Pancreatic islets make up the endocrine pancreas and they contain the only source of insulin in the body, beta cells. Hence, access to high quality preparations of pancreatic islets is fundamental for in vitro studies and to test pre-clinical applications in animal models in vivo. Access to healthy human islets is also crucial to improve transplantation procedures for diabetes. Given the susceptibility of pancreatic islets to the enzymatic digestion and mechanical stress required to obtain them, the isolation of islets is often considered as the delicate "work of a craftsman". This book, which is aimed at beginners and experts alike, is a survey of the current state-of-the-art in this field and it centres on the challenges, pitfalls and peculiarities of pancreatic islet isolation in the different species used in pre-clinical and clinical applications. It explores the similarities and differences between human islets and those from other relevant species (rodents, pigs and non-human primates), and how these influence islet isolation. The ultimate goal of this book is to improve the outcome of islet isolation and transplantation in pre-clinical and clinical applications.

Osteoarthritis (OA), the most common form of arthritis, is generally characterized by a slowly progressive degeneration of articular cartilage, particularly in the weight-bearing joints. It has a stronger prevalence in women, and its incidence increases with age. OA is a major and growing health concern in developed countries, owing to steadily increasing life expectancy and the demand for better quality of life. Because of its chronic nature and nonfatal outcome, OA affects the growing population of the elderly over an increasing time span. Moreover, despite its relatively benign character, OA is one of the most disabling diseases; it is responsible for increasing financial and social burdens in terms of medical treatments, forced inactivity, loss of mobility, and dependence. Despite a growing awareness of OA as a medical problem that has yet to reach its maximum impact on society, there is a surprising absence of effective medical treatments beyond pain control and surgery. So far, only symptom-modifying drugs are available, while there remains a major demand for disease-modifying treatments of proven clinical efficacy. This demand will hopefully be met in the future by some of the drugs that have been pressed into development and are now at different stages of clinical investigation. Nevertheless, the current lack of effective treatments reflects a still insufficient knowledge of cartilage with respect to its metabolism, interactions with other joint tissues, and causes and mechanisms (possibly of very different nature) leading to failure of its turnover.

Leading basic and clinical investigators from around the world summarize the most recent research on the molecular and cellular origins of lupus. Their cutting-edge articles review the mechanisms underlying abnormal immunity and introduce the powerful new concept that a disorder of multiple genes underlies the abnormal immune response, leading directly to the development of lupus. This pathophysiology is shown to involve a wide variety of cell types, including T cells, B cells, natural killer cells, macrophages/monocytes, and endothelial cells. Over time, the resulting long-term inflammation causes irreversible cell destruction and, ultimately, organ failure. Lupus: Molecular and Cellular Pathogenesis is a masterful new synthesis of all the new knowledge emerging today about lupus. Its new perspectives will sharpen the focus of research and ultimately lead to better and more effective treatment.

This collection of articles by leading orthopedic and craniofacial surgeons and researchers comprehensively reviews the biology of bone formation and repair, the basic science of autologous bone graft, allograft, bone substitutes, and growth factors, and explore their clinical application in patients with bone repair problems.

The small neck of the aneurysm afforded an easy surgical attack. An ordinary flat silver clip was placed over the sac and tightly compressed obliterated it completely. The clip was flush with the wall of the carotid artery. The sac, lateral to the silver clip, was then picked up with the forceps and thrombosed by the electocautery. Walter Dandy reporting his successful operation of a posterior communicating aneurysm on March 23, 1937. Walter Dandy's patient left the hospital in good health 2 weeks later, and from his report one may gain the impression that the operation was an easy task. Despite continuous developments during the following decades, it was not until the introduction of the operating microscope and microsurgical techniques that surgical treatment was generally accepted. During the microsurgical era surgical results have continued to improve due to diagnostical, neuroanaesthesi ological, and microsurgical refinements, and improved neurointensive care. Endovascular obliteration has become an important treatment alternative but this has not been included in this particular volume. The purpose of the present supplement of the ACTA NEUROCHIRURGICA is to review some of the elements in the neurosurgical management of patients with aneurysmal subarachnoid haemorrhage that are important for a successful outcome. Professor Helge Nornes has been a major force in the development of new techniques and research strategies in this area for a number of years and has recently retired from the National Hospital in Oslo."

This volume of "Advances and Technical Standards in Neurosurgery" is devoted entirely to the spine. Like other volumes in the series, it presents important recent progress in the field and offers detailed descriptions of standard procedures to assist young neurosurgeons. Among the advances considered are approaches to spinal navigation, including intraoperative imaging based navigation, and concepts of spinal robotics. The value of sagittal balance as a parameter for the neurosurgeon is examined, and a novel surgical approach to longitudinal pathologies within the spinal canal is presented. Developments in surgery for kyphosis are also discussed, with a focus on pedicle subtraction osteotomy. The technical standards section critically reviews the latest evidence regarding cervical disc arthroplasty and pedicle-based non-fusion stabilization devices. The book concludes by discussing the treatment of craniovertebral junction instability as a result of juvenile chronic arthritis.

Leading clinicians and scientists in solid organ transplantation review the current status of the field and describe cutting-edge techniques for detecting the immune response to the allografted organ. The authors present the latest techniques for HLA typing, detecting HLA antibodies, and monitoring T-cell response, and examine more specialized methods utilizing proteomics, laser dissection microscopy, and real-time polymerase chain reaction. The area of tolerance induction and reprogramming of the immune system is also covered, along with a discussion of up-to-date methods of organ preservation, of today's optimal immunosuppressive drug regimens, as well as the difficulty of mimicking chronic rejection in experimental models. Introductory chapters provide a theoretical update on current practices in renal, liver, islet, and lung transplantation and on the pathways of antigen presentation and chronic rejection.

Cardiac surgery is performed on hundreds of thousands of patients a year, and can have an important beneficial impact on the outcomes of patients with coronary and valvular heart diseases. Despite the favorable recovery of most patients, some will have their post-operative period interrupted by the development of atrial fibrillation, with a host of potential complications including stroke. High risk subgroups may develop atrial fibrillation in more than half of cases, and often despite aggressive prophylactic measures. Treatment of atrial fibrillation and its aftermath can also add days to the hospital stay of the cardiac surgical patient. In an era of aggressive cost cutting and optimization of utilization of health care resources, the financial impact of this arrhythmic complication may be enormous. Experimental studies have led to a greater understanding of the mechanism of atrial fibrillation and potential precipitating factors in the cardiac surgical patient. Prophylactic efforts with beta-blockers, antiarrhythmic drugs and atrial pacing are being used, or are being investigated in clinical trials. New methods of achieving prompt cardioversion with minimal disruption of patient care, and prevention of the thromboembolic complications of atrial fibrillation, are also important therapeutic initiatives. This text is designed to aid health care professionals in the treatment of their patients in the recovery period after cardiac surgery, and to instigate additional research efforts to limit the occurrence of, and the complications following, this tenacious postoperative arrhythmia.

This book provides a comprehensive yet accessible look at organ donation and transplantation, including coverage of scientific, medical, social, legal, and ethical issues. Readers will also discover how new technologies and medical advances are shaping the future of organ donation. Donated organs and tissues have improved or saved the lives of hundreds of thousands of individuals. But these life-changing procedures raise many logistical and ethical questions. How can organs be effectively allocated to those in need? Should individuals be allowed to purchase organs from living donors? What role does religion and culture play in someone's decision to donate or accept an organ? Will new technologies like bioprinting change the future of organ donation? Part of Greenwood's Health and Medical Issues Today series, Organ Donation is divided into three sections. Part I explores different aspects of the donation and transplantation process, including which tissues and organs can be donated, living versus deceased donation, religious and cultural perceptions, and cutting-edge alternatives to traditional organ transplants. Part II delves deep into a variety of issues and controversies related to the subject, offering thorough and balanced coverage of such hot-button topics as opt-in versus opt-out systems, organ trafficking, and transplant tourism. Part III provides a variety of useful materials, including case studies, a glossary, and a directory of resources. Explains the topic from a variety of angles, including scientific, historical, legal, and cultural, giving readers a holistic introduction to this complex and multifaceted subject Highlights important issues and controversies relevant to the topic, providing balanced and unbiased coverage Offers illuminating case studies that use engaging real-world scenarios to highlight key ideas and debates discussed in the book Provides readers with a curated Directory of Resources to guide their search for additional information

Percutaneous cardiac and endovascular procedures performed by a variety of interventional physicians continue to evolve and expand. One of the most important steps in performing these procedures is vascular access and their Achilles heel is vascular access site complications. This volume is here to help the clinician, providing a practical overview of the techniques and technologies used in top catheterization laboratories to access the arterial and venous beds. Dr. Mazen Abu-Fadel and his contributors, part of the renowned cardiovascular team at the University of Oklahoma College of Medicine, carefully walk the reader through the various techniques used to obtain vascular access into most arterial and venous sites. They thoroughly describe current data, techniques, advantages, risks, and benefits of each vascular access site. Covering everything from anatomic landmarks to closures devices, Arterial and Venous Access in the Cardiac Catheterization Lab offers a complete overview of each procedure. In addition, it provides an up-to-date guide to the best medical technologies and equipment used when performing these procedures. Arterial and Venous Access in the Cardiac Catheterization Lab is an invaluable resource for a wide range of clinical personnel, from attending physicians and trainees to nursing staff and vascular technicians. Written by experienced leaders in the field, it demonstrates how to perform complex, risky procedures while providing patients with expert care.

Cochlear implants are currently the standard treatment for profound sensorineural hearing loss. In the last decade, advances in auditory science and technology have not only greatly expanded the utility of electric stimulation to other parts of the auditory nervous system in addition to the cochlea, but have also demonstrated drastic changes in the brain in responses to electric stimulation, including changes in language development and music perception. Volume 20 of SHAR focused on basic science and technology underlying the cochlear implant. However, due to the newness of the ideas and technology, the volume did not cover any emerging applications such as bilateral cochlear implants, combined acoustic-electric stimulation, and other types of auditory prostheses, nor did it review brain plasticity in responses to electric stimulation and its perceptual and language consequences. This proposed volume takes off from Volume 20, and expands the examination of implants into new and highly exciting areas. This edited book starts with an overview and introduction by Dr. Fan-Gang Zeng. Chapters 2-9 cover technological development and the advances in treating the full spectrum of ear disorders in the last ten years. Chapters 10-15 discuss brain responses to electric stimulation and their perceptual impact. This volume is particularly exciting because there have been quantum leap from the traditional technology discussed in Volume 20. Thus, this volume is timely and will be of real importance to the SHAR audience.

In children, the central nervous system tumors complished through advances in the three main are exceeded in incidence only by leukemia and antineoplastic therapeutic modalities-surgery, are more common than any of the other malig- radiation therapy, and chemotherapy. Improve- nancies of childhood. Childhood central nervous ments in neurosurgical technique concomitant system tumors encompass a range of histo- with improvements in anesthesia and periopera- logic varieties from the histologically benign- tive supportive care have resulted in decreased appearing pilocytic astrocytoma to the extremely morbidity and mortality from neurosurgical malignant-appearing glioblastoma multiforme procedures together with an increased likelihood of accomplishing a gross total resection of and the undifferentiated primitive neuroecto- dermal tumors. Similarly, the biologic behavior tumor. Radiotherapy has evolved from using orthovoltage (200-250 KV) equipment to of childhood brain tumors varies not only ac- cording to histology but also with location of supervoltage equipment with much-improved the tumor and age. Unlike primary central nerv- penetration, thus allowing for the administra- ous system tumors in adults, many varieties of tion of accurate homogeneous high doses to childhood brain tumors have the propensity to large volumes without significant effects on the disseminate via the cerebrospinal fluid path- overlying skin and soft tissues. Preliminary data ways.

This new volume reviews current progress on different approaches of in vivo reprogramming technology. Leaders in the field discuss how in vivo cell lineage reprogramming can be used for tissue repair and regeneration in different organs, including brain, spinal cord, pancreas, liver and heart. Recent studies on in vivo cell reprogramming towards pluripotency are reviewed; examples are given to show its potential in regenerative medicine. In each chapter, the regenerative potential of different in vivo reprogramming approaches is discussed in detail. More specifically, how different tissue failures or damages can be treated with this technology is explained. Examples from various animal models are given and the regenerative potential of in vivo reprogramming is compared to that of cell transplantation studies. The last chapter discusses current challenges of these preclinical studies and gives suggestions in order to improve the current strategies. Future directions are indicated for the transition of in vivo reprogramming technology to clinical settings. This is among the first books in the literature which specifically focuses on the in vivo reprogramming technology in regenerative medicine and these chapters collectively cover one of the most important and exciting topics of regenerative medicine.

The book will be written by the experts in the disease including imaging, interventional cardiology and surgical valve expertise. The book has five main sections: Aortic Valve Disease Mitral Valve Disease Tricuspid Valve Disease Pulmonic Valve Disease Multimodality Imaging The main objectives of the book are: 1- to provide the main guidelines to clinicians on how to identify and diagnose valvular heart disease 2- to provide an overview of what the near future will bring in the diagnosis, prevention and risk stratification of patients to catheter versus surgical approaches 3- to outline the possible implications for medical therapies in slowing progression of calcific aortic valve disease and myxomatous mitral valve disease

This book opens with a unique historical review of natural amputations due to congenital absence, disease, frostbite, animal trauma, and to punishment and ritual. The advent of surgical amputation and its difficulties form a major part of the book, summarising the evolution of the control of haemorrhage and infection, pain relief, techniques, instrumentation, complications, prostheses, results and case histories. Alternative procedures, increasingly important in the last two centuries, are also debated.

Provides the comprehensive knowledge required to perform ERCP safely and effectively Authored by the very best in the field, this "how-to" guide to mastering the crucial yet complex gastrointestinal procedure called endoscopic retrograde cholangiopancreatography (ERCP) covers the entire range of both standard and advanced techniques, using a highly practical approach. It also places a strong emphasis on patient education, safety, and minimizing risks, offering "tips and tricks" and key points throughout to aid rapid understanding. The book is filled with over 250 illustrations Covering ERCP preparation, techniques, clinical applications, and quality and safety, ERCP: The Fundamentals, 3rd Edition begins with chapters on "getting prepared," including training and competence; facilities and equipment; risk assessment and reduction; sedation, anesthesia, and medications. It then covers "what can be done," describing standard devices and techniques; intraductal therapies; ampullectomy; and reporting and documentation. Next it has chapters on "what should be done," clinical applications of ERCP in acute cholangitis; peri-cholecystectomy; difficult bile duct stones; biliary pain; and numerous forms of pancreatitis. The book finishes with coverage of adverse events and how to ensure competent practice. Teaches all of the standard and advanced ERCP techniques Focuses on patient safety/comfort throughout Brilliantly-illustrated with endoscopic, EUS and radiologic images, and anatomical drawings Offers a step-by-step, practical approach to ERCP--highlighting potential technical and anatomical hazards Packed with tips and tricks boxes and key points boxes to assist comprehension 20 high-definition videos of ERCP performed by the experts, perfect to improve clinical technique Full reference to the very latest ASGE, ACG, ASG and UEGW guidelines throughout Brought to you by world pioneers in endoscopy, ERCP: The Fundamentals, 3rd Edition is an essential purchase for gastroenterologists and endoscopists of all levels.

Advances in Materials Science and Implant Orthopedic Surgery brings together experts from major university hospitals, materials scientists specializing in bio-materials, and development engineers working for implant manufacturers to address such issues as: mechanisms of fixation; foreign-body immune response; generation and consequences of ionic and wear debris; materials selection, design and manufacturing schemes; and surgical techniques to maximize the safety and efficacy of the devices.

The Tohoku University Graduate School of Dentistry first introduced the concept of "Interface Oral Health Science", designed to establish and maintain healthy oral cavities, which are home to a number of mixed systems. Included in those systems are: (1) host tissues such as teeth, mucosa, muscle and bone, (2) parasites and microorganisms cohabiting the surfaces of the oral cavity and (3) biomaterials that are used for the rehabilitation of oral functions. In addition, (4) these systems are subject to severe and complex mechanical forces. Therefore, it is critical to promote dental studies that integrate a wide range of interdisciplinary research as medicine, agriculture, material science, engineering, and pharmacology. With this incentive, international symposiums for interface oral health science have been held several times in the past. The concept has since refined and expanded, the result being the "Biosis-Abiosis Intelligent Interface," and projects aiming at the creation of highly functional and autonomic intelligent interfaces are ongoing. This book brings together a number of studies on incentives and projects by leading authors. Topics include biosis-abiosis interface of dental implants, biomaterials in interface science, biomedical engineering interface and cell manipulation and tissue regeneration. Readers not only from the field of dentistry but also many related areas will find this book a valuable resource.

Anesthesia and Analgesia in Laboratory Animals focuses on the special anesthetic, analgesic, and postoperative care requirements associated with experimental interventions. Fully revised and updated this new edition provides the reader with agents, methods, and techniques for anesthesia and analgesia that ensure humane, reproducible, and successful procedural outcomes. The content is structured in six sections. The first deals with ethical, regulatory, and scientific considerations. Chapters in this section include US and international regulatory considerations, and optimization of anesthesia and analgesia. Part two is dedicated to the principles of anesthesia and analgesia with chapters covering topics in a non-species-specific way, but with a slant towards laboratory animals, including relevant pharmacology of the agents. Part three covers Anesthetic equipment and monitoring. Section four deals with periprocedural care including dedicated chapters to the assessment and management of pain in laboratory species. Part five provides practical considerations by species, including relevant anatomy, physiology, and behavior of a broad range of lab animal species. Part six closes the book with special topics covering management of chronic pain, fetus and neonate interventions, considerations for in-vivo imaging and the study of pain. Anesthesia and Analgesia in Laboratory Animals is the complete reference for veterinarians involved in lab animal research as well as senior graduate, graduate students, post-docs, and researchers who utilize animals in biomedical research.

This text provides a state of the art overview of tools for guiding surgeons in the modern operating room. The text explains how many modalities in the current armamentarium of radiologic imaging have been brought to the operating room for real time use. It also explains the current use of near infrared, fluorescent, and chemo-luminescent imaging to guide minimally invasive and open surgery to improve outcome. The book is separated into two sections. The first, discusses the biologic principles that underlie novel visualization of normal organs and pathology. The currently available equipment and equipment anticipated in the near future is covered. The second section summarizes current clinical applications of advanced imaging and visualization in the OR. Novel means of visualizing normal anatomic structures such as nerves, bile duct, and vessels that enhance safety of many operations are covered. Novel biologic imaging using radio-labeled and fluorescent-labeled molecular probes that allow identification of inflammation, vascular abnormalities, and cancer are also discussed.Authored by scientists who pioneer research in optics and radiology, tool makers who use this knowledge to make surgical equipment, and surgeons who innovate the field of surgery using these new operative tools, Imaging and Visualization in the Modern Operating Room is a valuable guide for surgeons, residents and fellows entering the field.

are then selected and must meet the general 'biocompatibility' require ments. Prototypes are built and tested to include biocompatibility evalua tions based on ASTM standard procedures. The device is validated for sterility and freedom from pyrogens before it can be tested on animals or humans. Medical devices are classified as class I, II or III depending on their invasiveness. Class I devices can be marketed by submitting notification to the FDA. Class II and III devices require either that they show equivalence to a device marketed prior to 1976 or that they receive pre-marketing approval. The time from device conception to FDA approval can range from months (class I device) to in excess of ten years (class III device). Therefore, much planning is necessary to pick the best regulatory approach. 2. Wound Dressings and Skin Replacement 2.1 Introduction Wounds to the skin are encountered every day. Minor skin wounds cause some pain, but these wounds will heal by themselves in time. Even though many minor wounds heal effectively without scarring in the absence of treatment, they heal more rapidly if they are kept clean and moist. Devices such as Band-Aids are used to assist in wound healing. For deeper wounds, a variety of wound dressings have been developed including cell cultured artificial skin. These materials are intended to promote healing of skin damaged or removed as a result of skin grafting, ulceration, burns, cancer excision or mechanical trauma."