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.

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

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."

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.

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.

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.

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

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.

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.

This book contains the extended abstracts of 90 papers and posters presented at the 2nd Biannual meeting of the International Research Society of Spinal Deformities, which was concerned with fundamental issues relating to the detection, diagnosis, prevention and treatment of spinal deformities, especially in children. It provides readers with the latest information and scientific ideas with an emphasis on three-dimensional and morphological aspects of spine and trunk asymmetry, improved understanding of mechanisms underlying the etiology, pathomechanism, and treatment of spinal deformity. The International Research Society of Spinal Deformities (IRSSD) was established in 1994 to advance the study and research into Spinal Deformities by providing a forum for the presentation and encouragement of research relating to spinal deformity and to disseminate the results of such research.

In this issue of Clinics in Plastic Surgery, guest editor Dr. Neil Tanna brings his considerable expertise to the topic of Breast Reconstruction. Top experts in the field cover key topics such as modern approaches to oncoplastic surgical treatment; modern approaches to implant-based breast reconstruction; pre-pectoral breast reconstruction; breast implant-associated anaplastic large cell lymphoma; operative efficiency; and more. Contains 18 relevant, practice-oriented topics including preoperative assessment of the breast reconstruction patient; revision of implant-based breast reconstruction; modern approaches to abdominal flap-based breast reconstruction; the hybrid breast reconstruction; robotic breast surgery and robotic breast reconstruction; and more. Provides in-depth clinical reviews on breast reconstruction, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

In this issue, guest editors bring their considerable expertise to this important topic. Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize

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.

Minimally Invasive Gynecologic Surgery provides a complete, practical and timely review of the minimally invasive surgical techniques used to treat gynaecologic diseases and conditions. Recent advances in technology and instrumentation, particularly the use of robot-assisted surgery, mean that minimally invasive approaches have become increasingly established as alternatives to traditional open surgeries. This book describes the full range of minimally invasive procedures in current gynaecologic practice, with discussion of the indications and contraindications and a summary of available evidence. The book opens with a section describing instrumentation, electrosurgery, how to avoid and manage complications and single port surgery. Subsequent sections cover procedures for benign and malignant conditions and relevant robotically assisted surgeries. Highly structured chapters provide practical guidance to key steps of each procedure, alternative management options; contraindications and available evidence Stellar contributors from leading centers in the USA, Brazil, Chile, Canada, France, Italy and Belgium ensure coverage reflects global best practice

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.

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."

Integrates basic research and practical clinical information on the neuropsychology of epilepsy under one cover. Provides inside knowledge on how neuropsychological assessments are performed and evaluated. A comprehensive reference that will serve as a clinical resource for working with epilepsy patients. Epilepsy is a prevalent condition affecting approximately 1% of the general population. Its behavioral effects on cognition and memory can be as debilitating as the physical aspects caused by ongoing seizures. This book is intended primarily for clinical neuropsychologists who encounter patients with epilepsy, either through employment in academic medical centers or in general practice. The book is of particular value to those working in a comprehensive epilepsy center, as the volume provides extensive coverage of the many clinical procedures performed in that setting. Procedures reviewed in this volume include neuropsychological testing, the Wada procedures, and brain mapping. Chapters include descriptions of the purpose of these procedures, reviews of the recent literature, clinical vignettes, in addition to concrete recommendations on how to actually conduct the procedures. Many chapters provide examples of test forms and stimuli useful for conducting some of the procedures reviewed in this book. Neurologists and pediatricians will also find this book to be helpful, as many medical practitioners consider the activities of clinical neuropsychologists working in their settings to be somewhat mysterious. This book makes the details of neuropsychological practice in an epilepsy setting more accessible than what has been present in prior literature. Content Level Research Keywords Brain mapping - Children with epilepsy - Cognitive remediation - Epilepsy - Epilepsy in children - FMRI - MEG - Movement disorder - Neuropsychological testing - Refractory seizure - Seizure - Seizure disorder - Wada test Related subjects Neurology - Ne

Periprosthetic Joint Infection of the Hip and Knee is a practical reference for the diagnosis and treatment of total joint infections following hip and knee arthroplasty. In addition to useful chapters presenting common tests and algorithms used for diagnosis, the book gives background on the epidemiology, risk factors, and prevention strategies of periprosthetic joint infection. Additionally, practical clinical information is given, including antibiotic treatment strategies and delivery methods and medical optimization techniques for physicians to follow for patient care and follow-up. Covering a topic that is currently underrepresented in the medical literature, Periprosthetic Joint Infection of the Hip and Knee will be useful to orthopedic surgeons, rheumatologists, and other physicians involved in the care of patients with hip and knee prosthetic implants.

Rheumatoid arthritis (RA) is the most common and most severe form of inflammatory arthritis. The pathogenesis of RA has been the subject of intense research for several decades. The prevailing hypotheses have changed over the years, and have attempted to incorporate the most recent data. Although T cells represent an important component of the cells which infiltrate the joint synovium, their contribution at a late stage of the disease remains a matter of debate. The goal of this book is to outline the major arguments and data suggesting that T cells may, or may not, be central players in the pathogenesis of chronic RA. While each of the editors and authors has his/her own bias (as will be clear by reading the respective chapters), our hope is that the readers will enjoy a complete and balanced view of the critical questions and experiments. This is not just an intellectual exercise since the direction of future therapeutic interventions depends heavily on how one interprets the pathogenesis of RA and the contribution of T cells.