This open access book deals with imaging of the abdomen and pelvis, an area that has seen considerable advances over the past several years, driven by clinical as well as technological developments. The respective chapters, written by internationally respected experts in their fields, focus on imaging diagnosis and interventional therapies in abdominal and pelvic disease; they cover all relevant imaging modalities, including magnetic resonance imaging, computed tomography, and positron emission tomography. As such, the book offers a comprehensive review of the state of the art in imaging of the abdomen and pelvis. It will be of interest to general radiologists, radiology residents, interventional radiologists, and clinicians from other specialties who want to update their knowledge in this area.
Three distinct types of contractions perform colonic motility functions. Rhythmic phasic contractions (RPCs) cause slow net distal propulsion with extensive mixing/turning over. Infrequently occurring giant migrating contractions (GMCs) produce mass movements. Tonic contractions aid RPCs in their motor function. The spatiotemporal patterns of these contractions differ markedly. The amplitude and distance of propagation of a GMC are several-fold larger than those of an RPC. The enteric neurons and smooth muscle cells are the core regulators of all three types of contractions. The regulation of contractions by these mechanisms is modifiable by extrinsic factors: CNS, autonomic neurons, hormones, inflammatory mediators, and stress mediators. Only the GMCs produce descending inhibition, which accommodates the large bolus being propelled without increasing muscle tone. The strong compression of the colon wall generates afferent signals that are below nociceptive threshold in healthy subjects. However, these signals become nociceptive; if the amplitudes of GMCs increase, afferent nerves become hypersensitive, or descending inhibition is impaired. The GMCs also provide the force for rapid propulsion of feces and descending inhibition to relax the internal anal sphincter during defecation. The dysregulation of GMCs is a major factor in colonic motility disorders: irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and diverticular disease (DD). Frequent mass movements by GMCs cause diarrhea in diarrhea predominant IBS, IBD, and DD, while a decrease in the frequency of GMCs causes constipation. The GMCs generate the afferent signals for intermittent short-lived episodes of abdominal cramping in these disorders. Epigenetic dysregulation due to adverse events in early life is one of the major factors in generating the symptoms of IBS in adulthood.
The Oxford Textbook of Medical Mycology is a comprehensive reference text which brings together the science and medicine of human fungal disease. Written by a leading group of international authors to bring a global expertise, it is divided into sections that deal with the principles of mycology, the organisms, a systems based approach to management, fungal disease in specific patient groups, diagnosis, and treatment. The detailed clinical chapters take account of recent international guidelines on the management of fungal disease. With chapters covering recent developments in taxonomy, fungal genetics and other 'omics', epidemiology, pathogenesis, and immunology, this textbook is well suited to aid both scientists and clinicians. The extensive illustrations, tables, and in-depth coverage of topics, including discussion of the non-infective aspects of allergic and toxin mediated fungal disease, are designed to aid the understanding of mechanisms and pathology, and extend the usual approach to fungal disease. This textbook is essential reading for microbiologists, research scientists, infectious diseases clinicians, respiratory physicians, and those managing immunocompromised patients. Part of the Oxford Textbook in Infectious Disease and Microbiology series, it is also a useful companion text for students and trainees looking to supplement mycology courses and microbiology training.
The microcirculation of the gastrointestinal tract is under the control of both myogenic and metabolic regulatory systems. The myogenic mechanism contributes to basal vascular tone and the regulation of transmural pressure, while the metabolic mechanism is responsible for maintaining an appropriate balance between O2 demand and O2 delivery. In the postprandial state, hydrolytic products of food digestion elicit a hyperemia, which serves to meet the increased O2 demand of nutrient assimilation. Metabolically linked factors (e.g., tissue pO2, adenosine) are primarily responsible for this functional hyperemia. The fenestrated capillaries of the gastrointestinal mucosa are relatively permeable to small hydrolytic products of food digestion (e.g., glucose), yet restrict the transcapillary movement of larger molecules (e.g., albumin). This allows for the absorption of hydrolytic products of food digestion without compromising the oncotic pressure gradient governing transcapillary fluid movement and edema formation. The gastrointestinal microcirculation is also an important component of the mucosal defense system whose function is to prevent (and rapidly repair) inadvertent epithelial injury by potentially noxious constituents of chyme. Two pathological conditions in which the gastrointestinal circulation plays an important role are ischemia/reperfusion and chronic portal hypertension. Ischemia/reperfusion results in mucosal edema and disruption of the epithelium due, in part, to an inflammatory response (e.g., increase in capillary permeability to macromolecules and neutrophil infiltration). Chronic portal hypertension results in an increase in gastrointestinal blood flow due to an imbalance in vasodilator and vasoconstrictor influences on the microcirculation. Table of Contents: Introduction / Anatomy / Regulation of Vascular Tone and Oxygenation / Extrinsic Vasoregulation: Neural and Humoral / Postprandial Hyperemia / Transcapillary Solute Exchange / Transcapillary Fluid Exchange / Interaction of Capillary and Interstitial Forces / Gastrointestinal Circulation and Mucosal Defense / Gastrointestinal Circulation and Mucosal Pathology I: Ischemia/Reperfusion / Gastrointestinal Circulation and Mucosal Pathology II: Chronic Portal Hypertension / Summary and Conclusions / References / Author Biography
A comprehensive reference standard for the discipline, Canine and Feline Gastroenterology covers the biology, pathobiology, and diagnosis and treatment of diseases of the gastrointestinal, pancreatic, and hepatobiliary systems. An international team of experts, including 85 authors from 17 different countries, led by Robert Washabau and Michael Day, covers everything from minor problems such as adverse food reactions to debilitating inflammatory, infectious, metabolic, and neoplastic diseases of the digestive system. This authoritative text utilizes an evidence-based approach to reflect the latest science and research, complemented by principles of problem solving, algorithms to improve clinical diagnoses, and extensive full-color illustrations. For generalists and specialists alike, this gastroenterology reference should be part of every serious practitioner's professional library. - A comprehensive, 928-page reference standard covers the discipline of canine and feline gastroenterology. - An international focus is provided by 85 authors from 17 different countries, including renowned experts in veterinary gastroenterology, internal medicine, pathology, clinical pathology, radiology, and infectious disease. - Coverage of the entire breadth and depth of gastroenterology ranges from biology to pathobiology, as well as diagnosis and treatment of diseases of the gastrointestinal, pancreatic, and hepatobiliary systems. - Current information on GI microflora, immunology, cellular growth, and systems integration provides a foundation for treating clinical problems. - Coverage of diseases in dogs and cats includes the oral cavity, esophagus, stomach, small intestine, large intestine, colon, anorectum, liver and biliary tract, exocrine pancreas, peritoneum, and associated vasculature. - A focus on patient management examines the full range of procedures and techniques essential to diagnosis and treatment from clinical signs and diagnosis to nutritional support and pharmacologic management of disease. - Clear explanations of current diagnostic modalities include laboratory tests, molecular methods, diagnostic imaging, endoscopy, and histopathology, also showing how to interpret and utilize results. - A strong clinical approach emphasizes need-to-know information for managing the common and not-so-common G.I. clinical problems of everyday practice. - Full-color photographs and illustrations depict concepts, conditions, and procedures. - An evidence-based medicine perspective reflects the latest research as well as the modern practice of veterinary medicine. - Logical, coherent, and consistent internal organization makes this a reader-friendly edition. - Problem-based algorithms help in diagnosing every G.I. clinical problem from A to Z. - A stand-alone section on the pharmacologic approach to G.I. disease offers quick and easy drug reference.
Provide evidence-based perspectives on all clinically relevant topics, explaining step by step how to apply the latest advances in practice. Succinct yet comprehensive discussions provide just the right amount of clinical detail. Plus, a consistent organization and full-color art program enable you to quickly and easily access needed information. Offers more than 1,000 illustrations, photographs, and tables (400 in full color) that promote a visual grasp of the material. Presents coverage of the hottest topics in today's practice, including GERD, non-alcoholic fatty liver disease, ulcerative colitis, and Barretts esophagus, as well as the psychosocial aspects of gastrointestinal and liver diseases. Features four new chapters covering complimentary and alternative medicine palliative care gastrointestinal stromal tumor (GIST) and eosinophilic disorders, plus expanded information on obesity and nutrition.
This new edition is a unique combined resource for physicians and scientists addressing the needs of both groups. In addition to stimulating exchange and collaboration and shortening the path between discovery and application of new knowledge, the book helps clinicians understand new therapeutic concepts from their origins. The volume serves as a comprehensive guide to the current diagnostic modalities, including enhanced imaging techniques such as MRI and CT enterography, virtual colonoscopy, ultrasound, and endomicroscopy, as well as conventional and complex immunomodulatory principles. The latest edition also includes revised chapters from the previous edition, as well as new chapters reflecting current developments in the field. Written by experts in their field, Crohn’s Disease and Ulcerative Colitis: From Epidemiology and Immunobiology to a Rational Diagnostic and Therapeutic Approach, Second Edition is of great value to gastroenterologists, surgeons, internists, pediatricians and gynecologists trainees, as well as all those involved in Crohn’s disease, ulcerative colitis, and related autoimmune disorders.
