Bones and joints are always under mechanical loading a key concept in understanding bone metabolism. Among the most common diseases of bones and joints in the elderly are osteoporosis and joint osteoarthritis. Dynamic changes in mechanical loading give rise to problems resulting in stenosis of the spinal column at the cervical, thoracic, and lumbar levels. Mechanical loading also accelerates joint destruction caused by inflammation from such conditions as chronic rheumatoid arthritis. An understanding of mechanical loading is essential therefore to clinicians, basic researchers, and engineers working with bones and joints. Providing up-to-date research and clinical findings, the contents of this volume are from the papers, symposia, and special lectures presented at the 12th Annual Meeting of the Orthopaedic Research Meeting of the Japanese Orthopaedic Association in Niigata, in October 1997.

In his exceptionally thought-provoking and moving memoir, neurosurgeon Joseph D. Stern explores how personal loss influences the way physicians relate to patients and their families. How does a doctor who deals with the death of patients on a regular basis confront his own loss when his beloved family member is living out her last days? Despite a career as a neurosurgeon, Joseph Stern learned more about the nature of illness and death after his younger sister Victoria developed leukemia than his formal medical training ever taught him. Her death broke down the self-protective barriers he had built to perform his job and led to a profound shift in his approach to medicine. During the year of her illness, Dr. Stern developed a greater awareness of the needs of patients and their families; of the burdens they carry; of the importance of connection, communication, and gratitude; and of what it means to ask the right questions. Grief Connects Us intimately explores the impact of personal loss on physicians and the ways in which they integrate it into their professional lives, providing a blueprint for change that places compassion and empathy at the centre of the practice of medicine.

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.

Total joint arthroplasty has brought manifold benefits to patients suffering from joint diseases, but the durability of prostheses remain a persistent problem, often requiring correction through revision surgery. Among the issues remaining to be resolved are wear and periprosthetic osteolysis after total joint arthroplasty. Today's researchers are investigating the pathogenesis and reduction of osteolysis and wear, and practitioners and engineers are working together to develop new types of prostheses for total hip and knee arthroplasty. This book presents the work of eminent orthopedic surgeons, biomedical engineers, and other researchers who have devoted their efforts to the creation and implementation of more durable total joint prostheses. The latest information on new concepts and clinical trials is included, with chapters on ostcolysis, recent developments in metal-on-metal and ceramic-to-ceramic articulation, and future trends in total joint arthroplasty.

Complications of Female Incontinence and Pelvic Reconstructive Surgery reviews the prevention, evaluation and management of complications arising from female pelvic surgery. Potential complications of both routine and specialized female pelvic procedures such as transvaginal slings, cystocele and rectocele repairs, urethral diverticulectomy, and transvaginal mesh repairs are reviewed. The chapters are divided by procedure allowing the reader to easily find what they are looking for. Images and figures of methods of evaluation and repair of these complications are included throughout. The volume is organized based on the specific types of surgeries performed and the user is able to look up the type of surgery performed and immediately find all of the potential complications and their treatments. This text will serve as a comprehensive guide and reference allowing the surgeon quick and ready access to information about the complications of female pelvic surgery.

The Atlas of Robotic Urologic Surgery provides a detailed, step-by-step guide to common robotic urologic procedures for the purpose of helping novice surgeons in their transition to robotic surgery and seasoned robotic surgeons to refine their surgical technique and expand their repertoire of robotic procedures. In addition, less commonly performed robotic procedures such as those for male infertility, pelvic organ prolapse, urinary tract reconstruction and pediatrics are included. Each chapter is written by the thought leaders in robotic urologic surgery with descriptive step-by-step text, complimented by figures and intraoperative photographs detailing the nuances of each procedure. Emphasis is placed on operative setup, instrument and equipment needs and surgical techniques for both the primary surgeon as well as the operative assistant. The use of ancillary equipment and robotic instrument and endoscope exchanges are highlighted throughout the procedural text by tables designed to aid surgeons and their teams in improving efficiency. This volume will provide unique insights into robotic urologic surgery and reduce the learning curve of accomplishing these increasingly popular procedures.

The International Brain Hypothermia Symposium 2004was the second time I have had the honor of opening such a gathering on brain hypothermia treatment. It was a great pleasure to greet the participants in the hope that their valuablecontributions would make the Tokyo meeting memorable. Brainhypothermia has long been seen as a promising method that may overcome current limitations on brain resuscitation in patients with severe brain damage. However, although excellentresults have been obtained in experimental animal models, for some reason brain hypothermia has not alwaysbeen successful clinically, and resolving this problem has been a major challenge facing physicians specializing in brain therapies. The ICUmanagement of recent research has uncovered newmechanisms ofbrain damage not seen in animal models, including brain thermo-pooling at temperatures above 40 C in severe brain damage, masking neuronal hypoxia even with normal cerebral blood flow. Stress-related hyper glycemia with brain hypothermia was expected to generate useful results in patients with external injuries, cerebral occlusive stroke, and cardiac arrest. In recent clinical studies of brain hypothermia treatment, many excellent results began being reported on the manage ment of severe brain injury, ischemic stroke, and post-resuscitation after cardiac arrest. However, in clinical brain hypothermia treatment many questions remained about appro priate treatment targets, leu management technique, prevention of complications, control of brain tissue temperature, management of hypothermia insult, and mechanisms underly ing the onset of vegetative states."

The long-awaited Second Edition of Kempe's Operative Neurosurgery is being prepared by Dr. Michael Salcman with the assistance of Edward R. Laws, MD (pituitary surgery, epilepsy surgery, peripheral nerve surgery); Roberto Heros, MD (brain surgery, carotid endarterectomy); and Volker Sonntag, MD (spinal surgery). The book will be thoroughly updated and revised, but will preserve the user-friendly aspects of the original book: brevity and ease of practical application in the operating room environment.

This book describes the specific surgical techniques currently employed in patients with intractable epilepsy; it also covers the relevant technical aspects of general neurosurgery. All of the approaches associated with the various foci of epilepsy within the cerebral hemispheres are considered, including temporal and frontal lobectomies and corticectomies, parietal and occipital lobe resections, corpus callosotomy, hemispherectomy, and multiple subpial incisions. In addition, an individual chapter is devoted to electrocortical stimulation and functional localization of the so-called eloquent cortex. The more general topics on which guidance is provided include bipolar coagulation (with coverage of the physical principles, strength of the coagulating current, use of coagulation forceps, the advantages of correct irrigation, and use of cottonoid patties) and all of the measures required during the performance of operations under local anesthesia. The book is designed to meet the need for a practically oriented source of precise information on the operative procedures employed in epilepsy patients and will be of special value for neurosurgical residents and fellows.

Brain injury is one of the most unacceptable complications sustained during heart surgery. This book presents the current results and thinking of a number of leading clinical investigators in this area. Nearly all have been active in serious studies designed to define various aspects of brain physiology, patho physiology, or protection during cardiac operations performed with cardio pulmonary bypass. We were particularly interested in obtaining contributions from younger investigators. Brain injury is a problem which has long troubled those involved with perioperative care of the cardiac surgical patient. The first chapter by Dr. Torkel Aberg presents a summary of his extensive investigations into this problem. It is intended both to present the perspective of a surgeon interested in this problem, and to serve as an introduction to the overall issue of avoiding brain injury during heart surgery. The next three chapters discuss the problem of perfusion pressure, outcome, and brain blood flow. Dr. Sarnquist's contribution stems from his extensive experience with low flow bypass as practiced at Stanford University and the results of the studies he performed in collaboration with Dr. Fish. Drs. Govier and Reves discuss in some detail the general effects of anesthetic agents upon brain metabolic needs as well as their important data demonstrating preserva tion of brain blood flow autoregulation during cardiopulmonary bypass (CPB) as practiced at the University of Alabama. Finally Dr.

In addition to such topics as the theoretical foundation of orthopedagogics and diagnosis and assistance, the essentials of various developmental and learning problems experienced by children - including handicapped children - are discussed in depth. There is also a section on orthopedagogical research.

Whether switching on the TV, picking up a newspaper or simply logging on to the internet, one is constantly faced with images of natural disasters, conflict and human suffering. Humanity has experienced these problems throughout time and we have evolved methods and mechanisms for alleviating suffering, from trauma care following a traffic accident to international pacts and the Millennium Development Goals. In exploring such diverse cases of aid intervention, Disaster Medicine: A Case Based Approach provides interesting, easily accessible content and context for understanding disaster medicine and global health. In each case the reader will be put in the position of the decision maker and as in real life some of the cases will portray success and some will show failure. It is hoped the reader will consider the issues and problems for themselves and perhaps consider things they would choose to do differently. Written by a team of experts with extensive experience in the field and a progressive perspective Disaster Medicine: A Case Based Approach is a valuable text for students and professionals of disaster medicine.

In this issue of Facial Plastic Surgery Clinics, guest editor Dr. Jessyka G. Lighthall brings her considerable expertise to the topic of Injectables and Nonsurgical Rejuvenation. Many patients seek facial rejuvenation without having to undergo a surgical procedure, and optimal rejuvenation often requires a multi-faceted approach to their concerns about aging. In this issue, top experts in the field provide up-to-date information on available treatments for aesthetic physicians as primary or adjunctive procedures for facial and neck rejuvenation. Contains relevant, practice-oriented topics including patient evaluation and treatment planning for the aging face patient; medical grade skin care for optimal facial rejuvenation; injectables in facial plastic surgery; treatment of periocular vascularity, erythema and hyperpigmentation; advances in non-surgical periocular rejuvenation; and more. Provides in-depth clinical reviews on injectables and nonsurgical rejuvenation, 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 of Surgical Clinics, guest editor Dr. John M. Kane brings his considerable expertise to the topic of A Surgeon's Guide to Sarcomas and Other Soft Tissue Tumors. In 2021, more than 13,400 new soft tissue sarcomas will be diagnosed. This issue provides a timely update for management of the most common sarcomas, including discussions of pathology, imaging, chemotherapy, radiation, and reconstruction. Contains 13 relevant, practice-oriented topics including the implications of an unplanned sarcoma excision (the "Whoops" operation); the importance of preoperative pathology and the optimal biopsy of soft tissue masses; gastrointestinal stromal tumors (GIST) and the general surgeon; the evolving management of desmoid/aggressive fibromatosis; plastic surgery reconstruction of sarcoma resection defects; and more. Provides in-depth clinical reviews on sarcomas and other soft tissue tumors, 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.

Principios de fisiopatologia quirurgica Actualmente, en la mayoria de las escuelas de Medicina y durante las residencias medicas, se acostumbra tener para cada materia, un libro de texto unico, el que frecuentemente es traducido de una lengua ajena al castellano. Los autores hemos pensado que el estudio de la Cirugia General, requiere no solo poder repetir algo escrito en una sola fuente de informacion, y menos que sea ajena a nuestro medio, sino que esta especialidad, al igual que las demas quirurgicas, obliga a un proceso ordenado de razonamiento, que dote al cirujano de una vision panoramica, basada en la informacion suficiente, que le permita entender el por que de las enfermedades a las que se enfrenta en su practica cotidiana. Esta obra, precisamente pretende sumarse al arsenal bibliografico del estudioso de la cirugia, para hacerle agradable el aprendizaje, dotarle de suficientes elementos para facilitar su quehacer cotidiano y, sin duda, proporcionarle no solo de principios para simplificar el proceso diagnostico, sino para justificar el tratamiento que le va a ofrecer a su paciente. Nos sentiremos mas que satisfechos si alcanzamos a despertar su curiosidad mas alla del contenido del texto, para verse obligado a complementarlo, con otras fuentes de informacion, asi como imagenes, tratamientos, tecnicas quirurgicas etc.; es decir si logramos inquietarlo a seguirse preguntando por que? Pero...habremos, sin duda, superado nuestro proposito si ademas, conseguimos con ello, el que se maraville al descubrir los recovecos del inmenso universo que es la cirugia.

There is no single certification system available Nationally or Internationally for Urological Laparoscopy. Skill training and certification are needed to protect both patients and doctors from the pitfalls of uncertified practice. The book focuses on the details of training within this field. The next step will be to agree nationally and internationally how to assess and certify the skills attained through training in Laparoscopic Urology. The Training Courses of Urological Laparoscopy takes experts in Laparoscopic Urology together from across the world to share their ideas and experience of training, from basic stems in the dry lab through to hints and tricks for problem solving in complex scenarios. The editors want to make this contribution to the literature with the aim to shortly establish robust assessment and certification globally for Laparoscopic Urologists.

This book describes advances in implantable neural stimulation technology to restore partial sight to people who are blind from retinal degnerative diseases such as age-related macular degeneration and retintis pigmentosa. Many scientific, engineering, and surgical challenges must be surmounted before widespread practical applications can be realized. The book summarizes the state of research and clinical practice in the field and reviews the current ideas and approaches of its leading researchers and practitioners.

Robotic Renal Surgery: Benign and Malignant Surgery for the Kidneys and Ureters provides a comprehensive review of the role of and technical considerations regarding robotic surgery for conditions of the kidney and associated conditions of the upper urinary tract. In addition to serving as a reference regarding indications, preoperative and postoperative management, complications, and evidence-based outcomes, this text also serves as a practical guide for surgeons in how to perform the complete array of robotic kidney and upper tract surgery. Included are detailed descriptions of positioning, instrumentation, and surgical steps for the surgeon newly adopting robotic surgery or for those refining their techniques. All chapters are written by recognized and published experts in the various techniques, creating an authoritative text on the subject. Robotic Renal Surgery: Benign and Malignant Surgery for the Kidneys and Ureters will be of great value to urologists, robotic surgeons, fellows in urologic oncology or endourology as well as urology residents in training and surgical nurses and other surgery team members involved in these procedures.

Recent Advances in Surgery 31 is the latest volume in the successful and well-established Recent Advances series. This title is updated annually, covering the latest trends within surgery and reflecting any changes to the professional examinations for surgeons. Suitable for experienced medical professionals, as well as students and candidates of the MRCS/AFRCS, this edition reviews the latest trends within surgery and forms a useful update of general surgery for candidates of the Intercollegiate examination. Over 30 contributors, who are recognized experts in their particular field, provide in-depth reviews of important topics relevant to the management of all surgical patients and advancing areas in surgical subspecialties.

Over the last 18 years, there have been many advances in the field of intraoperative monitoring. This new edition of Neurophysiology in Neurosurgery: A Modern Approach provides updates on the original techniques, as well as other more recent methodologies that may either prove beneficial or are commonly used in neuromonitoring. The purpose of this book is to describe the integration of neuromonitoring with surgical procedures. Each methodology is discussed in detail as well as chapters describing how those methodologies are applied to multiple surgical procedures and the evidence used to support those uses. The second edition features a surgical procedure section, which focuses on specific surgical procedures and the type of monitoring used during these procedures. The original chapters have been updated, expanded, and the structure modified to ensure the book is beneficial to both physiologists and surgeons. This book is written for neurosurgeons, neurophysiologists, neurologists, anesthesiologists, interventional neuroradiologists, orthopedic surgeons, and plastic surgeons.

An authoritative panel of researchers and clinicians critically reviews the entire field to provide a comprehensive guide to modern brain tumor immunotherapy and thereby enhance future research in this area. The contributors detail many of the key laboratory experiments and clinical protocols that are currently being investigated, integrate the available information from previous and ongoing research, and help define the current status of the field. Topics range from adoptive cellular and antibody-mediated immunotherapy of brain tumors to tumor vaccines and related strategies, and include many vanguard experimental strategies and immunological techniques for studying brain tumor immunotherapy. Cutting-edge and comprehensive, Brain Tumor Immunotherapy brings together all the important recent advances in our understanding of central nervous system tumor immunology and illustrates in powerful detail the many new applications now harnessing the immune response for brain tumor therapeutics.

Targeted intraoperative radiotherapy is a major advance in the management of cancer patients and has been attracting massive interest worldwide following publication of the results of an important randomized controlled trial in The Lancet. This textbook is designed to introduce this innovative technology in a comprehensive manner to clinicians dealing with cancer patients. Throughout, the emphasis is on practical aspects, and the text is supported by many excellent illustrations. The editors of the book have extensive experience in targeted intraoperative radiotherapy and include co-directors of the TARGIT Academy, which runs international training courses on the technology in the United Kingdom and Germany. They have brought together multidisciplinary contributors from different centers across the world who have wide experience in the field and whose work has been recognized internationally. It is the editors' hope that this book will succeed in ensuring that targeted intraoperative radiotherapy is used effectively worldwide.

Written and edited by world-renowned experts in the field, Benzel's Spine Surgery: Techniques, Complication Avoidance and Management, 5th Edition, provides expert, step-by-step guidance on the evaluation and management of disorders of the spine. This definitive, two-volume work explores the full spectrum of techniques used in spine surgery, giving you the tools you need to hone your skills and increase your knowledge in this challenging area. Clearly organized and extensively revised throughout, it features contributions from both neurosurgeons and orthopaedic surgeons to present a truly comprehensive approach to spine disease. Offers a thorough overview of the effective management of patients with spinal disorders, including fundamental principles, biomechanics, applied anatomy, instrumentation, pathophysiology of spinal disorders, surgical techniques, motion preservation strategies, non-surgical management, and complication avoidance and management, as well as controversies. Focuses on both pathophysiology and surgical treatment of spine disease, with an increased emphasis on minimally invasive surgery. Contains new features such as key points boxes at the beginning of chapters and algorithms to help streamline the decision making process. Covers today's hot topics in spine surgery, such as health economics, artificial intelligence, predictive analytics, new less invasive techniques including endoscopic spine surgery, and the future of spine surgery. Provides expert coverage of key topics including biomechanics of motion preservation techniques, spinal injuries in sports, biologics in spine fusion surgery, anterior sub-axial cervical fixation and fusion techniques, complex lumbosacropelvic fixation techniques, and many more. Features more than 1,500 high-quality illustrations, as well as new procedural videos on en bloc spondylectomy, minimally invasive endoscopic posterior cervical foraminotomy, cervical total disc replacement, minimally invasive lumbar decompression of stenosis, and more. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.