Long-term oxygen therapy (LTOT) usually represents the final step in the management of severe chronic respiratory diseases: a large proportion of patients suffering from these conditions is involved and the corresponding impact for the Health Institutions and the Society is dramatically increasing. Although LTOT is well known and widely used since long ago in most modern countries, it still represents a challenging topic due to the huge amount of variables which can affect both its efficacy and effectiveness. Unfortunately, patients, doctors, care-givers, together with health institutions and political decision makers frequently have different visions on LTOT, thus highly contributing to obtain uneven results and changing outcomes. The focus of this volume is on new insights and novel perspectives of LTOT. Starting from consolidated experiences, it's aim is also to emphasize the strategic value of developing technologies and innovative organizational models uniquely to find out even more opportunities and advantages for the management of chronic respiratory patients needing long-term oxygen treatment.

Bringing together top-level contributions on all aspects of the subject, this book provides an overview of the recent advances in the genetics of respiratory control in health and disease. It also shows how combined studies in humans and mouse models have helped to improve our understanding of the mechanisms that underlie genetically determined respiratory control disorders with the goal of developing new therapeutic interventions.

Cancer is initiated by activation of oncogenes or inactivation of tumor suppressor genes. Mutations in the K-ras proto-oncogene are responsible for 10-30% of adenocarcinomas. Clinical Findings point to a wide variety of other cancers contributing to lung cancer incidence. Such a scenario makes identification of lung cancer difficult and thus identifying its mechanisms can contribute to the society. Identifying unique conserved patterns common to contributing proto-oncogenes may further be a boon to Pharmacogenomics and pharmacoinformatics. This calls for ab initio/de novo drug discovery that in turn will require a comprehensive in silico approach of Sequence, Domain, Phylogenetic and Structural analysis of the receptors, ligand screening and optimization and detailed Docking studies. This brief involves extensive role of the RAS subfamily that includes a set of proteins, which cause an over expression of cancer-causing genes like M-ras and initiate tumour formation in lungs. SNP Studies and Structure based drug discovery will also be undertaken.

A Clinical Guide to Occupational and Environmental Lung Diseases delivers a concise compendium to the diagnosis and management of occupational and environmental lung diseases, incorporating evidence-based guidelines where available. Each chapter provides an updated review and a practical approach to different occupational and environmental lung diseases. With rapidly changing technology, new conditions and exposures will undoubtedly emerge. Clinicians need to remain vigilant about assessing the potential link between lung diseases and environmental exposures, and this book provides a practical guide to recognize, diagnose, and prevent occupational and environmental lung diseases. Written for practicing clinicians including internists, pulmonologists, and primary care providers, as well as industrial hygienists and environmental regulators, A Clinical Guide to Occupational and Environmental Lung Diseases is a timely and important new volume and an invaluable contribution to the literature.

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.

The extension of clinical, endoscopic, and bioptic lung examination proce- dures and function analyses has resulted in more detailed knowledge of the pathology and pathogenetic factors of numerous bronchopulmonary dis- eases. Morphometric, histochemical, ultrastructural, and immunologic ex- amination methods are now constituent parts oflung pathology. This volume, written by numerous experts treats the special subjects of bronchial system pathology, pulmonary circulation, inflammatory and fibrous lung tissue diseases, and borderline areas oflung tumors. With regard to the results, some of which have been obtained experimentally, great im- portance has been attached to the presentation of the applied morphometric, histochemical, immunologic, and ultrastructural investigation methods. The book is intended to improve and extend the discussion between clinicians and morphologists. For the majority of lung diseases, which are discussed in detail in chapters dedicated to the morphological aspects, definitive cat- egorization and assessment of the findings are only possible if clinical picture and disease progress are known. Furthermore, the fmdings documented here, which can be grasped morphologically, provide important indications for the evaluation and classification of syndromes and for prophylactic clinical measures. I would like to thank Professor Grundmann, who initiated this volume, and the contributing authors. Special appreciation and recognition are due the staff of Springer-Verlag for their cooperation and for the organization, printing, and perfect illustration of the contributions. Bochum K. -M. Milller Contents Methods and Results of Postmortem Studies of Airway Dynamics in Normal Lungs and Lungs with Minimal Obstruction. With 11 Figures W. Wierich ...

The work presented in this monograph marks a new era, we believe, both in the development of quantitative anatomy of the lung, and in the correlation of anatomy with physiology. For many years, physiologists interested in the overall functioning of the lung have felt a need for better quantitative descriptions of pulmonary anatomy. As physiologists, we know a good deal about the forces operating to producepulmonary ventilation, and the quantities that define this function in rest and exercise ; and the same for effective distribution of air within the lung - "alveolar" ventilation-, and for the exchange of respiratory gases between air and blood. There have been no correspondingly precise quantitative measurements of the pulmonary structures that serve theese functions. The great advances in the study of pulmonary anatomy in the past decade have been chiefly in the realm of "fine structure". This has tended to bring together anatomy and biochemistry or physical chemistry, rather than anatomy and physiology. This conjunction has aided, for example, the conception of diffusion as a physicochemical process, but not that of diffusion as a metabolic bodily function. It was, therefore, a remarkably fortunate circumstance which brought together in our laboratory, about three years ago, Professor DoMINGO GoMEZ and Dr. EWALD R. WEIBEL: Professor GoMEZ a mathematician and biophysicist of dis tinction and long experience; Dr. WEIBEL a young anatomist trained under Pro fessor GIAN ToeNDURY in Zurich, and with additional research experience with Professor A VERILL LIEBOW at Y ale.

The Human Respiratory System combines emerging ideas from biology and mathematics to show the reader how to produce models for the development of biomedical engineering applications associated with the lungs and airways. Mathematically mature but in its infancy as far as engineering uses are concerned, fractional calculus is the basis of the methods chosen for system analysis and modelling. This reflects two decades' worth of conceptual development which is now suitable for bringing to bear in biomedical engineering. The text reveals the latest trends in modelling and identification of human respiratory parameters with a view to developing diagnosis and monitoring technologies. Of special interest is the notion of fractal structure which is indicative of the large-scale biological efficiency of the pulmonary system. The related idea of fractal dimension represents the adaptations in fractal structure caused by environmental factors, notably including disease. These basics are linked to model the dynamical patterns of breathing as a whole. The ideas presented in the book are validated using real data generated from healthy subjects and respiratory patients and rest on non-invasive measurement methods. The Human Respiratory System will be of interest to applied mathematicians studying the modelling of biological systems, to clinicians with interests outside the traditional borders of medicine, and to engineers working with technologies of either direct medical significance or for mitigating changes in the respiratory system caused by, for example, high-altitude or deep-sea environments.

This textbook is intended primarily for medical students. It has been required in the Cardiovascular/Pulmonary Course for second year medical students at the University of Texas Medical Branch, Galveston. This book is meant to be a companion to my other text, Cardiovascular Physiology, 3rd Edition.

Familiarity with nitric oxide is essential to a modern understanding of pathophysiologic mechanisms of infectious disease. Recent research has established nitric oxide and related reactive nitrogen intermediates to be important molecular mediators of diverse physiologic processes such as control of vascular tone, regulation of the immune system, and microbial and tumor cell growth. This book contains chapters by the leading researchers in the field and examines the biology and biochemistry of nitric oxide and its role in a variety of specific infections ranging from sepsis, tuberculosis and malaria to viral myocarditis, influenza, and AIDS.

This book contains the refereed contributions from the 41st annual meeting of ISOTT. The annual meetings of ISOTT bring together scientists from various fields (medicine, physiology, mathematics, biology, chemistry, physics, engineering, etc.) in a unique international forum. Traditionally, ISOTT conferences are a place, where an atmosphere of interaction is created, where many questions are asked after each presentation and lively discussions occur at a high scientific level. This vivid interaction is the main motivation for members to participate and gain new ideas and knowledge in the broad field of oxygen transport to tissue. The papers in this volume summarize some of the outstanding contributions from the 41st annual meeting. Special features in this volume include invited presentations from senior members of ISOTT for the theme "the wisdom of ISOTT" in which founders, past presidents and prize winners from previous meetings provided both cutting edge new knowledge and integrated overviews of critical aspects of the field. The presentations and manuscripts also include those provided by the special opportunity provided by having part of the ISOTT meeting overlap with the EPR-2013 meeting where both focused on preclinical and clinical measurements of oxygen, with a particular emphasis on cancer. Chapters 22, 24, 25 and 26 are open access under a CC BY 4.0 license via link.springer.com.

This book consists of 23 essays about prominent people and events in the history of respiratory physiology. It provides a first-hand chronicle of the advancements made in respiratory physiology starting with Galen and the beginnings of Western physiology. The volume covers every aspect of the evolution of this important area of knowledge: pulmonary circulation, Boyle's Law, pulmonary capillaries and alveoli, morphology, gas exchange and blood flow, mechanics, control of ventilation, and comparative physiology. The book emphasizes societal and philosophical aspects of the history of science. Although it concentrates on physiology, it also describes how cultural movements, such as The Enlightenment, shaped the researchers discussed. This book is published on behalf of the American Physiological Society by Springer. Access to APS books published with Springer is free to APS members.

In a simplified form, epigenetics refers to heritable changes in phenotype that are not due to changes in the underlying DNA sequence. In this book, epigenetic mechanisms of regulation and dysregulation in health and disease are explored in great depth. Detailed chapters on epigenetic processes including DNA methylation and chromatin post-translational modifications including potential interventions with DNA methyltransferase inhibitors and histone deacetylase inhibitors are explored in initial chapters. These provide a detailed overview and important background to the entire field. The book is then focussed on epigenetic mechanisms involved in various diseases including anti-inflammatory and autoimmune conditions. Important accounts relating to the effects of epigenetics in metabolic syndrome, cardiovascular disease and asthma are the focus of subsequent chapters. The role of epigenetic dysregulation in malignancy is a current topic of interest and represents an intense field of research. A large component of this book is dedicated to the analysis of aberrant epigenetic processes in carcinogenesis and cancer progression. Further, chapters are focused on emerging cancer prevention using nutritional components and anti-cancer therapies particularly with histone deacetylase inhibitors, which have already been approved for the treatment of cutaneous T-cell lymphoma. The emerging role of nanoparticle preparations, especially in the context of delivering potential epigenetic therapies to target cells in various diseases, is also explored in this book. Overall, this book encompasses a wide range of topics related to epigenetic mechanisms in health and disease and would appeal to anyone with an interest in epigenetics, chromatin biology and emerging epigenetic interventions and therapies.

Based on the 38th annual conference of the International Society on Oxygen Transport to Tissue (ISOTT), held in Ascona, Switzerland in July 2010, this volume covers all aspects of oxygen transport from air to the cells, as well as looking at organs and organism, instrumentation, and methods to sense oxygen and clinical evidence.

From the 40th annual conference of the International Society on Oxygen Transport to Tissue (ISOTT), held in Bruges, Belgium in August 2012, this volume covers aspects of clinical applications, muscle oxygenation, cancer, measurement technologies, oxygen transport modelling and Near-Infrared Spectroscopy (NIRS), cell metabolism and brain oxygenation. Each topic was presented by one or two invited speakers, and a series of contributed talks.

Respiratory motion causes an important uncertainty in radiotherapy planning of the thorax and upper abdomen. The main objective of radiation therapy is to eradicate or shrink tumor cells without damaging the surrounding tissue by delivering a high radiation dose to the tumor region and a dose as low as possible to healthy organ tissues. Meeting this demand remains a challenge especially in case of lung tumors due to breathing-induced tumor and organ motion where motion amplitudes can measure up to several centimeters. Therefore, modeling of respiratory motion has become increasingly important in radiation therapy. With 4D imaging techniques spatiotemporal image sequences can be acquired to investigate dynamic processes in the patient's body. Furthermore, image registration enables the estimation of the breathing-induced motion and the description of the temporal change in position and shape of the structures of interest by establishing the correspondence between images acquired at different phases of the breathing cycle. In radiation therapy these motion estimations are used to define accurate treatment margins, e.g. to calculate dose distributions and to develop prediction models for gated or robotic radiotherapy. In this book, the increasing role of image registration and motion estimation algorithms for the interpretation of complex 4D medical image sequences is illustrated. Different 4D CT image acquisition techniques and conceptually different motion estimation algorithms are presented. The clinical relevance is demonstrated by means of example applications which are related to the radiation therapy of thoracic and abdominal tumors. The state of the art and perspectives are shown by an insight into the current field of research. The book is addressed to biomedical engineers, medical physicists, researchers and physicians working in the fields of medical image analysis, radiology and radiation therapy.

Pulmonary emphysema is a disease which develops because of a localized imbalance between endogenous proteinase inhibitors and proteinases leaking from neurophils during phagocytosis at inflammatory foci within the lung. This volume not only reviews at a biochemical level what is known about the natural inhibitors and proteinases involved in connective tissue destruction within the lung, but also suggests novel methodologies for reestablishing proper enzyme-inhibitor balance, including the use of natural or synthetic inhibitors for supplementation or gene therapy.

This volume covers data describing the role of free radicals and antioxidants in respiratory disorders, including the data that deal with clinical and pre-clinical trials. Chapters describe the relationship of oxidative stress to a number of respiratory and pulmonary conditions from a basic science and clinical perspective, including chronic obstructive pulmonary disease, asthma, acute lung injury, pulmonary hypertension, toxicity and fibrosis, cancer and asbestosis. The book also discusses the use of conventional biomarkers of oxidative stress and breath condensates as adjuncts to classical laboratory testing, the effect of antioxidants on cellular protection, as well as the development of novel antioxidant modalities.

This book represents an actual view on the current trends in the area of respiratory therapy research. The amount of new information in each field of clinical medicine is astonishing and therefore we considered it very important to catch this exciting movement in the form of monograph dedicated to the advances in therapy research of various respiratory diseases. The chapters analyse the therapeutic strategies and perspectives in the management of the most common chronic diseases, especially in childhood. Due to very rapid progress in this area, it is very important that the authors succeed in summarising the most knowledge and data about the available and possible future therapies of bronchial asthma, primary ciliary dyskinesia, chronic and acute cough, and obstructive sleep apnea syndrome. Aside from clinical chapters, the readers can also find experimental studies analysing the possible therapeutic application of different medications and chest physiotherapy. A very important part of each chapter is the current view on the pathogenesis of particular diseases, in which understanding is crucial for better, targeted therapy and research of novel therapeutic modalities. We hope that this book will find its readers and will help physicians and other interested people to understand the most recent trends in the treatment and management of respiratory diseases.

This volume contains a collection of papers from the research program Protective Artificial Respiration (PAR) . In 2005 the German Research Association DFG launched the research program PAR which is a joint initiative of medicine and fluid mechanics. The main long-term objective of this program is the development of a more protective artificial respiratory system to reduce the physical stress of patients undergoing artificial respiration. To satisfy this goal 11 projects have been defined. In each of these projects scientists from medicine and fluid mechanics do collaborate in several experimental and numerical investigations to improve the fundamental knowledge on respiration and to develop a more individual artificial breathing concept. "

In this book, authors review the current knowledge on acute lung injury (ALI). ALI/acute respiratory distress syndrome (ARDS) is characterized by diffuse alveolar damage, alveolar capillary leakage, lung edema, neutrophil-derived inflammation, and surfactant dysfunction. These changes lead to clinical manifestations of decreased lung compliance, severe hypoxemia, and bilateral pulmonary infiltrates. In the first chapter the authors describe how two different models of multi-causality (intuitively appealing threshold model and abstract sufficient cause model), both of which are commonly used in the description of the etiology of diseases, can be applied to transfusion related acute lung injury (TRALI) and can both be used to describe the same observed relations between multiple risk factors and TRALI. In the second chapter, a dysfunction of the normal endothelialepithelial barriers and its role in the development of acute lung injury is described. Two leading pathogenic mechanisms of ALI are increased endothelial permeability and reduced alveolar liquid clearance capacity. Understanding of the fundamental mechanisms involved in the regulation of endothelial permeability is essential for the development of barrier protective therapeutic strategies. The following two chapters are focused on novel therapeutic strategies used in the treatment of ALI and more severe form acute respiratory distress syndrome (ARDS). Appropriate treatment involves protective lung ventilation, optimal fluid management, and pharmacological treatment. Despite that there are several possibilities of potentially beneficial pharmacotherapy of ALI/ARDS, the results of experimental and clinical studies are often controversial. The authors review the use of various pharmacological agents (including corticosteroids, neutrophil elastase inhibitors, anticoagulants, pulmonary vasodilators, antioxidants, methylxanthines, exogenous surfactant, gene-therapy, cell therapy, nitric oxide, myorelaxants, beta-agonists) and critically evaluate their effects in animal models and in patients with ALI/ARDS.

Asthma as seen by Otolaryngologists as part of the patient workup, diagnosis, and treatment of the spectrum of disorders of rhinitis and allergy is presented. Otolaryngologists are frequently the de facto allergy specialist for patients presenting with allergies and chronic rhinosinusitis. Allergy, Rhinology, and Pediatric Airway are covered. ENT physicians will find current information for Data gathering and Interpretation (screening and testing), Diagnosis, combined surgical and non-surgical Treatment, and Basic Science related to Asthma in this publication.

Intermittent hypoxia can cause significant structural and functional impact on the systemic, organic, cellular and molecular processes of human physiology and pathophysiology. This book focuses on the most updated scientific understanding of the adaptive (beneficial) and maladaptive (detrimental) responses to intermittent hypoxia and their potential pathogenetic or prophylactic roles in the development and progression of major human diseases. This is a comprehensive monograph for clinicians, research scientists, academic faculty, postgraduate and medical students, and allied health professionals who are interested in enhancing their up-to-date knowledge of intermittent hypoxia research and its translational applications in preventing and treating major human diseases.

Untoward reactions to environmental chemicals, particularly when a subject reports difficulties with exposures to chemicals of diverse classes involving more than one organ system, have been poorly understood and an area of great controversy. Studies of airway inflammation induced by respiratory irritants have established neurogenic inflammation as the mechanism for irritant asthma and rhinitis. Remodeling of the airway after an acute irritant exposure can lead to a heightened sensitivity to irritants that persists. Recognition that rhinitis, while sometimes regarded as a trivial disease, is associated with extra-airway manifestations such as fatigue and disturbances of sleep, mood, and cognition, further elucidates how chemical exposures can be serious for susceptible individuals.
This book reviews current scientific understanding of irritant airway inflammation and related conditions, including cardiovascular effects of particulate exposures, airborne contact dermatitis and irritant dermatitis, and the brain as a target organ for both allergic and irritant reactions. It is essential reading for physicians and other healthcare workers caring for patients with environmental intolerances. Allergists, toxicologists, occupational and environmental physicians, and pulmonologists will find the materials particularly valuable. Patients and advocates for those with chemical intolerances will also find the book of interest.