Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.

The First International Symposium on Mechanism and Treatment in Essential Hypertension was held on October 23 and 24, 1985 in Nagoya. The Second International Symposium, which was held on May 30,31, and June 1, 1988 in Nagoya, was a success thanks to the endeavors of all the participants. These symposiums were made possible by the generous support of the city of Nagoya, Aichi Prefec ture, and various contributions. Understanding of the mechanisms of gene (major gene, essential) hypertension is impossible unless we comprehend the physiological properties of arterial smooth muscle. Since Langendorff's discovery of the role of calcium ions in muscle contraction in 1895, we have made immense progress in our knowledge of the role of the calcium ion in the excitation-contraction coupling of the arterial smooth mus cle. Investigation of the molecular mechanisms controlling the cellu lar basis of calcium ion action has been established with the discovery of the calcium binding protein (Ebashi 1963). The participation of the calcium induced calcium mechanism in the contraction of muscle has been directly demonstrated by using chemically skinned smooth muscle fibers (Endo et al. 1977). Methods for intracellular free cal cium contents and calcium channel activity have been developed and contribute to the study of the role of the calcium ion in arterial smooth muscle contractility. Such recent progress promotes study of the basic physiological, biochemical, and molecular properties of the calcium channel, and, in the field of hypertension research, the sodium and potassium channels."

Understanding the many complex cellular and molecular mechanisms underlying human vascular diseases is essential in improving the treatment of this important and wide-ranging group of diseases that affect a large proportion of the world po- lation. This book is based on lectures presented at an International Vascular Biology Workshop held in London and chaired by Professor Dame Carol Black. The c- tents are complemented by some invited chapters, all written by world experts in areas of basic science and clinical medicine highly relevant to vascular biology and disease. We are particularly grateful to Professor Arshed Quyyumi, Professor of Medicine and Cardiology at Emory University, who with his research group and clinical colleagues, has provided a substantial contribution to this book. In common with our previous book - Vascular Complications in Human Disease: Mechanisms and Consequences published by Springer in 2008, our aim with this book is to highlight some of the established relationships between basic science and clinical medicine, and to outline new and exciting fields of research and practice in vascular biology and pathobiology. There are two sections: Basic Science of Vascular Biology and Clinical Aspects of Vascular Biology. In the first section, dealing with basic science, we have included three important growth areas: "Genetics and Gene Therapy" cover approaches to gene therapy and delivery systems, "Animal Models to Study Vascular Disease" with chapters on animal models of scleroderma, animal models of atherosclerosis, and finally on the endothelin system.

Vortex Formation in the Cardiovascular System will recapitulate the current knowledge about the vortex formation in the cardiovascular system, from mechanics to cardiology. This can facilitate the interaction between basic scientists and clinicians on the topic of the circulatory system. The book begins with a synopsis of the fundamentals aspects of fluid mechanics to give the reader the essential background to address the proceeding chapters. Then the fundamental elements of vortex dynamics will be discussed, explaining the conditions for their formation and the rules governing their dynamics. The main equations are accompanied by mathematical models. Cardiovascular vortex formation is first analyzed in physiological, healthy conditions in the heart chambers and in the large arterial vessels. The analysis is initially presented with an intuitive appeal grounded on the physical phenomena and a focus on its clinical significance.In the proceeding chapters, the knowledge gained from either clinical or basic science literature will be discussed. The corresponding mathematical elements will finally be presented to ensure the adequate diligence. The proceeding chapters ensue to the analysis of pathological conditions, when the reader may have developed the ability to recognize normal from abnormal vortex formation phenomenon. Pathological vortex formation represents vortices that develop at sites where normally laminar flow should exist, e.g. stenosis and aneurisms. This analysis naturally leads to the interaction of vortices due to the surgical procedures with respect to prediction of changes in vortex formation. The existing techniques, from medical imaging to numerical simulations, to explore vortex flows in the cardiovascular systems will also be described. The presentations are accompanied by the mathematical definitions can that be understandable for reader without the advanced mathematical background, while an interested reader with more advanced knowledge in mathematics can be referred to references for further quantitative analyses. The book pursues the objective to transfer the fundamental vortex formation phenomena with application to the cardiovascular system to the reader. This book will be a valuable support for physicians in the evaluation of vortex influence on diagnosis and therapeutic choices. At the same time, the book will provide the rigorous information for research scientists, either from medicine and mechanics, working on the cardiovascular circulation incurring with the physics of vortex dynamics.

How can prenatal testing help your patients?

In utero diagnosis has undergone an amazing revolution in recent years. More tests are available; the indications for prenatal diagnosis have expanded - you can now advise your patients about disorders you could not have previously detected. Medical training for obstetricians, medical geneticists, and genetic counselors has not kept pace with these developments. Clinical exposure to common and unusual problems in prenatal diagnosis is limited.

"Prenatal Diagnosis: Clinical Cases and Challenges"," " based on the authors' several decades of experiences, fills this gap. Real cases portray diagnostic problems as a route to the underlying biology, the available testing options, and the results that might be obtained. The authors discuss the challenges of management, interpretation, and counseling.

Cases used throughout emphasize three types of clinical problems: Chromosomal abnormalitiesMendelian disordersFetal structural abnormalities

The decision to enter the world of prenatal diagnosis should be very carefully considered by any prospective mother. "Prenatal Diagnosis: Clinical Cases and Challenges" will help you discuss the issues in an informed manner with your patients.

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.

Medical students encounter many challenges on their path to success, from managing their time, applying theory to practice, and passing exams. The Medical Student Survival Skills series helps medical students navigate core subjects of the curriculum, providing accessible, short reference guides for OSCE preparation and hospital placements. These guides are the perfect tool for achieving clinical success. Medical Student Survival Skills: ECG is an indispensable resource for students new to ECG interpretation and cardiac arrhythmia recognition and treatment. Integrating essential clinical knowledge with practical OSCE advice, this portable guide provides concise and user-friendly coverage of all aspects of ECG monitoring, including atrial and ventricular fibrillation, myocardial infarction, and 12 lead ECG interpretation. Easy-to-find information, plentiful illustrations, OSCE checklists and expert discussions of actual ECG trace examples help medical students and junior doctors quickly get up to speed with ECG interpretation skills.

Coronary Heart Disease: Clinical, Pathological, Imaging, and Molecular Profiles presents a comprehensive picture of ischemic heart disease for practitioners, students, and investigators dealing with the varied facets of this complex subject. Individual chapters introduce the anatomy of the coronary blood vessels and cardiac development, while others consider current imaging modalities utilized for ischemic heart disease, including stress echo, nuclear diagnostic tests, non-invasive coronary artery imaging, and coronary angiography. Imaging chapters provide key clinical information on techniques and indications, and include examples of both normal and abnormal patterns. The principle thrust of the book concerns coronary atherosclerosis, the pathology of which is presented in conjunction with the results of anatomic, non-invasive imaging and angiographic studies. Related chapters cover atherogenesis, presenting new insights into the pathophysiology of the vulnerable plaque, the role of progenitor cells in vascular injury, inflammation and atherogenesis, and the genomics of vascular remodeling. Additional topics covered include angina pectoris, acute coronary syndromes, healed myocardial infarction and congestive heart failure, catheter-based and surgical revascularization, and surgical treatment of myocardial infarction and its sequelae. With contributions from a diverse group of internationally-known physicians with broad experience in the diagnosis and treatment of coronary heart disease, this book will be a valuable resource for practitioners in clinical cardiology, thoracic surgery, pathology, and cardiovascular molecular research, as well as for students in training.

For over 30 years, the stepped care approach has been used in the management and treatment of hypertension. This approach advocates the use of initial monotherapy to reach the desired blood pressure, and the subsequent use of additional drugs with complementary modes of action, until the target BP is achieved. However, current control rates for hypertension suggest that such an approach may be outdated and no longer effective in the management of hypertension. Clinical trials have shown that more than 50% of patients require a combination of drug therapies to achieve their target BP. Some proponents of combination therapy have argued that the risk of adverse side effects and non-compliance will be lower than that compared to monotherapy, which initially requires higher doses to be administered to be effective. Consequently, there have been increasing calls of the necessity for a much more combined approach in the treatment of hypertension. Adding to this, Combination Therapy in Hypertension will cover current control rates of blood pressure worldwide, the benefits of monotherapy and combination therapy, examine the effectiveness, risk of adverse effects, compliance, and cost of the available therapies and will also include information on relevant outcome studies.

Volume 5 of Advances in Nutritional Research reflects a strong current interest in the relationship between nutrition and disease. The impact of disease on nutritional status is described for hepatic encephalopathy and cancer and for several ailments of hospitalized children. The impact of nutrition on disease is illustrated using the examples of retinol in tumorigenesis, vitamins A and E in inflammatory lung disease, fatty acids in atherogenesis and obesity, and folate in megaloblastic anemia. The contents will be of particular interest to clinicians and to students of nutritional biochemistry. vii Contents Chapter 1. Nutritional Management of Hepatic Encephalopathy ... Robert H. Bower and Josef E. Fischer 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2. The Nature of Hepatic Encephalopathy. . . . . . . . . . . . . . . . . . . . . . . . 2 2.1. The Ammonia Concept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2.2. The Amino Acid Neurotransmitter Concept. . . . . . . . . . . . . . . 3 3. Nutritional Support in Hepatic Insufficiency. . . . . . . . . . . . . . . . . . . . 6 3. 1. Therapeutic Implications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 3.2. Therapeutic Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 4. Experiments in Animals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 5. Experience with Patients in Hepatic Encephalopathy . . . . . . . . . . . . . 7 5.1. Acute Hepatic Encephalopathy . . . . . . . . . . . . . . . . . . . . . . . . . 7 5.2. Chronic Hepatic Encephalopathy........................ 9 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Chapter 2. Cellular Retinol-and Retinoic Acid-Binding Proteins... 13 Frank Chytil and David E. Ong 1 . Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 . . . . . . . . . . . . . . 2. Cellular Retinol-and Retinoic Acid-Binding Proteins . . . . . . . . . . 13 . 2.1. Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 . . . . . . . . . . . . 2.2. Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 . . . . . . . . . . . 3. Binding Proteins in Cultured Cells . . . . . . . . . . . . . . . . . . . . 19 . . . . . . . 4. Binding Proteins in Tumors. . . . . . . . . . . . . . . . . . . . . . . . 23 . . . . . . . . . 4.1. Binding Proteins in Experimental Tumors . . . . . . . . . . . . . 23 . . . 4.2. Binding Proteins in Human Tumors . . . . . . . . . . . . . . . . 23 . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 . . . . . . . . . . . . . . ix x Contents Chapter 3. Nutrition and 3-Methylindole-lnduced Lung Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 . . . . . . . . . . . . . .

This book covers a wide range of disorders such as atrial fibrillation, artificial heart valves, deep vein thrombosis, pulmonary embolism and stroke. Handbook of Oral Anticoagulation aims to provide an accessible overview of the exciting new developments in this field. Incorporating numerous quick-reference tables and figures and fully referenced throughout to key papers and the latest reviews, it will be a useful resource for all healthcare professionals involved in thromboprophylaxis.

Cardiovascular disease is a leading cause of death throughout the world. Chronic negative emotions such as depression and anxiety place cardiac patients at greater risk for death and recurrence of cardiovascular disease. In 2008 the editor published a book related to this topic, titled Psychotherapy with Cardiac Patients: Behavioral Cardiology in Practice (American Psychological Association). Aside from that book, there are very few resources specifically written for clinicians who treat psychologically distressed cardiac patients. Unlike other medical specialty areas such as oncology, the field of cardiology has been slow to integrate behavioral treatments into the delivery of service. Perhaps because the field has been largely defined and dominated by researchers, mental health clinicians are only starting to recognize behavioral cardiology as a viable arena in which to practice. There is a large void in the practitioner literature on behavioral cardiology. In a review of Psychotherapy with Cardiac Patients, Paul Efthim, Ph.D. wrote, "Her new book goes well beyond previous works by giving specific and detailed guidance about how to tailor psychological interventions with this variegated population." He added, "It would benefit from even more details about treatment approaches." This proposed volume goes beyond the editor's previous volume by providing in-depth descriptions of behavioral treatments for distressed cardiac patients written by eminent leaders in behavioral cardiology. This book describes a wide range of behavioral treatments for the common psychologically based problems encountered by clinicians who treat cardiac patients. The book is organized as follows: Part I focuses on the most psychologically challenging and common presentations of cardiac diagnosis; coronary artery disease, arrhythmia, and heart failure. This section also includes a chapter on heart transplantation, which is a treatment, not a diagnosis, but a treatment that incurs profound psychological impact for the individual. In Part II, behavioral interventions for the general cardiac population are described. Mainstream therapies such as stress management, cognitive-behavioral therapy, and medical family therapy are described, along with approaches that have less empirical support but considerable practical significance such as personality-guided therapy and interventions aimed at altering type D personality traits. The literature in behavioral cardiology has a rich history of investigating maladaptive personality traits and thus it is important to include behavioral approaches that target personality in this volume. Part III focuses on common behavioral problems encountered by clinicians who work with this patient population. Most patients who seek psychological help do so because they perceive themselves to be stressed due to their job or overextended in all areas of their life. Other people with heart disease present with sleep problems and/or an inability to motivate themselves to exercise or quit smoking. There are many practical behavioral approaches that can be helpful for patients with these difficulties and these are detailed in this section of the book. The conclusion of the book focuses on how to integrate the behavioral treatments described in the preceding chapters into a comprehensive treatment model.

Molecular and Translational Vascular Medicine will serve as a state-of-the-art resource for physicians and translational medical researchers alike who are interested in the rapidly evolving field of vascular medicine. The text provides new insight into the basic mechanisms of classic vascular pathophysiologic processes like angiogenesis, atherosclerosis, thrombosis, and vasculitis. Furthermore, it covers new areas of investigation including the role of the ubiquitin proteasome system in vascular disease, endothelial progenitor cells for disease treatment, and the genetic basis of thoracic aortic aneurysms. Lastly, this volume includes sections on the newly emerging field of therapeutic angiogenesis, and the developing technology of nanoparticle-based imaging and therapeutic treatment of the diseased vasculature. All chapters are written by established experts in their fields, including pathologists, cardiovascular surgeons, and internists as well as translational biomedical researchers in a wide range of disciplines. While comprehensive, the material is presented in a manner that simplifies the complex pathophysiologic mechanisms that underlie common vascular diseases. Molecular and Translational Vascular Medicine will be of great value to a broad audience including internists, cardiovascular and vascular surgeons, pathologists, residents and fellows, as well as translational biomedical researchers.

The biomolecular basis underlying essential hypertension and end organ damage associated with hypertension is characterized as polygenic diseases with complexities such as "environment gene" and "gene-gene" interactions. Despite intensive research in this field, this molecular book is aimed at providing the state-of-the-art reviews which define how the biologic systems sense changes in environment, alter their activities or function, and cross talk with other neurohormonal systems to modulate cardiovascular/renal function and blood pressure. This title will attract scientists and investigators in both academic and industrial fields, and clinicians.

The bicentenary of William Withering's now famous medical report entitled "An Account of the Foxglove and Some of its Medical Uses" has given us the occasion to analyze the state of the art. Cardiac glycosides in 1985 are considered tobe the basis for medical treatment of myocardial failure, together with diuretics and vasodilators in the more severe cases. Nevertheless, the controversy as to their exact place in the treatment of heart failure with sinus rhythm has never ceased. Although cardiac glycosides are of unquestionable value in tachycardia caused by atrial fibrillation or atrial flutter, the chronic use of these drugs in sinus rhythm is not generally accepted. The development of tolerance has been reported. It is of interest that Withering hirnself wrote: "-let it (foxglove) be continued until it either acts on the kidneys, the stomach, the pulse, or the bowels; Iet it be stopped upon the first appearance of any of these effects, and I will maintain that the patient will not suffer from its exhibition, nor the practitioner be disappointed in any reasonable expectation. " In West Germany alone, more than three million patients (about 5% of the total population) are constantly taking cardiac glycosides. These drugs are the most prescribed medicaments in many countries. Thus, we considered it worthwhile and necessary to review in a critical way today's knowledge about the foxglove; to report new findings and to evaluate old Statements.

The recent rapid advances in our knowledge of immunological and virological mechanisms involved in the pathogenesis of viral heart disease makes it difficult for everybody working in this field to keep up with the latest developments. How ever, much of what we know is still circumstantial and only vaguely substained. Interdisciplinary understanding and cooperation thus seems necessary to get a better insight into the mechanisms by which viruses may initiate immunological organ-specific tissue injury and disease! This volume evolved out of an international symposium by the same title held on May 25. -28. , 1988 in Tegernsee, near Munich, of which a wide spectrum ofim munological, virological, diagnostical and clinical problems was covered. Both review articles and new experimental and clinical data are included in this volume to give the reader an up-to-date information about current concepts and future aspects. Chapter I serves as an excellent introduction to the epidemiology and natural history of dilated cardiomyopathy / viral heart disease. Although a definite viral etiology in myocarditis and dilated cardiomyopathy is often difficult to establish, epidemiological and serological data incriminate a viral etiology underlying many cases of "dilated cardiomyopathy". Chapters II and III describe the current think ing on virological and immunological mechanisms involved in the pathogenesis of viral heart disease. Among others virus topism, virus persistance, possible mecha nisms and genetic basis of post-infection autoimmunity, and the virus-interaction with the immune system are discussed.

Breathlessness is increasingly recognised as a common, disabling symptom of many advanced diseases and one that is very difficult to treat. There is now an understanding that a multi-disciplinary approach to management can make a significant impact on the severity of the symptom improving both the patient s and their carers quality of life.

Breathlessness is one of the most difficult conditions that palliative care (and other clinicians who care for patients with advanced disease) have to treat. With the improvements in pain control, it is possibly now the most difficult symptom for clinicians to manage: many feel frustrated at not being able to give their patients better care. Many patients and families are enduring terrible suffering. There has been little progress in improving the symptom, in spite of an increase in the amount of research and interest in it over the last twenty years. The Cambridge Breathlessness Intervention Service (CBIS) has been established since 2004 and is a research-based service which has being evaluated since its inception: its model of caring has been shaped by the patients and families who use it and the clinicians who refer to it.CBIS has firm evidence of its effectiveness with patients with breathlessness with both malignant and non-malignant disease. This book will help others to manage breathlessness in their day-to-day clinical practice and, if so desired, set up their own breathlessness service. There is a well-established website which can be used in conjunction with the book. The book is written to give practical help in the clinical management of breathlessness and written so that the information is easy to access in clinic, ward or home."

Myocardial tissue engineering (MTE), a concept that intends to prolong patients life after cardiac damage by supporting or restoring heart function, is continuously improving. Common MTE strategies include an engineered vehicle, which may be a porous scaffold or a dense substrate or patch, made of either natural or synthetic polymeric materials. The function of the substrate is to aid transportation of cells into the diseased region of the heart and support their integration. This book, which contains chapters written by leading experts in MTE, gives a complete analysis of the area and presents the latest advances in the field. The chapters cover all relevant aspects of MTE strategies, including cell sources, specific TE techniques and biomaterials used. Many different cell types have been suggested for cell therapy in the framework of MTE, including autologous bone marrow-derived or cardiac progenitors, as well as embryonic or induced pluripotent stem cells, each having their particular advantages and disadvantages. The book covers a complete range of biomaterials, examining different aspects of their application in MTE, such as biocompatibility with cardiac cells, mechanical capability and compatibility with the mechanical properties of the native myocardium as well as degradation behaviour in vivo and in vitro. Although a great deal of research is being carried out in the field, this book also addresses many questions that still remain unanswered and highlights those areas in which further research efforts are required. The book will also give an insight into clinical trials and possible novel cell sources for cell therapy in MTE."

This monograph comprises 17 papers written by prominent authors in the field, each of whom presents his most recent experiences. The papers were not specially selected so that this work is far from being a comprehensive textbook covering all aspects of right ventricular hypertrophy and failure in chronic lung disease. Perhaps some of the papers dealing with more strictly physiological problems and experimental models will be somewhat difficult to relate directly to former modes of thinking of both cardiologists and pneumologists. Nevertheless, we hope and expect that this book will provide the reader with, an in-depth appreciation of the situation of present research in different laboratories and countries. Occasionally contradictions between different papers may be noticed. We have not tried to remove these, since each contradiction reflects current areas of dispute or uncertainty in this developing field. We wish finally to acknowledge the continuing support of the Clinica del Lavoro Foundation for projects aimed at promoting education in all fields related to medical rehabilitation. Vlastimil Jdek Mario Morpurgo Roberto Tramarin Foreword This volume is the sixth issue in the Series "Current Topics in Rehabilitation", which was ftrst conceived in 1987 with the aim of offering updated indications as to functional comprehensive evaluation strategies and rehabilitation programmes.

Venous insufficiency is a common cause of restricted activity, early retirement, and prolonged medical care, all of which contribute immensely to its social and economic burden. For many, it means disfiguring and troublesome skin conditions and ulcers in the legs. Despite the frequency and the exasperating nature of venous insufficiency, it is a largely under-diagnosed and under-treated condition. Yet, when identified and treated appropriately, the complications can be controlled, if not eliminated. This accessible text offers clear cut explanations of the causes of venous insufficiency and of the symptoms and findings that point to the diagnosis. It is designed to ease the labor-intensive burden of managing the results of venous insufficiency in the office practice while describing interventions that the patient and / or caregiver can apply at home.

Chronic Kidney Disease (CKD) is a recognized risk factor for cardiovascular events and death. The coexistence of CKD and heart failure is increasing in prevalence worldwide and requires a unique and subtle approach to patient management. The Kidney in Heart Failure focuses on the changes that occur in kidney physiology as a function of a failing heart. This comprehensive resource covers epidemiology, pathophysiology, management of kidney disorders and advances in nephropathy management. In addition, the latest therapies, common heart failure dilemmas and kidney disease markers are included. Each chapter is co-authored by a Nephrologist and Cardiologist, offering a unified perspective to these chronic conditions. This indispensible volume provides the reader with the depth-of-knowledge needed for assessing and treating the cardio renal patient.

This book updates clinicians on the most recent data regarding the medical management of patients of acute coronary syndrome (ACS), providing useful information and expert opinion on the large trials, international guidelines, and clinical practice. It reinforces the need for rapid intervention with pharmacologic therapies to treat and prevent coronary thromboembolism, and to prepare the patient for revascularization procedures, especially percutaneous coronary intervention. Pharmacological Treatment of Acute Coronary Syndromes describes conventional treatment - including anti-ischemic, antiplatelet and anticoagulant therapy - and discusses the clinical use of newer treatment options: the potent new P2Y12 platelet receptor inhibitors with the recently recommended ticagrelor and prasugrel, and new oral anticoagulant agents showing promise for acute management and secondary prevention in ACS. Triple therapy, while not initiated in the acute setting, may impact on future surgical and medical emergencies and their management. Also covered are the various recommendations for each of the antiplatelet and anticoagulant agents in terms of patient selection, pretreatment and timing of therapy, making this book an essential read for a wide range of health professionals.

The present book offers a bird's eye view of the clinical potential of nuclear medical techniques (including nuclear and magnetic resonance) in the practice of cardiology. It is based on 16 review publications which cover the most important areas in clinical cardiovascular nuclear medicine. The book has been grossly divided into three sections: (1) Physiology, (2) Techniques, and (3) Clinical Applications. The Physiology section deals with the nuclear medicine background of myocardial perfusion, myocardial metabolism, and cardiac function (Chapters 1, 2, and 3). The Techniques sections discusses the planar techniques, in particular for the perfusion tracer thallium-201, the Single Photon Emission Computed Tomography (SPECT) technique, and the Positron Emission Tomography (PET) technique (Chapters 4, 5 and 6). This section also addresses the physical background of Magnetic Resonance Imaging (MRI) (Chapter 7). The Clinical Applications section discusses the value of nuclear cardiology for a variety of cardiac diseases from detection ofmyocardial infarction to its merits for evaluating cardiomyopathies (Chapters 8-14). Chapter 10 shortly addresses the experimental and clinical value of Magnetic Resonance Spectroscopy (MRS). Chapter 15 describes the latest developments in nuclear cardiology with an emphasis on new cardiac imaging agents. Finally, Chapter 16 presents the currently advocated Guidelines in Nuclear Cardiology. The book will assist the clinical cardiologist, the cardiology resident, the nuclear medicine physician, and the radiologist in understanding the currently used cardiovascular nuclear medicine techniques. It will broaden knowledge of the nuclear cardiology techniques and will show the reader how indispensable these techniques are in clinical cardiology practice.

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."