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Since the discovery of nitric oxide as an endothelium-derived relaxing factor in 1987, investigations on its precise modes of action have been carried out at an extraordinary rate. Nitric oxide is now implicated in many physiological and pathological processes — not just in the control of vascular resistance, but in nerve transmission, cell proliferation, inflammatory responses and so on.Despite such rapid progress, no attempt has been made to combine the current knowledge of this subject matter in a single textbook. This volume has been written with the above in mind and presents a topical, comprehensive overview of the biochemistry and the physiological and pathophysiological effects of nitric oxide as they relate to the cardiovascular system. The therapeutic implications of nitric oxide are also considered. The text comprises contributions from many of the leading international authorities on the topic including Professor L J Ignarro, winner of the 1998 Nobel Prize in Physiology or Medicine.
This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.
Nitroglycerin and other organic nitrates have been used for over a century in the treatment of angina pectoris. Millions of patients, throughout the world, have placed nitroglycerin tablets under the tongue and have experienced rapid and dramatic relief from the chest pain that frequently occurs as a manifestation of disease of the coronary arteries. The empirical observation of the safe use of nitrates for tile alleviation of the symptoms of angina have led to their widespread medical acceptance. The use of organic nitrates preceded any knowledge of their mechanism of action or their ultimate metabolic fate. Thus, more simply stated, although sub lingual nitrates helped the patients, little was known concerning what these drugs do to the body or what the body does to the drugs. A substantial number of investigators have focused on these questions especially during the last two decades. We now have considerably more insight into the pathways of degradation of organic nitrates and the relationship of the metabolic processes to the biological action of these agents. Similarly, considerable effort has been expended in understanding the mechanism of action of these agents directly on vascular smooth muscle and on cardiac work and performance. Finally, there is a more substantive understanding of the physiology of the coronary circulation as well as the" pathophysiologic manifestations of myocardial disease.
Research on nitric oxide (NO) is a very hot topic since 1998, when three prominent researchers were recognized by Nobel prize awards. Addresses clinically pertinent issues related to nitric oxide in the pathophysiology and therapeutics of heart failure. Chapters written by basic scientists and clinicians to emphasize translation character of research in nitric oxide. An excellent reference source for researchers, practitioners and students.
An illustrated guide for anesthesia providers for congenital heart disease patients, with a focus on non-cardiac operating room settings.
Part of the Core Critical Care series, this book is an easy-to-read guide for the aspiring ECMO clinician. Doctors, nurses, physiotherapists, dieticians, pharmacists and all other key members of the team will learn the basics required to better understand the technology and care of the patient.
Vascular Innervation and Receptor Mechanisms: New Perspectives reviews the areas of structure, function, and pathophysiology of the circulatory system. The text focuses on the role of neuropeptides and structural function of endothelium. The book begins with a brief discussion on the background of autonomic and sensory nerves in the circulatory system, which is provided in Chapter 1. Having established the basic studies in the circulatory system, the book moves to the discussion on the analysis of peptidergic innervations and peptides in vascular control in various disorders. The last part of the book features the clinical applications of neuropeptides, perivascular peptides, and vasoactive peptides in different diseases and regulation, such as cardiovascular regulation, hypertension, congestive heart failure, and migraine and cluster headache. The text will be a good reference to both students and professionals in the fields of biology, chemistry, and medicine.
The yearbook compiles the most recent, widespread developments of experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.