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E.MARTIN Acute pain services are now established worldwide and guidelines have been drawn for the management of acute pain resulting from surgical or medical procedures and trauma. However, the treatment of pain after surgery is still inadequate and no progress has been made in recent years in several coun tries, including Germany. There are still innumerable patients who find the is also no early postoperative period to be an unpleasant experience. There doubt that pain plays a role in the pathogenesis of postoperative complica tions that could be avoided with effective pain management. However, concern about side effects and inadequate knowledge of the pharmacokinet ics and -dynamics of drugs is still putting constraints on treatment. An acute pain service should be responsible for adequately treating pain, training medical and nursing staff, and evaluating new and existing methods of treatment. As anesthesiologists deal with pain in the operating theater, it is not surprising that they claim a leading role for themselves in acute pain services choosing from the various postoperative pain treatment options.

This book provides a modern survey on the pathophysiological and clinical implications of the most frequent forms of Car- diomyopathies, including diagnostic tools and new pharmaco- logical therapeutical approaches. An interesting additional aspect is the new data on immunology on dilated cardiomyo- mypathies and sudden death in children as well as heart transplantation as ultimum rationale of treatment.

Knowledge of the mechanism of action of drugs at cellular, subcellular, or molecular levels is of vital importance not only in giving the basis of inter pretation of the systemic action of drugs but also in improving existing drugs; in designing new forms of drugs; and in giving the basis of therapeutic applications. Classical pharmacology, concerning the action of drugs at integrated levels, does not necessarily give sufficient information as to the mechanism of action of drugs. A variety of sophisticated concepts utilizing the methods of physics, chemistry, biophysics, biochemistry, and physiology must be synthesized to understand the mechanism of action. Only since the last decade, however, have these techniques been fully applied to pharma cological investigations. It is of utmost importance to realize that a new dimension of pharmacological research has indeed emerged as a result of such a multidisciplinary approach; this approach is encompassed in general and cellular pharmacology. Such recent studies of drug actions have led to a number of important findings. Certain chemicals and drugs were found to possess highly specific actions on cellular functions, so that they are widely being used as powerful tools for the study of a variety of physiological and pharmacological prob lems. Our knowledge of the cellular mechanisms of drug action has provided the basis for interpreting the systemic effects of the drugs and insight into the molecular mechanism involved.