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Ten years after the discovery of prostacyclin, our knowledge of its biochemical mode of action, pharmacological properties, pathophysiological significance and therapeutic applications is ever expanding. Prostacyclin is both complex and unique as demonstrated by its unusual feature of being chemically and meta bolically unstable when compared to other prostanoids and known amine or peptide mediators. Although physiologically essential, the chemical instability of prostacyclin poses a serious drawback in laboratory and clinical studies. It is one of the genuine objectives of pharmaceutical research to supply synthetic compounds which overcome the inherent drawbacks - considering investigational and therapeutic use - of endogenous compounds. Whereas metabolic instability in certain cases could be of advantage, chemical instability definitely is not. With Iloprost, a molecule has been designed which - according to all data so far available - pertains high receptor affinity, metabolic instability (clinically this equates with a fine control of Iloprost's effects) while chemical stability has been achieved. By virtue of these characteristics Iloprost can be considered as one step towards specific interaction within the arachidonic acid cascade, namely the prostacyclin receptor. The aim of the symposium was to provide a critical experimental appraisal concerning the biochemical mode of action and pharmacological properties of prostacyclin and Iloprost.
This open access book focuses on the molecular mechanism of congenital heart disease and pulmonary hypertension, offering new insights into the development of pulmonary circulation and the ductus arteriosus. It describes in detail the molecular mechanisms involved in the development and morphogenesis of the heart, lungs and ductus arteriosus, covering a range of topics such as gene functions, growth factors, transcription factors and cellular interactions, as well as stem cell engineering technologies. The book also presents recent advances in our understanding of the molecular mechanism of lung development, pulmonary hypertension and molecular regulation of the ductus arteriosus. As such, it is an ideal resource for physicians, scientists and investigators interested in the latest findings on the origins of congenital heart disease and potential future therapies involving pulmonary circulation/hypertension and the ductus arteriosus.
Written by the foremost authority in the field, this volume is a comprehensive review of the multifaceted phenomenon of hepatotoxicity. Dr. Zimmerman examines the interface between chemicals and the liver; the latest research in experimental hepatotoxicology; the hepatotoxic risks of household, industrial, and environmental chemicals; and the adverse effects of drugs on the liver. This thoroughly revised, updated Second Edition features a greatly expanded section on the wide variety of drugs that can cause liver injury. For quick reference, an appendix lists these medications and their associated hepatic injuries. Also included are in-depth discussions of drug metabolism and factors affecting susceptibility to liver injury.
This new bedside manual guides you through all the practical aspects of managing patients following cardiothoracic surgery and critically ill cardiology patients. Primarily designed to use in cardiothoracic intensive care units and coronary care units, it covers the perioperative management for the full range of cardiothoracic surgical procedures, the management of complications, and related issues. Core topics in cardiothoracic critical care, such as hemodynamic instability, arrhythmias, bleeding, and mechanical cardiac support, are afforded broad coverage. Also included are sections on advanced ventilatory techniques and veno-venous ECMO for treating severe respiratory failure, as well as nutritional support, treating and preventing infection, renal failure, and care of the dying patient. Concisely written and featuring liberal use of illustrations as well as an integrated, tightly edited style, and a limited number of key references, this volume will become your reference of choice for the care of of cardiothoracic surgery patients and critically ill cardiology patients. Find information quickly with concisely written text. Get a more complete picture with extensive illustrations. Focus on just the information you need using a a limited number of key references. Navigate the complexities of critical care for a fulll range of cardiothoracic surgery patients with in-depth coverage of perioperative care, management of complications, and more.
Detailing state-of-the-art developments in the various aspects of primary pulmonary hypertension (PPH), this practical reference explores the history, most current scientific concepts, and treatments of this disease. Includes new advances not yet formally published! Written by nearly 30 of the top international experts in the field, Primary Pulmonary Hypertension addresses the general histological features of the normal and hypertensive pulmonary vasculature and the pathology of PPH discusses etiological possibilities of pathogenesis, common morphological features, and findings in experimental models examines risks factors for PPH and looks separately at familial PPH and PPH in children presents an approach to the differential diagnosis of pulmonary hypertension, emphasizing the recognition of PPH elucidates the invasive and noninvasive modalities available for obtaining qualitative and quantitative hemodynamic data for the diagnosis of PPH covers a variety of therapeutic options and much more!
Fluorine and Health presents a critical multidisciplinary overview on the contribution of fluorinated compounds to resolve the important global issue of medicinal monitoring and health care. The involved subjects are organized in three thematic parts devoted to Molecular Imaging, Biomedical Materials and Pharmaceuticals. Initially the key-position of partially fluorinated low molecular weight compounds labelled either with the natural 19F-isotope for Magnetic Resonance Imaging (MRI) or labelled with the radioactive [18F]-isotope for Positron Emission Tomography (PET) is highlighted. Both non-invasive methods belong to the most challenging in vivo imaging techniques in oncology, neurology and in cardiology for the diagnosis of diseases having the highest mortality in the industrialized countries. The manifold facets of fluorinated biomaterials range from inorganic ceramics to perfluorinated organic molecules. Liquid perfluorocarbons are suitable for oxygen transport and as potential respiratory gas carriers, while fluorinated polymers are connected to the pathology of blood vessels. Another important issue concerns the application of highly fluorinated liquids in ophthalmology. Moreover, fluorine is an essential trace element in bone mineral, dentine and tooth enamel and is applied for the prophylaxis and treatment of dental caries. The various origins of human exposure to fluoride species is detailed to promote a better understanding of the effect of fluoride species on living organisms.Medicinally relevant fluorinated molecules and their interactions with native proteins are the main focus of the third part. New molecules fluorinated in strategic position are crucial for the development of pharmaceuticals with desired action and optimal pharmacological profile. Among the hundreds of marketed active drug components there are more than 150 fluorinated compounds. The chapters will illustrate how the presence of fluorine atoms alters properties of bioactive compounds at various biochemical steps, and possibly facilitate its emergence as pharmaceuticals. Finally the synthetic potential of a fluorinase, the first C-F bond forming enzyme, is summarized. - New approach of topics involving chemistry, biology and medicinal techniques - Transdisciplinar papers on fluoride products - Importance of fluoride products in health - Updated data on specific topics
In addition to its well known anti-platelet and hypotensive properties, prostacyclin activates neuronal receptors in the central, enteric and sensory nervous systems. This volume discusses the properties of prostacyclin receptors in the cardiovascular and nervous systems, as well as in cells involved in inflammatory reactions. The chemistry and pharmacology of prostacyclin mimetics are also explored, higlighting their therapeutic value.
The endothelium, a monolayer of endothelial cells, constitutes the inner cellular lining of the blood vessels (arteries, veins and capillaries) and the lymphatic system, and therefore is in direct contact with the blood/lymph and the circulating cells. The endothelium is a major player in the control of blood fluidity, platelet aggregation and vascular tone, a major actor in the regulation of immunology, inflammation and angiogenesis, and an important metabolizing and an endocrine organ. Endothelial cells controls vascular tone, and thereby blood flow, by synthesizing and releasing relaxing and contracting factors such as nitric oxide, metabolites of arachidonic acid via the cyclooxygenases, lipoxygenases and cytochrome P450 pathways, various peptides (endothelin, urotensin, CNP, adrenomedullin, etc.), adenosine, purines, reactive oxygen species and so on. Additionally, endothelial ectoenzymes are required steps in the generation of vasoactive hormones such as angiotensin II. An endothelial dysfunction linked to an imbalance in the synthesis and/or the release of these various endothelial factors may explain the initiation of cardiovascular pathologies (from hypertension to atherosclerosis) or their development and perpetuation. Table of Contents: Introduction / Multiple Functions of the Endothelial Cells / Calcium Signaling in Vascular Cells and Cell-to-Cell Communications / Endothelium-Dependent Regulation of Vascular Tone / Conclusion / References
The placenta is an organ that connects the developing fetus to the uterine wall, thereby allowing nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. Proper vascular development in the placenta is fundamental to ensuring a healthy fetus and successful pregnancy. This book provides an up-to-date summary and synthesis of knowledge regarding placental vascular biology and discusses the relevance of this vascular bed to the functions of the human placenta.
An excellent overview of recent advances in diagnosis, classification and treatment The pulmonary circulation is by nature difficult to evaluate for the clinician and a challenge to investigate by radiographic and hemodynamic methods. In recent years, the field has been revolutionized by major improvements in diagnostic approaches and therapies. Tools for the classification, diagnosis, and management of pulmonary embolism and pulmonary hypertension have been developed and optimized, providing clinicians with detailed and updated guidelines. This volume provides the latest information on the fast-growing and challenging field of acute and chronic pulmonary vascular disorders from some of the field's major leaders in research, education, and care. The topics discussed are relevant to chest physicians, thoracic surgeons, nurses, students, and teachers, and a well-balanced mix of contributions ensures that doctors, clinicians, and institutions from all around the world will find the information presented to be both informative and useful to their situations.