Humana Press – förlag

Kernicterus (bilirubin encephalopathy) is a highly interesting example of metabolic encephalopathy. It fills all the characteristics of a metabolic encephalopathy in that it can develop rapidly, produces signature signs and symptoms, and is amenable to successful treatment. In the absence of treatment kernicterus can produce devastating sequelae and death.The present volume will examine the biochemistry and physiology of bilirubin as well as its hepatic metabolism and renal excretion. Chapters will elaborate bodily disposition of bilirubin and its neuropathology. Both early treatments and current therapy will be discussed in detail. Phototherapy will be presented, and its efficacy and influence on incidence thoroughly examined.

The increased attendance required concurrent sessions for the 48 oral presentations and 190 submitted posters (for more details see Website: www.ct.ornl.gov/symposium). Attendees came from Australia, Austria, Belgium, Brazil, Canada, China, Denmark, Finland, Germany, Hungary, India, Japan, Korea, Mexico, The Netherlands, Russia, South Korea, Spain, Sweden, Turkey, and Ven­ ezuela, as well as from the United States. This international perspective was continued in a Special Topic Ses­ sion sponsored by the International Energy Agency (lEA) Bioenergy Pro­ gram on Biofuels and chaired by Jack Saddler and David Gregg from the University of British Columbia. Several of the 10 member countries in this network are approaching Demonstrations of the Biomass-to-Ethanol pro­ cess and have a range of more fundamental projects that look at various aspects of pretreatment, enzymatic hydrolysis, fermentation, and lignin utilization. Presenters from several of the participating countries described their country''s biomass-to-ethanol projects, and differential factors such as the type of biomass available, the maturity of the wood or agricultural processing industry, and the willingness of government to bear the risk/ cost of development and demonstration.

With the Twenty-Third Symposium, we sustained the tradition of providing an informal, congenial atmosphere that our participants find conducive to pursuing technical discussion of program topics. The techni­ cal program consisted of six sessions with 38 oral presentations, a roundtable forum, two special topic discussions and a poster session con­ sisting of 230 posters. A special luncheon talk on "Natural Capitalism" by Karl Rabago of the Rocky Mountain Institute was particularly enlightening. More infor­ mation on these provocative approaches to resources and societal needs can be found at their website, www.rmi.org. While plant biotechnology and genetically modified organisms (GMOs) for enzyme production and designer biomass emerged as exciting areas throughout the Symposium, the frank exchange in the special topic sessions indicated the importance of thinking beyond the purely technical details in this important research area. The preface for each session is included in the introductions. Session Chairpersons and Co-Chairpersons Session 1: Advances in Biomass Production and Processing Chair: Sharon Shoemaker, University of California, Davis, CA Co-Chair: David Boron, US Department of Energy, Washington DC Session 2: Enzyme and Microbial Biocatalysts Chair: Elba Bon, Chemistry Institute, UFRI, Rio de Janeiro, Brazil Co-Chair: Steve Picataggio, Dupont Central, Wilmington, DE Session 3: Bioprocess Research and Development Chair: Guido Zacchi, University of Lund, Lund, Sweden Co-Chair: Mark Holtzapple, Texas A&M University, College Station, TX Session 4: Oil and Ethanol: An Excellent Mix? Chair: Carol Tombari, Mountain Energy Consultation LLC, Conifer, CO Session 5: Emerging Biorefinery Opportunities

LA WRENCE G. RAISZ, MD Division of Endocrinology and Metabolism, University of Connecticut Health Center. Farmington. CT The rapid transfer of new knowledge concerning the pathogenesis, diagnosis, preven­ tion, and treatment of disease into clinical practice has always been a major challenge in medicine. This challenge is particularly difficult to meet in osteoporosis, not only because has been so much new knowledge generated in recent years, but also because this there disorder has not caught the attention of many practicing physicians. The goal of this volume is to help primary care physicians develop a better understanding of osteoporosis and a more effective approach to diagnosis, prevention, and treatment. As primary care physicians become more and more responsible for the maintenance of health and the prevention of disease, osteoporosis must become one of their important concerns. The magnitude of the problem of osteoporosis has been widely publicized. Within the next 30 years, the cost of hip fractures alone is expected to exceed $40 billion a year in the United States and will be a major cause ofincreased mortality. In addition, vertebral crush fractures will cripple more and more of our elderly population, both men and women. This enormous toll is not inevitable. Current methods of identifying individuals at risk and applying preventive programs could reduce the incidence offractures by 50% or more. This should be the minimum goal of clinicians.

In the Seventeenth Symposium on Biotechnology for Fuels and Chemicals, leading researchers from academia, industry, and government present state-of-the-art papers on how bioengineering can be used to produce fuels and chemicals competitively. This year''s program covered topics in thermal, chemical, and biological processing; applied biological processing; bioprocessing research; process economics and commercialization; and environmental biotechnology. The ideas and techniques described will play an important role in developing new biological processes for producing fuels and chemicals on a large scale, and in reducing pollution, waste disposal problems, and the potential for global climate change.

The comprehensive nature of this text will appeal To many physicians, the study of sinus disease to a wide range of physicians including generalists, reflects a discipline only slightly less interesting otolaryngologists, and allergists. Family physi­ than a Johnson and Johnson gauze pad, a pursuit cians, internists, pediatricians, and allergists will followed by dilettanti and eccentric professors. To each profit from having a single source that pro­ others, it represents a subsection of an undefined vides an in-depth review of topics pertaining to discipline that crosses barriers of internal medi­ sinus diseases. The otolaryngologist will benefit cine, pediatrics, allergy, chest disease, and oto­ from having a single text that provides a detailed laryngology. To patients, sinus problems are discussion of the many ancillary medical problems synonymous with headaches and a chronic source of morbidity. Yet few physicians have been pre­ that influence sinus function and, therefore, surgi­ cal outcome. We hope that all readers will enjoy the pared, until recently, to do much more than pre­ international choice of authors whose topics have scribe antibiotics, intranasal steroids, antihistamines, been purposely allowed to overlap in an effort to and commiserate for the misery involved. Fortu­ provide the broadest possible scope of informa­ nately, this picture shows significant signs of tion. We expect Diseases of the Sinuses to serve as impending remission. The disciplines of clinical immunology, allergy, and otolaryngology have the foundation of an ever-stronger ongoing effort to combat sinus disease.

In Genetics and You, John F. Jackson, MD, an eminent medical geneticist of many years'' experience, presents everything you need to know to understand and deal with inherited disease and its risks. He explains in simple understandable language the sometimes baffling principles of genetics that underlie genetic disorders. From these principles, Dr. Jackson clarifies the process of genetic counseling, demonstrates the importance of constructing a family pedigree, and describes the latest methods of prenatal diagnosis. You will also learn about the role of environmental factors in producing birth defects, how the new techniques from molecular biology can help in their early detection and prevention, and what your reproductive options may be. A glossary of terms reduces to everyday language the sometimes mystifying technical jargon used by geneticists. There is also an annotated bibliography describing other books to consult, as well as a list of organizations to contact for further information and help with specific problems.

Leading practitioners describe in detail advanced methods of mass spectrometry used in structural characterization of biomacromolecules of both natural and recombinant origin. They demonstrate by example how these methodologies can solve a wide array of real-world problems in protein biochemistry, immunology, and glycobiology, as well as for human bacterial pathogens, lipids, and nucleic acids. The book offers a unique opportunity to learn these techniques that are revolutionizing the field. Its authoritative assessment in the context of how to solve important and challenging problems in bioscience and medicine ensures a competitive advantage for today''s researchers.

Key workers in vascular medicine and biology apply state-of-the-art techniques in cell and molecular biology to study the endothelial and vascular smooth muscle cells. The distinguished scientists and clinicians open a new area of endocrinology, which sees the vasculature and kidney as endocrine organs and sheds new light on the hormonal regulation of the cardiovascular system. They also add significantly to our current understanding of the autocrine, paracrine, and endocrine regulation of vascular function in health and in those vascular disease states that accompany diabetes mellitus, dyslipidemia, and hypertension. Endocrinology of the Vasculature is the first book to comprehensively and systematically explore the vasculature as an endocrine organ.

In Alcohol, Cocaine, and Accidents leading experts provide concise yet focused scientific reviews of the role of alcohol and cocaine in automotive, aviation, and aquatic accidents. The authoritative contributors present both applied research and epidemiological studies, with emphasis on the prevention of injuries through an increased use of appropriate educational labels, law enforcement, and personal and community-based prevention programs. In addition to detailed topical coverage, the articles suggest prevention strategies and provide supporting data for the role of treatment in reducing accidents.Alcohol, Cocaine, and Accidents will be of interest to substance abuse researchers, law enforcement officials, treatment providers, policy makers, and legislators responsible for regulating alcohol and drug use, as well as safety issues in all areas of transportation.

Alcohol and other drugs of abuse cause significant physi­ ological changes, especially during development. The effects on the infant and child range from severe mental retardation to mild changes in activity and neurological functions. Although the level of intake needed to cause fetal damage is not clear, the magnitude of the problem is significant, with many long-term sequelae. As a result, it becomes critical to better diagnose and manage drug and alcohol use during pregnancy. This must involve special training for health care professionals. In addi­ tion, recognition of the psychosocial factors affecting alcohol use, especially by youth and young adults, is critical to modi­ fying behavior, and thus reducing fetal alcohol exposure. Cultural considerations can also come into play in modi­ fying alcohol and drug use by women so as to reduce fetal damage. The trends in alcohol and drug use by youth forecast rising levels of damage to infants. These children will need extensive medical and educational care for years to decades. Clearly, understanding of the role women must take in modifying their alcohol and drug use during pregnancy will facilitate changes in our cultural and educational practices that will help reduce fetal trauma from alcohol.

Nutrients in Cancer Prevention and Treatment contains articles that were presented by leading researchers and physicians in the field of nutritional oncology. Most of the previous conference proceedings on Nutrition and Cancer have dealt primarily with the issue of the role of nutrients in cancer prevention. This is logical because enormous quantities of laboratory and epi­ demiologic data have been published on the topic. Nutrients in Cancer Prevention and Treatment also contains several studies on the role of diet and vitamins in cancer treat­ ment. There are very few books that have reviewed laboratory and clinical studies and the role of vitamins in cancer treatment. There are preliminary data suggesting that daily supplementa­ tion with high doses of certain vitamins in combination with conventional therapeutic agents may enhance their growth inhibitory effects on tumor cells, and may protect normal tissues against some of their toxic effects. This book is unique in the sense that several articles have discussed the mechanisms of action of individual vitamins on cellular and molecular parameters. It is very exciting to note that some of the vitamins inhibit protein kinase C activity, increase the production of certain growth factors, and modulate the expression of a number of oncogenes. These studies, at least in part, offer rationales for the cancer protective effects of vitamins.

In a rapidly evolving and extremely important area of medical science, it is often difficult for the student, teacher, and researcher to keep abreast of all the important advances. The purpose of Molecular Biology ofDiabetes, Parts I and II is to bring to these individuals the latest knowledge of diabetes-related research in a comprehensive, yet concise manner. To this end, we have assembled chapters, written by most of the world''s experts in the field, that we believe compre­ hensively survey and synthesize a coherent understanding of the subject. Studies of the etiology of type I and type II diabetes are extremely exciting and essential, since we hope to one day prevent the disease using gene therapy. These aspects are covered in Molecular Biology of Diabetes: I. Autoimmunity and Genetics; Insulin Synthesis and Secretion. In type II diabetes, an abnormality in pancreatic secretion exists concomitantly with peripheral insulin resistance. This abnor­ mality of insulin secretion is believed to be related to a defect(s) in glucose sensing. Uncoupling of glucose sensing from insulin secre­ tion may be the crucial step in the pathogenesis of noninsulin-depen­ dent diabetes. In this volume, we have invited authors to describe their studies on all known factors affecting ~-cell function, including autoimmunity and genetics of diabetes, as well as molecular mecha­ nisms of insulin synthesis and secretion. In the last few years, the most rapidly advancing area of research in diabetes has been, in fact, related to insulin action.

Alcoholism, the oldest addictive illness, remains a serious problem because of its major modifications of many physiological systems. The genetic and neurological origins and mechanisms are complex and only partly understood. However, it is clear that alcohol use modifies the production of most hormones, directly and indirectly modulating the systems that hormones regulate. Acute and chronic alcohol consumption affects virtually all cellular functions of tissues like brain, liver, immune system, and reproductive and endocrine organs. The latter have major regula­ tory roles, affecting many functions from development to repro­ duction. Although stress can further modify alcohol''s effects on hormone production, it significantly causes most of alcohol''s modi­ fications of the body to occur via changes in hormone production and secretion. Ronald R. Watson vii Contributors Michael L. Adams • Department of Psychiatry, Washington University School of Medicine, St. Louis, MO Robert A. Anderson, Jr .• Ob/Gyn Research, Rush-Presbyterian-St. Luke''s Medical Center, Chicago,IL Kasibhatla Bhavani • Molecular Heptology Laboratory, Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA Theodore J. Cicero • Department of Psychiatry, Washington University School of Medicine, St.

Electrocardiography is a mature discipline, so familiar to both doctors and patients that it''s hardly noticed, one of those tests that have always been there, like the white count and hemoglobin, not something one has to think about much, or question. To some extent this view is valid, but it overlooks some important points. Like the white count and hemoglobin, electrocardiograms are produced by technicians using mechanical devices that turn out numbers, but there is a difference. The white count and hemoglobin are reported as single values to be interpreted by the doctor who knows the patient and ordered the test, but the graph produced by an EKG machine represents millions of numbers displayed as XY plots, a message written in a language different from one''s own. It requires transla­ tion, and this means that the translator must not only know the lan­ guage, but also be able to assess the effects on it of the many factors that may have modified its meaning between origin and delivery. There is potential for harm to the patient, as well as for help, in every facet of the process, and to lose sight of this, to see the tracing as a single whole, would be like seeing words as units without con­ sidering the letters that compose them. When we read, we do recog­ nize whole words, patterns, but, having learned the letters first, revert to this base intuitively when we encounter a new word, or one that is misspelled.

One comment often repeated to me by coworkers in the biotechnology industry deals with their frustration at not understanding how their particular roles fit into their company''s overall scheme for developing, manufacturing, and marketing biomedical products. Although these workers know their fields of specialty and responsibilities very well, whether it be in product research and development, regulatory affairs, manufacturing, packaging, quality control, or marketing and sales, they for the most part lack an understanding of precisely how their own contributory pieces fit into the overall scheme of the corporate biotechnology puzzle. The Biotech Business Handbook was written to assist the biotechnologist-whether a tech­ nician, senior scientist, manager, marketing representative, or college student interested in entering the field-in building a practical knowledge base of the rapidly expanding and maturing biotechnology segment of the healthcare industry. Because biotechnology in the United States and abroad covers many disciplines, much of the information presented in this book deals with the biomedical diagnostic aspects of the industry. Business subjects for the most part unfamiliar to technically oriented people, such as the types of biotechnology corpo­ rations, their business and corporate structures, their financing, patent, and trademark mat­ ters, their special legal issues, and the contributions of their consultants are treated in a manner designed to make them clear and understandable.

In Addictive Behaviors in Women, leading experts from psychiatry, psychology, sociology, and social work concisely review the addictive process and the characteristic behaviors of women who are dependent on alcohol and/or drugs. Topics include why women smoke, the role of personality in female addiction, sexuality issues in chemically dependent women, dieting and alcohol use in women, alcohol''s role in sexual assault, and the impact of drug abuse on the family and pregnancy. Addictive Behaviors in Women illuminates the causes and effects of the many lifestyle decisions women make that lead to addiction to drugs, work, sex, gambling, or to any of the many other elective aspects of our lives. It shows how addictive decisions can be avoided and/or treated, thereby making women''s lives safer, more productive, and healthier.

Offers a state-of-the-art review by international experts on all aspects of tachykinin receptors, including neuropeptide/peptide and G-protein-linked receptors in general. It covers the physiology, pharmacology, biochemistry, and molecular biology of these receptors from both clinical and basic research points of view.Topics treated by the distinguished contributors include the characterization of tachykinin receptors, the mechanisms of tachykinin receptor action, a reflection on future prospects, and a historical consideration of tachykinin research.

Much of our knowledge of the cerebral circulation has been derived from studies of species other than human. There is increas­ ing recognition of species differences and concern that studies in animals may be misleading if unquestioningly applied to the human. A dramatic example of this occurred in the early his­ tory of the study of the circulation of the brain. Galen of Pergamo (131-201 AD) described a rete mirabile or "marvelous network" of blood vessels at the base of the human skull that he must have derived from observations of certain animals. This vascular structure was supplied by the carotid arteries which, after penetrating the cranium,"are divided into a large number of very small and thin branches in the region between the cranium and the dura matter. Then . . . intersecting one another they give the impression of having forgotten their way in the brain. But this is not the case. In fact, these numerous arteries rejoin and unite like the roots of a tree trunk. . . . " The authority of Galen''s writings dominated scientific thought for about 1500 years. His description of a rete was unques­ tioned by Leonardo de Vinci, who included it in his anatomical sketches. William Harvey''s remarkable observations led to his definitive account of the circulation of blood.

Managing Your Migraine speaks to your needs as a migraine sufferer. It confirms that you suffer from a genuine physical illness and that others share your frustration, disappointments, and anger. Its goal is to move you beyond "learning to live with it" to a full understanding of its mechanisms, symptoms, and treatments. This book proves that you can take charge of your illness-and shows you how to do so safely, effectively, and with real confidence.

In The Best Guide to Allergy, medical experts answer all your personal concerns and questions about allergy and asthma in easily understood language. Drawing on their extensive experience in treating both children and adults, as well as on the latest research findings, they offer up-to-date, explanations of the causes, care, treatment, remedies, and prevention of these uncomfortable, often debilitating, and sometimes even life-threatening ailments.

When Dr. David Cundiff called me with a proposal to help research and write The Right Medicine I was intrigued but skep­ tical. His ideas for reform of the US health care system were visionary, radical, and highly original-but would they work? As a Wall Street analyst and long-time student of the health care system, I had my doubts. had read David''s book on hospice care, Euthanasia Is Not the I Answer, and was impressed. And I had recently witnessed the slow death of my grandmother from the complications of Alzheimer''s disease. Despite the fact that she was and had been suffering for years and despite the fact that her care was an extraordinary emotional and financial burden, nursing home administrators and physicians encouraged one last ditch treat­ ment after another, pulling her back each time from the brink of what would have been a merciful death. I knew that David was correct in his contention that hospice care and a more spar­ ing application of high technology medicine were major keys to improving health care. I also realized, after a decade of analyzing the health care industry, that a government-funded system along the lines of Canada''s was probably the only way to rein in rampant infla­ tion and provide universal coverage. But David had other ideas, too. He argued that preventive care could dramatically cut both the incidence and costs associ­ ated with the most common causes of illness in America today.

The Importance of Measuring Alcohol Consumption To date, alcohol studies have attended far more to issues of alco­ hol dependence and the harmful consequences of drinking than to the level of alcohol consumption itself. This is, perhaps, not surprising since dependence on alcohol is believed to constitute a meaningful and distinct medical syndrome, regardless of the level of alcohol consumption associated with it (Edwards and Gross, 1976). Also, of society is generally more concerned with the adverse consequences drinking (e. g. , traffic fatalities, homelessness, health care and legal expenses, and academiclbehavioral problems in young drinkers), than with the quantity of alcohol actually consumed. Nevertheless, accurate assessment of alcohol usage is important in its own right in at least four contexts: 1. Evaluating the effectiveness of alcoholism and alcohol abuse treatment and prevention efforts. Such efforts include both applied evaluations of existing programs and formal, well-controlled efficacy studies on experimental interventions. These investigations require rigorous methodologies to assess outcomes precisely and contrast what may be quite subtle differences between programs and between pre­ treatment and posttreatment outcomes. Although these studies are usually characterized by the employment of multiple measures of success-including general improvements in social and physical functioning, reduction in degree of dependence, and resolution of problems directly resultant from drinking-it is by their assessment of changes in drinking behavior that they are potentially able to achieve the highest level of objectivity and exactitude.

A major national goal is to improve the health of the populace while advancing our opportunities to pursue happiness. Simulta­ neously, there are both increasing health costs and increasing demands that more be accomplished with less financial support. With the number of deaths attributable to drug abuse, especially of tobacco, in the US at about 250,000 per year, the annual cost of drug addiction is over $150 billion. Improved treatment methods can both reduce these costs and improve health by preventing the continued exposure of abusers to the toxic effects of alcohol and other drugs. This fourth volume of Drug and Alcohol Abuse Reviews focuses on the strategies currently thought best for the treatment of drugs of abuse. A variety of approaches to drug abuse treatment employ those psychosocial factors that are known to influence drug use in youth and adults. Although the main emphasis is on the treatment of illicit drug use, a major cofactor in damaging the health of drug users is nicotine (tobacco) addiction, whose treatment is also reviewed. And the roles of learning and outpatient services are shown to affect treatment significantly. Thus, the problems confronted and solutions used in drug abuse treatment have here been analyzed in concise reviews that deal with the evidence for today'' s best hypotheses and conclusions. Some emphasis is also placed on reviewing new compounds used to prevent cocaine and opioid dependence.