The Novartis Foundation Series is a popular collection of the proceedings from Novartis Foundation Symposia, in which groups of leading scientists from a range of topics across biology, chemistry and medicine assembled to present papers and discuss results. The Novartis Foundation, originally known as the Ciba Foundation, is well known to scientists and clinicians around the world.
This presentation describes various aspects of the regulation of tissue oxygenation, including the roles of the circulatory system, respiratory system, and blood, the carrier of oxygen within these components of the cardiorespiratory system. The respiratory system takes oxygen from the atmosphere and transports it by diffusion from the air in the alveoli to the blood flowing through the pulmonary capillaries. The cardiovascular system then moves the oxygenated blood from the heart to the microcirculation of the various organs by convection, where oxygen is released from hemoglobin in the red blood cells and moves to the parenchymal cells of each tissue by diffusion. Oxygen that has diffused into cells is then utilized in the mitochondria to produce adenosine triphosphate (ATP), the energy currency of all cells. The mitochondria are able to produce ATP until the oxygen tension or PO2 on the cell surface falls to a critical level of about 4–5 mm Hg. Thus, in order to meet the energetic needs of cells, it is important to maintain a continuous supply of oxygen to the mitochondria at or above the critical PO2 . In order to accomplish this desired outcome, the cardiorespiratory system, including the blood, must be capable of regulation to ensure survival of all tissues under a wide range of circumstances. The purpose of this presentation is to provide basic information about the operation and regulation of the cardiovascular and respiratory systems, as well as the properties of the blood and parenchymal cells, so that a fundamental understanding of the regulation of tissue oxygenation is achieved.
This work demonstrates a novel approach to visceral osteopathy. Basing their ideas on anatomy and physiology, Jean-Pierre Barral and Alain Croibier propose manipulation of the arteries to treat the intestines and other internal organs by increasing their blood flow. The arteries, elastic and muscular in structure, and the innumerable nerve filaments which surround them, react ideally to manual treatment. To be effective, however, these manipulations must be specific and precise. Thanks to the authors' long experience as therapists, their mastery of osteopathic techniques and the aid of ultrasound technology, they have devised innovative techniques to improve the visceral vascular circulation. In this book the authors show the various sites of the principle pulses of the body and summarise the physiology of the circulation of the blood. The main organs and their physiology are addressed and include the heart, pancreas, small intestine, colon and other abdominal structures as well as the regions of the neck, skull and pelvic cavity. Rich in detailed, high quality illustrations, this book serves as both an anatomical reference and a guide to carrying out visceral vascular manipulations in the most effective way possible. The work is aimed at experienced osteopaths as well as those in training, and at other manual therapists who wish to widen their scope. - Offers practical and clinically relevant information to all practitioners and therapists working in the field - Abundant use of pull-out boxes, line artwork, photographs and tables facilitates ease of understanding - Prepared by experts of international renown - Covers treatment of the main organs including the heart, pancreas, small intestine, colon and other abdominal structures as well as the regions of the neck, skull and pelvic cavity - Serves as both an anatomical reference and a guide to carrying out visceral vascular manipulations in the most effective way possible - Suitable for osteopathic physicians and osteopaths, chiropractors, physical therapists, manual therapists, physiotherapists, and massage therapists
This book shows how new technologies and technical skills together with deeper understanding of pathophysiology of visceral and renal ischemia have contributed to significant improvements in the clinical outcomes in patients undergoing complex aortic repair involving splanchnic arteries. In recent years, aortic repair has expanded its borders, focusing more and more on the particularly challenging segments from which critical branches originate. Optimal results in this area are obtained through a multidisciplinary approach based on crucial elements such as sophisticated imaging techniques, advanced anesthesiological and pharmacological strategies, as well as updated surgical techniques and devices able to reduce ischemic injuries. The book presents problems tackled from different perspectives, by analyzing the main technical aspects of the surgical technique but also functional and metabolic issues. It also discusses concepts such as ischemic preconditioning and ischemia-reperfusion mechanisms, as well as innovative investigational approaches. In the “endovascular era”, it highlights the most recent updates in complex endovascular repair involving renal and visceral arteries, providing both practical tips and tricks and outcomes analyses. The volume also addresses specific, rarely reported problems in vascular surgery, including issues in renal transplant, oncologic surgery with involvement of splanchnic arteries and of the vena cava, and use of the deep veins in aortic surgery. This volume represents a powerful tool for both young and experienced operators who wish to approach the complex aortic pathology either by open surgery or through endovascular methods.”
The partition of fluid between the vascular and interstitial compartments is regulated by forces (hydrostatic and oncotic) operating across the microvascular walls and the surface areas of permeable structures comprising the endothelial barrier to fluid and solute exchange, as well as within the extracellular matrix and lymphatics. In addition to its role in the regulation of vascular volume, transcapillary fluid filtration also allows for continuous turnover of water bathing tissue cells, providing the medium for diffusional flux of oxygen and nutrients required for cellular metabolism and removal of metabolic byproducts. Transendothelial volume flow has also been shown to influence vascular smooth muscle tone in arterioles, hydraulic conductivity in capillaries, and neutrophil transmigration across postcapillary venules, while the flow of this filtrate through the interstitial spaces functions to modify the activities of parenchymal, resident tissue, and metastasizing tumor cells. Likewise, the flow of lymph, which is driven by capillary filtration, is important for the transport of immune and tumor cells, antigen delivery to lymph nodes, and for return of filtered fluid and extravasated proteins to the blood. Given this background, the aims of this treatise are to summarize our current understanding of the factors involved in the regulation of transcapillary fluid movement, how fluid movements across the endothelial barrier and through the interstitium and lymphatic vessels influence cell function and behavior, and the pathophysiology of edema formation. Table of Contents: Fluid Movement Across the Endothelial Barrier / The Interstitium / The Lymphatic Vasculature / Pathophysiology of Edema Formation
The aim of this treatise is to summarize the current understanding of the mechanisms for blood flow control to skeletal muscle under resting conditions, how perfusion is elevated (exercise hyperemia) to meet the increased demand for oxygen and other substrates during exercise, mechanisms underlying the beneficial effects of regular physical activity on cardiovascular health, the regulation of transcapillary fluid filtration and protein flux across the microvascular exchange vessels, and the role of changes in the skeletal muscle circulation in pathologic states. Skeletal muscle is unique among organs in that its blood flow can change over a remarkably large range. Compared to blood flow at rest, muscle blood flow can increase by more than 20-fold on average during intense exercise, while perfusion of certain individual white muscles or portions of those muscles can increase by as much as 80-fold. This is compared to maximal increases of 4- to 6-fold in the coronary circulation during exercise. These increases in muscle perfusion are required to meet the enormous demands for oxygen and nutrients by the active muscles. Because of its large mass and the fact that skeletal muscles receive 25% of the cardiac output at rest, sympathetically mediated vasoconstriction in vessels supplying this tissue allows central hemodynamic variables (e.g., blood pressure) to be spared during stresses such as hypovolemic shock. Sympathetic vasoconstriction in skeletal muscle in such pathologic conditions also effectively shunts blood flow away from muscles to tissues that are more sensitive to reductions in their blood supply that might otherwise occur. Again, because of its large mass and percentage of cardiac output directed to skeletal muscle, alterations in blood vessel structure and function with chronic disease (e.g., hypertension) contribute significantly to the pathology of such disorders. Alterations in skeletal muscle vascular resistance and/or in the exchange properties of this vascular bed also modify transcapillary fluid filtration and solute movement across the microvascular barrier to influence muscle function and contribute to disease pathology. Finally, it is clear that exercise training induces an adaptive transformation to a protected phenotype in the vasculature supplying skeletal muscle and other tissues to promote overall cardiovascular health. Table of Contents: Introduction / Anatomy of Skeletal Muscle and Its Vascular Supply / Regulation of Vascular Tone in Skeletal Muscle / Exercise Hyperemia and Regulation of Tissue Oxygenation During Muscular Activity / Microvascular Fluid and Solute Exchange in Skeletal Muscle / Skeletal Muscle Circulation in Aging and Disease States: Protective Effects of Exercise / References
"Osteopathy and other systems of manual medicine have developed a variety of models for understanding the mechanics of proper and improper motion of the musculoskeletal system. In this important and pioneering work, that same structural vision is applied to the visceral system. The central premise of 'Visceral Manipulation' is that the interrelationship of structure and function among the internal organs is at least as strong as that among the constituents of the musculoskeletal system; and that, like the musculoskeletal system, manipulation of the viscera can be beneficially used in the treatment of a wide variety of problems affecting any of the body's systems."--Publisher description.
In order to produce a superior scholarly treatise in bio medical science, three important conditions need to be met. First, the subject needs to be of recognized importance and preferably one in which a sizeable volume of new knowledge has been added recently. Second, it needs to be quite evident that the field involved re quires much more up-to-date coverage than it has received and third, the choice of the editors and in turn the authors needs to be recognized as outstanding. This major treatise fills these criteria in an admirable way. There are few who would deny the importance of knowledge concerning the circulatory system. This all pervasive system is the route by which virtually all of the cells and tissues of the body receive their nutrition and it is the major route by which metabolic waste products are carried away. Furthermore, the diseases that involve the circulatory system are, by far, the underlying causes of death and morbidity in the largest number of Americans, Western Europeans and several other populations of industrialized nations. Not only is atherosclerosis-induced-ischemic disease of the heart, brain and extremities widespread in these populations but venous occlusive disease also takes a great toll from phlebothrombosis, pulmonary embolism, etc.
This is the second edition of a well-received book that has been recommended for inclusion in any vascular library or vascular radiology suite. The first edition has been fully revised so as to provide a comprehensive, up-to-date account of vascular ultrasound that reflects recent advances. The emphasis remains on the clinical aspects most relevant to angiologists and vascular surgeons. Ultrasound anatomy is discussed, examination procedures explained, normal and pathological findings described, and the clinical impact of ultrasound assessed. Atlas sections present pertinent case material to illustrate typical ultrasound findings for both the more common vascular diseases and rarer conditions. This book will serve not only as an invaluable guide for beginners, but also as an indispensable reference for experienced sonographers, who will benefit from the detailed evaluation of the role of ultrasound as compared with other modalities and the discussion of ultrasound findings in their clinical context.
This book represents the first comprehensive textbook devoted to the standard of care, current guidelines and innovations in the field of mesenteric vascular disease. The book reviews imaging modalities, diagnostic work up, physiologic tests, traditional open surgical techniques and novel endovascular approaches. Technical aspects of both open surgical and endovascular techniques are provided by experts in the field, with illustrations and photographs of key steps for each type of procedure. Results of epidemiologic studies and national databases are summarized, as well as large institutional experiences. An evidence-based approach is used for recommendations regarding best therapies. Diagnostic approaches including imaging and novel physiologic tests, including gastric tonometry and oxygen light spectroscopy are covered. Mesenteric Vascular Disease: Current Therapy will serve as a very useful resource for clinicians, surgeons, interventionalists, gastroenterologists and researchers dealing with and interested in mesenteric vascular diseases.
