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This book is a survey of some aspects of current knowledge on
regional Cerebral Blood Flow (rCBF), mainly as studied by the
isotope clearance method. Although both theoretical and
methodological problems are discussed, attention is mainly
dedicated to data obtained from clinical studies. The papers which
make up this book were presented at the International Symposium on
the Clinical Applications of Isotope Clearance Measurement of
Cerebral Blood Flow, held in Mainz, Western Germany, on April
10-12, 1969. The previous meetings on Cerebral Blood Flow, held in
Lund in 1964* and in Lund and Copenhagen 1968**, had shown that the
moment had come to concentrate on the possibilities of introducing
rCBF measurements into clinical routine. This is why in the Mainz
Symposium attention was initially focused on methodological
aspects. This is also why theoretical problems of physiology of CBF
were not emphasized. Finally, this explains why such topics as
cerebrovascular disease, head trauma, coma, carotid surgery, brain
tumors and intracranial pressure were given pride of place. However
a survey of the clinical aspects of rCBF measurements would not be
complete without an account of the application of such measurements
to monitor cerebral circulatory changes during anesthesia and
therapeutic procedures like, for instance, hyperventilation and
hyperbaric treatment. Furthermore, it is now possible to obtain
data from correlative rCBF studies per formed before, during and
after surgical operations on the human brain."
The fourth volume of Progress in Orthopaedic Surgery is somewhat
different from pre vious publications of the series. The editors
have again tried to present two topics but the publications
presented from the European literature are of very recent origin.
In the age of total joint replacement it was felt to be imperative
to counteract the pre sent tendency to treat every joint which does
not seem to be healthy with an artificial re placement. Orthopaedic
surgery seems to be influenced by trends. In 1963, E. A. Nichol
discussing intracapsular hip fractures, quoted from Alice In
Wonderland in an editorial written for volume 45B of the Journal of
Bone and Joint Surgery "The Queen had only one way of settling all
difficulties, great or small, "Off with his head" ." Today one
could paraphrase his implied critizism by saying "Out with the
joint." No one doubts that joint replacements have been of great
value in treating degenerative joint changes, but it is already
apparent that replacement operations are not the ultimate answer
for treating every joint deformity. This volume represents the
European experience of different types of surgery in treat ing
arthrosis of the joints of the lower limb. A reader of the
Anglo-American literature will find suggestions in it which
reaffirm his uneasiness in considering only one solution for
problems concerning lower limb joints. I feel strongly that there
are other ways which allow a patient to function well with less
extensive operations."
This volume contains the papers presented at the 24th Annual
Meeting of the Deutsche Gesellschaft fur Neurochirurgie, held in
Mainz, Western Germany, on April 30 - May 3, 1973. Deliberate
choice was made of two crucial still hotly debated subjects which,
for ages, have meant a source of constant worry, and nights without
sleep to every neurosurgeon. Just as long as our special field
exists, there have been the problems of how to control brain edema
and .of how to reduce lethality and the secondary lesions in
surgery of cerebello-pontine angle tumors. Concerning the first
subject, new pathological, pathophysiological and chemical aspects,
the mechanisms of brain edema formation and resolution are
presented in the hope for better understanding. Furthermore, the
relationship between brain edema, intracranial pressure, cerebral
blood flow and metabolism are discussed. Finally, the therapeutical
consequences as well as the results of experimental and clinical
work are presented, and a comparison of effects between different
methods (hypertonic solutions, diuretics, steroids, controlled
hyperventilation, hyperbaric oxygen) is given. Concerning the
second main subject, any important contributions to the early
diagnosis of cerebello-pontine angle tumors have been included.
Nevertheless, it is of utmost interest for the neurosurgeon to know
which approach he is to prefer for the different stages of tumor
size and to be familiar with the trans labyrinthine approach or the
posterior craniotomy, as well as with the importance of the use of
the microscope in neurosurgery, the preservation of the facial
nerve and, in certain cases, its repair."
Organized by the European Association of Neurosurgical Societies,
Paris, July 15-20, 1979
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