Bone and joint tuberculosis is common in developing countries, and surgeons in these countries are often faced with the dual problem of diagnosing and treating this disease. However, bone and joint tuberculosis has not yet completely disappeared from industrialized countries, either. Therefore, this book is also intended for orthopedic surgeons in industrialized countries, who, faced with the rare but characteristic problems posed by bone and joint tuberculosis, are searching for reliable solutions. The last comprehensive textbook on this subject appeared more than 20 years ago, and that was a third edition of a pre-war work. Advances in chemotherapy had made this edition out-of-date even before it was published. The need for a definite up-to-date textbook has therefore been acute. The present book has been written to fill that need, and is based not only upon 20 years' experience with 700 cases, but also upon the results of clinical, bacteriologic, pathologic, and therapeutic research.

Sonography is an ideal real-time imaging technique for the evaluation of muscles and tendons of the extremities, and this book is a useful reference for both the technique of examination and normal ultrasound anatomy. The first part considers technical aspects of the examination such as sonographic equipment, water-path systems, and dynamic maneuvers. The basic sonographic patterns of normal muscles, tendons, and other components of the extremities are then presented. Emphasis has been placed on pitfalls and artifacts. The other available imaging techniques for muscles and tendons are also discussed. The second part comprises an atlas of normal ultrasound scans of shoulder, arm, elbow, forearm, wrist, hand, thigh, knee, leg, ankle, and foot, with accompanying explanatory line drawings.

The relationship between infection and arthritis has occupied the attention of everybody throughout the history of investigative rheu matology, no less today than formerlyl. The present issue is a com pilation of essays reflecting some of the facets of this particular diamond and I am especially grateful to authors and publishers alike in the unusual and tragic circumstances which attended its preparation. We were all stunned and saddened by the untimely death of Pro fessor John Calabro which deprived us of a good friend and wise counsellor as well as a much esteemed professional colleague. Prof. Calabro's contribution to medicine was considerable, spanning highly individual, exemplary and caring clinical management, enthusiastic charismatic teaching at all levels and major contributions to research particularly in the field of juvenile arthritis. As with Robert Burns, whose works John knew, "when will we see his like again?." A personal sadness is that I was looking forward to welcoming John and his wife to "Geordieland." There is a strong tradition of the highest level of competitive ballroom dancing here and John was looking forward to visiting us and demonstrating the considerable skills which he and his wife displayed in this arena. To his wife and family we all extend our heartfelt condolences. W. CARSON DICK 1. Atkin, S., Walker, D., Mander, M., Malcolm, A. and Dick, W. Carson. (1988). Observation on the causes of rheumatoid arthritis. Br. J. Rheumatol., 27 (Suppl."

High pressure in the lungs, or pulmonary hypertension, is most commonly due to smoking-related lung disease and conditions affecting the left heart, for example, high blood pressure in the arteries, faulty heart valves, and a weakened heart muscle. Pulmonary arterial hypertension (PAH), is a rare and complex disease, associated with many different medical conditions, which is caused by a growth of cells lining the inside of the lung arteries, resulting in high pressure in areas of the body. Both conditions lead to strain and potential failure of the right heart, and therefore awareness and early diagnosis of the condition is needed to lead to better outcomes: however this depends on education of all specialists and primary care clinicians about PAH. This practical handbook covers both PH and PAH, providing information required by the wide range of clinicians who will encounter these conditions, including cardiologists, respiratory physicians, rheumatologists, specialists in liver and AIDS medicine, and haematologists. It covers what it is, who it is likely to affect, how it is diagnosed, including the pitfalls of the various diagnostic tests, the different and evolving forms of treatment, long term management of this often devastating chronic disease, and the crucial role of multidisciplinary management in optimizing clinical care of these patients who usually have multi-system diseases. It also covers the up new classification for both PH and PAH, and new drugs that have recently become available.

Bone Metastases brings together the many recent developments that are gradually improving the prospects for patients with secondary involvement of the skeleton in a primary cancer elsewhere. The morbidity from bone metastases is extensive, and the palliative and supportive treatment that sufferers require for many months or even years constitutes a major health problem. A multidisciplinary approach is essential since a variety of specialists are involved: radiation and medical oncologists, general and orthopaedic surgeons, general physicians, radiologists and nuclear medicine physicians, symptom control and terminal care specialists. The book's editors, themselves authorities in the fields of oncology and bone disease respectively, have brought together experts from all these disciplines to provide comprehensive coverage of metastatic bone disease. They cover the biology and pathophysiology, hypercalcaemia, imaging, assessment of response to treatment, types of treatment (systemic, radiotherapy, surgery), and symptomatic and supportive care. Particularly new approaches included are magnetic resonance imaging, the assessment of skeletal response and isotope therapy.

Calcium plays an enormous and varied role in living systems now widely appreciated by clinicians.
Calcium in Internal Medicine demonstrates the physiological significance of calcium in clinical medicine and discusses the abnormal calcium metabolism in disorders such as renal failure, hypertension, atherosclerosis and osteoporosis.
Hirotoshi Morii (Editor) linked the clinical use of vitamin D analogues in bone diseases, Yoshiki Nishizawa (Editor) researched the connection between calcium metabolism and atherosclerosis and Shaul G. Massry (Editor) was the first to systematize the importance of excess PTH in chronic renal failure. In addition to these areas, Calcium in Internal Medicine covers basic physiology, pathophysiology, nutritional requirements and the role of calcium in the development and treatment of other various diseases. The importance of calcium and its regulatory systems is brought together in one publication providing a useful reference tool for internists, rheumatologists and endocrinologists.

The role of trace metals, especially copper and zinc, in the pathogenesis of rheumatic conditions has continued to receive much interest following the initial upsurge of research activity in the 1970s. Meantime also copper and zinc complexes receive continued attention for their potential anti-inflam matory actions. Since the previous major titles were published in this field some years ago (e. g. 1,2) it was considered timely to consider progress which has been made in the interceding period. Thus in this volume aspects are re viewed of the metabolism and biodisposition of copper and zinc, especially as they may be influenced by inflammatory processes, the mode of action of copper and zinc compounds in inflammatory states, and the actions of some newer copper complexes. While we still understand relatively little about how copper and zinc complexes work in inflammation, and indeed what the fate of the ligands and their complexed ions is in inflammation, it is hoped that this volume will be useful for giving a current view of the "state of art" in the field. Special thanks are given to the valued efforts of the contributors, Dr Peter Clarke (Publishing Director, Kluwer Academic Publishers) and Mrs Veronica Rainsford-Koechli for her help in proof-reading the manuscripts. K D Rainsford Hamilton, Ontario, Canada February 1989 References 1. Rainsford, K. D., Brune, K. and Whitehouse, M. W. (eds) (1981). Elements in the pathogenesis a treatment of inflammation."

Any physician travelling to other centres throughout the world must be struck by the similarity of the problems in diagnosis and management faced by fellow colleagues in rheumatology. Despite the international spread of journals and of standard textbooks, the same practical questions constantly appear - how do you manage the psychotic patient with cerebral lupus, or the patient with intractable polymyositis, or the rheumatoid patient who has failed on almost all known therapeutic agents. Is it worth differentiating various 'overlap' syndromes? How can one improve on the classification and treatment "i}f.vasculitis? Two questions - what is the patient telling us? and what can we do for the patient? are always central to the discussion. Although these high-minded ideals are often not fulfilled, frequently something new appears to come from individual case presentations. These cases, discussed at our weekly conferences, were contributed by a number of different staff members. Where possible, a standard format has been use in each case presentation and a comment added where indicated. A short list of relevant references has been included with each case. The aim of this book is to provide examples of these clinical problems and our own clinical approach to them - sometimes successfu~ sometimes not.

On May 24-27,1992 the European Society ofOsteoarthrology (ESOA) held its 19th sympo- sium in Noordwijkerhout, The Netherlands. The symposium was entitled "Joint destruction in arthritis and osteoarthritis" and sought to combine both clinical and experimental studies in this field. The present volume contains the proceedings of this meeting. The ESOA has organized most of its symposia in the eastern part of Europe, thanks to major input from Stanislav Havelka, who in recent years has been supported by Heikki Helminen. In appreciation of his efforts Stan Havelka was granted Honorary Presidentship of the ESOA at the meeting. In the era of European unification it seemed desirable to create a strong Uni- fied European Society, which would organize major meetings in both parts of Europe. Cartilage and bone research is expanding rapidly and the number of meetings in this field is continually growing. In line with these developments discussions took place with the recent- Iy founded "Eular Workshop on Bone and Cartilage Research" and the "Osteoarthritis Re- search Society (OARS)".

These two volumes contain the proceedings of a 3 day international meeting held at the University of Cambidge and Queens' College Cambridge from 31st July to 2nd August 1985 on the Side-Effects of Anti-Inflammatory Analgesic Drugs. The first meeting was held in Verona, (Italy) in 1982 and the organisers feIt that, with a number of recent developments including the. withdrawal of a num- ber of new anti-inflammatory drugs, and concern being expressed in the lay and specialist medical press and other media about the safety of these drugs, that it was appl'Qpriate to have a second such meeting. The meeting was attended by some 300 delegates and the dis- cussion focussed most intently on the recent issues, . e. g. the value of adverse drug reaction reporting of the non-. steroidal anti- inflammatory (NSAI) drugs, certain side-effects associated with particular NSAI drugs, the predictive value of animal models etc. Organising a meeting de novo without outside help would not have been possible without the immensely valuable help given en- thusiastica1ly by people and financial assistance given most generously by those pharmaceutical companies listed below. These financial contributions were given despite current economic dif- ficulties and moves to restrict the proportion of profits towards educational actlvities.

These two volumes contain the proceedings of a 3 day international meeting held at the University of Cambidge and Queens' College Cambridge from 31st July to 2nd August 1985 on the Side-Effects of Anti-Inflammatory Analgesic Drugs. The first meeting was held in Verona, (Italy) in 1982 and the organisers felt that, with a number of recent developments including the withdrawal of a num ber of new anti-inflammatory drugs, and concern being expressed in the lay and specialist medical press and other media about the safety of these drugs, that it was appropriate to have a second such meeting. The meeting was attended by some 300 delegates and the dis cussion focussed most intently on the recent issues, e. g. the value of adverse drug reaction reporting of the non-steroidal anti inflammatory (NSAI) drugs, certain side-effects associated with particular NSAI drugs, the predictive value of animal models etc. Organising a meeting de novo without outside help would not have been possible without the immensely valuable help given en thusiastically by people and financial assistance given most generously by those pharmaceutical companies listed below. These financial contributions were given despite current economic dif ficulties and moves to restrict the proportion of profits towards educational activities."

From the basic science to potential and approved clinical applications the most recent data in the rapidly growing field of bone morphogenetic proteins (BMPs) are summarized in this topical volume. Distinguished scientists present reviews on a range of scientific topics, including biochemistry, biology, molecular biology and preclinical animal studies on spinal fusion, cartilage repair, craniofacial and dental reconstruction using BMPs, as well as approved clinical applications in human bone non-unions.

This book provides a resource not only for experts in the field, but also for undergraduate students, newcomers and clinicians worldwide, given that the use of BMPs in orthopedic reconstruction has been already approved in Europe, Australia, Canada and the USA.

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.

Antibodies are crucial to the fine specificity of the immune system. An effective functioning of these molecules requires interaction with immune cells. Receptors for antibodies, Fc receptors, provide this critical link between the humoral and cellular branches of the immune system. This book presents a comprehensive overview of the different Fc receptors currently recognized. The first part of the book contains state-of-the-art overviews on the biological role of FcR. The latest information on FcR heterogeneity, FcR physiology, FcR-ligand recognition, their crucial coordinating role in immunity, interactions with other immunoreceptors, and the role of FcR in immunoglobulin transport and catabolism are discussed. The clinical importance of FcR is developed in the second part of the book. The well-recognized roles of FcR in allergy, inflammation, infectious diseases, autoimmune disorders, and immunotherapeutic importance are reviewed. The information in this book is easily accessible and should be helpful for researchers and clinical specialists as a convenient overview of the field, as well as a comprehensive introduction for students starting in this area of research.

In this monograph about gene therapy of autoimmune and inflammatory d- orders we have gathered international experts and leaders from different fields to review the state of the art advances on topics ranging from disease entities to vectors and engineered cells. The different approaches described in each chapter take into consideration the biomedical knowledge of these diseases and address the complexities of delivering long-term genetic interventions. Gene therapy also serves as a testing ground for new therapeutic entities and helps provide proof of principle for their potential therapeutic role in animal models of disease. Scaling up from mice to men still remains an important h- dle not only from the quantitative point of view, but also for currently unknown and unexpected secondary effects of the vector or the transgene. Some of these approaches have already been tested in the clinic, but much more needs to be done to understand the human conditions treated and the n- ural history of their pathology. We are indebted to the secretarial assistance of Ms. Lin Wells (Bone and Joint Research Unit, London, UK) and the help of Hans Detlef Kluber for his help in getting this book published. We hope this book will be of interest to c- nicians and scientists and inspiring to students of the subject who will use their own ingenuity and knowledge to further forward this discipline into clinical use.

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).

During the past decade there has been a burgeoning of interest in arthritis and related rheumatic diseases. The spe ciality of rheumatology, once regarded as a "Cinderella" speciality, is now one of the leading specialties in internal medicine. Indeed, just as infant mortality is a good index of the general health of a community, so a University Med ical School can be similarly judged by the quality of its Department of Rheumatology. Perhaps no other specialty has helped to advance knowledge in medicine as has rheu matology One might have thought that little could be added to the clinical and radiologic description of one of the most studied diseases in rheumatology rheumatoid arthritis. There are several excellent large radiology textbooks on bones and joints, and it is surprising that yet another book has been published. However, the reader will soon appreciate on reading this superb radiologic text on rheumatoid arthritis that here is something new and quite different from what has been published in the past. The combination of clinician and radiologist has produced a textbook which will become a standard reference on the subject. The authors are both well known in their respective fields and they have concentrated on the early changes in the disease-not only those in the articular surfaces but also those in the soft tissues. In 1948 the late Dr Philip Ellman coined the term "rheumatoid disease," to indicate the systemic nature of rheumatoid arthritis."

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.

Combining principles of contemporary immunology with applications to immunopathology, this up-to-date volume documents new developments in the understanding of the origin of autoimmune diseases. Emphasized are cellular and molecular approaches in both organ-specific and systemic autoimmunity. A comprehensive bibliography, numerous illustrations, and tables make it an invaluable source of information for immunologists, rheumatologists, pathologists, dermatologists, and nephrologists.

This important book fills a need in the developing area of Pain Medicine. It provides physicians with an up-to-date resource that details the current understanding about the basic science underlying the mechanism of action of the various CAM therapies used for pain. It summarizes the clinical evidence both for efficacy and safety, and finishes with practical guidelines about how such treatments could be successfully and safely integrated into a Pain practice.

This report on Future Trends in Inflammation III is the record of what is now firmly established as a series of multidisciplinary meetings organized by the European Biological Research Association. The aim of these meetings is to provide a forum for free exchange of information between basic scien tists of many disciplines and clinicians to provide better understanding of problems of common interest. The next major meeting wi1l be held in 1980.* The European Biological Research Association promotes scientific and clinical collaboration among the member countries ofthe EEe. It encourages exchange of information between scientists and clinicians from centres all over the world. In addition to the major international meetings small work shops are organized on specific problems of common interest. Once again the Editors have attempted to capture the spirit of the meeting by publishing 'verbatim' the discussion. It can be seen that the discussions were exciting and formed an important part of the meeting. It is possible that inaccuracies have crept into the discussions; if so we apologize. It was decided that the proceedings of such a meeting had maximum value with rapid publication. We would like to thank the participants for the enthusiasm and goodwill which persisted throughout the meeting both scientifically and socially. Above all we wish to thank H.R.H. The Duchess of Kent for acting as Patron of this meeting."

As we stated in our message in the book of abstracts for this congress, we have planned the programme over a long period with one clear objective: to present musculoskeletal medicine as an integral part of orthodox medical practice, rather than as something alternative or complementary. To this end we have based the plenary programme as far as possible on accepted epidemiological, anatomical, physiological and pathological phenomena. Scientifically well-validated material must surely be the base upon which any viable musculoskeletal medicine practice may be built. While we have chosen the plenary programme to reflect musculoskeletal medicine as a part of orthodoxy, we realize and wish to emphasize that there is a wealth of original work that has been carried out within FIMM. For this reason our first innovation for the congress was to invite members of the scientific advisory committee to select for a 'directed' programme the three topics they felt were of greatest current importance. The results of this democratic procedure was the choice of the sacroiliac joint, a comparison of manual therapies and biomechanics. This illustrates the broad direction of present thinking within FIMM.

It is with great pleasure that I write this Foreword to the Proceedings of the International Conference on Behcet's Disease which was held in Berlin in June 2002. This was the first International Conference held under the auspices of the International Society for Behcet's Disease which was founded in 2000 in Seoul. First, I congratulate our colleagues in Berlin, led by Professor Christos Zouboulis of the Department of Dermatology at the Free University of Berlin, for having organised a most successful conference and for having compiled these proceedings so rapidly. It will be realised immediately on scanning the contents of this book that the conference was truly international with 210 participants from 26 countries, as Professor Zouboulis has noted in his preface. These included basic scientists, epidemiologists, pathologists, clinicians and, importantly, representatives from patient organisations. The latter held their own conference alongside the scientific-medical conference to mutual benefit. The combined session of patients and doctors (abstracts on pp 601 - 626) gave the opportunity for an exchange of information and fruitful discussion. The wide ranging scope of the communications is evident from the index and it was most encouraging to see their origin - from all parts of the world, from senior and junior colleagues and, from many different disciplines. Many communications may be regarded as preliminary reports of research in progress and we look forward to seeing the definitive publications in appropriate journals in due course."

George Tsokos and a panel of authoritative clinicians and researchers synthesize the latest findings from across cell and molecular biology with the basic principles of rheumatology to create the first textbook of molecular rheumatology. These established experts describe the biochemical mechanisms by which apoptosis, cell signaling, complement, lipids, and viruses contribute to disease expression, and detail both immune and nonimmune cell function in rheumatic diseases. Their review of the major rheumatic diseases integrates the cellular, biochemical, and molecular biological mechanisms that are important in rheumatic disease pathogenesis. Path-breaking and illuminating, Principles of Molecular Rheumatology expands the envelope of clinical understanding to reveal the biological roots underlying rheumatologic disease, as well as the nature and roles of the powerful new therapeutics now emerging for its optimal treatment.

Azapropazone is a chemically unique non-steroidal anti-inflammatory drug (benzotriazine oxide) which has found successful clinical applications in the therapy of a wide variety of arthritic conditions. This book summarizes the progress and critically reviews the clinical use and experimental studies since its introduction 20 years ago. Several studies focus on the physiochemical, pharmacological and toxico logical properties of this drug. The studies suggest that it has some unique properties compared with other non-steroidal anti-inflammatory drugs. Among these the novel observations are that azapropazone inhibits several non-prostaglandin-related leucocyte functions, especially superoxide anion production. These serve as a basis for investigations which are reviewed showing the potential for the drug to prevent the pathological consequencies of myocardial ischaemia. The preparation of this book would not have been possible without the cooperation of the four companies who produce, market, or have research involvement with azapropazone, namely Siegfried AG (the manufacturers of the drug), A.H. Robins (U.K.) Co. Ltd., Robapharm AG (Switzerland) and E. . duPont de Nemours (U.S.A., Switzerland and F.R.G.)."