TThis volume contains expert articles on the physiology and function of the microvascular and microlymphatic systems, the physiology of microvascular fluid filtration and reabsorption, interactions between blood cells and the microvascular endothelium, and molecular mechanisms of leukocyte activation. The therapeutic goals in chronic venous insufficiency include reduction of postischemic leukocyte-endothelial cell interaction, repair of microvascular barrier and improvement of microlymphatic drainage. In addition to measures to counteract inflammatory reactions elicited by local ischemia, surgical procedures such as transplantation of lymph vessels and subfascial division of perforating veins by an endoscopic approach are reviewed. Written by leading experts in the field, this book provides the first synopsis of the role of microcirculatory disturbances in chronic venous insufficiency. It will be of particular interest to phlebologists, angiologists, dermatologists, gerontologists, vascular, plastic and reconstructive surgeons, and general physicians.
New updated edition first published with Cambridge University Press. This new edition includes 29 chapters on topics as diverse as pathophysiology of atherosclerosis, vascular haemodynamics, haemostasis, thrombophilia and post-amputation pain syndromes.
Now in its third edition, the Handbook of Venous Disorders continues to provide comprehensive and up-to-date information on acute and chronic venous and lymphatic diseases and malformations and to discuss the latest knowledge on epidemiology, pathophysiology, clinical evaluation, diagnostic imaging, medical, endovascular and surgical management. This revised, updated and expanded edition takes account of all the recent developments in these areas. New chapters on, for example, foam sclerotherapathy, radiofrequency treatment, laser treatment and open surgical reconstructions are included, as well as useful diagnostic and treatment algorithms for the various conditions that are dealt with in the book. Clinical guidelines are provided in each chapter, together with evidence scores to help the reader assess the recommendations. The Handbook of Venous Disorders is written and edited by leaders and founding members of the American Venous Forum, a society dedicated to research, education and the clinical practice of venous and lymphatic diseases. The Handbook also includes several international authors, all of whom are experts in venous disease, most being regular or honorary members of the American Venous Forum.
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 large number of cardiovascular diseases are accompanied by inflammation. This volume on the molecular basis of microcirculatory disorders gives a comprehensive summary of key steps in the inflammatory cascade. Leading investigators present a state-of-the-art analysis of the molecular determinants of leukocyte-endothelial cell adhesion, mechanotransduction in endothelial and inflammatory cells, mechanisms of cell activation, microvascular apoptosis with applications to ischemia-reperfusion in the brain, the heart and in venous disease, diabetes and hypertension. The book provides the latest thinking in these important cardiovascular problems, with the most contemporary literature and a look at the increasingly complex events during inflammation. Molecular biology tools, microvascular and modern bioengineering analysis are seamlessly integrated into the analysis of clinical problems. The book helps not only newcomers to gain entry into the interesting problems associated with microvascular disorders, but lays the foundation for the design of new therapeutic interventions.
For physicians and surgeons entrusted with the care of patients with morbid obesity and related diseases; also for nurses and other professionals on the team. „Principles of Metabolic Surgery“ delivers a succinct account of current knowledge and an excellent overview of modern treatment strategies for morbid obesity. Attractively designed, this user-friendly textbook provides the latest on therapy, monitoring, and management, including: -Completely up-to-date coverage of modern metabolic surgery -Current understanding of the pathophysiology of morbid obesity -Current clinical therapy strategies for conservative and surgical approaches -Recent references In concise, readable chapters, this well-illustrated textbook outlines major concerns and considerations surrounding metabolic surgery. With respect to new insights from basic and clinical research, clear guidelines and practical clinical advice are given to improve the outcome of treatment for morbid obesity.
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
In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.
Bringing together thousands of the best dermatologic clinical and pathological photographs and figures from researchers and scientists around the world, this volume focuses on the most prevalent dermatologic disorders as they relate to cutaneous infectious and neoplastic conditions and procedural dermatology. It includes atypical presentations of various disorders, giving insight into differential diagnoses, helping to familiarize the reader with some of the rarest dermatologic disorders. Atlas of Dermatology, Dermatopathology and Venereology Volume 3 is written for dermatologists, dermatopathologists, and residents and summarizes data regarding any dermatologic disorder and syndrome. Each entry includes an introduction, clinical and pathological manifestations, diagnosis, differential diagnosis, and treatment and prognosis. div>/div/div/div
