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Finn is the only surviving victim of the Chicago Heart Ripper. Struggling to come to terms with what happened, she fights against the amnesia that prevents her from identifying the serial killer. Caleb Sheppard is determined to protect Finn. He suspects that there is more to the prolific serial killer than meets the eye; why did he leave Finn alive? With the Ripper on their heels, they race against time to retrieve Finn's memories, keep her out of the murderer's clutches, and discover the secrets of his identity. What Finn does not realize is that Caleb is hiding secrets of his own - some of which she might not be able to accept.
Published in 1991: This book explores the possibilities of protecting the heart against stress and ischemia through adaptation to intermittent hypoxia or to mild, nondamaging stress exposure. These possibilities are based on studies that show an increase in the potency and efficiency of stress-limiting systems when subjected to repeated stress actions, adaptation to high altitude hypoxia, or adaptation to increased physical loads. Any stress reaction is coupled with an activation of central and local stress-limiting systems, such as GABA-ergic, opioidergic, and serotonergic systems in the brain, as well as antioxidants, prostaglandins, and adenosine in executory organs. The book also presents the use of metabolites of stress-limiting systems rather than adaptation as a means to prevent cardiac arrythmias. It also discusses genetically determined deficiencies of stress-limiting systems and their role in the etiology of stress-induced diseases. Cardiologists and researchers studying stress and its effect on cardiovascular systems will find this book extremely useful.
Over the past ?fty years, advanced techniques and strategies have arisen in the ?eld of myocardial protection. Meticulous trials, focusing on pulmonary protection during heart surgery requiring cardiopulmonary bypass (CPB), have been missing. This te- book is intended to serve as a useful tool to spread information on strategies for lung protection during heart surgery with CPB. Emphasis on pulmonary protection will be turned to lung perfusion as an adjunct for minimizing the deleterious effects of pulmonary ischemia-reperfusion injury in heart surgery. Many renowned authors have contributed by presenting their expe- ence on lung perfusion in basic research and clinical trials. Furthermore, they have enlightened the quality of this textbook with new ideas, concepts, and future perspectives. The scope of this textbook is of interest to different professionals, such as card- vascular surgeons, pulmonary surgeons, transplantation physicians, cardiothoracic anesthesiologists, intensive care physicians, cardiothoracic fellows, radiologists, basic sciences physicians, cardiologists, pulmonary medicine physicians, perfusi- ists, nurses, students, and researchers. This textbook has 7 sections, aimed at addressing general and speci?c aspects of pulmonary protection during heart surgery with CPB. The ?rst section on general concepts provides information about anatomic, physiologic, histologic, molecular, and radiologic considerations regarding the lungs. The second section focuses on ischemia-reperfusion injury and is composed of several interesting chapters, addressing the basic science aspects of pulmonary p- tection, as well as experimental and clinical experiences from different heart surgery centers worldwide.
Brain injury is one of the most unacceptable complications sustained during heart surgery. This book presents the current results and thinking of a number of leading clinical investigators in this area. Nearly all have been active in serious studies designed to define various aspects of brain physiology, patho physiology, or protection during cardiac operations performed with cardio pulmonary bypass. We were particularly interested in obtaining contributions from younger investigators. Brain injury is a problem which has long troubled those involved with perioperative care of the cardiac surgical patient. The first chapter by Dr. Torkel Aberg presents a summary of his extensive investigations into this problem. It is intended both to present the perspective of a surgeon interested in this problem, and to serve as an introduction to the overall issue of avoiding brain injury during heart surgery. The next three chapters discuss the problem of perfusion pressure, outcome, and brain blood flow. Dr. Sarnquist's contribution stems from his extensive experience with low flow bypass as practiced at Stanford University and the results of the studies he performed in collaboration with Dr. Fish. Drs. Govier and Reves discuss in some detail the general effects of anesthetic agents upon brain metabolic needs as well as their important data demonstrating preserva tion of brain blood flow autoregulation during cardiopulmonary bypass (CPB) as practiced at the University of Alabama. Finally Dr.
Finn is the only surviving victim of the Chicago Heart Ripper. Struggling to come to terms with what happened, she fights against the amnesia that prevents her from identifying the serial killer. Caleb Sheppard is determined to protect Finn. He suspects that there is more to the prolific serial killer than meets the eye; why did he leave Finn alive? With the Ripper on their heels, they race against time to retrieve Finn's memories, keep her out of the murderer's clutches, and discover the secrets of his identity. What Finn does not realize is that Caleb is hiding secrets of his own - some of which she might not be able to accept.
Finn is the only surviving victim of the Chicago Heart Ripper. Struggling to come to terms with what happened, she fights against the amnesia that prevents her from identifying the serial killer. Caleb Sheppard is determined to protect Finn. He suspects that there is more to the prolific serial killer than meets the eye; why did he leave Finn alive? With the Ripper on their heels, they race against time to retrieve Finn's memories, keep her out of the murderer's clutches, and discover the secrets of his identity. What Finn does not realize is that Caleb is hiding secrets of his own - some of which she might not be able to accept.