Synchrotron radiation has important applications in medical imaging, especially in such areas as intravenous coronary angiography, mammography, bronchography, and monochromatic computed tomography. In medicine, phase contrast imaging is a particularly exciting development, with the potential to become a new X-ray eye in the 21st century. To discuss these and related topics, medical doctors met with physicists and other researchers in Haga, Japan, in August 1997. This volume contains the proceedings of the International Workshop on Medical Applications of Synchrotron Radiation (HAGA 97), where practitioners from the world of medicine could communicate directly with researchers from the world of physics to discuss practical and theoretical aspects of medical imaging with synchrotron radiation. This volume, presenting the outcome of the discussions and presentations in the workshop, is a valuable resource to all who are interested in medical imaging and physics.

Intracranial injury, caused by a transorbital penetrating object, is a neglected topic in neurosurgery. With few exceptions, only occasional publications, often containing merely case histories, are present in the literature. Through a perusal of the world literature - for the first time - the author has collected and combined all available and relevant information, trying to give a thorough description of this rare, but extremely dangerous injury. This book is a major and definitive contribution to neurosurgery, but is also of importance to ophthalmology, neurology, traumatology, neuro-radiology and pediatrics.

The investigation of the brain by means of ultrasound has acquired increasing importance in the last years because it permits insight into the spatial relationships within the intact human skull in a short time without endangering the patient. The road from the first ultra sonic investigations on the exposed brain to the detection of intracranial midline shifts on the intact skull, the registration of echo pulsations and recently, to ultrasonotomography has been a long one already. However, this development is by no means at an end. Following the suggestion of numerous colleagues concerned with echo-encephalography in this country and abroad, the Neurosurgical Clinic of the University of Erlangen-Nuremberg organized an "International Symposium on Echo-Encephalography" on April 14th and 15th, 1967. Here there was an open exchange of experience on the results obtained up to the present. The limitations of the method and sources of error as well as the directions of future development of the ultrasonic echo procedure were discussed."

The contemporary management of patients with cancers of the head and neck is under careful scrutiny and major changes are being introduced in order to improve the potenti al not only for long-term control but also for less in the way of disfiguring and distres sing complications associated with the treatment programs. In 1988, the American Cancer Society estimates that there will be 42400 new cases of malignant tumors of the head and neck diagnosed with 12 850 deaths. In general, the prognosis for patients with malignant tumors of the head and neck re gion depends upon the site of origin, the local and regional extent of the tumor, the Kar nofsky status of the patient as well as the patient's general medical condition. The poten tial for cure for early stage tumors is extremely high particularly for those lesions involving the vocal cord, oral cavity, and the anterior two-thirds of the tongue. Major advances have been made in the management of head and neck cancer by the innovative utilization of surgery with radiation therapy. Small tumors can be cured by ei ther surgery or radiation therapy with equally good results. However, far advanced tu mors are more complicated and more difficult to cure requiring combined, integrated, multimodal programs of management. Therefore, the previously general poor prognosis for advanced tumors is becoming better with more aggressive treatment regimens."

This revised and updated second edition - now with two new chapters - is the only book to give a comprehensive overview of computer algorithms for image reconstruction. It covers the fundamentals of computerized tomography, including all the computational and mathematical procedures underlying data collection, image reconstruction and image display. Among the new topics covered are: spiral CT, fully 3D positron emission tomography, the linogram mode of backprojection, and state of the art 3D imaging results. It also includes two new chapters on comparative statistical evaluation of the 2D reconstruction algorithms and alternative approaches to image reconstruction.

Over 10 years have passed since the first edition of The Mediastinum was published in 1977. I have been very gratified by the response to the first edition and determined to do a second edition as soon as possible. However, good intentions are sometimes difficult to achieve and a decade has passed. This period has been one of enormous growth in the discipline of diagnostic imaging. In the study of the mediastinum, computed tomog raphy, and more recently magnetic resonance, have revolutionized our diagnostic capabilities. This second edition of the mediastinum is in tended to emphasize the importance of these modalities to the evalua tion of mediastinal disease. In addition, an attempt will be made to integrate into the text the many new and important observations relat ing to all aspects of mediastinal imaging which have appeared in the literature since 1977. The overall emphasis, however, will remain the same: that accurate radiologic diagnosis is based upon a thorough understanding of corre lated radiographic anatomy and pathology. No matter what the imag ing modality, this principle remains fundamental to each and every radiographic interpretation. I would like to express once again my deep appreciation to Dr. Stephen A. Kieffer, Chairman of the Department of Radiology at the State University of New York Health Science Center at Syracuse for his continued support and encouragement."

At first glance it appears that little has happened in our understanding of bronchogenic carcinoma, since five year survival rates have not changed appreciably over the past ten years. This is partially true, however the depth of our understanding has increased and will continue to do so at a rapid pace over the next five to ten years. Information on the basic tumor biology, identification of important groups at high risk and im proved delivery of cytotoxic agents in the treatment of lung cancer, will all add to improve the outcome. The purpose of this text is to provide useful background information and to serve as a reference for approaching the patient with lung cancer. Therefore it will serve as a review for some and as a beginning for others. An important starting point in any discussion of lung cancer is an epidemiological survey of the topic (Chapter I). For those who do not avoid the hazards and present with symptoms, what is the most logical approach in determining the diagnosis (Chapter II). This chapter is intended to provide a general overview of the subjects covered in detail in the remainder of the text."

In the developed world, images of brain structure are available as an everyday diagnostic aid, and the characteristic appearances of most pathological conditions can be looked up in a textbook. Functional brain imaging is to this day less widely used, partly because most pressing diagnostic questions can be answered by refer ence to the patient's cerebral anatomy, partly for reasons of technical limitations of functional techniques. PET as a technique is sufficiently resource-demanding and complex to inhibit its use as an everyday diagnostic technique. SPECT lacked suitable tracers for many years, and early systems had poor spatial resolution. However, rotating gamma camera technology has advanced to the point where images of the brain of reasonable quality can be obtained at most large hospitals, and practical tracers, particularly of regional cerebral blood flow, are easily avail able. As research advances, clinical applications are emerging. A recent report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology details a number of currently recognised clinical appli cations, some of which are dealt with in this book. Given this recognition, it is increasingly important that clinicians (particularly neuroclinicians, psychiatrists and specialists in cerebrovascular disease), nuclear medicine specialists and physicists acquire an idea of the major applications of the technique, and the research background on which these applications are based."

Primary reconstructive surgery is assuming increasing importance in the management of fractures of the spine. Analysis of the injury and thus surgical decision-making are greatly facilitated by the diagnostic power of CT and MRI. This volume provides a systemic introduction to the interpretation of CT and MRI images of injuries to the spinal column and the spinal cord, with special emphasis on the assessment or residual stability. Since survey X-rays remain the indispensable first step in radiodiagnosis, the typical appearances of spinal injuries on conventional films are also shown. This will help the reader interpret the CT and MRI images and also reflects the procedure in radiologic practice. The books classification of spinal fractures, together with the attempt to conclude how the injury happened by analyzing the damage caused, paves the way for individually oriented therapy.

Progress in traumatology of the vertebral spine has been restrained for a long time by two hindering factors. The first obstacle is presented by the differences in approach and a conflict of competences. The neurosurgeons, considering only the spinal chord, have confined themselves to indications for laminectomy, an insufficient and usually ineffective intervention. The orthopedic surgeons, on the other hand, obsessed by the fear of medullary lesions, have long hesitated to apply the fundamental rules for the treatment of fractures, namely precise reduction followed by strict immobilization, thus depriving themselves of the efficacy of radiculomedul lar decompression and of the protection this procedure affords to these structures when they are themselves involved in the trauma. Taking these facts into account, together with the rather poor results of laminectomy, the specialists have wisely and successfully recommended that one should abstain from treating the initial lesion, but rather attenuate the damage by appropiate nursing care and adequate reeducation. The second hindering factor was the insufficient knowledge of the extreme complexity of the anatomic lesions. This explains the orthopedists' relative caution; one only treats well what one knows well. More precise analysis of the lesions, not only of the bones but also of the joints, i. e., the osteofibrous involvement, is mainly based on strict radiologic semiology, which is rendered difficult because these structures are simultaneously affected. We are greatly indebted to Dr. DOSCH, radiologist at our Center, for having untertaken this difficult task, using all available conventional radiologic techniques."

Echo-encephalography, introduced by LEKS ELL in 1955, has gained increasing importance for the early detection of numerous intracranial lesions in the last decade. The main advantage of this diagnostic procedure lies in the fact that it permits a rapid orientation about the spatial relationships within the skull without stressing or endangering the patient. Although this method alone only rarely allows a complete diagnosis, the echo-encephalographic findings always indicate which further diagnostic measures are most suitable for establishing the diagnosis with the greatest accuracy in every case. However, the correct interpretation of an echo-encephalogram is possible only, if the findings which are assumed to be pathological are evaluated in the light of the clinical symptomatology. Since JEPPSSON'S excellent monograph on the origin of the midline echo and its importance for the diagnosis of intracranial expansivities, published in 1961, a great deal of work has gone into the development of echo-encephalography all over the world. For this reason the possibilities of this procedure today go far beyond the mere demonstration of a supratentorial shift. Now we can frequently outline the width of the ventricles exactly and localize tumors or hematomas by means of abnormal reflections. Since a detailed description of the technique, application and present-day diagnostic uses of echo-encephalography has not been available as yet, we undertook to fill this gap in the German literature in 1967 with a monograph summarizing the hitherto existing experience as well as our own extensive case mate rial.

Recent radiologic procedures in bone and joints, some of which eliminate the need for surgery are exposed, including: trephine biopsies of the thoracic and lumbar spine, sacro-iliac joints, peripheral bones synovial membrane and soft tissues, using either fluoroscopic echographic or CT guidance - chemonucleolysis - vascular embolization of skeletal tumors and management of vertebral hemangiomas - selective steroid injection in a broad spectrum of diseases including vertebral facet syndrom, cervicobrachial nerve root pain, rotator cuff calcium deposits, bone cysts. This unique volume supplies the reader with complete information regarding the performance of all these techniques.

The second common meeting of the European Section and the Cervical Spine Research Society took place in Marseille (France) from June 12 to 15, 1988 and was organized by Rene Louis. More than 130 specialists from every part of Europe, from America and Asia participated, representing, among others, the fields of Orthopedics, Neurosurgery, Traumatology, Neurology, Anatomy, Rheumatology and Radiology. This meeting again was convincing proof of the growing interest which exists in Europe in research into injuries and diseases of the cervical spine. The main topics of this meeting were the subluxation of the lower cervical spine (chapter 1) and the infectious diseases of the cervical spine (chapter 2). Chapters 3 and 4 of this volume deal with degenerative lesions and the upper cervical spine. In chapter 5 experimental reports are presented, so that a good synopsis is provided of our present state of knowledge of diseases of the cervical spine. The European Section of the Cervical Spine Research Society was founded by Mario Boni in 1984, who unfortunately died in 1986 and was proclaimed Honory President of the European Section. There is a European meeting every summer and one every three years with our colleagues from the United States of America, Canada and Japan organized in Europe. The first combined meeting was organized by Pierre Kehr in Strasbourg (France) in 1985 and the presented papers were published in Cervical Spine I (Springer, Wien-New York, 1987).

The term picture archiving and communications system (PACS) was initiated during the first International conference and workshop on the topic sponsored by The International Society for Optical Engineering (SPIE) in Newport Beach, California in 1982. The research and development (R&D) progress for PACS has been slow until 1988. The earlier PACS modules were mostly off the shelf components connected together to solve a very specific clinical problem. The three major players in PACS R&D are the European countries, United States of America, and Japan. For various reasons, the European coun tries concentrated in modeling and simulation, U.S.A. pre ferred in-house development or purchased PACS modules from a manufacturer, whereas Japan organized the PACS as a national project. Between 1989 and 1990 PACS R&D took a dramatic positive turn. Large scale P ACS projects were planned and some are of implementation, especially in newly con at various stages structed hospitals. Examples are the Hokkaido University, Japan; Hammersmith Hospital, United Kingdom; Social and Medical Center East (SMZO), Vienna, Austria; the U.S. Armed Force Medical Diagnostic Imaging Support (MDIS) project; and the UCLA Medical Plaza ambulatory care center. Another phenomenon is the organization of the EC-countries which provides a tremendous impetus for the European PACS R&D efforts. This book "Hospital Integrated Picture Archiving and Communication Systems: edited by Professor M. Osteaux and others is a direct product from these efforts."

The dramatic evolution of new technology in diagnostic and therapeutic radiology has changed the whole field of medicine. Ultrasonography, computed tomography, nuclear magnetic resonance, and digital radiography are those new techniques which are undergoing continuous development, providing us with increasingly re fined methods for establishing the cause of disease and for treating the patient. Using radiologic technique, ingenious methods are continuously being developed to en sure less expensive, less traumatic, and more efficient therapy. Transluminal angio plasty, embolization of tumors or bleeding vessels, extraction or dissolution of stones, and regional infusions are some of these therapeutic methods in modem diagnostic radiology. Every day new ideas arise which are published in a multitude of papers. This heavy flow of information limits the possibility of selecting from a core of information and often prevents radiologists from communicating efficiently with their colleagues in other countries or continents. European radiologists are additionally hampered from participating in international communication because of the language barriers created by the national journals. As a result, Europe's contribution to scientific progress in this interdisciplinary field has influenced only regional developments."

"Dost thou love life? Then do not squander time, for that's the stuff life is made oj' Benjamin Franklin This book describes the technical principles and applications of echo-planar imaging (EPI) which, as much as any other technique, has shaped the develop ment of modern magnetic resonance imaging (MRI). The principle of EPI, namely, the acquisition of multiple nuclear magnetic resonance echoes from a single spin excitation, has made it possible to shorten the previously time-con suming MRI data acquisition from minutes to much less than a second. Interest ingly, EPI is one of the oldest MRI techniques, conceived in 1976 by Sir Peter Mansfield only 4 years after the initial description of the principles of MRI. One of the inventors of MRI himself, Mansfield realized that fast data acquisition would be paramount in bringing medical applications of MRI to full fruition. The technological challenges in implementing EPI, however, were formidable. Until the end of the 1980s few people believed that EPI would be clinically useful, since its complexity was far greater than that of "conventional" MRI methods."

The production of a textbook of the pathology of bone work with isotopic markers to refine their classifica- tion. tumours is a hard task to embark upon, but Andre In this book, the author takes up a firm position Mazabraud has certainly succeeded. about the difference between osteoid osteoma and oste- It is the outcome of a very long experience, provided oblastoma, about "tumoral associations" and about the initially by his hospital training, then by his collabora- so-called malignant forms of disorders described as tion with Rutishauser at the Institut de Pathologie at benign. His personal stamp is evident throughout the Geneva and with Dahlin at the Mayo Clinic. The bonds various chapters. he forged then have never been loosened. Certainly, treatment in the area is rapidly changing Subsequently, his duties as head of the department and advancing, but this book does not risk obsoles- of pathology at the Institut Curie directed him finally cence since treatment is not its focus. The extent and towards tumour pathology. At the Institute, he was not nature of the author's experience explain the essentially satisfied with routine examinations but very soon linked anatomo-pathological orientation taken by this semi- up with the research team and worked especially on nal book. It also provides valuable clinical information Ewing's sarcoma and the problems of ultrastructure, and a good radiological study.

A few evenings ago in the Hall of the Neurological Clinic of Bologna University Dr. HENRI HEcAEN gave a lecture on the physiopathology of writing. As I was listening to his learned exposition, memories returned to me of times when my reaction to his work was not always the enjoyment of a quiet listener; namely, of the times when, ten years before, during the" seances du samedi" at the Neurosurgical Center of Saint' Anne Hospital in Paris, our meetings often consisted of disputes, in a sparkling tangle of alliances and hostilities, which would often result in clashes between TALAIRACH,AJURIAGUERRA, BREGEAT, M. , and Mme DELL,KLoTz (each one passionately pleading for his own speciality), with a brillant chorus of collaborators: CONSTANS, ABouLKER, DELIGNE, SADOUN, BANCAUD ...enlivening the scene. I re- member the discussions on clinical cases, the "lettres au directeur et aux medicins soignants" in which GUILLY was a master of diplomacy, the biting hints at the administrators, the smiles between allies or lovers. And in that casbah-like uproar of students, doctors, patients, attendants, technicians, and spectators, the voice of the "Grand Chef," preceded by a slam on the table, ringing out loudly: "Nom de Dieu! Voulez-vous vous taire et nous foutre la paix?" Monsieur David was always able to humanize any abstract problem. Saint' Anne! An arena where we dealt with the latest findings of neurology, psychiatry, stereotaxis, neurosurgery, neurophthalmo- logy, electroencephalography and neuroradiology. lowe my career to having met Erik Lindgren and Marcel David.

Written by internationally renowned experts, this volume is a collection of chapters dealing with imaging diagnosis and interventional therapies in neuroradiology and diseases of the spine. The different topics are disease-oriented and encompass all the relevant imaging modalities including X-ray technology, nuclear medicine, ultrasound and magnetic resonance, as well as image-guided interventional techniques. It represents a unique experience for residents in radiology as well as for experienced radiologists wishing to be updated on the current state of the art.

A multidisciplinary overview of techniques for monitoring acute head trauma patients is given in this book. It includes neuroimaging procedures (TCD, MRI, SPECT) and multiple neurophysiological approaches: EEG, videomonitoring and integrated computer systems with clinical applications. Results that have been obtained by using new drugs to protect the brain as well as progress made in recovering techniques are emphasized. The long-term consequences of acute lesions are also discussed. The relationship between acute and long-term seizures is studied in posttraumatic epilepsy cases, and the relationship between neurophysiological and long-term clinical patterns, especially in posttraumatic epilepsy, is discussed. The socio-economic costs of traffic accidents are analysed - based on data from epidemiological studies - and then compared with reported data.

I am particularly pleased to be able to write the introduction to this book that resulted from a collaborative effort by the Radiology De partment, under the auspices of the Boerhaave Committee for Postgraduate Medical Education of the Faculty of Medicine, at the University of Leiden and the Department of Medical Imaging and Radiological Sciences at Van derbilt University. Magnetic resonance imaging affords the opportunity to interrogate organ and system structure and function in a nondestructive manner without se rious biological implications. Tissue contrast with this modality is ex quisite and inherently superior to that of x-ray computed tomography. The advances to improve signal capture, development of rapid data acquisition techniques, fabrication of more appropriate pulse sequences, and availa bility of contrast agents portend increased versatility and specificity of these studies. Despite the proliferation of numerous general and specialized texts, the developments in MRI occur at such a pace that data in these references are necessarily dated. The technical horizon of MRI is vast with almost li mitless possibilities of signal generation and plan reconstruction. Tissue contrast is so importantly affected by the coupling of signal generation and capture that collective experience of institutions and investigators is extremely important to the initiate and useful even to those indivi duals with the greatest clinical experience."

What is the best way to plan surgical research? What problems are most often encountered in clinical research? How should a research report be presented at a scientific meeting? These questions and more are all answered in Principles and Practice of Research.The second edition has added new sections on animal research models, the molecular and cellular dimension of surgical research, and practical guidelines for obtaining government and third-party funding. Other improvements include a friendlier discussion of statistics and updated material about on-line computer literature searches. This book provides every clinical researcher with a roadmap around the pitfalls of poorly designed studies, through the jungle of incomprehensible statistics, and over the hurdles of research reporting to a successful study from start to finish. From the reviews of the first edition: "For me, it is a bible and a "must" for every Ph.D. or M.D. involved in clinical research, especially in the field of surgery. It should be on the table - not on the book shelf - of both the young as well as the experienced investigator as a readily accessible source of information to avoid the trial-and-error approach to problems in surgical research." #"World Journal of Surgery"#1 ..".a carefully conceived, concise blend of factual theory and principles, practical guidelines, and philosophical perspective... ...I have found it hard to identify any omission (even a selected bibliography on laboratory animals, their care, handling, and anatomy is included) and impossible to single out any individual contribution: each is a treasure - well written, concise, and complete." #"The " "Lancet"#2 "The feature of the book is that, despite attention to detail, it maintains a clear and practical approach to the whole field, beginning with the reasons for carrying out research, the types of research, and above all the reporting of research... ...Almost all aspects of research are covered, from small retrospective studies to departmental, institutional, national and international projects... ...The chapter on writing for publication should be compulsory reading for all budding authors." #"Journal of Bone and Joint" "Surgery"#3

In the past few years there have been impressive advances in the implementation of modern MRI techniques for the assessment of MS patients with the ultimate goal to define MRI markers of MS evolution. The authors of this volume not only review these new techniques, such as magnetization transfer (MT) MRI, diffusion-weighted (DW) MRI and proton MR spectroscopy (MRS), that are increasingly being used to monitor MS evolution, but also those, such as functional MRI (fMRI), cell-specific MRI, perfusion MRI, and microscopic imaging with ultra-high field MRI, that are emerging as additional promising tools for improving our understanding of MS pathophysiology. Strengths and weaknesses of all these modern quantitative MRI techniques for the study of MS are extensively covered in this book. The book also provides a valuable summary of the state of the art.

This volume contains the proceedings of a symposium held in Marseille on April 6, 1992, on the topic "Heterogeneity of Alzheimer's disease. " This was the eighth of a continuing and very successful series of meetings related to Alzheimer's disease organized by the Fondation Ipsen pour la Recherche Therapeutique. These symposia, known as "Colloques medecine et recherche," started in 1987 and have dealt with widely different aspects of the disease such as immunology, genetics, neuronal grafting, biological markers, imaging, growth factors, and last year's less conventional topic of Neurophilo- sophy and Alzheimer's disease. The next IPSEN symposium dedicatet to Alz- heimer's disease will take place in Lyon on June 21, 1993, and will deal with "Amyloid protein precursors in development, aging, and alzheimer's disease. " It is being organized by Konrad Beyreuther, Colin Masters, Marc Trillet, and Yves Christen. Until a few years ago, several names were used to refer to the most common cause of dementia in the elderly. They included such terms as "senile psycho- sis," "organic brain syndrome," and "senile dementia. " Following Kraepelin, the term "Alzheimer's disease" was often restricted to an uncommon condition starting at a younger age (before 60 or 65 years of age).

The International Skeletal Society is now fifteen years old and as measured in human terms has outgrown its childhood. During this time the ISS has earned worldwide respect and praise for successful work. The International Skeletal Society is an interdisciplinary working group concerned with skeletal diseases, their pathogenesis, diagnosis, and treatment at all ages. At the Annual Closed Meetings of the ISS prominent scientists representing many countries from all over the world gather to exchange ideas in the fields of radiology, pathology, orthopedic surgery, nephrology, and endocrinology. Follow ing these meetings Refresher Courses are offered for students, physicians in train ing, and interested collegues from the various medical specialities. The purpose of these courses is to present the latest developments in clinical practice and research with regard to skeletal diseases. The Society's internationally well-known journal "Skeletal Radiology," which is published by Springer-Verlag, Heidelberg, adds in exchanging updated developments in the field of skeletal disorders. The hereby presented first Book of Members contains a record summarizing the most important milestones and events of the history of the International Skeletal Society up to 1987 in the form of short biographies regarding the members of the Society. The task of gathering all important informations for this book was accom plished by one of the members during his term as President of the ISS. The other one - honorary member - took upon himself the tasks related to publication."