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An Atlas of Radioscopic Catheter Placement is unique, and has been conceived as a handy reference guide for students, interventional cardiologists, nurses and electrophysiology technicians. It includes plenty of schemes and X-ray images, and every EP correct catheter positioning is explained step by step through detailed descriptions of the necessary manoeuvres, including some "trucks" brought about by the experience.
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.
This book highlights the differences, in terms of neoplastic dissemination pathways, between various types of thoracic cancers. It presents and discusses a comprehensive schematic overview of tumors of the lung parenchyma, of the mediastinum, of the pleura, and of the chest wall. For each tumor, it details the local spread and the lymphatic and vascular dissemination, and it describes the challenging staging of lung tumors with mutations. Illustrations and artwork enrich the content and help readers to understand and visualize tumor spread. The book is of great interest to professionals involved in the study, diagnosis and treatment of thoracic pathologies, as well as to residents in radiology, oncology and pulmonology.
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.
Much has been written about reperfusion injury in the past decade but unfortunately the information has been generally presented in the form of original specialist papers and little if any integral publication exists on the topic, summarising and analysing the clinical impact of the condition and its management. The pathophysiology and molecular mechanisms of reperfusion injury are complex and, regarding diagnosis, individual diagnostic techniques have been proposed but without a proper assessment of the relative values of these methods. A publication dealing with integral diagnostic strategies would be welcome by the managing physician. Management of the condition is also problematic, as strategies that appear to work in the experimental models do not translate into beneficial interventions in patients. There is a need for these issues to be addressed and discussed in a monographic fashion. Management of Myocardial Reperfusion Injury will tackle these issues in a modern and systematic way and the information will be delivered in a fashion that will be appealing to the reader.
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.
Minimally invasive surgical techniques have the minimally invasive procedure allow far made a significant impact in lowering morbidity modifications in anesthetic technique. The and mortality and in changing the indications basics of this endeavor are weIl covered in this for operative surgery in the abdomen. Only section. recently have these minimally invasive tech- The basic techniques of thoracoscopic surgery niques been applied to the diseases of the tho- were developed in various diagnostic maneu- rax. The standard posterior lateral thoracotomy vers. It was this initial diagnostic application of infamous for its post-operative pain and atten- thoraeoseopy whieh aIlowed these teehniques to dant complications, is already being replaced in be developed and further therapeutie applica- a large number of situations by minimally inva- tions to be forwarded. This text nicely illustrates sive thoracoscopic techniques. eurrent diagnostie techniques and their applica- This text by Gossot, Kleinmann and Levi pro- tion. vides basic information required for surgeons In addition, the most commonly applied thera- interested in approaching the most common peutie proeedures in the pleura, lung and eso- diseases in the ehest utilizing thoracoscopic phagus are weIl eovered as are their indications techniques. The text is a well organized attempt and potential eomplications.
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.
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.
Cardiovascular disease is the major cause of morbidity and mortality worldwide. While the past 40 years have brought major progress in cardiac valve repair and replacement, there remain large patient populations that do not receive such therapies. This, in turn, implies a great need for future basic, applied, and clinical research and, ultimately, therapeutic developments. Heart Valves is a state-of-the-art handbook dedicated to: 1) cardiac valve anatomy, 2) models for testing and research methods; 3) clinical trials; and 4) clinical needs and applications.
Principles and Practice of Interventional Pulmonology provides a comprehensive text covering all aspects of Interventional Pulmonology. Providing both pathophysiologic background as well as illustrated and clear instruction on how procedures ought to be performed, this text will be of great value to interventional pulmonologists, thoracic surgeons, surgical oncologists, and interventional radiologists.
In recent years, The impact of the inflammatory response in cardiovascular surgery has been a focus of much attention within the field of cardiac surgery. Despite that, scientific research on the topic is still lacking in the health science literature. To develop the bank of information available to all involved in the field, the Editors of this book have assembled a group of leading experts to investigate the most current and exciting topics related to inflammation and cardiovascular surgery. As such Inflammatory Response in Cardiovascular Surgery is vital reading for all involved in the management of cardiovascular surgical patients, such as cardiovascular and transplant surgeons, anesthesiologists, intensive care physicians, cardiovascular and vascular fellows, and researchers.
With the growing age of the general population, the proportion of elderly patients with diffuse coronary artery disease and severe comorbidities is increasing. When medical therapy cannot relieve the symptoms in these patients, their characteristics render them unsuitable for currently rec- ognized invasive procedures, namely coronary artery bypass grafting and percutaneous transluminal angioplasty. There is an urgent need for new treatment modalities which can alleviate their symptoms and increase blood flow to the ischemic myocardium while being less inva- sive for their fragile condition. The idea for this book was to relate my personal experience in the research and clinical fields and the current state of knowledge as reported in the literature. An additional aim was to provide anatomical and physiological background as well as a complete review of the new methods of revascularization currently being developed. To this purpose, I have analyzed many studies on the microvascula- ture of the heart, the historical forerunners of the new procedures, and the new treatment modalities themselves: transmyocardiallaser revascu- larization, therapeutic angiogenesis, and neurostimulation. I wish to thank my teachers in surgery, cardiology, and medicine: B. Faidutti (Geneva), J.-P. Berger (Vevey), 1. Kappenberger (Lausanne), F. Harder (Basel), T. Amery (Frimley), K. Arnold (Brig), and especially 1.K.
Transmediastinal gunshot injuries present the risk of immediately life threatening injuries. Stable patients have been evaluated by a combination of esophageal swallow and endoscopy, aortography and bronchoscopy. There is an increasing trend favoring CT scan. Unstable patients require immediate exploration, being prepared to enter both hemi-thoraces. Selected References: * Bergsland J, Karamanoukian HL, Soltoski PR, Salerno TA. Single suture forcircumflex exposure in coronary artery bypass grafting. Ann Thorac Surg.1999;68: 1428-1430. * Fedalen PA, Bard MR, Piacentino V, et al. Intraluminal shunt placement and off- pump coronary revascularization for coronary artery stab wound. J Trauma 200 1;50: 133-135 * Hanpeter DE, Demetriades D, Asensio JA, Berne TV, Velmahos G, Murraygunshot wounds. J Trauma 2000;49(4):689-695. * MacPherson D. Bullet Penetration: Modeling the dynamics and the incapacitation resulting from wound trauma. Ballistics Publications, EI Segundo, CA, 1994 * Wall MJ, Soltero E. Damage control for thoracic injuries, Surg Clin North AmI997;77(4):863-878. * Rozycki GS, Feliciano DV, Oschner MG, Knudson MM, Hoyt DB, Davis F, Hammerman D, Figueredo V, Harviel JD, Han DC, Schmidt JA. The role ofUltrasound in patients with possible penetrating cardiac wounds: aProspective multicenter study. J Trauma 1999; 46(4):543-552. * Roussseau H, Soula P, Bui B, D'Othee BJ, Massabuau P, Meites G, Concina P,Mazzerolles M, Joffre F, Otal P. Delayed treatment of traumatic ruptureof the thoracic aorta with endoluminal covered stent. Circulation 1999 Feb2; 99(4): 498-504.
Subjects of the book are Heart Failure and Atrial Fibrillation, two emerging pathologies in the field of cardiology, to which many investigators are now addressing their research. Their diffusion in the sick population represents a major public health problem at the beginning of the third millennium. The volume aims to present the latest approaches to the management of heart failure and atrial fibrillation, emphasising in particular the intrinsic relation existing between them, the results after 10 years of biventricular pacing, the innovative pacing techniques now available, and the use of new drugs, devices or ablation procedures for the prevention and treatment of atrial fibrillation recurrences.
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.
I am extremely honored and pleased to have the opportunity to write a few introductory words for this timely volume on Na + /It exchange. This is a field of investigation that I entered into by challenge and necessity, embraced with passion and fmally left in my quest for new discoveries in growth control. Ten years, one third of my scientific life, has been devoted to uncovering the mysteries of intracellular pH (PH;) regulation with respect to growth factor action. I got started on this new topic in 1980, when I heard a rather provocative hypothesis presented by Enrique Rozengurt at an ICN-UCLA Keystone meeting on "Cell Surface and Malignancy." He showed that all mitogens induced amiloride-sensitive Na + entry into resting cells and proposed that, if a compound stimulates Na + influx, it could be a mitogen. In support of his proposal Enrique reported that the amphipathic polypeptide, mellitin, which induced Na+ influx, was indeed mitogenic for 3T3 cells. This was only correlation at this stage. However, I was fascinated by this talk. I immediately approached Enrique to inform him of my skepticism about this beautiful story, and to indicate that I would only be convinced when I succeeded in isolating mutant fibroblasts lacking the amiloride-sensitive Na+ transporter. ''Good luck " was his response.
In recent years much enthusiasm and energy has been directed toward the development of human gene therapies, especially for inherited conditions and cancers. However, current gene transfer technology is limited in its transduction efficiency and ability to permanently and safely correct genomic defects. Thus the promise of gene therapy for these conditions is as yet unrealized. The progression of gene transfer technology will eventually surmount these limitations. Gene Therapy for Acute and Acquired Diseases includes selected examples of ongoing studies in molecular genetics that have the potential to evolve into human therapies for acute illnesses. These chapters are intended to highlight lesser known applications of gene therapy for acquired disorders. It is expected that human gene therapy trials for these conditions will be forthcoming in the near future, leading to previously unimaginable therapies. Thus, this first-ever book about gene therapy for acute and acquired diseases is intended to serve as a glimpse into the future.
The last five years have witnessed an increasing interest in the subject of transmyocardial revascularization (TMR). The ideas and concepts associated with this particular method of myocardial revascularization have changed dramatically over a short period of time. The original premise of 'de-evolving' mammalian hearts to recreate a reptilian-like myocardial circulation by multiple channels through the myocardium has been almost completely dismissed. Now, the most popular notion is that there is an angiogenic response to myocardial channel making. It is this development of new blood vessels that is thought to be responsible for the apparent improvements in symptoms and blood flow. Along the way, the idea that a channel could stay open and allow blood to flow directly from the ventricular chamber has found little support. Rather than directly explore all of these issues and merely duplicate previously published articles, our aim was to take a novel approach: that is, to step back from these arguments and provide perspective from the vantage point of distance.In the case of transmyocardial revascularization, distance comes both in terms of history and in terms of methodology and knowledge from other fields of research. The purpose of Direct Myocardial Revascularization: History, Methodology, Technology is to provide the necessary perspective to stimulate investigators (both clinicians and basic scientists) to ask the appropriate questions in their own experiments and, in time, determine whether direct myocardial revascularization has a place in the treatment of coronary artery disease.
Heart failure occurs in almost epidemic proportions, placing a huge burden on both the healthcare system, and sufferers and their families. This can only rise over coming years as the ageing population, particularly in industrialized countries, increasingly suffers from heart failure and its related comorbidities. The care of this group of patients has evolved significantly over recent years as our knowledge and understanding of the pathophysiology of heart failure has developed. It has become evident that supportive care is integral to comprehensive heart failure care, and this book provides an evidence-based overview of heart failure aetiology, its management, and the supportive care required by patients throughout the course of their disease. Supportive Care in Heart Failure integrates the complexities of heart failure care, bridging knowledge bases from cardiology and cardiothoracic surgery, general medicine and palliative care. The book reviews essential information about epidemiology and pathophysiology of heart failure, and evidence-based medical, device, surgical and interdisciplinary management. It addresses the evaluation and management of quality of life, common symptoms and problems associated with heart failure, and the holistic approach to supportive care throughout the course of the illness through the end of life. Prognostication, communication, and ethical decision making are reviewed in detail. Heart failure has traditionally presented a challenge to physicians, as a generally progressive condition with significant symptoms, a poor quality of life, and high mortality. But by applying the principles of palliative medicine, it is possible to offer a supportive care approach that synthesizes the experience of both the heart failure specialist and the palliative care physician, and offers the best possible quality of care to this group of patients.
Thisisthefirstvolumeinthe CerelJral Cortexseriesdevotedtomathematicalmodels ofthecortex. Itwasmotivatedbytherealizationthatcomputationalmodelsof individualneuronsandensemblesofneuronsareincreasinglyusedinresearchon corticalorganizationandfunction. Thisis,inpart,becauseofthenowubiquitous presenceofpowerfulandaffordablecomputers. Suitablemachineswereformerly rareinresearchlaboratoriesandrequiredsubstantialprogrammingexpertisetobe usedinconstructingandusingneuronalmodels. However,computersarenow routinelyusedinallareasofneurobiologyandanumberofsoftwarepackagesallow scientistswithminimalcomputerscienceandmathematicalbackgroundstocon- structseriousneuronalmodels. Asecondfactorleadingtotheproliferationof modelingstudiesisthedevelopmentoftechnologiesthatallowthekindsofdata collectionneededtodeveloprealisticmodelsofcorticalneurons. Characterization ofthekineticsofvoltage-andligand-gatedchannelsandreceptorshadbeenlim- itedtorelativelylargeneurons. However,therapiddevelopmentofsliceprepara- tions,patch-clampmethods,andimagingmethodsbasedonvoltage-sensitivedyes andintracellularcalciumindicatorshasresultedinasignificantdatabaseonthe biophysicalfeaturesofcorticalneurons. Thescopeofmodelingapproachestocorticalneuronsandfunctionsiswide anditseemednecessarytolimitthepurviewofthevolume. Thefocusisonattempts tounderstandthepropertiesofindividualcorticalneuronsandneuronalcircuitry throughmodelsthatincorporatesignificantfeaturesofcellularmorphologyand physiology. Noattemptwasmadetoincludemodelingapproachestounderstanding corticaldevelopmentandplasticity. Thus,workdealingwiththedevelopmentof oculardominancecolumnsandtheorientationselectivityofneuronsinvisualcortex isnotconsidered. Similarly,modelsdealingwiththecellularmechanismsunderlying long-termplasticityandwithapproachestolearningandmemorybasedonmodifica- tionofHebbiansynapsesarenotconsidered. Relativelyabstractattemptstounder- standhigherlevelandcognitiveprocessesbasedonneuralnetsrepresentasecond, majorareaofworkthatisnottreated. Modelsofcognitiveprocessesbasedon dynamicalsystemsmethodsinwhichnoattemptismadetoincludethebiophysical featuresofindividualneuronsarealsonotconsidered. vii viii Thetenmajorchaptersfallintothreegroups. Thefirstgroupdealswith compartmentalmodelsofindividualcorticalneurons. LyleBorg-Grahamprovides PREFACE anintroductiontothemethodsinvolvedinconstructingcompartmentalmodels andthenreviewstheexistingmodelsofhippocampalpyramidalcells. Becauseof theeffectivenessofhippocampalslicepreparations,theseneuronshavewell-ehar- acterizedbiophysicalproperties. Thischapterillustrateshowcompartmentalmod- elscanbeusedtosynthesizeexperimentaldataandprovideanintegrativeviewof thepropertiesofindividualneurons. PaulRhodescontinuesthethemebyfocusing ontheroleofvoltage-gatedchannelslocatedonthedendritesofcorticalneurons. Thisisanareainwhichtechnologicaladvancesinthevisualizationofneuronsin slicepreparationsbasedoninfraredmicroscopyhavegreatlyexpandedtheinfor- mationavailableondendriticfunctioninjustafewyears. Thechapterbothreviews theexperimentaldataonactivedendriticconductancesandemphasizestheirpo- tentialfunctionalroles. Thesecondgroupofchaptersdealwiththegenerationofreceptivefield propertiesofneuronswithinvisualcortex. Theyaddressissuesstemmingfromthe originalattempttounderstandhowthereceptivefieldpropertiesofneuronsincat andmonkeyprimaryvisualcortexaregeneratedbyinteractionsbetweengenicu- lateafferentsandcorticalneurons. ThechapterbyFlorentinWorgotterevaluates modelsthathavebeenusedtoanalyzethegenerationofreceptivefieldproperties. RodneyDouglasandhiscolleaguesaddressaspecificsetofissuesdealingwiththe roleofintracorticalexcitationmediatedbypyramidalcellcollaterals. Animportant featureofthischapterisitsrelationtoattempttoconstructfabricatedcircuitsthat duplicatethefunctionsofcorticalcircuits. ThechapterbyPhilipUlinskifocuseson thegenerationofmotion-selectivepropertiesincorticalneurons. Itseekstoidenti- tycellularmechanismsusedbyneuronsthatrespondpreferentiallytovisualstimuli movingwithparticularspeedsordirections. MatteoCarandiniandhiscolleagues discussthefeatureofcorticalneurons,knownasgaincontrol,thatallowsneurons torespondeffectivelytovisualstimulibypoolinginformationacrosspopulationsof corticalneurons. ThechapterbyHughWilsondealswiththereceptivefieldproper- tiesofextrastriateareasandintroducesnewworkanalyzingface-selectiveneurons. Thefinalsetofchaptersconsidermodelsofensemblesofthalamicandcortical neurons. ThechapterbyWilliamLyttonandElizabethThomasusesthetheoryof dynamicalsystemstoanalyzethetemporalrelationshipsbetweenthalamicand corticalneurons. Animportantfeatureoftheinteractionbetweenthalamusand cortexisthepresenceofoscillationsthatdependinpartuponthevoltage-gated conductancespresentonindividualneuronsandinpartonthestructureofthe overallnetwork. PaulBushcontinuesthisemphasisonoscillationsbydiscussinga modelthatdealswiththegenerationofsynchronizedoscillationsinvisualcortex. Oscillationsofthiskindhaveattractedsubstantialattentioninrecentyearsbecause oftheirpotentialroleincognitiveprocesses. Thelastchapter,byMichaelHasselmo andChristianeLinster,reviewstheirworkonmodelingpiriformcortex,emphasiz- ingtheroleofcholinergicmechanismsinmodulatingtheactivityofcorticalneu- rons. Anattempthasbeenmadethroughouttomakethevolumeaccessibleto readerswithminimalmathematicalbackgrounds. Thevolumethusbeginswitha shorthistoryofmodelsofcorticalneuronsandcircuitrythatintroducestheprinci- palmodelingstyles. ThechaptersbyWorgotterandUlinskicontainmoreextensive ix introductionstosomeofthemodelingmethodsthathavebeenusedtostudyvisual cortex,andthemathematicallychallengedreaderwillfindthatthechapterby PREFACE LyttonandThomascontainsareadableintroductiontotheuseofdynamical systemstheoryinneurobiology. PhilipS. Ulinski EdwardG. Jones Chicago and Davis Contents Chapter 1 ModelingCorticalCircuitry:AHistoryandProspectus PhilipS. Ulinski 1. Introduction "...1 2. LorentedeNothroughDynamicalSystemsModels...2 2. 1. LorentedeNo...2 2. 2. CellAssembliesandNeuralNets...3 2. 3. DynamicSystemsModels...8 3. HodgkinandHuxleythroughNetworkModels...11 3. 1. HodgkinandHuxley...11 3. 2. WilfridRall...11 3. 3. SoftwarePackages...13 3. 4. RealisticModelsofCorticalNetworks...14 4. Prospectus...14 5. References...15 Chapter 2 InterpretationsofDataandMechanismsforHippocampalPyramidal CellModels LyleJ Borg-Graham 1. Introduction...19 1. 1. NeuronModelEvolution-followingElectrophysiology...19 1. 2. NeuronModelEvaluation-followingtheParameters...21 1. 3. WhyHippocampus? 21 1. 4. OrganizationofThisChapter...22 xi xii 2. TheDatabaseforSingle-NeuronModels...23 2. 1. VoltageClampversusCurrentClamp...23 CONTENTS 2. 2. Single-ChannelversusMacroscopicCurrents...24 2. 3. TypeofPreparation...24 2. 4. KineticandPharmacologicalDissection...25 2. 5. TemperatureDependence...26 2. 6. AgeDependence...27 2. 7. HippocampalSubfieldDependence...27 2. 8. DifferencesinFiringPropertiesbetweenSharpversusPatch Recordings...28 2. 9. TheMeasuredVoltage...
The book will be written by the experts in the disease including imaging, interventional cardiology and surgical valve expertise. The book has five main sections: Aortic Valve Disease Mitral Valve Disease Tricuspid Valve Disease Pulmonic Valve Disease Multimodality Imaging The main objectives of the book are: 1- to provide the main guidelines to clinicians on how to identify and diagnose valvular heart disease 2- to provide an overview of what the near future will bring in the diagnosis, prevention and risk stratification of patients to catheter versus surgical approaches 3- to outline the possible implications for medical therapies in slowing progression of calcific aortic valve disease and myxomatous mitral valve disease
The papers presented at the Fifth International Symposium on Heart Valves and published in this volume discuss clinical experience with heart valve replacement in pediatric patients, in adults (age 65 and younger), and in the elderly (age 66 and older). Special considerations in heart valve replacement, such as valve selection, reoperation, results of double valve implantation, quality of life, and the use of valved conduits are also included. Finally, long term clinical follow-up with the ST. JUDE MEDICAL (R) heart valve, giving 7- and 8-year data is discussed. HEART VALVE REPLACEMENT IN PEDIATRIC PATIENTS Anticoagulation Anticoagulation in children is a difficult and interesting problem. Three princi pal considerations in the use of anticoagulants are patient education, timing, and anticoagulating substance. Additional considerations are patient tolerance and compliance. Generally, the findings indicate, if pediatric patients receive anticoagulation following mechanical valve replacement, it is well accepted and results in few complications. If children are not anticoagulated, complications arise. Conflicting results regarding the efficacy of PERSANTINE (R) and the use of aspirin vs. COUMADIN (R) were reported. Doctor Sade's data address some of these questions. * After a 5-year study in * See J Thorac Cardiovasc Surgery 1988; 95:533-561.
The topic of heart failure although extensively researched and reported, has several gray areas. This is especially seen in determining strategies for combating advanced heart failure. The global burden of ischemic heart disease is increasing at an alarming rate to almost pandemic proportions. Even in the presence of state-of the art technology for prompt and successful coronary reperfusion, the population progressing to ischemic cardiomyopathy is substantial. The treatment strategies for ischemic cardiomyopathy do not always ensure optimal clinical results, the reasons for which are varied. The proper patient selection is vital as is the tailoring of suitable therapy. The approach is thus multi-pronged, of which surgical ventricular restoration (SVR) has a definite role. Despite various randomized studies like the STICH-hypothesis 2, where there was a huge selection bias, with patients subjected to an erroneous technique of SVR, with inadequate ventricular remodelling assessment. The present need is to understand the unique anatomy of the left ventricle, its function and perturbations with the onset of heart failure, in order to plan therapeutic strategies to restore near normal anatomy and function. A study of the hemodynamics in ischemic cardiomyopathy is essential, as it differs in certain aspects from other causes of heart failure like idiopathic dilated cardiomyopathy and valvular heart diseases. Since information on these aspects are scattered in various scholarly articles, a concise source in the form of a book would be appropriate and useful for both cardiologists and cardiac surgeons. This project represents a concise review of normal and abnormal cardiac anatomy and physiology, the evolution of SVR to EVLPP with validation of near normal ventricular restoration, plus act as a reference guide for cardiac surgeons with interest in SVR.
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