A comprehensive description of macroscopic, microscopic, and radiological methods for the diagnosis of bone diseases. The book presents all the procedures involved in diagnosis, using not only radiological and histological techniques, but also modern immunohistochemical and scintigraphic methods. Succinct and well-structured therapeutic recommendations are provided for an array of bone diseases, making this a practice-oriented reference work for pathologists, radiologists, rheumatologists, and orthopedists.

Cell-Cycle Mechanisms and Neuronal Cell Death examines the role of cell cycle activation in the molecular mechanisms leading to neuronal degeneration. Leading Authors discuss this topic in relation to the major neurological disorders, including Alzheimer 's disease, stroke and epilepsy. This book serves to gain new insights into the molecular determinants of neuronal death and to establish new targets for therapeutic intervention.

Re-EngineeringoftheDamagedBrainandSpinalCord isdedicatedtoTetsuoKanno,M. D. ProfessorofNeurosurgery Bypresenting theoriginal papers thatmakeupthis thefeaturesofthelocalmedicallandscapeinthe- third supplement we wish to make a further contri- gionswheretheyareenacted. Whatismore,progr- bution to the issue of functional rehabilitation, this sivenew?ndingsmustbealsosubjectedtoafrequent soimportantandfascinatingmodernareaofresearch revision. Ontopofthis,itshouldnotbeforgottenthat inthe?eldofneurosciences. Thecongresspaperswe even when committal therapy guidelines are c- haveselectedconstituteagoodre?ectionofthetrans- sistentlyapplied,thereareconsiderablevariationsin disciplinary objectives. The literature references are therangeofpotentialcomplicationsandintheo- designedasaguidetoleadtheinterestedreadertoa comeofprospectivecontrolledmulti-centreandmul- deeperandmoredetailedunderstandingoftheindi- nationalstudiesontheissueofqualitymanagement. vidualissues. Functionalrehabilitationhasbeenanoriginaltask The demand for "evidence-based medicine" is well ofneurosurgeryfromtheveryoutset. The1990shave justi?ed; however, it rapidly comes up against the enteredtheannalsofbrainresearchasthe"Decadeof limitsoffeasibility,especiallywherecontrolledthe- theBrain". Sincethentherehasbeenaneverstronger peuticstudiesareconcerned. TheCochrancollection growthofneuroscienti?cinterestworldwide,accom- of high-quality evidence-based healthcare databases paniedbysubstantial?nancialengagement. Thishas hasthusfarbeenofnohelptousindrawingupthe- primarily resulted in advances in basic neuro- peutic recommendations for the re-engineering of biologicalandneurophysiologicalresearchandalsoin brain and spinal-cord lesions. Today as ever, the thegrowthofneuroscienti?cknowledgeaboutbasic opinion of experts and empirically based medical mechanismsformotor control,paincontrol,aware- treatment and posttraumatic neurorehabilitation ness, cognition, learning and memory. The conse- continuetooccupyanindispensablepositionforthe quencemustbetoensurethattheadvancesmadeinthe everydayclinicalpracticeofneurosurgicalandneu- neuroscienti?cresearchareaareadequatelyexpanded traumatological therapies. Promising adjunct - intopracticalneurosurgicalcareandre-engineeringof proachesincludeneuropharmacology,forcascadesof brainandspinalcordlesionsandtoensureuponnew molecular interactions are known to be underlying approaches. Following this a fundamental path will activity-dependent plasticity and skills learning, as resultinanimprovedandmoree%ocientpreventionin many of these processes involve the major tra- thefuture,themeasuresthatstandrightatthefore- mitters. Furthermore,biologicalinterventionsby- front of all rehabilitation principles, meaning that ingendogenousneuronsandgliaaswellasexogenous conventionalconceptsmustbemodi?edtokeeppace stemcells,bone-marrowcells,macrophages,andother withthemoretask-speci?c,intensive,andprogressive types may promote the regeneration of nerve cells, demands. In this connection a series of guidelines, tissue, and neural circuitry. Class one studies have recommendations, and expert opinions and also beenmade,andnowclasstwostudieshavebeeni- algorithms have been elaborated by national and tiated, for example in connection with acute spinal international expert panels and multidisciplinary as- cord injury (SCI). The clinical application of fu- sociationsfortheacutemedicalcareofpatients.

This book is an up-to-date reference on all aspects of anticoagulation and hemostasis in neurosurgery. After an opening section on basic principles and drug classes in current use, detailed consideration is given to coagulation issues relevant to all patients, not just neurosurgical ones. The coverage includes, for example, deep vein thrombosis, pulmonary embolism, and disseminated intravascular coagulation. A variety of important issues specific to neurosurgical practice are then addressed, and a summary of current guidelines and best practices is provided. By bringing together the latest knowledge from across the discipline, this book will serve as a sound basis for informed decision making in surgical practice. It will be of daily value for neurosurgeons and trainees worldwide and will also be of interest to emergency room physicians, surgeons in general, critical care physicians, neurologists, and hospital medicine specialists.

Transferring hematopoietic stem cells and immune cells has continued to be a promising therapeutic alternative and a fascinating area of cell biology as well as a field of persistent procedural problems. This explains why substantial parts of basic research on cell growth and differentiation, immune tolerance and antitumor effects, gene transfer, minimal residual disease and supportive care have settled around clinical transplantation in hematology and oncology. This second volume updates the current role of allogeneic and autologous transplantation in leukemias, lymphomas and solid cancers, including controversial strategies and novel experimental approaches. Outstanding representatives of leading groups guarantee first-hand information and indicate how we can work and cooperate more effectively to the benefit of our patients.

Advances in Cosmetic Surgery reviews the year's most important findings and updates within the field in order to provide surgeons with the current clinical information they need to improve patient outcomes. A distinguished editorial board identifies key areas of major progress and controversy and invites preeminent specialists to contribute original articles devoted to these topics. These insightful overviews in cosmetic surgery inform and enhance clinical practice by bringing concepts to a clinical level and exploring their everyday impact on patient care. Contains 25 articles on such topics as non-surgical rhinoplasty; laser and device assisted drug delivery; facial transgender surgery; otoplasty; breast implant illness; special considerations in the treatment of skin of color; and more. Provides in-depth, clinical reviews in cosmetic surgery, providing actionable insights for clinical practice. Presents the latest information in the field under the leadership of an experienced editorial team. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

Written by neurosurgery residents for neurosurgery residents, The Neurosurgical Consult Book focuses on the initial care and treatment of the neurosurgical consult patient, providing the key guidance you need when quick clinical management decisions are critical. You'll learn to recognize the acuity of patient presentation and determine how to immediately triage the needs of the patient at an appropriate level of care. This portable, practical guide helps you quickly steer neurosurgical patients to medical stability and safety until a definitive clinical management plan is determined. Features a real-life approach, based on actual consults, with chapters titled by the symptoms and clinical presentation of the patient, not by neurosurgical diagnosis. Begins each chapter with the actual consult notification from the consulting team, mimicking how the neurosurgery provider is notified about a new patient in practice. Presents initial imaging as it occurs in real life-whether imaging has already been done or whether the consulting physician needs guidance on what imaging is needed. Includes "Walking Thoughts", guidance on how to tailor your thoughts toward the most important and pressing issues facing the patients before even meeting them, so that upon evaluation, the most important questions are asked first. Covers the most essential neurosurgical grading scales, key physical exam findings, the systematic thought process behind triage management, and learning points to remember when seeing a particular type of neurosurgical patient. Summarizes evidence-based standards of care and key literature. Stepwise video demonstration of the most common emergent bedside procedures. An excellent learning tool for neurosurgery residents as well as neurosurgery fellows, neurology residents, emergency room providers, neurocritical care providers, registered nurses, clinical fellows, physician assistants, nurse practitioners, clinical nurse specialists, medical students, and nursing students. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, videos, and references from the book on a variety of devices.

Written by the world's leading authority in the field, Atlas of Reconstructive Surgery: A Case-Based Approach offers a case-based, highly illustrated approach to optimizing care for the reconstructive surgery patient. Dr. Lee L.Q. Pu invites you to learn from real cases that he has worked on throughout his years of surgical practice, providing detailed content on each case in an easy-to-follow, templated format. Superb illustrations, before and after case photos, and operative videos help you visualize exactly how Dr. Pu achieves improved outcomes for each patient. Presents a wide variety of cases covering reconstructive surgery of the body, face, and upper and lower limbs. Details how to optimize every aspect of care for the reconstructive surgery patient, including postoperative care and long-term follow-up for each case. Demonstrates Dr. Pu's techniques through intraoperative photos and procedural video clips. Includes key procedures such as facial reconstruction, complex leg reconstruction, and staging and combining of reconstructive surgeries. Includes surgical pearls throughout. An eBook version is included with purchase. The eBook allows you to access all of the text, figures and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud.

This issue of Thoracic Surgery Clinics, guest edited by Dr. Bryan M. Burt, is devoted to Malignant Pleural Mesothelioma. Dr. Burt has assembled expert authors to review the following topics: Biomarkers for the Diagnosis and Monitoring of Malignant Pleural Mesothelioma; Taken Together: Effective Multimodal Approaches for Malignant Pleural Mesothelioma; Pleurectomy/Decortication for Malignant Pleural Mesothelioma; Preoperative Identification of Benefit from Surgery for Malignant Pleural Mesothelioma; The Role of Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma; The Molecular Basis of Malignant Pleural Mesothelioma; Radiation Therapy for Malignant Pleural Mesothelioma; The Staging of Malignant Pleural Mesothelioma; Intraoperative Adjuncts for Malignant Pleural Mesothelioma: The Fourth Dimension; The Pathology of Malignant Pleural Mesothelioma; and more!

Quantitative coronary angiography has become an invaluable tool for the interventional cardiologist, providing objective and reproducible measurements of coronary artery dimensions, which can be used to study progression or regression of coronary atherosclerosis, as well as the immediate and long term effects of percutaneous interventions. Until recently, this powerful imaging technology was confined to a small number of so-called high level institutions. Fortunately, with the development of digital cardiac imaging equipment and adaptation of cine-angiographically based computer software for on-line use in the catheterization room, quantitative coronary angiography is now available to all interventionalists. This book is a timely guide for the impending QCA user, providing practical as well as theoretical and scientific information. A comprehensive evaluation of the clinical usefulness of QCA is covered, from the fundamental principles through experimental validation studies, application to clinical trials of a wide range of pharmacological and interventional therapies in the full spectrum of clinical presentation of coronary disease syndromes, evaluation of the therapeutic efficacy of various new devices for coronary intervention, together with extensive presentation of its physiological, functional and anatomical correlations, by comparison with other intracoronary measurement and imaging techniques. In addition, evolving theories and concepts in the ever topical restenosis phenomenon' after percutaneous intervention, based on serial QCA studies, are presented and discussed and a potentially unifying methodological approach to further study of this ubiquitous problem is offered. Thisbook, thanks to the collaboration of many experts in the field of intracoronary imaging and measurement, provides stimulating, interesting and practical information, both for the academic scientist and practising clinician.

This manual reviews the definitions and typical approach to quality assurance in healthcare and includes a review of the most prominent quality studies. A program for quality management in surgery is presented with chapters reviewing patient safety and external reporting requirements. An introduction to medical malpractice and risk management is also provided and followed by a chapter on how to implement the necessary behavioral changes to improve quality practices. The appendix includes useful protocols, forms and order sets.

The scope and importance of hip fractures is almost incomprehensible. With a world wide incidence of close to 2 million cases per year, these fractures pose a daunting challenge to our ability to affect and treat this epidemic. The incidence of these fractures is predicted to grow to 6 million in 2050 including a near term baby boom spike. Add the hospital mortality rate of up to 4% and the one mortality of from 8% to 20% and the life ending effect of these fractures becomes a glaring reality. Of those who initially survive their fracture, about 50% never walk the same again. The social problem in the care of these elderly people is enormous. Of course, any real solution to this problem will include education, prevention, surgical and hospital treatment protocols, long term rehabilitative efforts, social - justments and a generous contribution of money. This publication is primarily directed to the amplification of a new treatment modality that addresses only a fraction of the problem. It is, however, a quantum leap in the evolution of fixation with compression hip screws which are still the gold standard for surgical stabilization of pertrochanteric hip fractures. The Dynamic Martin Screw (DMS) addresses the issue of adjustability of the fixation angle with appropriate mechanical strength characteristics that were la- ing in its historical predecessors.

The second congress of the Paci?c Asian Society of Minimally Invasive Spine Surgery (PASMISS) held in Phuket,Thailand,August 5-6,2002,was highly s- cessful. Dr.Akira Dezawa, the president, had worked hard in organizing the congress,which was well attended.All scienti?c papers presented were of the highest standard and were worthy of publication in book form.This scienti?c meeting brought to light the practice of this modern surgical technique as it is being performed by spine surgeons in the Asia-Paci?c region.Dr.Dezawa has made a great effort to collect the papers from the congress,and to have them edited and published as a text that covers all aspects of the minimally invasive spine surgical approach. Minimally invasive spinal surgery will be a highlight of operative approaches in the twenty-?rst century and already has been popularized worldwide.This procedure will provide surgical options that address several pathological conditions in the spinal column without producing the types of morbidity commonly seen in open surgical procedures. The contents of this book provide highly relevant and detailed information. I certainly believe that it will be a great bene?t to all orthopedic surgeons who are interested in performing minimally invasive spine surgery. Charoen Chotigavanich,M.D. Chairman,Spinal Section The Royal College of Orthopedic Surgeons of Thailand V Preface Recent decades have been characterized by revolutionary changes in spinal surgery. Concurrent progress in implant technology and functional en- scopes and the improvement of less invasive surgical techniques has opened a new dimension for spine surgery.

The motivation for this book was the recognition by two of us (RL and TL) that, despite our training as cardiologists, we had a limited understand ing of many aspects of the surgical management of our patients. Conversa tions with other cardiologists at our own institution and at other medical centers around the country convinced us that many of our colleagues shared our uncertainty about the details of surgical procedures and the factors that determine decisions in the perioperative period. As surgical techniques continue to evolve, this knowledge gap can become only more severe. We therefore compiled information about cardiac surgery that might be useful for cardiologists and other nonsurgeons. We asked cardiologists what questions they would like to ask their surgical colleagues and provided these questions to the authors of the chapters. Thus, the goal of these chapters is to help nonsurgeons answer their own questions about common cardiac procedures, and to help prepare these physicians to address the questions raised by their patients. In addition, we hope that insight into these issues will improve communication between surgeons and their col leagues-and, ultimately, lead to better patient care. Contents Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi 1 Chapter 1. Anesthesia for Cardiac Surgery JONATHAN B. MARK Chapter 2. Cardiopulmonary Bypass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 DANIEL FITZGERALD Chapter 3. Myocardial Protection in Cardiac Surgery . . . . . . . . . . . . . . . . . . 23 JEFFREY SELL Chapter 4. Coronary Artery Bypass Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 HENDRICK B. BARNER Chapter 5. Surgery for Left Ventricular Outflow Obstruction: Aortic Valve Replacement and Myomectomy . . . . . . . . . . . . . ."

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.

This manual reviews the important critical functions of a department of surgery which are synthesized into specific departmental roles. A departmental organizational structure and the required personnel is presented along with the appropriate job descriptions and the role of hospital committees for a department of surgery. To help with process management, a listing of policies, protocols and communications are provided. To ease the access to external oversight, the conditions of participation from CMS related to surgery are reproduced and this is followed by a chapter on change management and program development. The appendix includes useful forms and templates.

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.

Eureka: General Surgery and Urology is an innovative book for medical students that fully integrates core science, clinical medicine and surgery. The book benefits from an engaging and authoritative text, written by specialists in the field, and has several key features to help you really understand the subject: Chapter starter questions - to get you thinking about the topic before you start reading Break out boxes which contain essential key knowledge Clinical cases to help you understand the material in a clinical context Unique graphic narratives which are especially useful for visual learners End of chapter answers to the starter questions A final self-assessment chapter of Single Best Answers to really help test and reinforce your knowledge The book starts with the First Principles chapter which clearly explains key concepts such as assessment of the patient fitness for surgery, patient consent and pain management. The Clinical Essentials chapter provides an overview of the symptoms and signs of surgical disease, investigations and management options. A series of disease-based chapters briefly describe, by system, relevant structure and function, history and examination and main surgical presentations, each chapter introduced by engaging clinical cases that feature unique graphic narratives. The Emergencies chapter covers the principles of immediate care in situations such as acute appendicitis. Finally, the Self-Assessment chapter comprises 80 multiple choice questions in clinical Single Best Answer format, to thoroughly test your understanding of the subject. The Eureka series of books are designed to be a 'one stop shop': they contain all the key information you need to know to succeed in your studies and pass your exams.

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.

This newly updated and expanded second edition brings together the information that every trainee needs to know when faced with paediatric cases in their clinical practice and the FRCS (Tr and Orth) examination, as well as the European Board of Orthopaedics and Traumatology, FRACS (Orth), FRCSC (Orth) and the American Board of Orthopaedic Surgery examinations. The content is organised according to body regions, with step-by-step guides to common paediatric orthopaedic operations. This new edition includes colour illustrations, additional clinical photographs, charts and radiographs, and updated management guidelines. Tips, tricks and avoidance of common pitfalls guide candidates to success in their examinations, and the book gives particular attention to areas of the syllabus that trainees find particularly challenging. The concise, evidence-based chapters are written by practising paediatric orthopaedic surgeons to reflect the core knowledge expected of a newly appointed consultant. This is the essential revision guide for the paediatric component of the FRCS (Tr and Orth) and other orthopaedic examinations.

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.