The joint workshop between the European Society of Cardiology and the European Society ofCardiovascular Surgery, held October 14-15, 1983 in Innsbruck, Austria, was a unique event. The idea originated in Atlanta, 1982, with C. Hahn and was supported by V. Bjork and N. Browse. H. Denolin and F. Loogen brought added impact from the European Society of Cardiology. The joint workshop specifically emphasized new trends and controversies in coronary artery surgery. The contri- butions appearing in this edition were selected by a scientific committee: H. Deno- lin, H. Kraft-Kinz, F. Unger, F. Loop, L. Cohn, F. Loogen, P. Lichtlen, T. Killip, and F.Kaindl. The specific aim was to evaluate controversial review points in coronary artery surgery. These were covered in six discussions and in nine forums with slide presen- tations. The topics were: 1. Indications for coronary artery surgery 2. Graft patency and long-term results 3. New operative techniques 4. Myocardial preservation and anesthetic management 5. Combined procedures 6. Long-term follow-up Coronary artery surgery is a model for comprehensive cardiology, whereby sur- gery serves as a link between diagnosis and rehabilitation. Because coronary artery surgery has become a routine procedure with standardized techniques, the demand is increasing dramatically as reflected by enormous waiting lists. Hospital mortality can be kept under 1 %, so that the value of this operation can also be discussed with regard to its social and economic aspects. In the majority of cases, patients improve and finally retum to work, finding life most enjoyable again.

Since the last meeting "Myocardial Biopsy - Diagnostic Signifi cance" was held under the auspices of the International Society and Federation of Cardiology (ISFC) in Munich, many new data and new aspects have been developed in the field of myocardial dis eases. Most importantly, the classification of cardiomyopathies and specific heart muscle diseases, as described in the report of the WHO-ISFC task force (see reference 1 in the Introduction), is now widely accepted as a basis for clinical practice and scientific work. Investigators from all over the world have again assembled un der the auspices of the ISFC at an international workshop on viral heart disease and its implications with regard to congestive cardio myopathy, which was held in Munich January 1983. This book con tains the significant results of the workshop. For practical use, the authors have incorporated important points made in the discussions into their contributions and a subject index has been provided. First of all I should like to thank Professor Riecker, Director of the Medizinische Klinik, Klinikum Grol3hadern, University of Mu nich, West Germany. Without his friendly support in many aspects, this meeting would not have been possible. I should like to thank Professor Goodwin and Dr. Olsen from the ISFC for their active participation and advice in organizing the meeting. Last but not least, I am particularely grateful to all the contributors, whose co operation has made this book possible."

Valvular heart medicine revolves around the need to accurately identify locations of pathological structures and/or the interventional tools needed to manage that pathology. The imaging of the valves is developing at an enormous pace and the clinician must be aware of the advantages of each modality and how it compares to the others available. There is a need for a practical, clinical atlas designed to work the reader through cases and assessing the gold standard choices available to physicians. This atlas will represent the full multimodality imaging decisions needed when assessing mitral valvular disorders. Within this atlas the authors will be presenting a comprehensive pictorial overview of the highly complex pathology/treatment techniques and management in this diverse group of patients with varied mitral valvular pathologies. Imaging modalities move fast representing challenge to practitioners. This atlas will enable them to learn the choices available and be well versed in techniques. It will therefore be essential reading for all cardiac imagers, surgeons, interventionalists, anesthetists and trainees in these disciplines.

In recent years the approach towards rib fractures has evolved. Abandoned in the past, due to inadequate instrumentation and lack of evidence, rib fixation has recently re-emerged as a treatment option for trauma patients. There have been a number of advances over the last 25 years that now allow surgeons to internally fix rib fractures that otherwise may have not had other options. However, as a result there has been a rapid increase in literature and many institutions interested in initiating rib fixation programs. Due to a variety of practitioners involved namely, trauma surgeons, orthopedic surgeons, and thoracic surgeons there has been no comprehensive guide to patient selection, technique, and post-operative care. The purpose of this text is to fill the educational gap for those trauma, orthopedic, and thoracic surgeons interested in learning the cutting edge evidence-based approaches to treatment of rib fractures. This topic has caught the interest of many and has been a recurrent theme at surgical meetings over the last two years. Although there has been ever increasing levels of interest and experience nationally there are many questions which remain. This text will provide not only the theoretical background for improving outcomes in those with rib fractures but also serve as a practical guide to those interested in starting new programs. The text will include tips and tricks that can be used in the OR or at the bedside to improve patient care. Therefore, the focus will be on a comprehensive review but also including tips and tricks from the most experienced surgeons around the country who are performing internal fixation for rib fractures.

Mankind in the second half of the twentieth century has encountered a number of social and economic problems, which, as never before, determine its future. Among the main problems facing medicine, meriting distinction is organization of the struggle against the increase of cardiovascular and oncological diseases which, with the birthrate, are the main demographic indices of our planet. According to the World Health-Organization, the deathrate from diseases of the cardiovascular system has risen by 60% in recent years, and there has been a sharp increase of myocardial infarctions and cases of sudden death in young people aged 25-30. The "geography" of heart and blood vessel diseases has changed: a dramatic increase of morbidity has been recorded in rural regions, and in districts where 10-20 years ago the native population was practically unaffected by atherosclerosis. Diseases of the cardiovascular system have become widespread among women as well as men. Cardiovascular diseases tax the national economy: they are responsible for over half the mortality among people at the prime of their productive life. More than 50% of temporary disability is also accounted for by ischemic heart disease, hypertension, stroke, etc.

Microcirculation is a rather new field which has been of predominant interest to basic scientists, linking togeth~r technical, hemodynamic, and biochemical aspects. The fmdings elaborated, however, are not only of theoretical interest, but bear in addition great clinical implications. In clinical cardiology this became quite evident by the use of tracers in order to study myocardial perfuSion and by the deSCription of certain clinical entities - such as angina with normal coro nary arteries - which are best explained by "disturbed microcirculation". With respect to this new developing theoretical and clinical field of cardiac microcirculation it was the aim of the Microcirculation Working Group of the European Society of Cardiology to have a symposium on which all different but clinically relevant aspects of cardiac microcirculation will be covered. This symposium, held in Heidelberg in January 1980, was planned not only for the exchange of concepts and ideas, but was expected to be in addition partially a teaching session; the basic scientists should be directed toward a better under standing of the clinical problems, and the clinicians should learn more about the basic mechanisms regulating substrate and ion exchange in such an impor tant organ as the heart, and furthermore the theoretical limitations of some of the diagnostic and therapeutical procedures should be taught. Without a lot of help we would never have succeeded in organizing the sym posium and editing its results.

Significant changes have taken place in the realm of cardiac, thoracic, and vascular surgery during the last five to ten years. Many new operative procedures have been developed which remain relatively unknown to cardiothoracic surgeons. This practical manual covers a wide variety of these new processes, several of which are interventions offered to cardiologists practicing in the field of electrophysiology who are unaware that these interventions exist and can help them in situations they cannot solve. It includes general practical techniques; cardiac, thoracic, and vascular surgery procedures; and advances in cardiology and electrophysiology. Throughout the book, illustrations accompany the technical descriptions and show in step-by-step detail how to perform the operations and various procedures using proper equipment. Cardiothoracic Surgical Procedures and Techniques: A Practical Manual is an essential resource for physicians and related professionals, residents, fellows, physician assistants (PA), and graduate students in cardiology, cardiac surgery, thoracic surgery, and vascular surgery.

The International Congresses of Angiology have had a 25-year tradition. Let us remember the 10 previous International Congresses, the first of which took place in Paris in 1952. On this occasion a stimulus for the foundation of the International Union, "Union Internationale d Angeiologie" came into existence. The period of 25 years is lon.qenough to evaluate the scientific progress which has been made in diagnosis, therapy and prevention of vascular diseases. Proceedings of the previous International Congresses of Angiology became attractive resources for scientific information in libraries all over the world. They represent really historic documents of remarkable development of angiology and wittness successful international cooperation in the settlement of serious medical problems of the twentieth century. The Proceedings of the XI. International Congress of Angiology held in Prague 1978 under the stimulating title "Adaptability of Vascular Wall" contains 284 original papers dealing with scientific and clinical research in arterial, venous and lymphatic circulation. The papers are incorporated into 12 chapters according to the main topics. In the first sections the questions of atherogenesis and thrombogenesis are discussed with regard to the adaptability of vascular wall in various metabolic, immunobiologic, and hemodynamic disorders. In the further sections attention is paid to new procedures in investigation, treatment, and prevention of arterial, venous, and lymphatic diseases. Peri pheral microangiopathies, renovascular hypertension, and coronary circulation represent another part."

The first cardiovascular operation in Duesseldorf, a ligation of an open ductus arteriosus (Botallo), was performed in 1938 by E. K. Frey. During the Second World War and the subsequent years many difficulties hindered cardiovascular surgery in Duesseldorf. However, it was resumed on 3 May 1949 by Prof. Ernst Derra, again by ligating an open ductus arteriosus. This was the starting pOint of the successful cooperation between the cardiological and surgical working groups - the "birthday" of the Duesseldorf Heart Centre. Further highlights in cardiac surgery were the introduction of open heart surgery by means of surface-cool- ing hypothermia (9 February 1955) and extracorporeal circulation (21 February 1959) . In addition to cardiac catheterization and surgery in patients with acquired and congenital heart disease, the diagnosis and treatment of arrhythmias was one of the focal points of the centre. On 3 October 1961 the first pacemaker was implanted in a patient with a third-degree AV-block after he had been treated using an external device for about 1 year. In recent years interest has increasingly turned to the tachy- arrhythmias. Close cooperation between the medical and surgical teams made possible the application of new pacing techniques for the treat- ment of tachycardia. In patients with intractable arrhythmias, surgical interventions were made to eliminate the "focus" of the arrhythmia. In the past 2 years intraoperative electrophysiologic studies (endo-cardi- al and epicardial mapping) were applied to enhance the success of the surgical procedures.

This book is designed to present readers with comprehensive, high-quality research results on almost all aspects of this carcinoma in clinical management, from correct determination of the esophagogastric junction, issues on cardiac mucosa, epidemiology, and natural history, to clinical, endoscopic, and histopathologic features and diagnostic pitfalls of this carcinoma at both early and advanced stages. Once diagnosed and correctly staged, clinical management of this carcinoma at the early stage is addressed primarily with endoscopic therapy employing the latest endoscopic technology such as endoscopic submucosal dissection, in which detailed technical topics of the endoscopic therapy are written by experts in the field with sections from pre-resection staging and patient preparation to post-resection complications and management. Subsequently, clinical management of gastric cardiac carcinoma at advanced stages is discussed at length with a personalized, multidiscipline approach with strategies from surgical resections with various methods, to pre-, peri- and post-resection chemoradiation therapies as well as the most advanced immunotherapy. A state-of-art approach with the results of meta-analyses and large-scale randomized double-blinded clinical trials are employed throughout these chapters. For patients at the terminal ill stage, the appropriate palliative care plan is presented by experienced clinicians armed with the latest clinical practice guidelines to better manage and help those patients in the last period of their lives.

Chest Surgery provides readers with a comprehensive and authoritative text that explains and illustrates all thoracic surgery procedures, with the exception of those on the heart and esophagus. The easy-to-read text is supported by clear, instructive line drawings and intraoperative photographs. The result is a well-illustrated practical guide for the seasoned and novice practitioner alike. The contributors, who are all acknowledged experts, demonstrate simple and safe forms of operation by distilling their experience into the most efficient methods for both standard and less common procedures. For ease in following a surgical procedure, the text description of each step is coupled with an appropriate drawing. There are often numerous ways of performing an operation, and this book takes care to impart the basic principles underlying surgery. It will be the "must-have" guide for all thoracic surgery residents who wish to acquaint themselves with the latest developments in this constantly expanding field.

Mechanical Circulatory Support: Principles and Applications offers innovative approaches to complex clinical scenarios and represents the current state-of-the-art for managing patients on mechanical circulatory support devices. Topics are presented in a concise fashion, making it a practical resource for care givers who need a user's manual in the heat of the moment during patient care as well as a reference for a better understanding of the unique components of every device available for human use. This book provides a comprehensive, up-to-date analysis of the most relevant issues facing health care providers in the management of advanced heart failure. With content that features patient selection strategies, implantation techniques, device specific considerations, and management of clinical challenges in the post-operative setting, this textbook offers evidence-based answers to the complex questions facing nurses, perfusionists, advanced practice providers, and physicians.

Summary A comprehensive review is given of the literature, and the advantages and disadvantages of the bypass operation are discussed in detail. Of all surgical interventions aiming at revascularisation of the myocardium the aorto coronary bypass operation is the one which indoubtedly has earned its place in cardiac surgery. The most suitable candidates for this operation are those with a normal left ventricular angiogram and a good peripheral vascular pattern. Even in these people the question still remains whether the vein can stay patent for many years; moreover what happens to the proximal coronary arteries is as yet uncertain. In the case of poorly contracting ventricles little good is to be expected from the by pass operation. Possible, anastomosis of the internal mammary artery with a stenotic coronary artery merits preference over a venous bypass. To demonstrate the ultimate influence of this type of surgical intervention on life expectance and on a secondary pre vention of angina pectoris and myocardial infarction, Chalmers (1972) and Spodick (1971) favour follow-up studies of patients who are divided at random into a surgical and a non-surgical group. 1.1. OBJECT The object of this investigation is to establish on basis of the results and complications of saphenous vein bypass grafting (briefly termed bypass surgery): - reliable indications for this operation; - to provide the surgeon with a guide to the choice of surgical technique.

There is no standard textbook at this time on endovascular management of thoracic aortic pathologies. Atlas of Thoracic Aortic Endografting contains clinical case scenarios as well as controversies to highlight the use of this new technology. The various aortic pathologies are discussed, combining etiology, diagnostic tools like intravascular ultrasound (IVUS) and 64 slice CT scans which are all state of the art technologies, endovascular treatment, management of endoleaks, reinterventions combined with techniques of trouble shooting. This book highlights the new changes in the management of thoracic aortic diseases.

Comprehensive, yet practical and concise, the Oxford Specialist Handbook of Pacemakers and ICDs is the ideal training guide on how to implant, follow-up, and troubleshoot pacemakers and ICDs. Fully updated to include new technologies such as subcutaneous ICDs and MRI compatible devices, this new edition provides the latest guidelines and management strategies for the cardiology trainee and cardiac technician. Covering the principles, programming, potential complications, and troubleshooting for pacemakers, ICDs, and cardiac resynchronisation therapy, this title is an invaluable aid for anyone charged with providing or contributing to a pacing, ICD, or implantable loop recorder service. Written in a succinct bullet-point style, the second edition of the Oxford Specialist Handbook of Pacemakers and ICDs delivers key information in an accessible manner, with over 120 figures including x-rays and annotated ECGs to demonstrate pacing techniques and troubleshooting solutions.

Idiopatic pulmonary fibrosis (IPF) represents one of the most important devastating diseases that affects the lungs. Traditionally, the development of acute or chronic respiratory failure in disiorepresents an important dilemma for pulmonologists, intensivists, internists and anesthesiologists, due to the limited respiratory and functional reserve of these patients. In the last decade, we have witnessed a novel development of non-invasive mechanical ventilation and high flow oxygenation systems, representing an attractive option for patients compared to those patients with well-known poor results of invasive mechanical ventilation. In this book, we analyze all the options of non-invasive mechanical ventilation, indications, ventilatory modes, protocols, technology, equipment and applications in acute and chronic phase of patients with IPF, in addition to an exhaustive approach of all complementary techniques that optimize the application of these procedures. There are no previous descriptions or updates that incorporate this comprehensive analysis. This book, thus, serves as an updated scientific and practical reference for the knowledge of all spectrum respiratory failure presentations in idiopatic pulmonary fibrosis.

This book analyses and describes the whole spectrum of technical elements related with non-invasive mechanical ventilators technologies, ventilator modes and complementary technologies for correct interpretation and clinical indications. With the aim of addressing different topics, authors have presented in each chapter and section a rigorous summary of non-invasive mechanical ventilators principles and technologies, as well as clinical indications in order to understand lung function. Moreover, this book also offers a comprehensive examination of how mechanical ventilators interact, for example, in case of asynchrony (diagnosis/treatment), and other tools. The patient-mechanical ventilator interactions sections have been planned from a physiological basis, as they include physical description of the ventilator elements and the non-invasive algorithms that allow adequate patient-ventilator interaction. We describe the correct interpretation and monitoring of positive pressure, airflow and volume waveforms, leakages impact and analysis and interface options and technology (facial mask, nasal mask and other new interface). From a practical point of view, authors describe non-invasive mechanical ventilators device selection, indications and evaluation in different clinical conditions, acute and chronic setting from hospital (emergency/critical care/anesthesiology/pneumology) and from home non-invasive mechanical ventilation. We consider this to be an original and exhaustive book crucial and practical for the correct understanding of mechanical ventilators principles of technology and science of non-invasive mechanical ventilation.

This issue of Thoracic Surgery Clinics of North America, guest edited by Dr. Edward D. Verrier, is devoted to Education and the Thoracic Surgeon. Dr. Verrier has assembled expert authors to review the following topics: The Master surgeon as educator; How does the adult surgeon learn?; How to obtain meaningful assessment in thoracic surgery education; How to give effective formative feedback in thoracic surgery education; Bias: How to minimize the hidden impact on thoracic surgical education; The educational challenges of the operating room; Effective classroom teaching and the impact of e-learning in thoracic surgery education; The alternative surgical curriculum; Deliberate practice and the emerging roles of simulation in thoracic surgery; Teaching, mentorship, and coaching in thoracic surgical education; Faculty development: using education for career advancement; The potential of virtual or augmented reality to enhance thoracic surgical education; How will artificial intelligence impact (cognitive) decision making in thoracic surgery; and more!

This text is a fully updated and revised third edition of a highly successful text. The format of this text is unique and has been very successful. A total of 286 short chapters organized into 24 Sections provide operative dictation templates for all of the common and the vast majority of the uncommon and even rare operations performed by general and vascular surgeons. Each chapter also provides a succinct synopsis of the operation through bullet-ed lists which include Indications, Essential Steps, Note these Variations, and Complications. The book thus serves two purposes: these operative dictation templates can be used verbatim when dictating the operative note for a procedure; and the book provides ready reference to the trainee going into the operating room to do the procedure for the first time, or to someone preparing for their Board examinations. Space for notes allows surgeons to personalize the book and turn it into a resource unique to their situation. Fully updated and expanded, Operative Dictations in General and Vascular Surgery, Third Edition includes significant additions that include flexible endoscopic procedures (now recognized as a core part of general surgery training and practice), single incision laparoscopic cholecystectomy, and robotic approaches to the rectum. The endovascular procedures have been significantly expanded, as have the approaches to venous disease and to A-V fistula creation. Operative Dictations in General and Vascular Surgery, Third Edition is intended for practicing surgeons, who may modify each template to reflect their own individual practice. It also serves as a concise reminder of essential steps in those operations that may be only rarely performed.

Ein umfassender Leitfaden zur richtigen Planung, Programmierung und Implementierung heutiger Schrittmacher und anderer Herzimplantate, inkl. Problemloesungsstrategien. Dieses praktische Nachschlagewerk fuhrender Ausbilder im Klinikbereich richtet sich an angehende AErzte und Klinikmitarbeiter, die uber keine oder wenig Erfahrung in der Programmierung und dem Management von Implantaten verfugen. Best-Practice-Informationen sind in ein Referenzwerk geflossen, das sich auf die wichtigsten Schritte, haufige Fehlerquellen und moegliche Komplikationen konzentriert. Jedes Kapitel ist auf die Praxis ausgerichtet und gibt Handreichungen, um auch schwierigste, geratebezogene Aufgaben, wie Programmierung und zielfuhrende Problemloesung bei Komplikationen, schnell zu meistern. Die heutigen Schrittmachen und EP-Gerate sind im Vergleich zu fruheren Entwicklungen das, was Smartphone und Telefone mit Wahlscheibe gemein haben. Sie sind nicht nur kleiner und fur den Patienten komfortabler, sondern bieten auch komplexe Programmieroptionen, die es Klinikern ermoeglichen, Gerate ganz individuell auf die Anforderungen der Patienten anzupassen. Je kleiner, intelligenter und anpassbarer die Gerate werden, desto groesser sind die Herausforderungen fur Kliniker in puncto Konfiguration, Management und UEberwachung. Mit dieser einzigartigen Kurzreferenz lasst sich diese wichtige Technologie viel einfacher handhaben. AErzte und Techniker erhalten genau die Informationen, die sie benoetigen. - Konzentriert sich auf die Aufgaben, die Kliniker durchfuhren, inkl. der Schritte vor der Implantation, Planung, Programmierung, Management, Problemloesung etc. - Zeigt anhand von Beispielen aus der Praxis, wie Experten im klinischen Umfeld optimale Ergebnisse im eigenen Labor erzielen. - Bietet mehr als 300 Fotos, einschliesslich EKG-, Roentgen- und Fluoroskopie-Aufnahmen, Bilder von Gerateabfragen, intrakardiale Elektrogramme sowie farbige elektroanatomische Maps. - Begleitende Website mit Videos zu allen wichtigen Aufgaben und Verfahren.

While there are many outstanding resources providing in-depth review of electrophysiology topics, this extensively updated book is one of the few case-based books that comprehensively cover clinical electrophysiology, devices and ablation. Case review offers a simple, yet effective way in teaching important concepts, offering insight into both the basic pathophysiology of a problem as well as the clinical reasoning that leads to a solution. As the field of cardiac electrophysiology evolves, the challenge remains to educate new generations of cardiac electrophysiologists with the basics as well as the latest advances in the field. Cardiac Electrophysiology: Clinical Case Review collates the most comprehensive case-based reviews of electrophysiology designed to appeal to all students of the field whether they are fellows, allied professionals or practicing electrophysiologists. The Editors have recruited some of the true experts in the field to contribute cases that they have encountered and summarizing the important learning objectives in a succinct way. Covering clinical electrophysiology, device troubleshooting and analysis as well as intracardiac electrogram analysis and ablation, readers will find the cases useful as a review of electrophysiology or in their day to day interactions with patients.

This book combines medicinal and engineering knowledge to present engineering modelling applications (mainly computational, but also experimental) in the context of facilitating a patient-centred approach to treating congenital heart disease (CHD). After introducing the basic concepts of engineering tools, it discusses modelling and the applications of engineering techniques (e.g. computational fluid dynamics, fluid-structure interaction, structural simulations, virtual surgery, advanced image analysis, 3D printing) in specific congenital heart diseases. It also offers a number of clinical case studies describing the applications in real-life clinical practice. The final section focuses on the importance of surgical training, counselling and patient communication. Considering the unique anatomical arrangement pre/post repair in CHD, as well as the different surgical strategy and device options (e.g. stents) for interventions, a patient-specific approach is certainly warranted in this area of medicine, and engineering is helping improve our understanding of individual patients and their particular anatomy and physiology. To reinforce the idea of a necessary dialogue between clinicians and engineers, this book has not only been edited by two cardiologists and two bioengineers, but each chapter has been written by a clinician and an engineer, incorporating both voices in the description of state-of-the-art models for different CHDs.

This book provides a focused resource on how cardiac surgery capacity can be developed and how it assists in the sustainable development and strengthening of associated health systems. Background is provided on the extent of the problems that are experienced in many nations with suggestions for how suitable frameworks can be developed to improve cardiac healthcare provision. Relevant aspects of governance, financial modelling and disease surveillance are all covered. Guidance is also given on how to found and nurture cardiac surgery curriculum and residency programs. Global Cardiac Surgery Capacity Development in Low and Middle Income Countries provides a practically applicable resource on how to treat cardiac patients with limited resources. It identifies the key challenges and presents strategies on how these can be managed, therefore making it a critical tool for those involved in this field.

Offering patients a higher safety profile and less discomfort than radio-frequency ablation, catheter cryoablation is a safe, effective and efficient alternative for clinicians treating atrial fibrillation and other arrhythmias. In The Practice of Catheter Cryoablation for Cardiac Arrhythmias, cardiac electrophysiologists, cardiologists and cardiology fellows will be able to gain an in-depth update in this rapidly advancing field. Those who wish to offer their patients this treatment option will learn how to master various procedural techniques related to catheter cryoablation. Edited by the pioneer of cryoablation therapy in Asia, with chapters written by expert cardiac electrophysiologists from centers in Asia, Europe and the US who have extensive experience using cryoablation to treat patients, this new book: * Provides comprehensive, clinically-focused guidance on all applications of catheter cryoablation for the treatment of arrhythmias * Focuses on catheter-based techniques that can be performed in the EP laboratory * Reflects global best practices form centers with extensive experience in cryoablation techniques * Covers the use of catheter cryoablation in both adult and pediatric arrhythmias To further enhance reader's understanding of the emergent techniques covered in the text, the book's companion website features video clips of live cryoablation procedures, plus case-based self-assessment questions for selected chapters.