice, and suggested readings. * Concise discussions keep cases brief and informative, allowing for efficient learning and interpretation.