Surgical Management of Benign Esophageal Disorders: The "Chicago Approach" covers all stages of the diagnosis and treatment of the most common benign esophageal disorders in a concise and easy-to-read format.Indications, patient preparation, operative techniques, and strategies for avoiding and managing complications are included and based both on evidence-based data and the experience of the most famous esophageal surgeons in the United States and abroad. Each chapter includes a summary of the current management strategy for the disease process, and a review of current state of the art techniques provided by world leaders on esophageal disease, surgeons and gastroenterologists alike. A special emphasis is given to emerging procedures in laparoscopy, thoracoscopy, and endoscopy. Surgical Management of Benign Esophageal Disorders: The "Chicago Approach" is illustrated throughout with line diagrams that depict fundamental anatomic or technical principles and is a valuable resource for surgeons and gastroenterologists in residence and training.

A detailed instruction manual including high definition open access online videos For the first time the editors of this volume have brought together text, illustrations and high-definition videos to create an expert video atlas in the field of pediatric airway surgery. The publication which includes the book and free online access to the videos provides a detailed review of the pros and cons and clinical pearls involved in various modes of pediatric airway surgery. Discussed are all the main open airway surgeries including laryngotracheal reconstruction, cricotracheal resection, tracheal resection and re-anastomosis, and slide tracheoplasty. Further covered is a range of endoscopic procedures such as endoscopic repair of laryngeal clefts and endoscopic treatment of vocal fold immobility. The high-definition videos with audio overlay and the text complement provide an excellent detailed instruction manual for surgeons willing to carry out these operations. This publication is designed for all levels, from medical student through residency and fellowship as well as the pediatric otolaryngologist or pediatric surgeon preparing for pediatric airway surgery.

This book explores the non-interventional aspects of interventional pulmonology, focusing on diseases of the central airways. As the field of bronchology and interventional pulmonology expands, newer conditions involving the central airways are being recognized with increasing frequency. Current literature has mainly focused on technical aspects of the subspecialty, but this book illuminates what else interventional pulmonology has to offer the pulmonologist, including diagnosis and alternate therapeutic options. Diseases of the Central Airways: A Clinical Guide presents techniques for the diagnoses, management and treatment of patients with intriguing central airway conditions such as: black bronchoscopy, tracheobronchomalacia, endobronchial tuberculosis, and tracheobronchopathia osteochondroplastica. In-depth chapters are written by international experts and are up-to-date and comprehensive reviews. This important new book will contribute significantly to the welfare of patients with lung ailments of the central airways.

Clinical lung transplantation has seen an early start within the history of solid organ trans plantation, marked by the 1963 first lung transplant by James D. Hardy. This was prompted by the seemingly easy way of joining the transplanted organ to the recipient by me ans of a few well-defined anastomoses, i.e. bronchus, pulmonary artery and pulmonary vein carry ing left atrial cuff. The following decade thus witnessed a number of such mostly unilateral lung transplants in several centres, in Germany represented by the two only lung transplants performed by E. S. Bucherl, then at the Neukolln City Hospital in Berlin in 1969. As with most other such attempts these two patients suffered early and lethai graft failure. There was only one single lung transplant patient who lived up to ten months after the transplant at Gent, Belgium, having been operated on by Derom in 1969. The alm ost universal failure during this initial phase was attributed to bronchial anasto motic insufficiency, pulmonary infection of either the transplanted lung or the left-in-place contralateral lung and a far-reaching lack of knowledge how to cope with transplant rejec tion. In the early 1970s it had become gene rally accepted that lung transplantation could not be performed successfully."

This book covers the latest information on the anatomic features, underlying physiologic mechanisms, and treatments for diseases of the heart. Key chapters address animal models for cardiac research, cardiac mapping systems, heart-valve disease and genomics-based tools and technology. Once again, a companion of supplementary videos offer unique insights into the working heart that enhance the understanding of key points within the text. Comprehensive and state-of-the art, the Handbook of Cardiac Anatomy, Physiology and Devices, Third Edition provides clinicians and biomedical engineers alike with the authoritative information and background they need to work on and implement tomorrow's generation of life-saving cardiac devices.

This comprehensive resource brings together the most current theories, evidence and best practice parameters for the use of nocturnal non-invasive ventilation (nNIV). Chapters focus on the application of acute and chronic nNIV in patients with cardio-respiratory disorders over a range of major medical settings. Updates on past and recent research in this field are highlighted. Authored by leading clinicians and investigators, Nocturnal Non-Invasive Ventilation provides practical and cutting-edge knowledge to physicians, researchers and allied health professionals on the front lines of treating cardio-respiratory and sleep disorders.

A pioneering group of authors describes in this book, for the first time, the state of the art of spinal cord stimulation for chronic critical limb ischemia. This method, a progeny of pacemaking in cardiac rhythm disorders, is a promising, innovative procedure; it presents a modern challenge in treatment of endstage peripheral vascular disease or neuropathic pains. Spinal cord stimulation may have a tremendous future if it further develops to become a standard treatment in special indications.

Advances in heart surgical treatment have been impressive in the last 15 years. In end-stage heart disease, procedures are now performed routinely which were only experimental one or two decades ago. Heart transplantation has become a well-established procedure. According to the Gen eral Registry of the International Society of Heart and Lung Transplantation. 40,738 heart transplantations had been performed through the end of 1997 with survival rates of 78 % at one year, 65 % at five years, and 42 % at ten years. The progress in this field has been due to intense efforts in understanding and modulating immune responses to the trans planted heart, to elaborate therapeutic strategies to constrain infections, and to improved out-patient care. Accordingly, heart transplantation is integrated into the facilities of the health care systems, the routine of physicians, and the awareness of patients. The resulting increase in potential organ recipients has not been met, however, by an equivalent increase of available donor organs. This increasing discrepancy has forced the technical improvement and clinical evalua tion of mechanical circulatory support systems as an option for treatment of critically ill patients with a failing heart. Initially, these assist devices were only used to maintain sufficient circulation in post-cardiotomy heart failure until myocardial function had recov ered. Since the late 1980s, their primary use has been that of bridging patients with heart failure until a suitable organ is available so that heart transplantation can be performed."

Over the past 15 years, mechanical valves, and in particular, bileaflet mechanical valves, have made considerable strides in durability and hemodynamic per- formance. However, biocompatibility in terms of thrombo- embolism, thrombosis, and hemolysis has remained an area where improvement is needed. "New Development in Bileaflet Mechanical Heart Valve" discusses advances in these important areas of prosthetic valve function and provides clinical experience with a new open pivot, bileaflet mechanical valve.

It was the genius of Gordon Murray in Toronto that introduced the use of allografts into cardiac surgery in the 1950s. Soon after this on opposite sides ofthe world, Sir Brian Barratt-Boyes in Auckland, New Zealand, and Mr. Donald Ross in London, undertook to use allografts for the replacement of diseased aortic valves. Since that time the global interest in allografts has been patchy, episodic, and without a con sensus. Nonetheless, for the last 20 years at least three groups in the world have steadfastly pursued the development of new and relevant information concerning the use of allograft valves in humans. These are the centres of Sir Brian Barratt Boyes, Mr. Donald Ross, and Mark O'Brien in Brisbane. More recently, talented investigators, including Drs. Yankah, Yacoub, and others, have been developing information concerning the immunological aspects of the use of allografts, as well as their clinical use. No doubt, at present, cardiac valve allografts of one sort or another are the devices of choice for conduits and have an important place in the surgery of aortic valve replacement. Even so, in the mind of this writer at least, the future usefulness of allografts for the replacement of diseased cardiac valves and conduits between a ventricle and the pulmonary artery, remains problematic, and depends upon improvements in other devices for this purpose and upon improve ments that may be made in preparing and using allografts."

Spinal Cord Stimulation II (SCS) contains the state of the art of this innovative method in the treatment of peripheral vascular disease.
The volume presents such topics as: Spinal Cord Stimulation for Chronic Pain.- Management of Critical Limb Ischemia.- Spinal Cord Stimulation for Angina Pectoris.- Buerger's Disease.- Miscellaneous.

Our common interest in surgery of the vertebral artery was born in 1976, when as residents in the same hospital, we attended an attempt by two senior surgeons to treat an aneurysm of the vertebral artery at the C 3 level. Long discussions had preceded this unsuccessful trial, to decide if surgery was indicated and to choose the surgical route. Finally a direct lateral approach was performed, but access was difficult and correct treatment was impossible, resulting in only partial reduction of the aneurysmal pouch. Following this experience, we decided to seek a regular and well defined approach for exposition of the vertebral artery. Review of the literature indicated some surgical attempts, but the descriptions did not give the impression of safety and reproducibility. No landmark on the described surgical route appeared sufficiently reliable. Henry's anatomical work (1917) gave the only accurate description on vertebral artery anatomy, and it became the basis for our work. When the same patient was referred again one year later, after a new stroke in the vertebro-basilar system, we had behind us repetitive experience on cadavers of an original approach to the distal vertebral artery.

This book represents the first comprehensive textbook devoted to the standard of care, current guidelines and innovations in the field of mesenteric vascular disease. The book reviews imaging modalities, diagnostic work up, physiologic tests, traditional open surgical techniques and novel endovascular approaches. Technical aspects of both open surgical and endovascular techniques are provided by experts in the field, with illustrations and photographs of key steps for each type of procedure. Results of epidemiologic studies and national databases are summarized, as well as large institutional experiences. An evidence-based approach is used for recommendations regarding best therapies. Diagnostic approaches including imaging and novel physiologic tests, including gastric tonometry and oxygen light spectroscopy are covered. Mesenteric Vascular Disease: Current Therapy will serve as a very useful resource for clinicians, surgeons, interventionalists, gastroenterologists and researchers dealing with and interested in mesenteric vascular diseases.

New Techniques for Thoracic Outlet Syndromes presents in a comprehensive format an up-to-date, state of the art reference that physicians can use in consultation to properly treat patients using the resources that modern medicine offers. This book offers the newer surgical approaches that have been developed during the past 30 years. Some of these techniques are modification of operations that were proposed previously but were not fully affective and left many patients suffering with permanent disability. This textbook is a compendium of the proper management of these patients that cannot be found in isolated reports of literature. The neurogenic-arterial thoracic outlet syndrome section covers how to diagnosis the illness using the proper tests, therefore eliminating the use of expensive, uncomfortable and inconvenient tests. The text is organized in three basic sections that cover all the aspects of the thoracic outlet syndromes. The first section addresses the neurogenic-arterial type, with the pertinent subsections: symptoms, diagnosis. A list of the useful tests is provided to make a correct diagnosis of this syndrome. This is followed by the sections on treatment, using the surgical approaches with historical aspects and evolution of the operations proposed. The second section involves the venous thoracic outlet syndrome divided into the corresponding subsections comprising: symptoms and physical findings, etiology, diagnosis. This section also includes a list of the usual tests to make the proper diagnosis. The last section of this text is dedicated to the presence of cervical ribs and their classification of the different types that occur, and also the proper surgical treatment when fusion of the upper ribs is present. New Techniques for Thoracic Outlet Syndromes offers the current, acceptable and most effective methods to handle thoracic outlet syndromes. It will be of great value to thoracic surgeons, vascular surgeons, interventional radiologists as well as fellows and residents in training for cardiothoracic and vascular surgery.

Computational Cardiovascular Mechanics provides a cohesive guide to creating mathematical models for the mechanics of diseased hearts to simulate the effects of current treatments for heart failure. Clearly organized in a two part structure, this volume discusses various areas of computational modeling of cardiovascular mechanics (finite element modeling of ventricular mechanics, fluid dynamics) in addition to a description an analysis of the current applications used (solid FE modeling, CFD). Edited by experts in the field, researchers involved with biomedical and mechanical engineering will find Computational Cardiovascular Mechanics a valuable reference.

In the last decade, technical improvements have changed the inventory of many research laboratories. New techniques and discoveries continuously give rise to observations that result in the de?nition of new research objectives. In the past, - search departments were clearly demarcated. Nowadays, technology that is shared by all lines of research stimulates convergence of research interests. This also - plies to cardiovascular research. Vascular occlusive disease is now core business for researchers employed by cardiology, vascular surgery, vascular medicine, - diology, cell biology, chemistry, physiology, and many other areas. Knowledge on actual research development is shared by researchers with different skills. It is sometimes dif?cult to acquire expertise when a researcher feels his experimental work could be improved by introducing a new research technique. In this book, the investigator will ?nd an overview of recent developments that are relevant for research in general but cardiovascular research in particular. Genomics, p- teomics, microarray, RNAi, stem cells, and progenitor cells are just some phrases that have become increasingly prevalent in literature in the last few years and that are recognized by many, but are fully understood by few. In this book, experts share the most appreciated new developments and techniques in cardiovascular research. We hope that this book will help the reader who is working in the ?eld of cardiovascular research to understand and critically appreciate current research, and that it will help improve the quality of experimental work. Dr G.

A comprehensive review of all known immune mechanisms for medically important fungal pathogens from the organ perspectives of the human body. This authoritative guide is organized by organ system, as one particular fungus can have several different effects.

Extracorporeal membrane oxygenation (ECMO) has been in clinical use for some 40 years, but it is only in the past decade that its application in the treatment of life-threatening circulatory and respiratory failure has truly flourished. This book presents a comprehensive overview of both pathophysiological and practical aspects of circulatory and respiratory extracorporeal support. The basics of ECMO, including its history, the "ECMO team," cannulation, materials, and blood- surface interactions, are first discussed. The various indications for and particular characteristics of circulatory and respiratory extracorporeal life support are then described in detail in the main part of the book. Patient care during ECMO and monitoring of the ECMO patient are also carefully covered, with explanation of the management of technical and clinical complications and transport-related problems. Further topics include long-term therapy options beyond ECMO, such as ventricular assist devices and transplants, outcome, the new frontiers of ECMO for organ procurement and future challenges. The authors are well-known experts in the field whose authoritative contributions and attention to practical aspects will be invaluable for novices and experienced practitioners alike.

This book focuses on how ventricular assist devices (VADs) can help provide destination therapy for patients with terminal heart failure, one of the most serious diseases in the world today because of the tremendous number of patients, the high mortality rate, and the cost of care. One means of providing cardiological support for patients suffering from heart failure is with VADs, and more than 10,000 patients worldwide have now been implanted with these devices. Half of them already have lived more than one year, and 2,000 patients more than two years, after surgery. This improved survival means that we have reached a point where VADs can be used for destination therapy, not just for bridge-to-recovery or bridge-to-transplant. In view of the increasing number of patients with advanced-stage heart failure and the availability and longevity of transplanted hearts, VADs can solve many problems. In addition to providing information about the devices themselves, this book includes vital guidelines on long-term management and support of VAD-implanted patients' everyday lives.

Cardiovascular disease is the leading cause of morbidity and premature death of modern era medicine. It is estimated that approximately 81 million people in the United States (US) currently have one or more of the many forms of cardiovascular disease, resulting in 1 in every 2.8 deaths, or 900,000 deaths per year. 40% of all deaths in Europe are a result of cardiovascular disease in people under the age of 75. Aneurysms form a significant portion of these cardiovascular related deaths and are defined as a permanent and irreversible localised dilation of a blood vessel greater than 50% of its normal diameter. Although aneurysms can form in any blood vessel, the more lethal aneurysms develop in the cranial arteries, and in the thoracic aorta and abdominal aorta. Frequently aneurysms are undetected and if left untreated may eventually expand until rupture with very high levels of morbidity and mortality. The biomechanics and mechanobiology of aneursymal diseases are not fully understood and this monograph aims to provide new insights into aneurysm aetiology and behavior based on the most recent biomechanics research related to this important topic. The contributors to this volume bring together a unique blend of expertise in experimental, computational and tissue biomechanics relating to aneurysm behavior and enable the reader to gain a fresh understanding of the key factors influencing aneurysm behavior and treatment. Biological risk factors such as tobacco smoking, sex, age, hypertension, family history and mechanobiological risk factors such as aneurysm geometry and shape as well as mechanical properties of the diseased tissues are considered in detail as are many of the diagnostic and treatment options.

This book originated as a senior design research project at the Colorado School of Mines. Michal Schafer took a very active interest in the acute aortic dissection after his surgical rotations, so we set this project up to investigate the biophysical aspects of aortic dissection and possible engineering perspectives to a treatment. This project lead to a number of options for treatment, and Michal's team is currently following up on one of these options with an engineering company. Since this was an undergraduate design course, the first goal of the course was to do a thorough review of the topic and current trends in treatment. This alone took almost a year. The students learned the basic cardiac anatomy, physiology, physics, and biology to be capable of understanding the literature and the science behind the acute aortic dissection. With all this investigation, it was only natural to combine the information into a book format to hand over to others who will work on the project in the future. Our hope is that this will lead to yearly updates of the book.

How to face 'the faces' of cardiac pacing represents an editor's compiled selection of lectures on cardiac pacing and electrophysiology. Electrical stimulation of the heart is an ever-changing and, at times, explosive field. The number of implanting centres is growing tremendously and pacing is not exclusively confined to arrhythmologists. Therefore, the editors attempted to organize a course being both practical in daily clinical management and instructive in understanding technical concepts. The glossary of terms have to be clearly understood before one is able to interpret the complex electrocardiograms of DDD and especially DDDR pacemakers. Those electrocardiograms have to be approached in a system atic way, using a step-by-step analysis. The main clinical symptom requiring pacemaker implantation is syncope. It cannot be over-emphasized that syncope is a clinical diagnosis merely based on history and physical examination. The organization of a pacemaker follow-up clinic depends on local facilities and needs. The effectiveness of pacing controls markedly increases when using a systematic approach. Repeated optimal adjustment of pro grammable functions is part of the control. Antiarrhythmic drugs are loosing popularity in the treatment of tachy arrhythmias. Nonpharmacologic treatment (antitachypacing, implantable defi brillators and antiarrhythmic surgery) at the present time have definite indications, probably expanding in the future. When complexity in electronic devices increases, repercussions on ex penses, either by the government or social and private insurances, needs consideration."

The review of clinical scenarios in cardiothoracic surgery was edited by the Thoracic Surgery Residents Association (TSRA) and authored by more than 50 thoracic surgery residents from programs around the country with over 70 chapters. To ensure the highest level of accuracy and clinical relevance, each chapter was meticulously reviewed by an established faculty member, a section editor, and two main editors. The book includes topics on General Thoracic Surgery, Adult Cardiac Surgery, and Congenital Cardiac Surgery. The TSRA is an organization that represents all thoracic surgery residents in the United States.

This book discusses contemporary features of ject, creating, therefore, a lacuna the could be diagnosis of endocrine diseases using the filled by this project. radiologic technique of percutaneous venous This book is intended to be a practical guide blood sampling for hormone assay. A compre- for vascular and interventional radiologists, in- hensive survey of the field is provided by the ternists, surgeons, endocrinologists, and other contributing authors, who have considerable physicians who care for patients with endocrine expertise in the subject. Some have published diseases. The intention is to provide a practical several articles in the literature; others have text covering anatomical data, clinical prob- extensive clinical experience. lems related to the diagnosis of the endocrine The approach to many of the endocrine dis- diseases, patient preparation for the sampling, eases has been markedly improved ~uring the blood sampling techniques, sample manipula- last two decades because of selective venous tion and storage, laboratory data, and clinical blood sampling, not only in the diagnosis of the significance of the hormone sampling and condition but especially in the precise localiza- assay. tion of the hormone-producing lesion and its clinical significance. Scattered informationbn venous blood sam- pling is available in the literature, but there is Renan Uftacker no comprehensive text dealing with the sub- Reingard Sorensen Contents Preface v Contributors xi 1 Selective Venous Sampling for the Differential Diagnosis of Female Hyperandrogenemia 1 Lathar Moltz and Reingard Sorensen Introduction ...1 Diagnostic Procedures ...2 Indications ...4 Anatomy and Anatomical Variations...