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This book focuses on menstrual cycle bleeding and pain disorders from menarche to menopause. Hormonal and tissue basis of menstrual cycle are described as well as the role of ultrasound in the evaluation of normal and abnormal endometrium and sex steroid hormones used in the treatment of such disorders. How to identify patients with coagulation disorders, the correlation of AUB in early menarche and PCOS later in adolescence and adolescent menorrhagia are extensively analysed for their clinical and therapeutic implication.Anovulatory syndromes and luteal phase defects are explained for their pathogenesis and role in women health. Dysmenorrhea and other pain syndromes as well PMS and PMDD are analysed for their diagnosis and management and the impact of endometriosis, adenomyosis and uterine myoma for the linkage of these organic diseases, inflammation and bleeding and pain disorders related to menstrual cyclicity. Endometrial hyperplasia and malignancy are also extensively examined for their pathogenesis, symptoms and role in uterine bleeding and pelvic pain as well as how to face oncological therapies induced amenorrhea. The last part of the book analyses and discuss the causes of menorrhagia in menopausal transition and the management of bleeding disorders under menopause hormone therapy.Written by experts in the field, this book will be of benefits to residents, general practitioners and specialists, gynaecologists, endocrinologists, paediatricians and GPs who deal with women's health care.

Dieses Standardwerk bietet allen Ärztinnen und Ärzten Sicherheit in der Durchführung und Bewertung endokrinologischer Funktionsteste. Es unterstützt bei einer effizienten Diagnostik, verhilft zu verwertbaren Ergebnissen und einer zuverlässigen Bewertung in der Endokrinologie, Diabetologie, Gynäkologie, Urologie, Andrologie, Kinder- und Jugendmedizin, Inneren Medizin. Die Inhalte orientieren sich an den Empfehlungen nationaler und internationaler Fachgesellschaften.Detailliert und praxisrelevant erhalten Sie einen raschen Überblick über Indikationen, Kontraindikationen, Nebenwirkungen, Testvorbereitung, Rahmenbedingungen, konkrete Handlungsanleitungen zur Testdurchführung, sichere Bewertung der Ergebnisse sowie Praxistipps und potenzielle Fallstricke. Die 5. Auflage wurde kompett aktualisiert und erweitert u.a. um folgende Themen: „Trouble shooting“ bei Immuno-Assays, paraneoplastische Syndrome, Screening der Malnutrition, basales und stimuliertes Copeptin, Metyrapon-Test, Macimorelin-Test und digitale Diabetes-Parameter (CGM).Orientierend an Empfehlungen nationaler und internationaler Fachgesellschaften

Allgemeinverständlich und kurzgefasst stellt dieses Buch die physiologischen Grundlagen der gynäkologischen Endokrinologie und Fortpflanzungsbiologie dar. Hierauf aufbauend werden die wichtigsten Krankheitsbilder und deren Pathophysiologie als auch Bedeutung für den unerfüllten Kinderwunsch dargelegt. Etablierte diagnostische und therapeutische Verfahren werden jeweils weitgehend vertieft und für den klinischen Gebrauch erläutert. Im Buch sind Kapitel zu unterschiedlichen Themenschwerpunkten zu finden:GrundlagenwissenEtablierte diagnostische Verfahren und gynäkologischen FertilitätsstörungenPraxisrelevante Aspekte männlicher Fruchtbarkeitsstörungen, Schilddrüsenerkrankungen im Rahmen des unerfüllten Kinderwunsches, Menopause und KontrazeptionMethoden und Facetten der Kinderwunschbehandlung, von perikonzeptioneller Beratung, natürlicher Familienplanung bis hin zu genetischen und psychologischen AspektenErläuterung von Risiken und VermeidungsstrategienRechtliche und ethische FragenQualitätssicherung in der Reproduktionsmedizin Ziel des Buchs ist die praktische Anwendung und kritische Auseinandersetzung mit den aktuellen Möglichkeiten der modernen Reproduktionsmedizin und gynäkologischen Endokrinologie. Es richtet sich an nicht spezialisierte Gynäkologen, Reproduktionsmediziner sowie Ärzten und Ärztinnen in der Weiterbildung.

Dieses Buch bietet einen Überblick über die neuesten Erkenntnisse zu den psychologischen Aspekten des polyzystischen Ovarsyndroms (PCOS) und ebnet den Weg für Fortschritte in diesem sich rasch entwickelnden Bereich. Anhand eines evidenzbasierten Ansatzes erläutert das Buch, wie PCOS Ängste und Depressionen verursacht, die Lebensqualität beeinträchtigt und mit anderen psychologischen Problemen einhergeht. Die psychologischen Auswirkungen der wichtigsten Merkmale von PCOS werden ebenfalls untersucht, wobei ein besonderer Schwerpunkt auf Insulinresistenz/Diabetes und Fruchtbarkeitsfragen liegt. Das Buch schließt mit einem Kapitel über praktische Empfehlungen, wie man am besten mit Angst und Depression bei PCOS umgeht. Ein wichtiges Merkmal dieses Buches ist, dass es aufzeigt, wie sich Testosteron, ein charakteristisches Merkmal von PCOS, auf die Psychologie auswirkt. Damit füllt es eine Lücke in der aktuellen Forschung und zeigt auf, auf welch komplexe Weise dieBiologie die Psychologie bei PCOS beeinflusst und wie die Psychologie genutzt werden kann, um die Biologie positiv zu beeinflussen. Das Buch richtet sich insbesondere an Wissenschaftler und Kliniker in den Bereichen Gesundheitspsychologie und Frauengesundheit.

••Selected for Doody's Core Titles® 2024 in Obstetrics & Gynecologyn•• Handbook of Obesity in Obstetrics and Gynecology addresses all aspects of general obstetrics and gynecology in obese patients, providing evidence-based guidance for the treatment and management of gynecological problems and pregnancy-related care in obese women. The book is a valuable resource for junior doctors, residents and obstetricians and gynecologists looking for a comprehensive guide that addresses the most relevant aspects of obstetric and gynecologic care that are impacted by obesity, an increasingly prevalent condition. The rising prevalence of global obesity is of public health concern, hence obese women suffer from a higher incidence of menstrual disorders, polycystic ovaries, infertility issues, and more. In pregnancy, obesity is associated with an increased risk of early pregnancy loss, recurrent pregnancy loss, fetal developmental abnormalities, thrombo-embolic disease, gestational diabetes, dysfunctional labor, post-partum hemorrhage and difficult operative deliveries. - Provides a compact, portable and comprehensive book that is a useful resource for patient management and decision-making in daily practice - Presents practical advice, along with key evidence-based guidelines on the treatment and management of all aspects of general obstetrics and gynecology in obese patients - Includes concise information, along with up-to-date research in obesity, providing a quick reference for office and bedside management

Dieses Buch bietet kompakt das gesamte praxisrelevante Wissen zu Hormonen und Stoffwechsel. Oft handelt es sich um angeborene bzw. chronische Erkrankungen. Hier ist es wichtig, frühzeitig die richtigen Weichen zu stellen und die potentiell lebenslange Therapie optimal auf den Patienten anzupassen. Diagnostik, Differentialdiagnostik Leitsymptome, FrüherkennungWelche Verdachtsdiagnose ist plausibel?Erkrankungen zuverlässig nachweisen bzw. ausschließenWelche Begleit- und Folgeerkrankungen müssen bedacht werden?Stufendiagnostik: Was ist medizinisch und wirtschaftlich sinnvoll und effizientTestdurchführung und –auswertungVerlaufskontrolle: Was, wann, wie häufig Therapiestrategien Individuell auf den Patienten abgestimmt(Alter, Schwangerschaft, Begleiterkrankungen, Lebensumstände …)Konservativ/operativ – interdisziplinär abgestimmtKomplikationenVerlauf, Prognose, Nachsorge, Beratung für Patienten und Familienangehörige Konkret und zuverlässig Zahlen, Fakten, Dosierungen in zahlreichen Algorithmen und TabellenTipps für die Praxis (z.B. Verhalten bei Sport, Reisen), FAQs, typische FehlerFallbeispiele Für die FacharztprüfungLern- und Strategiebuch, um sicher die Facharztprüfung Innere Medizin und Endokrinologie und Diabetologie zu bestehen.Für den erfahrenen AnwenderNachschlagewerk für den klinisch-praktischen Alltag für Endokrinologen, Internisten, Allgemeinmediziner, Gynäkologen, pädiatrische Endokrinologen, Nuklearmediziner.

This volume discusses menstrual cycle related disorders, which are a major concern from adolescence to menopause. Starting from hypothalamic pituitary gonadal axis regulation, it analyzes the characteristics and treatments of hypothalamic amenorrhea and eating disorders, as well as polycystic ovary and adolescent hyperandrogenism. It also examines the importance of body composition and physical performance. The book particularly focuses on the diagnosis of and therapies for hormone-related headaches, the management of trans sexuality in the gynecological outpatient area, dysfunctional uterine bleeding and premature ovarian insufficiency. Further, it analyzes the basic, clinical and therapeutic aspects of endometriosis, as well as the important opportunities that SPRMs (selective progesterone receptor modulators) offer in contraception and fibroid therapy. This book is a useful tool for gynecologists, endocrinologists and general practitioners,and is a valuable resource for all physicians involved in women's health.

This book analyzes the effects of estrogens and progesterone on brain cells, the immune system, neuro inflammation, myelin formation and steroid receptor distribution, as well as their clinical impacts. It also explores the relationship between sex-steroid withdrawal and the development of brain symptoms such as hot flushes, sleep disorders, mood changes, depression and also cognitive disorders and dementia, as well as the effects of hormone menopause therapy on such symptoms and diseases. Starting with obstetrical history and cardiovascular risk in later life, the second part of the book examines the effects of estrogens and progestogens on vascular tissues, atherosclerosis and coronary heart diseases, as well as the impact of hormone replacement therapies on cardiovascular risks and mortality. This volume is a useful, clear and up-to-date tool for gynecologists, endocrinologists, neurologists and cardiologists, and serves as a valuable source of information for all physicians involved in women's health.

This volume represents an up-to-date overview on pre-Menopause and Menopause, with their respective clinical implications and therapies. The aim is to clarify possible doubts and clinical approaches to this particular period in a woman's life and how to face it, both offering solutions to actual problems and focusing on the potential impact of preventive medicine in improving women's health and quality of life. The volume is published within the International Society of Gynecological Endocrinology (ISGE) Series, and is based on the 2017 International School of Gynecological and Reproductive Endocrinology Winter Course. This book, covering a very wide range of topics with particular focus on fertility in pre- and peri-menopausal women, climacteric and menopausal symptoms, impact of PCOS on post-menopausal health, breast disease, surgical treatments and therapies, will be an invaluable tool for gynecologists, endocrinologists, and experts in women's health.

“The Textbook of Clinical Sexual Medicine utilizes the biopsychosocial approach to inform physicians, practitioners, residents, trainees, and students about the latest science has to offer today for the evaluation and treatment of sexual dysfunctions especially the utilization of the full armamentarium of assessment methods and treatment interventions in order to restore of sexual health and enhance quality of life.” Louis Ignarro, Ph.D., Nobel LaureateThis textbook is a comprehensive resource covering sexual disorders in depth, from etiology, pathophysiology, phenomenology, treatment, to prognosis. The book highlights aspects the biological and psychosocial factors predisposing, precipitating, and perpetuating sexual dysfunction, and the importance of integrating biological and psychosocial treatments. Specialized chapters cover specific common medical complaints, including erectile, ejaculatory, and orgasmic disorders in the male; desire, arousal and orgasmic disorders in the female; and an integrated approach to the couple. With its focus on educational tools including over 100 figures, easy-to-use DSM-5 criteria table, and quick-guide appendices, this textbook is specially designed to educate readers on the psychiatric evaluation, treatment, and management of a wide range of sexual disorders. The Textbook of Clinical Sexual Medicine is a vital resource for medical students, residents, fellows, graduate students, psychiatrists, psychologists, women's health specialists, urologists, endocrinologists, general practitioners, social workers, and all medical professionals and trainees working with patients suffering from sexual disorders.

This volume represents an up-to-date overview on ovarian functions and reproduction, providing the reader with the latest advances in gynecological endocrinology. It is published within the International Society of Gynecological Endocrinology (ISGE) Series, and is based on the 2015 International School of Gynecological and Reproductive Endocrinology Winter Course. The book covers a very wide range of topics with particular focus on ovulation and assisted reproduction, ovarian aging and fertility, and premature ovarian failure. The volume will be an invaluable tool for gynecologists, endocrinologists, obstetrician, and experts in women's health.

This book brings together the most up-to-date information about the physiology of progestogens. Addressing the bidirectional communication between hormones, fertility, tumors, and autoimmunity, it provides the basic science and clinical perspectives of progestogens which have not been previously available in one volume. In addition to estrogens, androgens, mineralocorticoids and glucocorticoids, progestogens are a major class of steroid hormone. While present in certain phases of estrous and menstrual cycles, progestogens are named for their function in maintaining pregnancy. This book is essentially practical in orientation, addressing the specific issues that confront the practitioner, and provides information to Obstetricians, Gynecologists, Reproductive endocrinologists, as well as Gynecological Oncologists and Rheumatologists. Contributions are from an international team of experts in the field, now completely updated in this new edition with new developments in primary dysmenorrhea and contraception.

In this definitive new text, the major medicines, devices and vaccines used by women worldwide are brought together for the first time in a single volume. Written and edited by international experts with an evidence-based approach, the book offers a comprehensive summary of all the key areas of women's medicines. In the first part, issues relating to female drug exposure and considerations for prescribing for subgroups of women - for example during pregnancy and lactation - are presented in the context of contemporary clinical practice. In the second part, specific groups of pharmaceutical products are reviewed, including oral contraceptives, emergency contraception, treatment of chronic pelvic pain, hormone replacement therapy, bisphosphonates, herbal medicines for women, contraceptive devices and human papilloma virus (HPV) vaccines. Every chapter reviews and summarises the efficacy and safety of each group of products and concludes with a useful set of clinical take home messages. In the third part, broader perspectives are presented - from a primary care overview of prescribing for women, through to regulatory, political and religious aspects, including issues with women's medicines in developing countries. The final two chapters focus on risk communication and conclude that women themselves should be placed at the centre of all discussions about their medicines.The book is aimed at prescribers, other healthcare professionals and students in the field of women's health throughout the world. It is an extremely valuable resource for all in clinical practice, for students of medicine, nursing, pharmacy and related sciences, and also for those in medicines regulation, pharmacovigilance and the pharmaceutical industry.

Prostaglandine haben in den letzen Jahre in der Gynäkologie und Geburtshilfe zunehmende Bedeutung gewonnen. In diesem Buch wird der Einsatz der Prostaglandine in der Reproduktionsmedizin dargestellt, wobei sowohl die Aspekte der Grundlagenforschung als auch die klinische Anwendung besprochen werden. Es vermittelt den derzeitigen aktuellen Wissensstand auf diesem Gebiet und ist für jeden Gynäkologen und Geburtshelfer in Praxis, Klinik und Forschung ein unerläßlicher Ratgeber für die Anwendung dieser interessanten, aber auch mit gewissen Risiken behafteten Substanz.

Die zentralen Themen der Andrologie sind Infertilität, Hypogonadismus, Kontrazeption und erektile Dysfunktion. Das Buch vermittelt einen vollständigen Überblick über die klinische Praxis dieses Gebiets und die relevanten naturwissenschaftlichen Grundlagen (einschl. Molekularbiologie und -genetik). Der Kliniker wird umfassend informiert über die Aspekte der Paarbehandlung, andrologierelevante Gynäkologie und moderne Verfahren der assistierten Fertilisation, über psychologische Faktoren der Infertilität, Endokrinologie und reproduktive Funktionen des alternden Mannes sowie über ein wichtiges Teilgebiet der Andrologie, den männlichen Beitrag zur Kontrazeption. Juristische und ethische Fragen kommen ebenfalls zur Sprache.

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Dieses Standardwerk ist aus der Praxis für die Praxis geschaffen und richtet sich überwiegend an niedergelassene Frauenärzte und Ärzte in der Weiterbildung. Der theoretische Teil ('Normale Hormonfunktionen') des Buches erklärt die biologischen und physiologischen Grundlagen der Endokrinologie und führt in die klinische Anwendung molekulargenetischer Verfahren ein. Der praktische Teil ('Gestörte Hormonfunktionen') berücksichtigt besonders die alltäglichen Belange in der Frauenarztpraxis und gibt detaillierte Anweisungen für die Hormondiagnostik und -therapie zu weit verbreiteten weiblichen Hormonstörugen, geht aber auch auf seltene Krankheitsformen ein. Die Neuauflage wurde inhaltlich stark überarbeitet, aktualisiert und erweitert, insbesondere wurden interdisziplinäre Aspekte aufgenommen.

Die regelhaften und gestörten Funktionen des Hormonsystems vom Säuglings- bis zum jugendlichen Erwachsenenalter sind das Thema dieses bewährten Standardwerkes für Pädiater, Endokrinologen und alle anderen Ärzte, die Kinder und Jugendliche behandeln. Diagnose, Klinik, pathophysiologischer Hintergrund und Therapie der täglich in der Praxis vorkommenden Krankheitsbilder werden detailliert erörtert. Für die 3. Auflage wurden alle Kapitel aktualisiert, didaktisch überarbeitet und in einem neuen zweifarbigen Layout gestaltet. Die neuesten wissenschaftlichen Erkenntnisse, die sich besonders in der Molekulargenetik und Hormonanalytik ergeben haben, sind berücksichtigt. Als Grundlage für die Beurteilung endokrinologischer Störungen bei Kindern und Jugendlichen ist das Buch von großem praktischem Wert.

Professor Egon Diczfalusy, a pioneer in gynaecological endocrinology and in particular female contraception, celebrated his 80th birthday with a scientific symposium. The participants were scientists from all over the world who had been scholars and close collaborators at different points in time. The interdisciplinary meeting consisted of lectures on the epidemiological impacts of ageing, its challenge for the pharmaceutical industry, philosophical aspects of the future of mankind, and the history and future of contraception. Three round table discussions addressed the hormonal control of reproduction and ageing, new approaches and future perspectives of contraception for women and men, and hormone replacement in the elderly.

Pathologie, Band 3 behandelt in zweiter, neubearbeiteter Auflage die Pathologie der Leber, Gallenblase, extrahepatischen Gallengänge, Vater-Papille, des exokrinen Pankreas, Peritoneums und Retroperitoneums, der Hernien sowie der Atmungsorgane einschließlich Pleura auf dem neusten Kenntnisstand. Durch die Berücksichtigung der klinisch praktischen Konsequenzen ist das Nachschlagewerk nicht nur für Pathologen, sondern auch für Kliniker relevant.

Der alternde Mann - eine Entwicklung, die seit jeher trotz ihrer Allgegenwärtigkeit tabuisiert wurde. Von der Entstehung antiker Kulturen an versuchte man, den Verlust vegetativer, psychischer, sexueller und körperlicher Stabilität auf vielfache Weise zu verhindern oder zu kompensieren. Die Ursache für diese Entwicklung liegt im sogenannten'Hormontief'des Mannes ab 50, dessen Entdeckung einen kausalen Lösungsansatz z.B. in Form der Testosteronsubstitutionstherapie ermöglichte. Neben Fachärzten für Urologie bietet das Werk insbesondere hausärztlich tätigen Fachärzten für Innere- und Allgemeinmedizin eine Anregung zu adäquater Aufklärung und Prävention sowie konkrete Optionen für Diagnostik und Therapie des sekundären Hypgonadismus.

Das Ziel dieses Buches ist es zu zeigen, dass die Knochengesundheit nicht nur Aufgabe jeden Arztes ist, sondern auch vom Patienten konsequente Mitarbeit abverlangt: Bone is EveryBody's Business. Es werden praktische Richtlinien für Diagnostik, Therapie und Prävention der Osteoporose gegeben - von der Pädiatrie bis hin zur Geriatrie. Dieses Buch informiert Ärzte aller Disziplinen darüber, dass die Osteoporose heute eine vermeidbare und auch behandelbare Krankheit geworden ist. Es wurde vor allem benutzerfreundlich geschrieben, damit jeder Arzt Informationen auch über besondere Themen der Osteoporose unkompliziert und rasch findet.

Die Hyperprolaktinämiesyndrome gehören zu den facettenreichsten endokrinen Erkrankungen. Innerhalb der gynäkologischen Endokrinologie wird die Hyperprolaktinämie als Ursache von Zyklusstörungen bei ca. 15% der Frauen mit Amenorrhö gefunden. Bei Männern gehört die Hyperprolaktinämie zu den wichtigsten somatischen Ursachen der Impotenz. Außerdem spielt sie als Begleiterkrankung anderer endokriner Störungen eine Rolle. Das vorliegende Buch gibt eine Übersicht über die heute akzeptierten theoretischen, klinischen und therapeutischen Konzepte bei der Hyperprolaktinämie. Völlig neu ist dabei die Integration eines Konzeptes über psychologische Befunde. Das Buch ist für interessierte Ärzte, welche Patienten mit Hyperprolaktinämiesyndromen behandeln, eine unerläßliche Informationsquelle.

Die Zahl der Frauen, die Leistungssport betreiben, hat in den letzen Jahren deutlich zugenommen. Das vorliegende Buch enthält die Beiträge eines Symposiums, auf dem Ärzte, Psychologen, Physiotherapeuten, Trainer sowie eine Athletin u. a. zu Fragen des Einflusses von Leistungssport auf die endokrine Regulation, Schwangerschaft, Eßgewohnheiten, Zyklusverhalten und den Einsatz von Anabolika Stellung nehmen. Die vielfältigen Probleme des Frauensports zusammen mit den aktuellen Ergebnissen der wissenschaftlichen Forschung werden in diesem Buch erstmalig zusammen dargestellt.

Die Osteoporose ist eine der großen Volkskrankheiten - kaum eine andere Erkrankung der westlichen Gesellschaften zeigt einen derartig steilen Anstieg der Erkrankungshäufigkeit.Alle, die sich mit diesem Krankheitsbild beschäftigen, finden in diesem Buch eine aktuelle Übersicht zu: Pathophysiologie, Diagnostik, Prophylaxe, Behandlungsmöglichkeiten und Rehabilitation.

Das Buch ist auf die Bedürfnisse der Praxis abgestimmt, ohne sich ins Detail zu verlieren oder auf wichtiges Grundlagenwissen zu verzichten. Besonderer Wert wurde auf die Vorbeugung und Behandlung diabetesassoziierter Spätkomplikationen gelegt, wie sie nach langer Krankheitsdauer in der Form des diabetischen Fußes oder einer Beschleunigung der arteriellen Verschlußkrankheit auftreten können.

Dieses Buch vereint Beiträge namhafter Fachleute zu einer umfassenden Darstellung des derzeitigen Wissens über Östrogene. Die Grundlagen des Östrogenstoffwechsels und der Nutzen von Östradiol- und Östriolbestimmungen zur Zyklusdiagnostik sowie während der Schwangerschaft werden ebenso behandelt wie die Anwendung von Östrogenen zur Behandlung von klimakterischen Beschwerden sowie zur Prävention von Osteoporose und Herz-Kreislauf-Erkrankungen. Die Leser erhalten so einen aktuellen und kritischen Überblick über die Einsatzmöglichkeiten von Östrogenen in Diagnostik und Therapie.

Hohe Trainingsbelastungen lösen bei Leistungssportlerinnen häufig lang anhaltende Zyklusstörungen aus. Die Folge sind ein verminderter Östrogenspiegel und eine gestörte Entwicklung des im adoleszenten Alter notwendigen Knochenaufbaus. Bei den betroffenen Athletinnen kommt es gehäuft zu Ermüdungsbrüchen der unteren Extremitäten, als deren Ursache neben biomedizinischen Faktoren die verminderte Knochendichte angesehen werden kann. Bisher wurde die Streßfraktur als rein orthopädisches Problem angesehen. In diesem Buch wird das Thema zum ersten Mal interdisziplinär diskutiert von Wissenschaftlern aus den Gebieten der internistischen Osteologie, gynäkologischen Endokrinologie, diagnostischen Radiologie, Orthopädie und Ernährungswissenschaft. Erfahrungen aus der Trainingslehre, der Sportphysiotherapie und von betroffenen Athletinnen runden die Darstellung ab.

Periodically in the evolution of an important branch of clinical medicine there develops a critical need for a textbook which combines with the clinical aspects of disease syndromes an in-depth review of the sciences basic to the disorders discussed, as well as a carefully selected but com­ prehensive review of pertinent literature. LABHART'S Clinical Endo­ crinology revised and translated into English provides for this need in the field of endocrinology in an exemplary manner. Prof. LABHART has selected his individual authors with great care, and they in turn have provided authoritative monographs. An interesting, useful and informative introduction to each chapter is provided by a tabulation of the dates of important or significant contributions to the field. The chapter subdivisions present in great detail a wide variety of subjects such as embryology, anatomy, biochemistry, physiology, indi­ vidual hormones and their analogues, biosynthesis, metabolism and regulation of hormone release as well as a full discussion of the clinico­ pathological correlations. The bibliography is unusually extensive and will provide an important source book for all investigators and students in the field.

It is about 15 years since the first presentation on uteroglobin was given to a group of developmental biologists, reproductive physiologists, and geneticists who had gathered in November 1966 at Konstanz (Germany). In the following decade so much knowledge was accumulated that a special symposium seemed appropriate. This was organized as a satellite symposium to the International Congress of Endocrinology at Hamburg and brought together 50 scientists at Aachen. These scientists, working in the field of pro­ teins and steroids, in early pregnancy, recognized the impact of what had been reported, and many of them later agreed to contribute to this booN. and thus to present their research d,!ta available until December 1980. The present volume covers a relatively broad spectrum of data and observations which shed some light on preimplantational embryonic life and on the supports and obstacles provided by the maternal organism with respect to final accomplishment of normal im­ plantation and establishment of pregnancy. The book will serve both as a textbook and as a scientific dictionary for Ph.D. students, postdoctoral fellows and advanced scientists working in this area. The course of early pregnancy depends very much on a proper balance of steroid hor­ mones, and the induction of protein synthesis by steroid hormones is one of the well­ known fundamental processes in cellular differentiation and embryonic development.

The International Life Sciences Institute (ILSI) was estab­ lished in 1978 to stimulate and support scientific research and educational programs related to nutrition, toxicology, and food safety, and to encourage cooperation in these programs among scientists in universities, industry, and government agencies to assist in the resolution of health and safety issues. To supplement and enhance these efforts, ILSI has made a major commitment to supporting programs to harmon­ ize toxicologic testing, to advance a more uniform inter­ pretation of bioassay results worldwide, to promote a common understanding of lesion classifications, and to encourage wide discussion of these topics among scien­ tists. The Monographs on the Pathology of Laboratory Ani­ mals are designed to facilitate communication among those involved in the safety testing of foods, drugs, and chemicals. The complete set will cover all organ systems and is intended for use by pathologists, toxicologists, and others concerned with evaluating toxicity and carcinogen­ icity studies. The international nature of the project - as reflected in the composition of the editorial board and the diversity of the authors and editors - strengthens our ex­ pectations that understanding and cooperation will be im­ proved worldwide through the series. Alex Malaspina President International Life Sciences Institute Preface This book, on the integumentary system, is the seventh volume of a set prepared under the sponsorship of the International Life Sciences Institute (ILSI).

Man is entering a new era as a result of advances in human reproduction. Techniques have been developed to assist in the creation of man-artificial insemination and, now, in vitro fertilization (IVF). Soon, other new methods, based upon current advances of the IVF procedure, will develop to improve the quality of human reproduction. The book describes the conceptual framework and details of technique concerned with in vitro fertilization and embryo transfer (ET). Edwards and Steptoe first described the technique of IVF and ET and the subsequent births of two normal babies. Since then, the success rate of the system has been improved by the use of fertility drugs to provide more oocytes and preincubation to mature the oocyte before fertilization. As a result of the continued research from Melbourne and Cambridge, more than 100 babies have been born. A free interchange of information between the Cambridge and Melbourne groups has led to a predictable success rate of 15%-20% per laparoscopy, and infertility centres all over the world are now copying the techniques. It is an appropriate time to inform doctors and scientists to help them understand the various procedures involved in IVF and ET. While many advances will occur in the future, the establishment of high success rates in several of the critical steps in the procedure-oocyte pick-up rate (90%), fertilization (>90%) and early embryo development (70%-90%)-signifies that some of the new techniques are stabilized sufficiently to warrant transmission of information by text, rather than scientific journal.

The European School of Oncology came into existence to respond to a need for informa­ tion, education and training in the field of the diagnosis and treatment of cancer. There are two main reasons why such an initiative was considered necessary. Firstly, the teaching of oncology requires a rigorously multidisciplinary approach which is difficult for the Univer­ sities to put into practice since their system is mainly disciplinary orientated. Secondly, the rate of technological development that impinges on the diagnosis and treatment of cancer has been so rapid that it is not an easy task for medical faculties to adapt their curricula flexibly. With its residential courses for organ pathologies and the seminars on new techniques (laser, monoclonal antibodies, imaging techniques etc.) or on the principal therapeutic controversies (conservative or mutilating surgery, primary or adjuvant chemotherapy, radiotherapy alone or integrated), it is the ambition of the European School of Oncology to fill a cultural and scientific gap and, thereby, create a bridge between the University and Industry and between these two and daily medical practice. One of the more recent initiatives of ESO has been the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on future developments in specific fields of oncology.

During the past 3 years, little has been added to our funda­ mental knowledge of hormonal disorders in gynecology. Diagnostically, however, there has been an almost com­ plete departure from traditional chemical methods in favor of radioimmunoassay techniques. As a result, diagnostic capabilities which previously were restricted to large cen­ ters have now been extended to the office and small clinic. Accordingly, the chapters dealing with these techniques have been revised and updated. There is also new material on advances in the hormonal treatment of endometriosis and hyperprolactinemic states. Finally, the bibliography has been extensively revised to include a number of recently published books and survey articles of general interest. Paul J. Keller v Preface to the First German Edition Menstrual disorders and sterility are among the most com­ mon complaints noted by both the specialist and general practitioner. For many patients they are far more distress­ ful than is generally assumed. Recent years have brought our knowledge. While this has led to great advances in major improvements in the results of treatment, it has made it difficult for the nonspecialist to keep abreast of developments in the field of gynecologic endocrinology.

Research on the hormonal control oflactation - the subject of this monograph - has long been the major interest of this laboratory. Studies were initiated in the mid 1930s by the late Professor S. 1. Folley, FRS, who directed the work with immense enthusiasm and devotion until his untimely death in 1970. This fruitful area of basic and applied research has, in recent years, attracted widespread attention; there have been many exciting events and developments with a dramatic increase in the number of publications. These events are diverse and include the identification, isolation and sequencing of human prolactin; the identification and isolation of placentallactogens in several ruminant species with recognition of their importance in mammary growth and differentiation; the introduction of highly sensitive bioassay, radioimmuno- and radioreceptor-assay techniques for mammotrophic hormones; the growing clinical appreciation of the immunological and nutritional importance of colostrum and milk to the newborn; the intensification of studies on normal mammogenesis to establish a sound basis for studies on mammary cancer; and the exploitation of the mammary gland, with its characteristic differentiation patterns and multiple synthetic abilities, as a valuable tissue for the investigation of basic mechanisms involved in the synthesis under hormonal control of enzymes and secretory proteins; and for the study of hormone - receptor interactions.

Reevaluation of tumor classification, differential diagnosis and differential therapy based on modern knowledge. Revision of all chapters to incorporate new facts based on recent discoveries.

The 4th International Symposium on Women's Health and Menopause, organized by the Giovanni Lorenzini Medical Foundation (Milan, Italy and Houston, Texas) focused on the new strategies to improve the quality of life of post-menopausal women. This volume illustrates the findings of this conference and includes information on the age-related degenerative processes occurring after menopause including cardiovascular disease, cancer, fractures and dementia.

Key questions involved in the treatment of disseminated breast cancer are discussed in this well-presented overview. It is the result of an initiative taken by the Swiss Group for Clinical Cancer Research to reveal the most recent developments in experimental and clinical research. The topics discussed include: the comparison of in vitro cultures of epithelial cells with breast cancer cells, the effect of steroids and their antagonists, the involvement of suppressor genes in tumour progression, the modulation of transforming growth factors by estrogen, and prognostic factors such as cERB-2 and EGF-R in breast cancer.

Imaging studies are playing an increasingly role in the evaluation of endocrine diseases; accordingly, familiarity with the specific indications for the various modalities, and with the characteristic findings, is essential. This multi-author work, which is intended for both radiologists and endocrinologists, considers the role of all the recent imaging techniques, including ultrasound (particular color Doppler), computed tomography, MRI, and scintigraphy. Following an extensive introduction on the pituitary, subsequent chapters discuss in detail the normal anatomy and pathology of the female and male reproductive systems. Remaining chapters provide state-of-the-art data on the thyroid, parathyroids, pancreatic endocrine tumors, adrenal glands, hormonal tumors (carcinoids and MEN), and imaging of the complications of hormone therapy.

Endocrinologic investigations during pregnancy have focused in the last decades on placental hormones, the maternal endocrine system and maternal fetal interactions. Less is known about the fetus itself and the interaction of fetal hormonal response and physiological parameters. In this book physiologists, pediatricians and obstetricians active in experimental studies in both physiology and endocrinology combine both aspects of investigations. Historical remarks on the endocrine development of the fetus are followed by observations of the hormonal control of the cardiovascular system. Basic mechanisms of fetal endocrine control such as brain development, fetal growth, fetal behaviour, and thermoregulation are given particular consideration. Finally, carbohydrate metabolism and the mechanism of parturition are outlined.

The European School of Oncology came into existence to respond to a need for informa­ tion, education and training in the field of the diagnosis and treatment of cancer. There are two main reasons why such an initiative was. considered necessary. Firstly, the teaching of oncology requires a rigorously multidisciplinary approach which is difficult for the Univer­ sities to put into practice since their system is mainly disciplinary orientated. Secondly, the rate of technological development that impinges on the diagnosis and treatment of cancer has been so rapid that it is not an easy task for medical faculties to adapt their curricula flexibly. With its residential courses for organ pathologies and the seminars on new techniques (laser, monoclonal antibodies, imaging techniques etc.) or on the principal therapeutic controversies (conservative or mutilating surgery, primary or adjuvant chemotherapy, radiotherapy alone or integrated), it is the ambition of the European School of Oncology to fill a cultural and scientific gap and, thereby, create a bridge between the University and Industry and between these two and daily medical practice. One of the more recent initiatives of ESO has been the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on future developments in specific fields of oncology.

The European School of Oncology came into existence to respond to a need for information, education and training in the field of the diagnosis and treatment of cancer. There are two main reasons why such an initiative was considered necessary. Firstly, the teaching of oncology requires a rigorously multidiscipli­ nary approach which is difficult for the Universities to put into practice since their system is mainly disciplinary orientated. Secondly, the rate of technological development that impinges on the diagnosis and treatment of cancer has been so rapid that it is not an easy task for medical faculties to adapt their curricula flexibly. With its residential courses for organ pathologies and the seminars on new techniques (laser, monoclonal antibodies, imaging techniques etc.) or on the principal therapeutic controversies (conservative or mutilating surgery, primary or adjuvant chemotherapy, radiotherapy alone or integrated), it is the ambition of the European School of Oncology to fill a cultural and scientific gap and, thereby, create a bridge between the University and Industry and between these two and daily medical practice. One of the more recent initiatives of ESO has been the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on future developments in specific fields of on­ cology.

The epididymis has great significance in the reproductive biology of the male and it is gaining recognition as an organ worthy of study in its own right - where the secretory and absorptive activities of one tissue (the epithelium) profoundly modify the function of another (the spermatozoon). Apart from cases of epididymal agenesis or physical blockage, however, it is not yet known to what extent mal­ functions of the epididymis contribute to'unexplained'male infer­ tility, but its importance as a target for antifertility agents in the male is now widely appreciated. This monograph evolved from two lectures on epididymal func­ tion given at the National Research Institute for Family Planning, Beijing and the Sichuan Provincial Family Planning Research Insti­ tute, Chengdu, China in 1983. In order to stress for this audience the central importance of the epididymis in fertilisation, and so highlight its potential for attack by antifertility agents, the talks attempted to put the epididymis in reproductive perspective by stressing the func­ tional development of the sperm cells during their sojourn in the epididymis, rather than merely listing the changes observed in them.