Microcirculation
Current Physiologic, Medical, and Surgical Concepts
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Microcirculation: Current Physiologic, Medical, and Surgical Concepts is based primarily on a course and a series of lectures presented at a congress on microcirculation held at the University of California in August 1979. The book gives an overview of the concepts regarding the structure and properties of small vessels, a topic mostly read only in specialized journals. The primary focus of the text is on the function and dysfunction of small blood vessels. Three major parts comprise the text. Part I discusses the morphology, physiology, and pharmacology of circulation, and Part II presents the dynamics or role of the microcirculation in the study of diabetes. Finally, Part III discusses also the role of microcirculation in disease states, particularly hemoconcentration. The book will provide much information to researchers and students in the fields of biology, medicine, physiology, and pharmacology.
Table of Contents
List of Contributors
Preface
1 Introduction
Text
References
I Basic Structure and Function of the Bicrocirculation
2 Anatomy of the Microcirculation
Definition of Term
Functional Considerations
General Considerations
Structural Characteristics of the Microcirculation
Other Types of Blood Vessels within the Microvascular Bed
References
3 Assessment of Capillary Permeability Using Lymphatic Protein Flux: Estimation of the Osmotic Reflection Coefficient
Introduction
Theory Development
Summary
References
4 Capillary Exchanges: Small Solutes
Introduction
The Conventional Approach
The Phenomenological Approach
Summary
References
5 Pharmacology of the Microcirculation
Comparative Size and Ultrastructure of Muscular Microvessels
Density of Adrenergic Innervation
Pharmacologic Evidence Supporting Rich Adrenergic Innervation of Arterioles and Sparsity of Innervation in Muscular Venules
α-Adrenergic Receptors in Microvessels
Venular Size and Reactivity
β-Adrenergic Receptors in Microvessels
Relative Sensitivity of Muscular Microvessels to Different Constrictor Hormonal and Humoral Agonists and Specificity of Receptors
Dilator Humoral Agonists and Specificity of Dilator Receptors
Direct In Vivo Evidence Implicating Roles for Certain Humoral Substances in Regulation of Blood Flow
Electrophysiology of Arteriolar and Venular Smooth Muscle
Speculation on Mechanisms of Contraction and Relaxation in Arterioles versus Venules
Effects of Anesthetic Agents on Tone and Reactivity of Microvessels
Structure-Activity Studies on Muscular Venules: Microcirculatory Approach to Treatment of Low-Flow States
Conclusions
References
6 Structure and Function of the Sympathetic Nerves in the Pulmonary Vascular Bed of the Dog
Introduction
Methods
Results
Discussion
References
7 The Basement Membrane in the Microvasculature
Introduction
Morphology
Biochemistry
Antigenic Components of Basement Membranes
Origin of Basement Membranes
Turnover
Function
Summary and Conclusions
References
8 Endothelial Metabolism
Introduction
Anatomical Considerations
An Overview of Known Metabolic Activities
Therapeutic Implications
Concluding Remarks
References
II Diabetes Mellitus and the Microcirculation
9 The Dynamics of the Microcirculation as a Tool for the Study of Events in Diabetes
Disturbed Glucose Metabolism in Diabetes
Early Functional Changes in the Microcirculation
Hypoxia as a Factor for Retinal Changes
Impaired Erythrocyte Oxygen Delivery and Functional Microangiopathy
References
10 The Present Status of Basement Membrane Thickening in Diabetes
Introduction
Structure and Function of Capillary Basement Membrane
Frequency and Severity of Capillary Basement Membrane Thickening in Different Types of Diabetes
Pathophysiological Considerations and Pathogenesis of Capillary Basement Membrane Thickening
Relationship of Basement Membrane Thickening to Diabetic Nephropathy, Retinopathy, and Large Vessel Disease
Pathophysiological Consequences and Implications of Capillary Basement Membrane Thickening in Diabetes
References
11 The Microcirculation and Pathology of the Diabetic Retina
Pathology
Vascular Lesions
Pathogenesis
References
12 The Functional and Degenerative Pathology of the Diabetic Kidney
Introduction
Renal Function in Early Diabetes
Anatomic Renal Changes in Early Diabetes
Renal Function in Long-Standing Diabetes
Anatomic Changes in Diabetic Nephropathy
Why Does the Diabetic Kidney Fail?
What is the Sequence of Development of Diabetic Nephropathy?
Treatment Principles in Diabetic Nephropathy
Summary
References
III Hemorheology and Hemodilution
13 Factors Promoting and Preventing the Fluidity of Blood
Introduction
The Concept of Red Cell Fluidity
Disadvantages and Risk Factors of Blood Rheology: Pseudoplastic Behavior in Diseases
Interaction of Vasomotion and Blood Rheology
Abnormal Flow "Properties" in Disease: "Hyperviscosity Syndromes" and Blood Fluidity
Red Cell "Rigidification" ("Sclerocytosis")
References
14 Quantitative Assessment of Microvascular Integrity by Tissue Oxymetry in Patients
Clinical Tissue Oxymetry—Methods, Electrode Technology, Recording Instrumentation, and Data Processing
Recording Instrumentation
Physiological Significance of Tissue PO2
Clinical Tissue Oxymetry
Skeletal Muscle PO2 as a Diagnostic Tool in Intensive Care Medicine
Intraoperative Tissue Oxymetry
Summary
References
15 Hemodilution as a Therapy in Occlusive Vascular Disease of the Limbs
Introduction
Patient Selection, Procedures, and Measurements
Results
Discussion
Conclusion
References
16 Retinal Vascular Occlusions: Hemodilution, a New Therapeutic Concept?
Introduction
Methods
Results
Discussion
References
17 Stabilization of the Circulation by Hemodilution in Elective and Cardiac Surgery
Definition of Hemodilution
Hemodilution versus Hemoconcentration
Oxygen Transport and Tissue Oxygenation
Myocardial Performance, the Limiting Factor in Hemodilution
The Importance of Normovolemia and the Choice of the Diluent
Acute Preoperative Hemodilution in Elective Surgery
Hemodilution in Open Heart Surgery
Summary
References
Index
Product details
- No. of pages: 334
- Language: English
- Copyright: © Academic Press 1981
- Published: January 1, 1981
- Imprint: Academic Press
- eBook ISBN: 9780323155496