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This book contains the scientific contributions presented during the inter national symposium "Cerebral Ischemia and Hemorheology", held in Germany in June 1987. The purpose of the symposium was to bring together experts in the fields of cerebral circulation and rheology, in order to increase the knowl edge and scope of both of these groups by making the members of each group more aware of work in the complementary field. The organizers hoped to stimulate the discussion between both groups and to reach adecision about whether the alteration of rheologie parameters might change the course and fate of cerebral ischemia. The contributions also report on clinical and basic studies pertinent to the topic of the symposium. The book is a comprehensive description of the state of the art wich may help to define what is known and to find new strategies to better und erstand metabolie, circulatory, and rheologie changes during cerebral ischemia. The selection of papers for publication was the task of the advisory board. The editors would like to thank the members for their critical analyses and suggestions; they are: Shu Chien, New York; F. Gotoh, Tokio; K.A. Hossmann, Cologne; G. Schmid-Schönbein, Aachen; L. Symon, London; and F. Yatsu, Houston. Bonn ALEXANDER HARTMANN WOLFGANG KUSCHINSKY Contents Local Control ofthe Cerebral Circulation. W. KUSCHINSKY (With 2 Figures) . . . . . . . . . . . . . . . . . .
Professor Caplan has extensively edited the book to shape and organize the contents into a succinct presentation by experts of the basic science and clinical aspects of the topic. The text has been divided into sections: The Brain.- Macroscopic and microscopic molecular aspects of brain ischemia, including pathophysiology, pathology, biochemistry, and clinical measurement.- Blood Vessels.- Their constitution and the pathology and physiology of the endothelium and arterial wall.- Blood Flow.- Its physics, control, rheology, and pathophysiology.- Blood.- The role of the cellular and serological constituents in coagulation and fibrinolysis. - Heart.- Sources of embolism and cardiac changes caused by brain ischemia.- And Epidemiology, Databases, and Trials. Prefatory remarks by Professor Caplan introduce each section. At the end of each section he relates the basic concepts to patient problems in the clinic, integrates the various contributions in the section, and covers other areas not discussed by the individual contributors.
Cerebral Blood Flow: Quantifying Consciousness Although the heart may be the source of energy needed to generate blood flow,and other organs absolutely essential for normal living,the brain is the reason we are alive. The collected book chapters are aimed at addressing this most fundamental organ and its blood flow. These papers reflect detailed descriptions of similar topics presented over a two-day period as part of the 5th International Symposium on Applied Physiology of the Peripheral Circulation held in Pittsburgh, Pennsylvania, in June 2000. The symposium and this volume were organized into four distinct groupings that follow in a logical fashion. The initial papers focus on the basic unique physiology and pathophysiology of the cerebral circulation, including a historical reviewof the means to measure cerebral blood flow and its implications of the past 30 years. Dr. Walter D. Obrist was one of the original investigators to use radiolabeled markers to assess cerebral blood flow. His equations and initial studies form an impressive introduction to where we are now. As with much of the body's special organs, the brain too has many circulatory features unique to itself.These include the unique blood-brain barrier function ofthe endothelium, local neural regulation control, and intracranial pressure effects. These special issues,plus genetic factors that may predispose individuals to developing cere bral aneurysm, make up the initial section of the monograph.
Haemorheology is the study of how the blood, the blood cells and the vessels can function and interact as parts of the living organism. It is presented in this text as a sensitive tool for the recognition of the functional evidences and defects of blood flow.
In this volume, one of a series of monographs devoted to the problems of cerebral ischemia and related topics, we present the proceedings of an international conference on Cerebral Ischemia and Basic Mechanisms held in Bad Schachen/Lake Constance, Germany in June 1992. The enormous progress in research recently on the basic mechanisms associated with cerebral ischemia has provided greater insight into the pathophysiological mechanisms of reduced brain perfusion and decreased cerebral metabolism. The high technology instrumentation used to unravel the intricacies of cerebral blood flow and metabolism includes positron emission tomography and magnetic resonance imaging. A description of sophisticated neurophysiological techniques will give the reader insight into new models of reversible and irreversible tissue damage and changes at the molecular level have been described. The therapeutic approaches which have developed from this re search have been or will be used in clinical trials and will open new avenues in the treatment of stroke. The organizers of the meeting would like to thank the advisory board for its helpful suggestions and the Deutsche Forschungsgemeinschaft and other sponsors for their important support.
This publication primarily focuses on the macro- and micro- rheological behavior of blood and its formed elements, on interactions between the formed elements and blood vessel walls, and on the microvascular aspects of hemodynamics. Since many aspects of hemorheology and hemodynamics are affected by disease or clinical states, these effects are discussed as are hyperviscosity syndromes, therapy for disturbed blood rheology, and methods in hemorheology and hemodynamics. Sections of the Handbook include History of Hemorheology; Hemorheology, covering basic aspects, blood composition, blood rheology, cell mechanics, pathophysiology, methods and comparative studies; Hemodynamics, covering basic principles, microcirculation, in vivo effects, endothelium and methods; and Clinical Aspects of Hemorheology, covering hyperviscosity, clinical significance and treatment. The goal is to foster greater interchange between workers in the fields so as to promote collaborative efforts and, hopefully, improved health. In selecting topics for this handbook the editors have attempted to provide a general overview of both basic science and clinical hemorheology and hemodynamics. Hemorheology and hemodynamics are closely related, the former dealing with all aspects of the flow and interactions of the individual blood cells mostly studied in vitro, the latter with the in vivo relationships among vessel architecture, driving pressure, flow rate and shear stress. The linkage between the in vitro and in vivo research described in the book will be of interest to both basic science and clinical investigators. The editors of the handbook have each been active in the fields of bio- and hemorheology for many years, and have published extensively. They have successfully achieved their objective to publish a well-written and well-edited handbook that will be valuable for researchers and students in the field.