\r\n\t
",isbn:"978-1-83969-150-8",printIsbn:"978-1-83969-149-2",pdfIsbn:"978-1-83969-151-5",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"7409b2acd5150a93004300800918b736",bookSignature:"Prof. Karmen Pažek",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10548.jpg",keywords:"Lean Manufacturing, Agriculture, Production and Process, Costs Reduction, Lean Principles, Industry, Tools, Implementation, Sustainability, Modeling, Environment, Planning",numberOfDownloads:10,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 20th 2020",dateEndSecondStepPublish:"November 17th 2020",dateEndThirdStepPublish:"January 16th 2021",dateEndFourthStepPublish:"April 6th 2021",dateEndFifthStepPublish:"June 5th 2021",remainingDaysToSecondStep:"2 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Pažek is Head of the undergraduate study program Agricultural economics and rural development and Vice-dean for education. She is the author or co-author of 61 scientific papers, 6 scientific books, and 24 book chapters.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"179642",title:"Prof.",name:"Karmen",middleName:null,surname:"Pažek",slug:"karmen-pazek",fullName:"Karmen Pažek",profilePictureURL:"https://mts.intechopen.com/storage/users/179642/images/system/179642.jpg",biography:"Karmen Pažek achieved her Ph.D. at University of Maribor, Faculty of Agriculture in 2006. She is active as Full Professor for Farm management in the Department for Agriculture Economics and Rural Development on Faculty of Agriculture and Life Sciences, University of Maribor. Her research includes development of decision support tools and systems for farm management (simulation modeling, multi-criteria decision analysis, option models, investment analysis) and economics of agricultural production. She is involved in teaching activities as thesis supervisor at postgraduate study programs and involved in national and international research projects. She is author or coauthor of 61 scientific papers (including 34 papers in journals with impact factor), 6 scientific books and 24 book chapters. Currently she is Head of the undergraduate study program Agricultural economics and rural development and Vice dean for education. \r\n\r\nAcademic activities\r\nResearch:\r\n-\tFarm management\r\n-\tDecision support, simulation, forecasting, multi criteria decision making in the area of agriculture with emphasis on field crops, farm tourism and fruit producon\r\n\r\nCurrent Research work:\r\n- Financial parameters assessment based on perfect and in-perfect information in agrifood \r\n systems \r\n- Option modeling of agrifood projects\r\n-\tEfficiency assessment in farm tourism \r\n-\tEfficiency of sugar beet production systems \r\n\r\nTeaching:\r\nUndergraduate Programmes and Courses\r\n-\tFarm management I and II\r\n-\tIntroduction to decision theory\r\n-\tOrganic fam management\r\n-\tManagement od supplementary activities\r\n-\tEconomics and management of rural tourism\r\n-\tSelected issues in agricultural entrepreneurship\r\n\r\nMaster Programmes and Courses\r\n\r\n-\tResearch methods in farm management\r\n-\tDecision theory\r\n-\tProject planning and quality management\r\n-\tOrganic fam management\r\n\r\n \r\nPhD Programme and Course\r\n\r\n-\tProject management (transferable skills)\r\n-\tSelected issues in farm management",institutionString:"University of Maribor",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Maribor",institutionURL:null,country:{name:"Slovenia"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"11",title:"Engineering",slug:"engineering"}],chapters:[{id:"74769",title:"Development of Integrated Lean Six Sigma-Baldrige Framework for Manufacturing Waste Minimization: A Case of NAS Foods Plc",slug:"development-of-integrated-lean-six-sigma-baldrige-framework-for-manufacturing-waste-minimization-a-c",totalDownloads:10,totalCrossrefCites:0,authors:[null]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"247865",firstName:"Jasna",lastName:"Bozic",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/247865/images/7225_n.jpg",email:"jasna.b@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophanides",surname:"Theophile",slug:"theophanides-theophile",fullName:"Theophanides Theophile"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3621",title:"Silver Nanoparticles",subtitle:null,isOpenForSubmission:!1,hash:null,slug:"silver-nanoparticles",bookSignature:"David Pozo Perez",coverURL:"https://cdn.intechopen.com/books/images_new/3621.jpg",editedByType:"Edited by",editors:[{id:"6667",title:"Dr.",name:"David",surname:"Pozo",slug:"david-pozo",fullName:"David Pozo"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"33842",title:"Quality Assessment of E-Health Solutions in Primary Health Care - Approach Based on User Experience",doi:"10.5772/37287",slug:"quality-assessment-of-e-health-solutions-in-primary-health-care-approach-based-on-user-experience",body:null,keywords:null,chapterPDFUrl:"https://cdn.intechopen.com/pdfs/33842.pdf",chapterXML:null,downloadPdfUrl:"/chapter/pdf-download/33842",previewPdfUrl:"/chapter/pdf-preview/33842",totalDownloads:1464,totalViews:74,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,dateSubmitted:"June 1st 2011",dateReviewed:"October 10th 2011",datePrePublished:null,datePublished:"March 23rd 2012",dateFinished:null,readingETA:"0",abstract:null,reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/33842",risUrl:"/chapter/ris/33842",book:{slug:"applied-biological-engineering-principles-and-practice"},signatures:"Damir Kralj",authors:[{id:"112102",title:"MSc.",name:"Damir",middleName:null,surname:"Kralj",fullName:"Damir Kralj",slug:"damir-kralj",email:"damir.kralj@ka.t-com.hr",position:null,institution:{name:"University of Applied Sciences",institutionURL:null,country:{name:"Germany"}}}],sections:null,chapterReferences:null,footnotes:null,contributors:null,corrections:null},book:{id:"1640",title:"Applied Biological Engineering",subtitle:"Principles and Practice",fullTitle:"Applied Biological Engineering - Principles and Practice",slug:"applied-biological-engineering-principles-and-practice",publishedDate:"March 23rd 2012",bookSignature:"Ganesh R. Naik",coverURL:"https://cdn.intechopen.com/books/images_new/1640.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"2276",title:"Dr.",name:"Ganesh R.",middleName:null,surname:"Naik",slug:"ganesh-r.-naik",fullName:"Ganesh R. Naik"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},chapters:[{id:"33821",title:"Efficient Computational Techniques in Bioimpedance Spectroscopy",slug:"efficient-computational-techniques-in-bioimpedance-spectroscopy",totalDownloads:2035,totalCrossrefCites:5,signatures:"Aleksander Paterno, Lucas Hermann Negri and Pedro Bertemes-Filho",authors:[{id:"107801",title:"Dr.",name:"Aleksander",middleName:null,surname:"Paterno",fullName:"Aleksander Paterno",slug:"aleksander-paterno"},{id:"107817",title:"MSc.",name:"Lucas",middleName:null,surname:"Hermann Negri",fullName:"Lucas Hermann Negri",slug:"lucas-hermann-negri"},{id:"107952",title:"Dr.",name:"Pedro",middleName:null,surname:"Bertemes-Filho",fullName:"Pedro Bertemes-Filho",slug:"pedro-bertemes-filho"}]},{id:"33822",title:"Computer Simulation and Analysis of Three-Dimensional Tumor Geometry in Radiotherapy",slug:"computer-simulation-and-analysis-of-three-dimensional-tumor-geometry-in-radiotherapy",totalDownloads:1565,totalCrossrefCites:0,signatures:"Seishin Takao, Shigeru Tadano, Hiroshi Taguchi and Hiroki Shirato",authors:[{id:"108367",title:"Dr.",name:"Seishin",middleName:null,surname:"Takao",fullName:"Seishin Takao",slug:"seishin-takao"},{id:"149617",title:"Prof.",name:"Shigeru",middleName:null,surname:"Tadano",fullName:"Shigeru Tadano",slug:"shigeru-tadano"},{id:"149618",title:"Dr.",name:"Hiroshi",middleName:null,surname:"Taguchi",fullName:"Hiroshi Taguchi",slug:"hiroshi-taguchi"},{id:"149619",title:"Prof.",name:"Hiroki",middleName:null,surname:"Shirato",fullName:"Hiroki Shirato",slug:"hiroki-shirato"}]},{id:"33823",title:"Frequency-Domain Objective Response Detection Techniques Applied to Evoked Potentials: A Review",slug:"frequency-domain-objective-response-detection-techniques-applied-to-evoked-potentials-a-review",totalDownloads:1843,totalCrossrefCites:1,signatures:"Danilo Barbosa Melges, Antonio Mauricio Ferreira Leite Miranda de Sá and Antonio Fernando Catelli Infantosi",authors:[{id:"107956",title:"Dr.",name:"Danilo",middleName:"Barbosa",surname:"Melges",fullName:"Danilo Melges",slug:"danilo-melges"},{id:"113108",title:"Prof.",name:"Antonio Mauricio",middleName:"Ferreira Leite",surname:"Miranda De Sá",fullName:"Antonio Mauricio Miranda De Sá",slug:"antonio-mauricio-miranda-de-sa"},{id:"113110",title:"Dr.",name:"Antonio Fernando",middleName:null,surname:"Infantosi",fullName:"Antonio Fernando Infantosi",slug:"antonio-fernando-infantosi"}]},{id:"33824",title:"Extraction of 3D Geometrical Features of Biological Objects with 3D PCA Analysis and Applications of Results",slug:"extraction-of-3d-geometrical-features-of-biological-objects-with-3d-pca-analysis-and-results-applica",totalDownloads:2209,totalCrossrefCites:3,signatures:"Michal Rychlik and Witold Stankiewicz",authors:[{id:"109587",title:"PhD.",name:"Michal",middleName:null,surname:"Rychlik",fullName:"Michal Rychlik",slug:"michal-rychlik"}]},{id:"33825",title:"Mathematical Modelling of Gene Regulatory Networks",slug:"mathematical-modelling-of-gene-regulatory-networks-",totalDownloads:2572,totalCrossrefCites:2,signatures:"Ana Tušek and Želimir Kurtanjek",authors:[{id:"45081",title:"BSc",name:"Ana",middleName:null,surname:"Tusek",fullName:"Ana Tusek",slug:"ana-tusek"},{id:"88576",title:"Prof.",name:"Želimir",middleName:null,surname:"Kurtanjek",fullName:"Želimir Kurtanjek",slug:"zelimir-kurtanjek"}]},{id:"33826",title:"Modern Methods Used in the Complex Analysis of the Phonocardiography Signal",slug:"modern-methods-used-in-the-complex-analysis-of-the-phonocardiography-signal-",totalDownloads:2482,totalCrossrefCites:0,signatures:"Nicolae Marius Roman and Stefan Gergely",authors:[{id:"118593",title:"Prof.",name:"Nicolae Marius",middleName:null,surname:"Roman",fullName:"Nicolae Marius Roman",slug:"nicolae-marius-roman"},{id:"145124",title:"Dr.",name:"Stefan",middleName:null,surname:"Gergely",fullName:"Stefan Gergely",slug:"stefan-gergely"}]},{id:"33827",title:"Osteocytes Characterization Using Synchrotron Radiation CT and Finite Element Analysis",slug:"osteocytes-characterization-using-synchrotron-radiation-ct-and-finite-element-analysis",totalDownloads:1605,totalCrossrefCites:0,signatures:"Zully Ritter, Andreas Staude, Steffen Prohaska and Dieter Felsenberg",authors:[{id:"103587",title:"Dr.",name:"Zully",middleName:null,surname:"Ritter",fullName:"Zully Ritter",slug:"zully-ritter"}]},{id:"33828",title:"Specific Absorption Rate Analysis of Heterogeneous Head Models with EEG Electrodes/Leads at 7T MRI",slug:"specific-absorption-rate-analysis-of-heterogeneous-head-models-with-eeg-and-7t-mri-",totalDownloads:2204,totalCrossrefCites:0,signatures:"Leonardo M. Angelone and Giorgio Bonmassar",authors:[{id:"106190",title:"Dr.",name:"Leonardo",middleName:null,surname:"Angelone",fullName:"Leonardo Angelone",slug:"leonardo-angelone"},{id:"326527",title:"Prof.",name:"Giorgio",middleName:null,surname:"Bonmassar",fullName:"Giorgio Bonmassar",slug:"giorgio-bonmassar"}]},{id:"33829",title:"Simulating Idiopathic Parkinson's Disease by In Vitro and Computational Models",slug:"simulating-idiopathic-parkinson-s-disease-by-in-vitro-and-computational-models",totalDownloads:1489,totalCrossrefCites:1,signatures:"Tjitske Heida, Jan Stegenga, Marcel Lourens, Hil Meijer, Stephan van Gils, Nikolai Lazarov and Enrico Marani",authors:[{id:"101891",title:"Prof.",name:"Nikolai",middleName:null,surname:"Lazarov",fullName:"Nikolai Lazarov",slug:"nikolai-lazarov"},{id:"113864",title:"Dr.",name:"Tjitske",middleName:null,surname:"Heida",fullName:"Tjitske Heida",slug:"tjitske-heida"},{id:"136951",title:"Dr.",name:"Jan",middleName:null,surname:"Stegenga",fullName:"Jan Stegenga",slug:"jan-stegenga"},{id:"136952",title:"MSc.",name:"Marcel",middleName:null,surname:"Lourens",fullName:"Marcel Lourens",slug:"marcel-lourens"},{id:"136953",title:"Dr.",name:"Hil",middleName:null,surname:"Meijer",fullName:"Hil Meijer",slug:"hil-meijer"},{id:"136954",title:"Prof.",name:"Stephan",middleName:null,surname:"Van Gils",fullName:"Stephan Van Gils",slug:"stephan-van-gils"},{id:"136956",title:"Prof.",name:"Enrico",middleName:null,surname:"Marani",fullName:"Enrico Marani",slug:"enrico-marani"}]},{id:"33830",title:"Vascular Stent Design Optimisation Using Numerical Modelling Techniques",slug:"vascular-stent-design-optimisation-using-numerical-modelling-techniques",totalDownloads:2360,totalCrossrefCites:3,signatures:"Houman Zahedmanesh, Paul A. Cahill and Caitríona Lally",authors:[{id:"112385",title:"Dr.",name:"Caitriona",middleName:null,surname:"Lally",fullName:"Caitriona Lally",slug:"caitriona-lally"},{id:"112397",title:"Dr.",name:"Houman",middleName:null,surname:"Zahedmanesh",fullName:"Houman Zahedmanesh",slug:"houman-zahedmanesh"},{id:"140060",title:"Prof.",name:"Paul A.",middleName:null,surname:"Cahill",fullName:"Paul A. Cahill",slug:"paul-a.-cahill"}]},{id:"33831",title:"Functional Significance of Force Fluctuation During Voluntary Muscle Contraction",slug:"functional-significance-of-force-fluctuation-during-voluntary-muscle-contraction",totalDownloads:1837,totalCrossrefCites:0,signatures:"Kazushige Oshita and Sumio Yano",authors:[{id:"106092",title:"Dr.",name:"Kazushige",middleName:null,surname:"Oshita",fullName:"Kazushige Oshita",slug:"kazushige-oshita"},{id:"106233",title:"Dr.",name:"Sumio",middleName:null,surname:"Yano",fullName:"Sumio Yano",slug:"sumio-yano"}]},{id:"33832",title:"The Influence of Different Elbow Angles on the Twitch Response of the Biceps Brachii Muscle Between Intermittent Electrical Stimulations",slug:"influence-of-different-elbow-angles-on-biceps-brachii-twitch-response-between-intermittent-electrica",totalDownloads:1883,totalCrossrefCites:1,signatures:"Srdjan Djordjevič, Sašo Tomažič, Gregor Zupančič, Rado Pišot and Raja Dahmane",authors:[{id:"103856",title:"Prof.",name:"Raja",middleName:null,surname:"Dahmane",fullName:"Raja Dahmane",slug:"raja-dahmane"}]},{id:"33833",title:"Experimental Examination on the Effects and Adaptation Condition of the Fibula Excision Method Using the Stress Freezing Method on the Osteoarthritis of the Knee",slug:"experimental-examination-on-the-effects-and-adaptation-condition-of-the-fibula-excision-method-using",totalDownloads:1727,totalCrossrefCites:0,signatures:"Nobutaka Maezaki, Tsutomu Ezumi and Masashi Hachiya",authors:[{id:"68485",title:"Dr.",name:"Nobutaka",middleName:null,surname:"Maezaki",fullName:"Nobutaka Maezaki",slug:"nobutaka-maezaki"}]},{id:"33834",title:"Motor Unit Potential Train Validation and Its Application in EMG Signal Decomposition",slug:"motor-unit-potential-train-validation-and-its-application-in-emg-decomposition",totalDownloads:1754,totalCrossrefCites:0,signatures:"Hossein Parsaei and Daniel W. Stashuk",authors:[{id:"113268",title:"Dr.",name:"Hossein",middleName:null,surname:"Parsaei",fullName:"Hossein Parsaei",slug:"hossein-parsaei"}]},{id:"33835",title:"Role of Biomechanical Parameters in Hip Osteoarthritis and Avascular Necrosis of Femoral Head",slug:"role-of-biomechanical-parameters-in-hip-osteoarthritis-and-avascular-necrosis-of-femoral-head-",totalDownloads:1549,totalCrossrefCites:0,signatures:"Veronika Kralj - Iglič, Drago Dolinar, Matic Ivanovski, Ivo List and Matej Daniel",authors:[{id:"81114",title:"Prof.",name:"Veronika",middleName:null,surname:"Kralj-Iglič",fullName:"Veronika Kralj-Iglič",slug:"veronika-kralj-iglic"},{id:"150081",title:"Dr.",name:"Drago",middleName:null,surname:"Dolinar",fullName:"Drago Dolinar",slug:"drago-dolinar"},{id:"150082",title:"Dr.",name:"Matej",middleName:null,surname:"Daniel",fullName:"Matej Daniel",slug:"matej-daniel"},{id:"150083",title:"Dr.",name:"Matic",middleName:null,surname:"Ivanovski",fullName:"Matic Ivanovski",slug:"matic-ivanovski"},{id:"150084",title:"Dr.",name:"Ivo",middleName:null,surname:"List",fullName:"Ivo List",slug:"ivo-list"}]},{id:"33836",title:"Development and Clinical Application of Instruments to Measure Orofacial Structures",slug:"development-and-clinical-application-of-instruments-to-measure-orofacial-structures",totalDownloads:3524,totalCrossrefCites:0,signatures:"Amanda Freitas Valentim, Renata Maria Moreira Moraes Furlan, Tatiana Vargas de Castro Perilo, Andréa Rodrigues Motta, Monalise Costa Batista Berbert, Márcio Falcão Santos Barroso, Cláudio Gomes da Costa, Iracema Maria Utsch Braga and Estevam Barbosa de Las Casas",authors:[{id:"106418",title:"BSc.",name:"Amanda",middleName:null,surname:"Valentim",fullName:"Amanda Valentim",slug:"amanda-valentim"},{id:"113804",title:"MSc.",name:"Iracema Maria",middleName:null,surname:"Braga",fullName:"Iracema Maria Braga",slug:"iracema-maria-braga"},{id:"113857",title:"MSc.",name:"Renata",middleName:null,surname:"Furlan",fullName:"Renata Furlan",slug:"renata-furlan"},{id:"113858",title:"MSc.",name:"Tatiana",middleName:null,surname:"Perilo",fullName:"Tatiana Perilo",slug:"tatiana-perilo"},{id:"113860",title:"Prof.",name:"Andréa",middleName:null,surname:"Motta",fullName:"Andréa Motta",slug:"andrea-motta"},{id:"113862",title:"Prof.",name:"Márcio",middleName:null,surname:"Barroso",fullName:"Márcio Barroso",slug:"marcio-barroso"},{id:"113865",title:"MSc.",name:"Monalise",middleName:null,surname:"Berbert",fullName:"Monalise Berbert",slug:"monalise-berbert"},{id:"113867",title:"MSc.",name:"Cláudio",middleName:null,surname:"Costa",fullName:"Cláudio Costa",slug:"claudio-costa"},{id:"113868",title:"Dr.",name:"Estevam",middleName:"Barbosa",surname:"Las Casas",fullName:"Estevam Las Casas",slug:"estevam-las-casas"}]},{id:"33837",title:"In Vitro Blood Flow Behaviour in Microchannels with Simple and Complex Geometries",slug:"in-vitro-blood-flow-behaviour-in-microchannels-with-simple-and-complex-geometries",totalDownloads:2361,totalCrossrefCites:7,signatures:"Valdemar Garcia, Ricardo Dias and Rui Lima",authors:[{id:"108467",title:"Dr.",name:"Valdemar",middleName:null,surname:"Garcia",fullName:"Valdemar Garcia",slug:"valdemar-garcia"},{id:"113250",title:"Dr.",name:"Rui",middleName:null,surname:"Lima",fullName:"Rui Lima",slug:"rui-lima"},{id:"115013",title:"Dr.",name:"Ricardo",middleName:null,surname:"Dias",fullName:"Ricardo Dias",slug:"ricardo-dias"}]},{id:"33838",title:"Electroporation of Kluyveromyces marxianus and -D-galactosidase Extraction",slug:"electroporation-of-kluyveromyces-marxianus-and-d-galactosidase-extraction",totalDownloads:1374,totalCrossrefCites:0,signatures:"Airton Ramos and Andrea Lima Schneider",authors:[{id:"108526",title:"Dr.",name:"Airton",middleName:null,surname:"Ramos",fullName:"Airton Ramos",slug:"airton-ramos"},{id:"113731",title:"Dr.",name:"Andrea",middleName:null,surname:"Schneider",fullName:"Andrea Schneider",slug:"andrea-schneider"}]},{id:"33839",title:"Physiological Analysis of Yeast Cell by Intelligent Signal Processing",slug:"physiological-analysis-of-yeast-cell-by-intelligent-signal-processing",totalDownloads:1264,totalCrossrefCites:0,signatures:"Andrei Doncescu, Sebastien Regis, Katsumi Inoue and Nathalie Goma",authors:[{id:"79269",title:"Prof.",name:"Andrei",middleName:null,surname:"Doncescu",fullName:"Andrei Doncescu",slug:"andrei-doncescu"},{id:"90252",title:"Prof.",name:"Katsumi",middleName:null,surname:"Inoue",fullName:"Katsumi Inoue",slug:"katsumi-inoue"},{id:"90254",title:"Dr.",name:"Nathalie",middleName:null,surname:"Goma",fullName:"Nathalie Goma",slug:"nathalie-goma"},{id:"90256",title:"Dr.",name:"Sebastien",middleName:null,surname:"Regis",fullName:"Sebastien Regis",slug:"sebastien-regis"}]},{id:"33840",title:"Protocol of a Seamless Recombination with Specific Selection Cassette in PCR-Based Site-Directed Mutagenesis",slug:"protocol-of-a-seamless-recombination-with-specific-selection-cassette-in-pcr-based-site-directed-mut",totalDownloads:2788,totalCrossrefCites:0,signatures:"Qiyi Tang, Benjamin Silver and Hua Zhu",authors:[{id:"109758",title:"Dr.",name:null,middleName:null,surname:"Zhu",fullName:"Zhu",slug:"zhu"}]},{id:"33841",title:"Extraction of Drug from the Biological Matrix: A Review",slug:"extraction-of-the-drug-from-the-biological-matrix",totalDownloads:23711,totalCrossrefCites:6,signatures:"S. Lakshmana Prabu and T. N. K. Suriyaprakash",authors:[{id:"91590",title:"Dr.",name:"Sakthivel",middleName:null,surname:"Lakshmana Prabu",fullName:"Sakthivel Lakshmana Prabu",slug:"sakthivel-lakshmana-prabu"},{id:"128690",title:"Dr.",name:"Suriyaprakash",middleName:null,surname:"Tnk",fullName:"Suriyaprakash Tnk",slug:"suriyaprakash-tnk"}]},{id:"33842",title:"Quality Assessment of E-Health Solutions in Primary Health Care - Approach Based on User Experience",slug:"quality-assessment-of-e-health-solutions-in-primary-health-care-approach-based-on-user-experience",totalDownloads:1464,totalCrossrefCites:1,signatures:"Damir Kralj",authors:[{id:"112102",title:"MSc.",name:"Damir",middleName:null,surname:"Kralj",fullName:"Damir Kralj",slug:"damir-kralj"}]},{id:"33843",title:"Psychomagnetobiology",slug:"psychomagnetobiology",totalDownloads:2157,totalCrossrefCites:2,signatures:"José María De la Roca Chiapas",authors:[{id:"109016",title:"Dr.",name:"Jose Maria",middleName:null,surname:"De La Roca-Chiapas",fullName:"Jose Maria De La Roca-Chiapas",slug:"jose-maria-de-la-roca-chiapas"}]},{id:"33844",title:"Study on the Mechanism of Traumatic Brain Injury",slug:"study-on-the-mechanism-of-traumatic-brain-injury-",totalDownloads:2497,totalCrossrefCites:1,signatures:"Yuelin Zhang, Shigeru Aomura, Hiromichi Nakadate and Satoshi Fujiwara",authors:[{id:"108648",title:"Dr.",name:"Yuelin",middleName:null,surname:"Zhang",fullName:"Yuelin Zhang",slug:"yuelin-zhang"},{id:"113397",title:"Prof.",name:"Shigeru",middleName:null,surname:"Aomura",fullName:"Shigeru Aomura",slug:"shigeru-aomura"},{id:"114024",title:"Dr.",name:"Hiromichi",middleName:null,surname:"Nakadate",fullName:"Hiromichi Nakadate",slug:"hiromichi-nakadate"},{id:"114025",title:"Prof.",name:"Satoshi",middleName:null,surname:"Fujiwara",fullName:"Satoshi Fujiwara",slug:"satoshi-fujiwara"}]},{id:"33845",title:"Residual Stresses and Cracking in Dental Restorations due to Resin Contraction Considering In-Depth Young's Modulus Variation",slug:"residual-stresses-and-cracking-in-dental-restorations-due-to-resin-contraction-considering-in-depth-",totalDownloads:2036,totalCrossrefCites:1,signatures:"Estevam Barbosa de Las Casas, João Batista Novaes Jr., Elissa Talma, Willian Henrique Vasconcelos, Tulimar P. Machado Cornacchia, Iracema Maria Utsch Braga, Carlos Alberto Cimini Jr. and Rodrigo Guerra Peixoto",authors:[{id:"113804",title:"MSc.",name:"Iracema Maria",middleName:null,surname:"Braga",fullName:"Iracema Maria Braga",slug:"iracema-maria-braga"},{id:"113783",title:"Dr.",name:"Estevam",middleName:"Barbosa",surname:"Las Casas",fullName:"Estevam Las Casas",slug:"estevam-las-casas"},{id:"113793",title:"Prof.",name:"Tulimar",middleName:null,surname:"Cornacchia",fullName:"Tulimar Cornacchia",slug:"tulimar-cornacchia"},{id:"113796",title:"Prof.",name:"João Batista",middleName:null,surname:"Novaes Jr",fullName:"João Batista Novaes Jr",slug:"joao-batista-novaes-jr"},{id:"113800",title:"Mrs.",name:"Elissa",middleName:null,surname:"Talma",fullName:"Elissa Talma",slug:"elissa-talma"},{id:"113801",title:"Mr.",name:"Willian Henrique",middleName:null,surname:"Vasconcelos",fullName:"Willian Henrique Vasconcelos",slug:"willian-henrique-vasconcelos"},{id:"113806",title:"Prof.",name:"Carlos Alberto",middleName:null,surname:"Cimini Jr.",fullName:"Carlos Alberto Cimini Jr.",slug:"carlos-alberto-cimini-jr."},{id:"113808",title:"MSc.",name:"Rodrigo",middleName:null,surname:"Peixoto",fullName:"Rodrigo Peixoto",slug:"rodrigo-peixoto"}]},{id:"33846",title:"Genetic Engineering in a Computer Science Curriculum",slug:"genetic-engineering-in-a-computer-science-curriculum",totalDownloads:5525,totalCrossrefCites:0,signatures:"Nevena Ackovska, Liljana Bozinovska and Stevo Bozinovski",authors:[{id:"86146",title:"Dr.",name:"Nevena",middleName:null,surname:"Ackovska",fullName:"Nevena Ackovska",slug:"nevena-ackovska"},{id:"89499",title:"Prof.",name:"Liljana",middleName:null,surname:"Bozinovska",fullName:"Liljana Bozinovska",slug:"liljana-bozinovska"},{id:"89501",title:"Prof.",name:"Stevo",middleName:null,surname:"Bozinovski",fullName:"Stevo Bozinovski",slug:"stevo-bozinovski"}]},{id:"33847",title:"Design of a PC-Based Electrocardiogram (ECG) Recorder as - Internet Appliance",slug:"internet-appliance-electrocardiogram-ecg-recorder-design",totalDownloads:5619,totalCrossrefCites:1,signatures:"Mahmud Hasan",authors:[{id:"103497",title:"Dr.",name:"Mahmud",middleName:null,surname:"Hasan",fullName:"Mahmud Hasan",slug:"mahmud-hasan"}]},{id:"33848",title:"Implications of Corporate Yoga: A Review",slug:"implications-of-corporate-yoga-a-review",totalDownloads:2435,totalCrossrefCites:0,signatures:"Rudra B. Bhandari, Churna B. Bhandari, Balkrishna Acharya, Pranav Pandya, Kartar Singh, Vinod K. Katiyar and Ganesh D. Sharma",authors:[{id:"109265",title:"Mr.",name:"Rudra",middleName:null,surname:"Bhandari",fullName:"Rudra Bhandari",slug:"rudra-bhandari"}]}]},relatedBooks:[{type:"book",id:"3610",title:"Recent Advances in Biomedical Engineering",subtitle:null,isOpenForSubmission:!1,hash:null,slug:"recent-advances-in-biomedical-engineering",bookSignature:"Ganesh R Naik",coverURL:"https://cdn.intechopen.com/books/images_new/3610.jpg",editedByType:"Edited by",editors:[{id:"2276",title:"Dr.",name:"Ganesh R.",surname:"Naik",slug:"ganesh-r.-naik",fullName:"Ganesh R. Naik"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"},chapters:[{id:"9210",title:"Micro Macro Neural Network to Recognize Slow Movement: EMG based Accurate and Quick Rollover Recognition",slug:"micro-macro-neural-network-to-recognize-slow-movement-emg-based-accurate-and-quick-rollover-recognit",signatures:"Takeshi Ando, Jun Okamoto and Masakatsu G. Fujie",authors:[null]},{id:"9211",title:"Compression of Surface Electromyographic Signals Using Two-Dimensional Techniques",slug:"compression-of-surface-electromyographic-signals-using-two-dimensional-techniques",signatures:"Marcus V. C. Costa, Joao L. A. Carvalho, Pedro A. Berger, Adson F. da Rocha and Francisco A. O. Nascimento",authors:[null]},{id:"9212",title:"A New Method for Quantitative Evaluation of Neurological Disorders based on EMG signals",slug:"a-new-method-for-quantitative-evaluation-of-neurological-disorders-based-on-emg-signals",signatures:"Jongho Lee, Yasuhiro Kagamihara and Shinji Kakei",authors:[null]},{id:"9213",title:"Source Separation and Identification Issues in Bio Signals: a Solution Using Blind Source Separation",slug:"source-separation-and-identification-issues-in-bio-signals-a-solution-using-blind-source-separation",signatures:"Ganesh R Naik and Dinesh K Kumar",authors:[null]},{id:"9214",title:"Sources of Bias in Synchronization Measures and how to Minimize Their Effects on the Estimation of Synchronicity: Application to the Uterine Electromyogram",slug:"sources-of-bias-in-synchronization-measures-and-how-to-minimize-their-effects-on-the-estimation-of-s",signatures:"Terrien Jeremy, Marque Catherine, Germain Guy and Karlsson Brynjar",authors:[null]},{id:"9215",title:"Multichannel Analysis of EEG Signal Applied to Sleep Stage Classification",slug:"multichannel-analysis-of-eeg-signal-applied-to-sleep-stage-classification",signatures:"Zhovna Inna and Shallom Ilan",authors:[null]},{id:"9216",title:"P300-Based Speller Brain-Computer Interface",slug:"p300-based-speller-brain-computer-interface",signatures:"Reza Fazel-Rezai",authors:[null]},{id:"9217",title:"Alterations in Sleep Electroencephalography and Heart Rate Variability During the Obstructive Sleep Apnoea and Hypopnoea",slug:"alterations-in-sleep-electroencephalography-and-heart-rate-variability-during-the-obstructive-sleep-",signatures:"Dean Cvetkovic, Haslaile Abdullah, Elif Derya Ubeyli, Gerard Holland and Irena Cosic",authors:[null]},{id:"9218",title:"Flexible Implantable Thin Film Neural Electrodes",slug:"flexible-implantable-thin-film-neural-electrodes",signatures:"Sami Myllymaa, Katja Myllymaa and Reijo Lappalainen",authors:[null]},{id:"9219",title:"Developments in Time-Frequency Analysis of Biomedical Signals and Images Using a Generalized Fourier Synthesis",slug:"developments-in-time-frequency-analysis-of-biomedical-signals-and-images-using-a-generalized-fourier",signatures:"Robert A. Brown, M. Louis Lauzon and Richard Frayne",authors:[null]},{id:"9220",title:"Automatic Counting of Aedes aegypti Eggs in Images of Ovitraps",slug:"automatic-counting-of-aedes-aegypti-eggs-in-images-of-ovitraps",signatures:"Carlos A.B. Mello, Wellington P. dos Santos, Marco A.B. Rodrigues, Ana Lucia B. Candeias, Cristine M.G. Gusmao and Nara M. Portela",authors:[null]},{id:"9221",title:"Hyperspectral Imaging: a New Modality in Surgery",slug:"hyperspectral-imaging-a-new-modality-in-surgery",signatures:"Hamed Akbari and Yukio Kosugi",authors:[null]},{id:"9222",title:"Dialectical Classification of MR Images for the Evaluation of Alzheimer's Disease",slug:"dialectical-classification-of-mr-images-for-the-evaluation-of-alzheimer-s-disease",signatures:"Wellington Pinheiro dos Santos, Francisco Marcos de Assis, Ricardo Emmanuel de Souza and Plinio Bezerra dos Santos Filho",authors:[null]},{id:"9223",title:"3-D MRI and DT-MRI Content-adaptive Finite Element Head Model Generation for Bioelectomagnetic Imaging",slug:"3-d-mri-and-dt-mri-content-adaptive-finite-element-head-model-generation-for-bioelectomagnetic-imagi",signatures:"Tae-Seong Kim and Won Hee Lee",authors:[null]},{id:"9224",title:"Denoising of Fluorescence Confocal Microscopy Images with Photobleaching compensation in a Bayesian framework",slug:"denoising-of-fluorescence-confocal-microscopy-images-with-photobleaching-compensation-in-a-bayesian-",signatures:"Isabel Rodrigues and Joao Sanches",authors:[null]},{id:"9225",title:"Advantages of Virtual Reality Technology in Rehabilitation of People with Neuromuscular Disorders",slug:"advantages-of-virtual-reality-technology-in-rehabilitation-of-people-with-neuromuscular-disorders",signatures:"Imre Cikajlo and Zlatko Matjačić",authors:[null]},{id:"9226",title:"A Prototype Device to Measure and Supervise Urine Output of Critical Patients",slug:"a-prototype-device-to-measure-and-supervise-urine-output-of-critical-patients",signatures:"A. Otero, B. Panigrahi, F. Palacios, T. Akinfiev and R. Fernandez",authors:[null]},{id:"9227",title:"Wideband Technology for Medical Detection and Monitoring",slug:"wideband-technology-for-medical-detection-and-monitoring",signatures:"Mehmet Rasit Yuce, Tharaka N. Dissanayake and Ho Chee Keong",authors:[null]},{id:"9228",title:""Hybrid-PLEMO", Rehabilitation System for Upper Limbs with Active / Passive Force Feedback Mode",slug:"-hybrid-plemo-rehabilitation-system-for-upper-limbs-with-active-passive-force-feedback-mode",signatures:"Takehito Kikuchi and Junji Furusho",authors:[null]},{id:"9229",title:"Fractional-Order Models for the Input Impedance of the Respiratory System",slug:"fractional-order-models-for-the-input-impedance-of-the-respiratory-system",signatures:"Clara Ionescu, Robin De Keyser, Kristine Desager and Eric Derom",authors:[null]},{id:"9230",title:"Modelling of Oscillometric Blood Pressure Monitor from white to black box models",slug:"modelling-of-oscillometric-blood-pressure-monitor-from-white-to-black-box-models",signatures:"Eduardo Pinheiro and Octavian Postolache",authors:[null]},{id:"9231",title:"Arterial Blood Velocity Measurement by Portable Wireless System for Healthcare Evaluation: the Related Effects and Significant Reference Data",slug:"arterial-blood-velocity-measurement-by-portable-wireless-system-for-healthcare-evaluation-the-relate",signatures:"Azran Azhim and Yohsuke Kinouchi",authors:[null]},{id:"9232",title:"Studying Ion Channel Dysfunction and Arrythmogenesis in the Human Atrium: A Computational Approach",slug:"studying-ion-channel-dysfunction-and-arrythmogenesis-in-the-human-atrium-a-computational-approach",signatures:"Sanjay R. Kharche, Phillip R. Law and Henggui Zhang",authors:[null]},{id:"9233",title:"Discovery of Biorhythmic Stories behind Daily Vital Signs and Its Application",slug:"discovery-of-biorhythmic-stories-behind-daily-vital-signs-and-its-application",signatures:"Wenxi Chen",authors:[null]},{id:"9234",title:"Linear and Nonlinear Synchronization Analysis and Visualization during Altered States of Consciousness",slug:"linear-and-nonlinear-synchronization-analysis-and-visualization-during-altered-states-of-consciousne",signatures:"Vangelis Sakkalis and Michalis Zervakis",authors:[null]},{id:"9235",title:"RFId Technologies for the Hospital. How to Choose the Right One and Plan the Right Solution?",slug:"rfid-technologies-for-the-hospital-how-to-choose-the-right-one-and-plan-the-right-solution-",signatures:"Ernesto Iadanza",authors:[null]},{id:"9236",title:"Improvement of Touch Sensitivity by Pressing",slug:"improvement-of-touch-sensitivity-by-pressing",signatures:"Hie-yong Jeong, Mitsuru Higashimori and Makoto Kaneko",authors:[null]},{id:"9237",title:"Modeling Thermoregulation and Core Temperature in Anatomically-Based Human Models and Its Application to RF Dosimetry",slug:"modeling-thermoregulation-and-core-temperature-in-anatomically-based-human-models-and-its-applicatio",signatures:"Akimasa Hirata",authors:[null]},{id:"9238",title:"Towards a Robotic System for Minimally Invasive Breast Interventions",slug:"towards-a-robotic-system-for-minimally-invasive-breast-interventions",signatures:"Vishnu Mallapragada and Nilanjan Sarkar",authors:[null]},{id:"9239",title:"Spectral Analysis Methods for Spike-Wave Discharges in Rats with Genetic Absence Epilepsy",slug:"spectral-analysis-methods-for-spike-wave-discharges-in-rats-with-genetic-absence-epilepsy",signatures:"Elif Derya Ubeyli, Gul Ilbay and Deniz Sahin",authors:[null]},{id:"9240",title:"A 3D Graph-Cut based Algorithm for Evaluating Carotid Plaque Echogenicity and Texture",slug:"a-3d-graph-cut-based-algorithm-for-evaluating-carotid-plaque-echogenicity-and-texture",signatures:"Jose C. R. Seabra and Joao M. R. Sanches",authors:[null]},{id:"9241",title:"Specular Surface Reconstruction Method for Multi-Camera Corneal Topographer Arrangements",slug:"specular-surface-reconstruction-method-for-multi-camera-corneal-topographer-arrangements",signatures:"A. Soumelidis, Z. Fazekas, A. Bodis-Szomoru, F. Schipp, B. Csakany and J. Nemeth",authors:[null]}]}]},onlineFirst:{chapter:{type:"chapter",id:"65052",title:"Emphysema",doi:"10.5772/intechopen.83273",slug:"emphysema",body:'\nEmphysema, enlarged airspaces due to destruction of alveolar walls, respiratory bronchioles, and alveolar ducts, is a well-defined disease. However, in the medical practice, it is mainly encountered as an essential component of the chronic obstructive pulmonary disease syndrome. Other components are chronic bronchitis, small airway disease, small airway hyperactivity, and inflammation. Chronic obstructive pulmonary disease presents with cough, sputum production, and exertional dyspnea. In advanced cases, patients are breathless while doing even simple daily activities and may develop resting hypoxemia (blue cyanotic lips and finger nails) that requires continuous application of supplemental oxygen. Chronic obstructive pulmonary disease during its course is complicated by viral, bacterial, and fungal infections, and pneumonias and chronic obstructive pulmonary disease are the fourth leading cause of death in the USA. Urban air pollution and industrial air pollution are contributory factors in the genesis of chronic obstructive pulmonary disease, and with increase in cigarette smoking in developing countries, an estimate is that the chronic obstructive pulmonary disease will rise from the sixth to the third most common cause of death worldwide by the year 2020 [1].
\nA normal lung consists of airways and alveoli. Airways are tubes (pipes) that conduct air to alveoli where gas exchange occurs. Oxygen (O2) through alveolar wall enters into red blood cells in the alveolar capillaries and binds to hemoglobin, while carbon dioxide (CO2) goes in opposite direction being released from hemoglobin, enters alveoli, and is being exhaled.
\nThe trachea beyond the carina undergoes to about 23 generations of dichotomous branching. Airway tubes with diameter of more than 1 mm are called bronchi. With each division the diameter of the bronchus becomes smaller, but the sum of the two diameters exceeds diameter of the parent bronchus meaning that with divisions resistance to air flow becomes smaller. The bronchus consists of the lumen, mucosa, submucosa, muscularis, cartilage, and adventitia that is composed of connective tissue and contains lymphatics (Figure 1).
\nPortion of the wall of the bronchus with respiratory epithelium with cilia, smooth muscle layer, and cartilage.
Bronchi are accompanied by branches of the pulmonary artery that have a diameter of similar size to the diameter of the bronchus they follow. The mucosa is mainly lined by columnar respiratory epithelium with cilia. All columnar cells lie on a basement membrane, but since columnar cells differ in their length, nuclei differ in their position regarding basal membrane, and respiratory epithelium appears stratified, but in fact it is pseudostratified. The mucosa also contains small number of mucinous cells that contain apical mucin, small number of basal cells, and rare neuroendocrine cells. Basal cells are precursors of ciliated cells and of mucinous goblet cells. Cilia arise from the apices of the respiratory cells and serve as escalator pushing mucin upstream to the throat and nose. Neuroendocrine cells are scattered singly and form small groups, neuroepithelial bodies near the airway bifurcations. The functional significance of the neuroendocrine cells is largely unknown. Beneath the pseudostratified ciliated mucosa is the submucosa that consists of loose connective tissue harboring bronchial mucous (seromucinous) glands, lymphoid tissue aggregates, and plasma cells. Mucinous glands secrete mucus composed of glycoprotein, proteoglycans, lipids, IgA (secretory) immunoglobulins, lysozyme peroxidase, and other substances to inactivate invading microorganisms, and trap air pollution particles. Cartilage plate and muscle bundles lie beneath the submucosa. The cartilage prevents collapse of the bronchial lumen. There are about 9–12 generations of bronchi. The smallest bronchi are 1 mm in diameter. Bronchi branch into the bronchiole. Bronchioles are less than 1 mm in diameter and they lack cartilage and exocrine mucinous glands in their walls. The larger bronchioles are called terminal bronchioles and measure on average 0.5–1 mm. Since terminal bronchioles do not contain cartilage, they are also called membranous bronchioles (Figure 2).
\nTerminal bronchiolus, lined by respiratory epithelium, with no cartilage and no exocrine glands.
Terminal bronchioles consist of respiratory mucosa composed of one layer of cuboidal ciliated respiratory cells and occasional Clara cells. Clara cells are non-ciliated columnar epithelial cells with protuberant apical cytoplasm that contains granules of surfactant and protease inhibitors. Clara cells are also precursors of bronchiolar epithelial cells. Goblet cells are generally not present or rare in the mucosa of the terminal bronchioles. Beneath the mucosa of the terminal bronchiolus is a layer of smooth muscle and connective tissue adventitia. Terminal bronchioles branch into the respiratory bronchioles. One side of the airway wall of the respiratory bronchiolus is lined by simple columnar to cuboidal bronchiolar epithelium without cilia. The opposite wall is lined by alveoli, that is, the wall consists of openings of the alveolar sacs. The average diameter of respiratory bronchioles is 0.15–0.2 mm. The respiratory bronchioles branch into about two more generations of respiratory bronchioles. Respiratory bronchioles branch into alveolar ducts, straight tubular spaces bounded entirely by alveoli (Figure 3).
\nAlveolar duct and alveoli (original magnification × 100) and alveolar septa with alveoli (original magnification × 400). Courtesy of Dr. Nadia N. Naumova.
In fact all alveoli (alveolar sacs) open into the alveolar ducts. Thus alveoli have incomplete wall and alveolar sacs are outpockets of alveolar ducts. Alveoli that appear lined with alveolar walls on all sides are in fact artifact of cut section. Alveolar ducts are not accompanied by the artery. The acinus is a functional unit of the lungs that consists of terminal bronchiolus with its respiratory bronchioles, alveolar ducts, and alveoli forming tridimensional spherical space with average diameter of 7.5 mm. There are about three generations of respiratory bronchioles inside the acinus and approximately 25,000 acini in normal adult male lungs with a volume of 5.25 liters [2]. Cluster of three to five terminal bronchioles, that is, acini, form pulmonary lobule. The pulmonary lobule is an anatomic unit, polygonal in shape, and bound by complete or incomplete connective tissue interlobular septa and measures about 1.5–3 cm.
\nGas exchange starts in respiratory bronchioles and mainly occurs in alveoli. The alveolar wall (also called alveolar septum) is very thin in order to permit efficient gas exchange (Figure 3). It consists only of one layer of epithelial cells called pneumocytes. Pneumocytes type 1 are very thin, flat, large epithelial cells that cover 90% of the alveolar surface and are not capable of mitosis. Pneumocytes type 2 are cuboidal cell with large basal nucleus and prominent nucleolus. Pneumocytes type 2 secrete surfactant, are able to divide and participate in repair, and may become hyperplastic in response to alveolar damage. Pneumocytes type 2 are also precursors of pneumocytes type 1. Pneumocytes lie on the basal membrane that is fused with the basal membrane of the capillary endothelial cell. Thus the alveolar wall (septum) consists only of capillary sandwiched between the two layers of pneumocytes from two adjacent alveoli (Figure 3). An occasional myofibroblast may be present in the alveolar wall as well as rare scattered small lymphocytes, rare mesenchymal cells, and rare macrophages. Hematoxylin and eosin-stained sections of the normal lung on high magnification show delicate alveolar walls (septa) containing inconspicuous capillaries, occasional cuboidal cells of pneumocytes type 2, and nuclei of pneumocytes type 1, endothelial cell nuclei, and nuclei of rare scattered lymphocytes, mesenchymal cells, and macrophages. The cytoplasm of pneumocytes type 1 is too thin to be visible without special immunoperoxidase stains. Alveolar macrophages egress from capillaries, are increased in number in chronic inflammatory settings, and are involved in phagocytosis of foreign material as well in the inflammatory and immune responses.
\nThe interstitium provides the connective tissue framework of the lungs and is composed of collagen fibers, elastic fibers, mesenchymal cells, and few inflammatory cells. In normal lungs the interstitium is generally inconspicuous and can be recognized only along bronchovascular bundles, around veins, and where it forms interlobular septa. In the children up to 4 years of age, the interstitium is more apparent and presents as thickening of the alveolar walls [3]. The term “small airways” includes airways with diameter of 2 mm and smaller and thus includes small bronchi, terminal bronchioles, and respiratory bronchioles.
\nEmphysema is permanent enlargement of airspaces distal to the terminal bronchiole (acinus) due to the destruction of the walls of the alveoli, alveolar ducts, and the respiratory bronchioles. Grossly, the lung is hyperinflated and spongy.
\nAccording to the location of the hyperinflated alveoli inside the acinus, there are four types of emphysema: centriacinar (centrilobular, proximal), panacinar (panlobular), distal acinar (paraseptal), and irregular (associated with scar). Each of the emphysema type has characteristic microscopic morphology and characteristic etiology.
\nThe most frequent is centriacinar emphysema which comprises more than 95% of all emphysemas. Centriacinar emphysema involves proximal respiratory bronchiolus and adjacent alveoli, which is in the center of the acinus, hence the name centriacinar emphysema (Figure 4).
\nCentriacinar emphysema caused by coal mine dust. Some alveoli are normal, some emphysematous. Hematoxylin and eosin stain, original magnification 20×.
Inhaled cigarette smoke or mineral dust, most frequently coal mine dust, reach respiratory bronchioles. There are no cilia in the respiratory bronchioles; cigarette smoke particles and coal dust particles (silica particles in the coal dust are the most toxic ones) stick there and initiate processes of inflammation and destruction. The first damaged structure is thus respiratory bronchiolus with its dilatation or disappearance. In the beginning, alveolar ducts and alveoli are spared. Soon their destruction and coalescence into the larger air space follows. In the acinus, which contains several (about 14) respiratory bronchioles, some bronchioles and alveoli are damaged, enlarged, and emphysematous, and some are not damaged and are normal in size. Thus characteristic microscopic feature with low power magnification of centroacinar emphysema is that some alveoli are normal and some emphysematous (Figures 4 and 5).
\nCentriacinar emphysema and interstitial fibrosis caused by birefringent silica/silicate particles from coal mine dust. This is the same area as in Figure 4, but with original magnification × 400 and photographed under polarized light to highlight birefringent silica/silicate particles; small white dots in the interstitium and silvery collagen fibers of interstitial (septal alveolar) fibrosis.
Cigarette smoke produces similar damage, and in fact the most frequent cause of centriacinar emphysema is cigarette smoking. Centriacinar emphysema predominantly involves the upper and posterior portions of the lungs and upper parts of the individual lobes. In severe emphysema, emphysematous spaces may coalesce and form bullae which may reach several centimeters in diameters. By definition bulla is at least 1 cm in diameter. Bullae are usually located in the lung apices and subpleurally but can occur anywhere in the emphysematous lungs.
\nPanacinar emphysema (panlobular emphysema) comprises 1% of emphysemas. It involves the entire acinus, that is, all alveoli in the acinus are about equally dilated, and all acini in the lobule are involved by panacinar (panlobular) emphysema (Figure 6). In centriacinar emphysema, some alveoli are enlarged and some are normal.
\nPanacinar emphysema (left) and normal lung (right). In panacinar emphysema, all alveoli are enlarged. Figure 6, is reproduced with permission from the American Registry of Pathology from the Atlas of Nontumor Pathology Series; Non-Neoplastic Disorders of the Lower Respiratory Tract by William D. Travis et al published by the American Registry of Pathology and the Armed Forces Institute of Pathology Washington DC, USA, Copyright© 2002.
Panacinar emphysema is associated with alpha-1-antitrypsin deficiency, an autosomal codominant genetic disorder. Since defect is present in the gene (chromosome 14, segment q32.1), every cell, in which this gene is active and its product anti-protease alpha-1 antitrypsin enzyme pertinent, is affected. Thus all respiratory bronchioles, alveolar ducts, and alveoli are affected and about equally damaged and equally hyperinflated. The lungs are diffusely affected by panacinar emphysema, and histologically there is diffuse enlargement of the alveoli affecting the entire acinus. Normal level of alpha-1 antitrypsin in the serum is 20–48 \n
Panacinar emphysema caused by drug abuse. Mild interstitial fibrosis is present as well as birefringent deposits of talc in the interstitium. Figure 7 is reproduced with permission from the American Registry of Pathology from the Atlas of Nontumor Pathology Series; Non-Neoplastic Disorders of the Lower Respiratory Tract by William D. Travis et al published by the American Registry of Pathology and the Armed Forces Institute of Pathology Washington DC, USA, Copyright© 2002.
Distal acinar emphysema (paraseptal emphysema) involves distal part of the acinus including alveolar ducts and alveoli. It is rare. Distal acinar emphysema is most often present in the upper lobes beneath the pleura and along septa between lobules and also is called paraseptal, subpleural, or localized emphysema. The pathogenesis of distal acinar emphysema is unknown. Distal acinar emphysema produces apical bullae which may cause spontaneous pneumothorax in young adults.
\nIrregular emphysema is airspace enlargement due to lung destruction associated with scarring, also termed scar emphysema, paracicatrical emphysema, and perifocal emphysema. Foci of irregular emphysema are asymptomatic and clinically insignificant. The National Heart, Lung, and Blood Institute does not regard irregular emphysema as a form of emphysema but as “airspace enlargement with fibrosis” [5].
\nThe pathogenesis of centriacinar and panacinar emphysema is conceptually similar and based on proteinase-antiproteinase imbalance, that is, inequity between enzymes that degrade the extracellular matrix and proteins that oppose this proteolytic activity [6]. The first clue appeared in 1963 when Laurell and Eriksson identified patients with alpha-1 antitrypsin (more appropriate name is alpha-1 antiproteinase) deficiency on serum electrophoresis who had severe emphysema of early onset and in 1964 when Gross and coworkers demonstrated that proteolytic enzyme papain can produce emphysema in rats [7, 8]. Alpha-1 antitrypsin is a proteinase inhibitor that inhibits proteolytic enzymes, primarily neutrophil elastase. Elastase is an enzyme that destroys elastin fibers, and if it is not adequately inhibited by alpha-1 antitrypsin, destruction of acinar tissue follows leading to emphysema. Imbalance between other proteolytic enzymes (metalloproteinases including interstitial collagenase-1, interstitial collagenase-3, metalloelastase, matrilysin, gelatinase A and gelatinase B, cathepsins) and their inhibitors (tissue inhibitors of matrix metalloproteinases, elafin, epithelium-derived secretory leukoprotease inhibitor) also contributes to emphysema and chronic obstructive pulmonary disease [3, 6].
\nCigarette smoking is the most frequent cause of emphysema and accounts to 80–90% of chronic obstructive pulmonary disease cases in the USA [9]. Cigarette smoke and coal mine dust cause emphysema by a similar pathophysiologic pathway. Inhaled cigarette smoke as well as coal mining dust particles travel by airflow to respiratory bronchioles and alveoli where they interfere with epithelial cells, alveolar macrophages, and neutrophils. Cigarette smoke contains per puff an estimated 10\n15\n–1017 oxidants/free radicals and about 4700 different chemical compounds, including reactive aldehydes and quinones [10, 11]. Toxic oxidant compounds in cigarette smoke induce DNA damage and peroxidation of lipids, harm proteins, fold proteins, and cause them to aggregate in the cytoplasm of the respiratory cells and alveolar cells [12]. Alveolar epithelial cells and macrophages damaged by cigarette smoke release cytokines which invite inside alveoli inflammatory cells mainly macrophages but also T cells (T8 more than T4) and small number of neutrophils. Characteristic histologic findings in cigarette smokers are tobacco-associated respiratory bronchiolitis with the presence of macrophages containing smoker granules (yellow-brown) inside alveoli (Figure 8). Macrophages and neutrophils activated by cigarette smoke or silica (quartz) [13] particles in coal mine dust release abovementioned proteolytic enzymes that destroy collagen and elastic alveolar tissue causing connective tissue breakdown and alveolar tissue destruction, that is, emphysema [14]. Oxidative radicals in the cigarette smoke as well as quartz-generated hydrogen peroxide not only damage intracellular proteins but also inactivate alpha-1 antitrypsin by oxidizing the SH group of methionine to methionine sulfoxide [14]. Other proteins, for example, proteasome with caspase-like activity, are also impaired by this oxidation. The final effect of cigarette smoke and inhalation of coal mine dust is unopposed (or insufficiently inhibited) action of proteolytic enzymes that destroy lung parenchyma and cause emphysema.
\nTobacco-associated respiratory bronchiolitis. Macrophages with smoker granules inside alveoli. Hematoxylin and eosin stain, original magnification 400×.
Macrophages also produce transforming growth factor-beta, platelet-derived growth factor, and tumor necrosis-alpha, which all stimulate fibroblast growth, collagen production and repair with associated fibrosis [15]. Repair may not be perfect and interstitial fibrosis may occur. Bronchioles and small bronchi can be involved by fibrosis and contribute to the chronic obstructive pulmonary disease. Tobacco-caused respiratory bronchiolitis-associated interstitial lung disease with fibrosis (Figure 9) is now a plausible and established term [16, 17].
\nTobacco-associated respiratory bronchiolitis with interstitial fibrosis. Hematoxylin and eosin stain, original magnification 200×. Right, same picture under polarized light to demonstrate collagen (silvery shine) fibers in thickened fibrotic alveolar septa.
It is obvious that tobacco-associated emphysema and tobacco-associated interstitial fibrosis are related and that the first step in their genesis is accumulation of macrophages with smoker granules in the alveoli. The similar process can be elicited by silica and silicates from coal mine dust. The first sign of exposure to coal mine dust is accumulation of silica/silicate particles and anthracotic pigment in the alveolar macrophages (Figure 10) [18].
\nInitial event in development of emphysema and interstitial fibrosis in coal miners is appearance of macrophages laden with silica and silicate particles and anthracotic pigment inside alveoli. Hematoxylin and eosin stain, original magnification 400×. Right side, same picture under polarized light to demonstrate birefringent silica and silicate particles in the cytoplasm of macrophages. Very small and faint white dots are silica particles, and small bright dots are silicate particles.
In coal miners with complicated coal worker’s pneumoconiosis, the role of smoking in causing fibrosis is insignificant in comparison with that of silica/silicate particles from coal mine dust [18]. Since smoking and coal mine dust simultaneously may cause pulmonary fibrosis and emphysema by destruction of lung tissue and healing by fibrosis, it is plausible that in some patients emphysema is dominant, in others interstitial fibrosis, and in some others combined pulmonary fibrosis and emphysema syndrome (Figure 11) may occur [18, 19].
\nTobacco caused emphysema and tobacco caused respiratory bronchiolitis-associated interstitial lung disease with fibrosis, called combined pulmonary fibrosis and emphysema syndrome. Courtesy of Dr. Nadia N. Naumova.
Alpha-1 antitrypsin deficiency is not the only one known genetic cause of emphysema. Telomere length is also associated with emphysema [20]. Both tips (ends) of the chromosomes are capped (protected) by telomeres composed of tandemly repeated DNA sequences. Telomeres are highly conserved and practically identical from protozoa to vertebrates. In humans, the TTAGGG repeat region is 10–15 kilobytes long. With each mitosis terminal nucleotides at the tail of telomeres are lost, and telomeres become shorter with each cell division. When telomere becomes critically short, the cell cannot divide anymore and thus becomes an old cell that will finally end up in apoptosis. Telomerase is an enzyme that synthesizes telomeres. Mutations in telomerase gene and telomere genes cause short telomere length for cell age and disease spectrum called short telomere syndrome/accelerated aging syndrome. The main presentation (90%) of short telomere syndromes are idiopathic pulmonary (interstitial) fibrosis and emphysema. They may be associated with other features of premature aging including early graying, osteoporosis, liver disease, predisposition to bone marrow failure, infertility, as well as myelodysplastic syndrome and acute myeloid leukemia [21]. Reduced telomere length may be identified in 25% of patients with sporadic idiopathic pulmonary fibrosis and half of those cases with family aggregation [22]. Telomerase deficiency and telomere shortening are responsible for only 1% of all emphysemas but are conceptually important as a link between interstitial fibrosis, emphysema, combined emphysema and interstitial fibrosis, and effect of environment on phenotypic presentation of genetic defect [21]. Pathogenic mechanism is premature senescence of alveolar epithelial stem cells, their apoptosis, disappearance of alveoli (emphysema), and abnormal repair with excessive interstitial fibrosis. The same genetic change, germline deletion in the Box H domain of the RNA telomerase, can cause in the father idiopathic pulmonary fibrosis, in one daughter emphysema, and in the other daughter combined pulmonary fibrosis and emphysema syndrome [20]. Interaction between the gene and environment determines lung disease. Never-smokers develop pulmonary interstitial fibrosis, while smokers develop an early onset emphysema alone or combined emphysema and pulmonary interstitial fibrosis [20, 21]. Cigarette smoke causes additive DNA damage to telomere function, and genetic defect in this setting expresses as emphysema [20].
\nIn short, the main causes of emphysema and interstitial fibrosis are cigarette smoking and in coal miners silica and silicate particles from coal dust. Hereditary emphysemas caused by alpha-1 antitrypsin deficiency and short telomere length are epidemiologically insignificant but can help to elucidate pathogenesis of emphysema and interstitial fibrosis. Not all smokers develop emphysema and chronic obstructive pulmonary disease. Only 10–20% of the smokers develop chronic obstructive pulmonary disease pointing at an additional risk factor such as genetic susceptibility reflected in polymorphisms in genes coding for various antiproteases, a disintegrin, and metalloproteinase 33 or antioxidant superoxide dismutase and proinflammatory mediators including tumor necrosis factor-alpha [10] and possibly genes associated with telomeres. Combined pulmonary fibrosis and emphysema are also in the vast majority of cases caused by cigarette smoking or in coal miners by coal dust, and the above mentioned genetic factors might contribute to a now unknown degree of susceptibility.
\nPatients with emphysema only are extremely rare, and in practice emphysema is component of the chronic obstructive pulmonary disease which affects about 24 million people in the USA. Chronic bronchitis is chronic mucous hypersecretion syndrome and is clinically defined as productive cough for at least 3 months in 2 successive years. Its pathohistological features (Figure 12) include enlargement of the mucus-secreting glands in the bronchial wall, goblet cell metaplasia of the respiratory epithelium, infiltration of the bronchial mucosa with lymphocytes, squamous metaplasia and dysplasia in the bronchial epithelium, increased bronchial smooth muscle, as well as mucous plugging, inflammation, and fibrosis of the bronchioles.
\nChronic bronchitis presenting with mucus in the lumen of the bronchus, partial goblet cell metaplasia of the respiratory epithelium, predominance of the mucinous cells in the bronchial exocrine gland, infiltration the bronchial wall by small lymphocytes and plasma cells, hypertrophy of the muscle layer, and peribronchial fibrosis.
Chronic bronchitis becomes chronic obstructive bronchitis when airflow obstruction occurs. It can be detected by spirometry or expiratory wheezing can be heard by auscultation. Bronchial airways are being compressed during expiration, and expiration is in chronic obstructive bronchitis difficult and prolonged. Auscultation reveals diminished breath sounds, prolonged expiratory phase, and expiratory wheezing. The main airflow obstruction occurs in small airways, with diameter less than 2 mm. Obstruction is caused by mucosal thickening, due to lymphocytic infiltration, fibrosis, edema, mucous plugging, and smooth muscle hypertrophy. Figure 13 demonstrates thickening of the wall of the terminal bronchiolus by fibrous tissue and smooth muscle hypertrophy caused by birefringent silica/silicate particles from coal mine dust.
\nThe wall of the terminal bronchiolus is thickened by fibrosis and smooth muscle hypertrophy and this is one of the essential pathologic bases for obstructive pulmonary disease. Birefringent silica and silicate particles are etiological factor. Hematoxylin and eosin stain, original magnification 200×, polarized light.
Clara cells that secrete surfactant are replaced by goblet cells, and decrease of surfactant increases surface tension at the air-tissue interface, and small bronchi and bronchiole are prone to collapse. Emphysema also contributes to airflow obstruction. Destruction and disappearance of respiratory bronchiole and alveolar ducts decrease total airway diameter. Destruction of acinar tissue with disappearance of elastic fibers decreases lung recoil and decreases expiratory air force. The net effect of chronic obstructive pulmonary disease is difficulty in breathing, prolonged expiration with expiratory wheezing, air trapping in the lungs with hyperinflation of lungs, increased residual volume, decreased vital capacity, and dyspnea.
\nThree cardinal features of chronic obstructive pulmonary disease are cough, sputum production, and exertional dyspnea. Dyspnea during physical activity may start insidiously, and patients complain of difficult breathing, gasping and air hunger, heaviness in chest in the beginning only during rather heavy physical work and later during light daily physical activity. Patients with chronic obstructive pulmonary disease poorly tolerate physical activity with arms but tolerate better physical work like pushing shopping cart when arms are fixed and enable the use of accessory respiratory muscles [1]. Acute exacerbations of chronic obstructive pulmonary disease are prominent feature of its natural history and are characterized by cough, increase in amount and character (color) of sputum, and dyspnea and may or may not be accompanied with fever, myalgia, and sore throat. The health-related quality of life of patients with chronic obstructive pulmonary disease better correlates (inverse correlation) with frequency of acute exacerbations than with the degree of airflow obstruction (Reilly-Harrison). Patients with advanced emphysema due to hyperinflation of lungs have barrel chest with poor diaphragmatic excursion as assessed by percussion and dramatic decrease in breath sounds and are sitting in the characteristic tripod position with stretched fixed arms to enable the use of accessory respiratory muscles including sternocleidomastoid, scalene, and intercostal ones [1]. Patients with predominant emphysema are called “pink puffers” because they breathe through pursed lips with the help of accessory respiratory muscles. When small airway obstruction ensues, patients become hypoxic and cyanotic in the lips and nail beds, and when fluid retains due to right heart decompensation, they become “blue bloaters.” However the majority of chronic obstructive pulmonary disease patients have some signs of both, “pink puffers” and “blue bloaters.” Advanced chronic obstructive lung disease is accompanied by systemic wasting due to high energy expenditure for increased work of breathing muscles including accessory breathing muscles and elevated levels of inflammatory cytokines including tumor necrosis factor-alpha. Such patients have a significant weight loss and diffuse loss of subcutaneous fatty tissue. Some patients with advanced chronic obstructive pulmonary disease have paradoxical inward movement of the lower rib cage (Hoover sign) due to diaphragmatic contraction in a setting of permanently hyperinflated lungs [1]. Advanced chronic obstructive pulmonary disease, especially during acute exacerbation, can be accompanied by right heart failure. Signs include right ventricular heave, third heart sound, distended jugular veins, congested liver, ascites, and edema of legs.
\nCardinal features of emphysema, hyperinflation of the lungs, and lung tissue destruction can be visualized by radiologic means. On the chest roentgenogram hyperinflation presents with increased lucency, increased retrosternal air space, depression and flattening of the diaphragm. Lung destruction presents in focal lucencies and areas of decreased vascularity. Mild emphysema is usually missed by standard chest X-rays.
\nHigh-resolution computerized tomography is superior to the chest X-ray in detecting emphysema. High-resolution computerized tomography can visualize focal areas of decreased attenuation sharply circumscribed without visible walls and with small centrilobular vessel in the areas of emphysema [3]. Several studies showed good correlation between the degree of pathologic findings and high-resolution computerized tomography findings [23]. However, mild focal areas might not be detected, and high-resolution computerized tomography cannot be used to rule out emphysema [24].
\nSpirometry and pulse oximetry are basic simple pulmonary function tests that can be performed in the ambulatory settings. The patient exhales in the spirometry instrument as completely as possible, then forcibly inhales as much as possible, and then forcibly exhales as much as possible. Forced vital capacity is the maximum amount of air forcibly expired after maximum inspiration. Residual volume is amount of air retained in the lungs after maximal and forceful exhalation, and it can be calculated after using gas dilution technique or body-box plethysmography. In the emphysema due to the destruction of respiratory bronchioles, spirometry will demonstrate obstructive pattern. Forced expiratory volume in 1 second will be decreased. Alveolar destruction in emphysema decreases amount of lung parenchyma, and thus forced vital capacity will decrease. Essentially emphysema is a mixed lung disorder, both obstructive and restrictive.
\nTranscutaneous pulse oximetry estimates oxygen (O2) saturation of capillary blood using instrument in shape of clip positioned on a finger. Estimation is accurate and correlates to 5% of measured atrial O2 saturation obtained by invasive procedure.
\nCentriacinar emphysema is a progressive disabling disease for which there are no good therapeutic options. Large bullae that compress functional lung tissue can be surgically removed. Patients with severe, predominantly upper lung emphysema, and low baseline exercise capacity may benefit from lung volume reduction by resection, including bronchoscopic lung volume reduction, of non-functioning emphysematous areas. Dyspnea decreases because of reduced hyperinflation and residual volume and because forced expiration volume in the first second is increased [25]. Exercise tolerance and 2-year mortality rate are improved supposedly to decreased residual lung volume, enhanced lung recoil, and improved diaphragmatic function. Long-term effects of the lung volume reduction surgery are unknown. Improvement after lung transplantation is better than after the lung volume reduction surgery. Candidates for lung transplantation are younger than 60 years, with an FEV1 less than 25% predicted or pulmonary artery hypertension. The 5-year survival after transplantation for emphysema is 45–60%. Lifelong immunosuppression brings risk of opportunistic infections.
\nNone declared.
\nAuthors are listed below with their open access chapters linked via author name:
",metaTitle:"IntechOpen authors on the Global Highly Cited Researchers 2018 list",metaDescription:null,metaKeywords:null,canonicalURL:null,contentRaw:'[{"type":"htmlEditorComponent","content":"New for 2018 (alphabetically by surname).
\\n\\n\\n\\n\\n\\n\\n\\n\\n\\nJocelyn Chanussot (chapter to be published soon...)
\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\nYuekun Lai
\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\n\\nPrevious years (alphabetically by surname)
\\n\\nAbdul Latif Ahmad 2016-18
\\n\\nKhalil Amine 2017, 2018
\\n\\nEwan Birney 2015-18
\\n\\nFrede Blaabjerg 2015-18
\\n\\nGang Chen 2016-18
\\n\\nJunhong Chen 2017, 2018
\\n\\nZhigang Chen 2016, 2018
\\n\\nMyung-Haing Cho 2016, 2018
\\n\\nMark Connors 2015-18
\\n\\nCyrus Cooper 2017, 2018
\\n\\nLiming Dai 2015-18
\\n\\nWeihua Deng 2017, 2018
\\n\\nVincenzo Fogliano 2017, 2018
\\n\\nRon de Graaf 2014-18
\\n\\nHarald Haas 2017, 2018
\\n\\nFrancisco Herrera 2017, 2018
\\n\\nJaakko Kangasjärvi 2015-18
\\n\\nHamid Reza Karimi 2016-18
\\n\\nJunji Kido 2014-18
\\n\\nJose Luiszamorano 2015-18
\\n\\nYiqi Luo 2016-18
\\n\\nJoachim Maier 2014-18
\\n\\nAndrea Natale 2017, 2018
\\n\\nAlberto Mantovani 2014-18
\\n\\nMarjan Mernik 2017, 2018
\\n\\nSandra Orchard 2014, 2016-18
\\n\\nMohamed Oukka 2016-18
\\n\\nBiswajeet Pradhan 2016-18
\\n\\nDirk Raes 2017, 2018
\\n\\nUlrike Ravens-Sieberer 2016-18
\\n\\nYexiang Tong 2017, 2018
\\n\\nJim Van Os 2015-18
\\n\\nLong Wang 2017, 2018
\\n\\nFei Wei 2016-18
\\n\\nIoannis Xenarios 2017, 2018
\\n\\nQi Xie 2016-18
\\n\\nXin-She Yang 2017, 2018
\\n\\nYulong Yin 2015, 2017, 2018
\\n"}]'},components:[{type:"htmlEditorComponent",content:'New for 2018 (alphabetically by surname).
\n\n\n\n\n\n\n\n\n\nJocelyn Chanussot (chapter to be published soon...)
\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nYuekun Lai
\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nPrevious years (alphabetically by surname)
\n\nAbdul Latif Ahmad 2016-18
\n\nKhalil Amine 2017, 2018
\n\nEwan Birney 2015-18
\n\nFrede Blaabjerg 2015-18
\n\nGang Chen 2016-18
\n\nJunhong Chen 2017, 2018
\n\nZhigang Chen 2016, 2018
\n\nMyung-Haing Cho 2016, 2018
\n\nMark Connors 2015-18
\n\nCyrus Cooper 2017, 2018
\n\nLiming Dai 2015-18
\n\nWeihua Deng 2017, 2018
\n\nVincenzo Fogliano 2017, 2018
\n\nRon de Graaf 2014-18
\n\nHarald Haas 2017, 2018
\n\nFrancisco Herrera 2017, 2018
\n\nJaakko Kangasjärvi 2015-18
\n\nHamid Reza Karimi 2016-18
\n\nJunji Kido 2014-18
\n\nJose Luiszamorano 2015-18
\n\nYiqi Luo 2016-18
\n\nJoachim Maier 2014-18
\n\nAndrea Natale 2017, 2018
\n\nAlberto Mantovani 2014-18
\n\nMarjan Mernik 2017, 2018
\n\nSandra Orchard 2014, 2016-18
\n\nMohamed Oukka 2016-18
\n\nBiswajeet Pradhan 2016-18
\n\nDirk Raes 2017, 2018
\n\nUlrike Ravens-Sieberer 2016-18
\n\nYexiang Tong 2017, 2018
\n\nJim Van Os 2015-18
\n\nLong Wang 2017, 2018
\n\nFei Wei 2016-18
\n\nIoannis Xenarios 2017, 2018
\n\nQi Xie 2016-18
\n\nXin-She Yang 2017, 2018
\n\nYulong Yin 2015, 2017, 2018
\n'}]},successStories:{items:[]},authorsAndEditors:{filterParams:{sort:"featured,name"},profiles:[{id:"105746",title:"Dr.",name:"A.W.M.M.",middleName:null,surname:"Koopman-van Gemert",slug:"a.w.m.m.-koopman-van-gemert",fullName:"A.W.M.M. Koopman-van Gemert",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/105746/images/5803_n.jpg",biography:"Dr. Anna Wilhelmina Margaretha Maria Koopman-van Gemert MD, PhD, became anaesthesiologist-intensivist from the Radboud University Nijmegen (the Netherlands) in 1987. She worked for a couple of years also as a blood bank director in Nijmegen and introduced in the Netherlands the Cell Saver and blood transfusion alternatives. She performed research in perioperative autotransfusion and obtained the degree of PhD in 1993 publishing Peri-operative autotransfusion by means of a blood cell separator.\nBlood transfusion had her special interest being the president of the Haemovigilance Chamber TRIP and performing several tasks in local and national blood bank and anticoagulant-blood transfusion guidelines committees. Currently, she is working as an associate professor and up till recently was the dean at the Albert Schweitzer Hospital Dordrecht. She performed (inter)national tasks as vice-president of the Concilium Anaesthesia and related committees. \nShe performed research in several fields, with over 100 publications in (inter)national journals and numerous papers on scientific conferences. \nShe received several awards and is a member of Honour of the Dutch Society of Anaesthesia.",institutionString:null,institution:{name:"Albert Schweitzer Hospital",country:{name:"Gabon"}}},{id:"83089",title:"Prof.",name:"Aaron",middleName:null,surname:"Ojule",slug:"aaron-ojule",fullName:"Aaron Ojule",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Port Harcourt",country:{name:"Nigeria"}}},{id:"295748",title:"Mr.",name:"Abayomi",middleName:null,surname:"Modupe",slug:"abayomi-modupe",fullName:"Abayomi Modupe",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/no_image.jpg",biography:null,institutionString:null,institution:{name:"Landmark University",country:{name:"Nigeria"}}},{id:"94191",title:"Prof.",name:"Abbas",middleName:null,surname:"Moustafa",slug:"abbas-moustafa",fullName:"Abbas Moustafa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94191/images/96_n.jpg",biography:"Prof. Moustafa got his doctoral degree in earthquake engineering and structural safety from Indian Institute of Science in 2002. He is currently an associate professor at Department of Civil Engineering, Minia University, Egypt and the chairman of Department of Civil Engineering, High Institute of Engineering and Technology, Giza, Egypt. He is also a consultant engineer and head of structural group at Hamza Associates, Giza, Egypt. Dr. Moustafa was a senior research associate at Vanderbilt University and a JSPS fellow at Kyoto and Nagasaki Universities. He has more than 40 research papers published in international journals and conferences. He acts as an editorial board member and a reviewer for several regional and international journals. His research interest includes earthquake engineering, seismic design, nonlinear dynamics, random vibration, structural reliability, structural health monitoring and uncertainty modeling.",institutionString:null,institution:{name:"Minia University",country:{name:"Egypt"}}},{id:"84562",title:"Dr.",name:"Abbyssinia",middleName:null,surname:"Mushunje",slug:"abbyssinia-mushunje",fullName:"Abbyssinia Mushunje",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Fort Hare",country:{name:"South Africa"}}},{id:"202206",title:"Associate Prof.",name:"Abd Elmoniem",middleName:"Ahmed",surname:"Elzain",slug:"abd-elmoniem-elzain",fullName:"Abd Elmoniem Elzain",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Kassala University",country:{name:"Sudan"}}},{id:"98127",title:"Dr.",name:"Abdallah",middleName:null,surname:"Handoura",slug:"abdallah-handoura",fullName:"Abdallah Handoura",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"École Supérieure des Télécommunications",country:{name:"Morocco"}}},{id:"91404",title:"Prof.",name:"Abdecharif",middleName:null,surname:"Boumaza",slug:"abdecharif-boumaza",fullName:"Abdecharif Boumaza",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Abbès Laghrour University of Khenchela",country:{name:"Algeria"}}},{id:"105795",title:"Prof.",name:"Abdel Ghani",middleName:null,surname:"Aissaoui",slug:"abdel-ghani-aissaoui",fullName:"Abdel Ghani Aissaoui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/105795/images/system/105795.jpeg",biography:"Abdel Ghani AISSAOUI is a Full Professor of electrical engineering at University of Bechar (ALGERIA). He was born in 1969 in Naama, Algeria. He received his BS degree in 1993, the MS degree in 1997, the PhD degree in 2007 from the Electrical Engineering Institute of Djilali Liabes University of Sidi Bel Abbes (ALGERIA). He is an active member of IRECOM (Interaction Réseaux Electriques - COnvertisseurs Machines) Laboratory and IEEE senior member. He is an editor member for many international journals (IJET, RSE, MER, IJECE, etc.), he serves as a reviewer in international journals (IJAC, ECPS, COMPEL, etc.). He serves as member in technical committee (TPC) and reviewer in international conferences (CHUSER 2011, SHUSER 2012, PECON 2012, SAI 2013, SCSE2013, SDM2014, SEB2014, PEMC2014, PEAM2014, SEB (2014, 2015), ICRERA (2015, 2016, 2017, 2018,-2019), etc.). His current research interest includes power electronics, control of electrical machines, artificial intelligence and Renewable energies.",institutionString:"University of Béchar",institution:{name:"University of Béchar",country:{name:"Algeria"}}},{id:"99749",title:"Dr.",name:"Abdel Hafid",middleName:null,surname:"Essadki",slug:"abdel-hafid-essadki",fullName:"Abdel Hafid Essadki",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"École Nationale Supérieure de Technologie",country:{name:"Algeria"}}},{id:"101208",title:"Prof.",name:"Abdel Karim",middleName:"Mohamad",surname:"El Hemaly",slug:"abdel-karim-el-hemaly",fullName:"Abdel Karim El Hemaly",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/101208/images/733_n.jpg",biography:"OBGYN.net Editorial Advisor Urogynecology.\nAbdel Karim M. A. El-Hemaly, MRCOG, FRCS � Egypt.\n \nAbdel Karim M. A. El-Hemaly\nProfessor OB/GYN & Urogynecology\nFaculty of medicine, Al-Azhar University \nPersonal Information: \nMarried with two children\nWife: Professor Laila A. Moussa MD.\nSons: Mohamad A. M. El-Hemaly Jr. MD. Died March 25-2007\nMostafa A. M. El-Hemaly, Computer Scientist working at Microsoft Seatle, USA. \nQualifications: \n1.\tM.B.-Bch Cairo Univ. June 1963. \n2.\tDiploma Ob./Gyn. Cairo Univ. April 1966. \n3.\tDiploma Surgery Cairo Univ. Oct. 1966. \n4.\tMRCOG London Feb. 1975. \n5.\tF.R.C.S. Glasgow June 1976. \n6.\tPopulation Study Johns Hopkins 1981. \n7.\tGyn. Oncology Johns Hopkins 1983. \n8.\tAdvanced Laparoscopic Surgery, with Prof. Paulson, Alexandria, Virginia USA 1993. \nSocieties & Associations: \n1.\t Member of the Royal College of Ob./Gyn. London. \n2.\tFellow of the Royal College of Surgeons Glasgow UK. \n3.\tMember of the advisory board on urogyn. FIGO. \n4.\tMember of the New York Academy of Sciences. \n5.\tMember of the American Association for the Advancement of Science. \n6.\tFeatured in �Who is Who in the World� from the 16th edition to the 20th edition. \n7.\tFeatured in �Who is Who in Science and Engineering� in the 7th edition. \n8.\tMember of the Egyptian Fertility & Sterility Society. \n9.\tMember of the Egyptian Society of Ob./Gyn. \n10.\tMember of the Egyptian Society of Urogyn. \n\nScientific Publications & Communications:\n1- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Asim Kurjak, Ahmad G. Serour, Laila A. S. Mousa, Amr M. Zaied, Khalid Z. El Sheikha. \nImaging the Internal Urethral Sphincter and the Vagina in Normal Women and Women Suffering from Stress Urinary Incontinence and Vaginal Prolapse. Gynaecologia Et Perinatologia, Vol18, No 4; 169-286 October-December 2009.\n2- Abdel Karim M. El Hemaly*, Laila A. S. Mousa Ibrahim M. Kandil, Fatma S. El Sokkary, Ahmad G. Serour, Hossam Hussein.\nFecal Incontinence, A Novel Concept: The Role of the internal Anal sphincter (IAS) in defecation and fecal incontinence. Gynaecologia Et Perinatologia, Vol19, No 2; 79-85 April -June 2010.\n3- Abdel Karim M. El Hemaly*, Laila A. S. Mousa Ibrahim M. Kandil, Fatma S. El Sokkary, Ahmad G. Serour, Hossam Hussein.\nSurgical Treatment of Stress Urinary Incontinence, Fecal Incontinence and Vaginal Prolapse By A Novel Operation \n"Urethro-Ano-Vaginoplasty"\n Gynaecologia Et Perinatologia, Vol19, No 3; 129-188 July-September 2010.\n4- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Laila A. S. Mousa and Mohamad A.K.M.El Hemaly.\nUrethro-vaginoplasty, an innovated operation for the treatment of: Stress Urinary Incontinence (SUI), Detursor Overactivity (DO), Mixed Urinary Incontinence and Anterior Vaginal Wall Descent. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/ urethro-vaginoplasty_01\n\n5- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamed M. Radwan.\n Urethro-raphy a new technique for surgical management of Stress Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/\nnew-tech-urethro\n\n6- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamad A. Rizk, Nabil Abdel Maksoud H., Mohamad M. Radwan, Khalid Z. El Shieka, Mohamad A. K. M. El Hemaly, and Ahmad T. El Saban.\nUrethro-raphy The New Operation for the treatment of stress urinary incontinence, SUI, detrusor instability, DI, and mixed-type of urinary incontinence; short and long term results. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=urogyn/articles/\nurethroraphy-09280\n\n7-Abdel Karim M. El Hemaly, Ibrahim M Kandil, and Bahaa E. El Mohamady. Menopause, and Voiding troubles. \nhttp://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly03/el-hemaly03-ss\n\n8-El Hemaly AKMA, Mousa L.A. Micturition and Urinary\tContinence. Int J Gynecol Obstet 1996; 42: 291-2. \n\n9-Abdel Karim M. El Hemaly.\n Urinary incontinence in gynecology, a review article.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/abs-urinary_incotinence_gyn_ehemaly \n\n10-El Hemaly AKMA. Nocturnal Enuresis: Pathogenesis and Treatment. \nInt Urogynecol J Pelvic Floor Dysfunct 1998;9: 129-31.\n \n11-El Hemaly AKMA, Mousa L.A.E. Stress Urinary Incontinence, a New Concept. Eur J Obstet Gynecol Reprod Biol 1996; 68: 129-35. \n\n12- El Hemaly AKMA, Kandil I. M. Stress Urinary Incontinence SUI facts and fiction. Is SUI a puzzle?! http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly/el-hemaly-ss\n\n13-Abdel Karim El Hemaly, Nabil Abdel Maksoud, Laila A. Mousa, Ibrahim M. Kandil, Asem Anwar, M.A.K El Hemaly and Bahaa E. El Mohamady. \nEvidence based Facts on the Pathogenesis and Management of SUI. http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly02/el-hemaly02-ss\n\n14- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Mohamad A. Rizk and Mohamad A.K.M.El Hemaly.\n Urethro-plasty, a Novel Operation based on a New Concept, for the Treatment of Stress Urinary Incontinence, S.U.I., Detrusor Instability, D.I., and Mixed-type of Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/urethro-plasty_01\n\n15-Ibrahim M. Kandil, Abdel Karim M. El Hemaly, Mohamad M. Radwan: Ultrasonic Assessment of the Internal Urethral Sphincter in Stress Urinary Incontinence. The Internet Journal of Gynecology and Obstetrics. 2003. Volume 2 Number 1. \n\n\n16-Abdel Karim M. El Hemaly. Nocturnal Enureses: A Novel Concept on its pathogenesis and Treatment.\nhttp://www.obgyn.net/urogynecolgy/?page=articles/nocturnal_enuresis\n\n17- Abdel Karim M. El Hemaly. Nocturnal Enureses: An Update on the pathogenesis and Treatment.\nhttp://www.obgyn.net/urogynecology/?page=/ENHLIDH/PUBD/FEATURES/\nPresentations/ Nocturnal_Enuresis/nocturnal_enuresis\n\n18-Maternal Mortality in Egypt, a cry for help and attention. The Second International Conference of the African Society of Organization & Gestosis, 1998, 3rd Annual International Conference of Ob/Gyn Department � Sohag Faculty of Medicine University. Feb. 11-13. Luxor, Egypt. \n19-Postmenopausal Osteprosis. The 2nd annual conference of Health Insurance Organization on Family Planning and its role in primary health care. Zagaziz, Egypt, February 26-27, 1997, Center of Complementary Services for Maternity and childhood care. \n20-Laparoscopic Assisted vaginal hysterectomy. 10th International Annual Congress Modern Trends in Reproductive Techniques 23-24 March 1995. Alexandria, Egypt. \n21-Immunological Studies in Pre-eclamptic Toxaemia. Proceedings of 10th Annual Ain Shams Medical Congress. Cairo, Egypt, March 6-10, 1987. \n22-Socio-demographic factorse affecting acceptability of the long-acting contraceptive injections in a rural Egyptian community. Journal of Biosocial Science 29:305, 1987. \n23-Plasma fibronectin levels hypertension during pregnancy. The Journal of the Egypt. Soc. of Ob./Gyn. 13:1, 17-21, Jan. 1987. \n24-Effect of smoking on pregnancy. Journal of Egypt. Soc. of Ob./Gyn. 12:3, 111-121, Sept 1986. \n25-Socio-demographic aspects of nausea and vomiting in early pregnancy. Journal of the Egypt. Soc. of Ob./Gyn. 12:3, 35-42, Sept. 1986. \n26-Effect of intrapartum oxygen inhalation on maternofetal blood gases and pH. Journal of the Egypt. Soc. of Ob./Gyn. 12:3, 57-64, Sept. 1986. \n27-The effect of severe pre-eclampsia on serum transaminases. The Egypt. J. Med. Sci. 7(2): 479-485, 1986. \n28-A study of placental immunoreceptors in pre-eclampsia. The Egypt. J. Med. Sci. 7(2): 211-216, 1986. \n29-Serum human placental lactogen (hpl) in normal, toxaemic and diabetic pregnant women, during pregnancy and its relation to the outcome of pregnancy. Journal of the Egypt. Soc. of Ob./Gyn. 12:2, 11-23, May 1986. \n30-Pregnancy specific B1 Glycoprotein and free estriol in the serum of normal, toxaemic and diabetic pregnant women during pregnancy and after delivery. Journal of the Egypt. Soc. of Ob./Gyn. 12:1, 63-70, Jan. 1986. Also was accepted and presented at Xith World Congress of Gynecology and Obstetrics, Berlin (West), September 15-20, 1985. \n31-Pregnancy and labor in women over the age of forty years. Accepted and presented at Al-Azhar International Medical Conference, Cairo 28-31 Dec. 1985. \n32-Effect of Copper T intra-uterine device on cervico-vaginal flora. Int. J. Gynaecol. Obstet. 23:2, 153-156, April 1985. \n33-Factors affecting the occurrence of post-Caesarean section febrile morbidity. Population Sciences, 6, 139-149, 1985. \n34-Pre-eclamptic toxaemia and its relation to H.L.A. system. Population Sciences, 6, 131-139, 1985. \n35-The menstrual pattern and occurrence of pregnancy one year after discontinuation of Depo-medroxy progesterone acetate as a postpartum contraceptive. Population Sciences, 6, 105-111, 1985. \n36-The menstrual pattern and side effects of Depo-medroxy progesterone acetate as postpartum contraceptive. Population Sciences, 6, 97-105, 1985. \n37-Actinomyces in the vaginas of women with and without intrauterine contraceptive devices. Population Sciences, 6, 77-85, 1985. \n38-Comparative efficacy of ibuprofen and etamsylate in the treatment of I.U.D. menorrhagia. Population Sciences, 6, 63-77, 1985. \n39-Changes in cervical mucus copper and zinc in women using I.U.D.�s. Population Sciences, 6, 35-41, 1985. \n40-Histochemical study of the endometrium of infertile women. Egypt. J. Histol. 8(1) 63-66, 1985. \n41-Genital flora in pre- and post-menopausal women. Egypt. J. Med. Sci. 4(2), 165-172, 1983. \n42-Evaluation of the vaginal rugae and thickness in 8 different groups. Journal of the Egypt. Soc. of Ob./Gyn. 9:2, 101-114, May 1983. \n43-The effect of menopausal status and conjugated oestrogen therapy on serum cholesterol, triglycerides and electrophoretic lipoprotein patterns. Al-Azhar Medical Journal, 12:2, 113-119, April 1983. \n44-Laparoscopic ventrosuspension: A New Technique. Int. J. Gynaecol. Obstet., 20, 129-31, 1982. \n45-The laparoscope: A useful diagnostic tool in general surgery. Al-Azhar Medical Journal, 11:4, 397-401, Oct. 1982. \n46-The value of the laparoscope in the diagnosis of polycystic ovary. Al-Azhar Medical Journal, 11:2, 153-159, April 1982. \n47-An anaesthetic approach to the management of eclampsia. Ain Shams Medical Journal, accepted for publication 1981. \n48-Laparoscopy on patients with previous lower abdominal surgery. Fertility management edited by E. Osman and M. Wahba 1981. \n49-Heart diseases with pregnancy. Population Sciences, 11, 121-130, 1981. \n50-A study of the biosocial factors affecting perinatal mortality in an Egyptian maternity hospital. Population Sciences, 6, 71-90, 1981. \n51-Pregnancy Wastage. Journal of the Egypt. Soc. of Ob./Gyn. 11:3, 57-67, Sept. 1980. \n52-Analysis of maternal deaths in Egyptian maternity hospitals. Population Sciences, 1, 59-65, 1979. \nArticles published on OBGYN.net: \n1- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Laila A. S. Mousa and Mohamad A.K.M.El Hemaly.\nUrethro-vaginoplasty, an innovated operation for the treatment of: Stress Urinary Incontinence (SUI), Detursor Overactivity (DO), Mixed Urinary Incontinence and Anterior Vaginal Wall Descent. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/ urethro-vaginoplasty_01\n\n2- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamed M. Radwan.\n Urethro-raphy a new technique for surgical management of Stress Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/\nnew-tech-urethro\n\n3- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamad A. Rizk, Nabil Abdel Maksoud H., Mohamad M. Radwan, Khalid Z. El Shieka, Mohamad A. K. M. El Hemaly, and Ahmad T. El Saban.\nUrethro-raphy The New Operation for the treatment of stress urinary incontinence, SUI, detrusor instability, DI, and mixed-type of urinary incontinence; short and long term results. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=urogyn/articles/\nurethroraphy-09280\n\n4-Abdel Karim M. El Hemaly, Ibrahim M Kandil, and Bahaa E. El Mohamady. Menopause, and Voiding troubles. \nhttp://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly03/el-hemaly03-ss\n\n5-El Hemaly AKMA, Mousa L.A. Micturition and Urinary\tContinence. Int J Gynecol Obstet 1996; 42: 291-2. \n\n6-Abdel Karim M. El Hemaly.\n Urinary incontinence in gynecology, a review article.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/abs-urinary_incotinence_gyn_ehemaly \n\n7-El Hemaly AKMA. Nocturnal Enuresis: Pathogenesis and Treatment. \nInt Urogynecol J Pelvic Floor Dysfunct 1998;9: 129-31.\n \n8-El Hemaly AKMA, Mousa L.A.E. Stress Urinary Incontinence, a New Concept. Eur J Obstet Gynecol Reprod Biol 1996; 68: 129-35. \n\n9- El Hemaly AKMA, Kandil I. M. Stress Urinary Incontinence SUI facts and fiction. Is SUI a puzzle?! http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly/el-hemaly-ss\n\n10-Abdel Karim El Hemaly, Nabil Abdel Maksoud, Laila A. Mousa, Ibrahim M. Kandil, Asem Anwar, M.A.K El Hemaly and Bahaa E. El Mohamady. \nEvidence based Facts on the Pathogenesis and Management of SUI. http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly02/el-hemaly02-ss\n\n11- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Mohamad A. Rizk and Mohamad A.K.M.El Hemaly.\n Urethro-plasty, a Novel Operation based on a New Concept, for the Treatment of Stress Urinary Incontinence, S.U.I., Detrusor Instability, D.I., and Mixed-type of Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/urethro-plasty_01\n\n12-Ibrahim M. Kandil, Abdel Karim M. El Hemaly, Mohamad M. Radwan: Ultrasonic Assessment of the Internal Urethral Sphincter in Stress Urinary Incontinence. The Internet Journal of Gynecology and Obstetrics. 2003. Volume 2 Number 1. \n\n13-Abdel Karim M. El Hemaly. Nocturnal Enureses: A Novel Concept on its pathogenesis and Treatment.\nhttp://www.obgyn.net/urogynecolgy/?page=articles/nocturnal_enuresis\n\n14- Abdel Karim M. El Hemaly. Nocturnal Enureses: An Update on the pathogenesis and Treatment.\nhttp://www.obgyn.net/urogynecology/?page=/ENHLIDH/PUBD/FEATURES/\nPresentations/ Nocturnal_Enuresis/nocturnal_enuresis",institutionString:null,institution:{name:"Al Azhar University",country:{name:"Egypt"}}},{id:"113313",title:"Dr.",name:"Abdel-Aal",middleName:null,surname:"Mantawy",slug:"abdel-aal-mantawy",fullName:"Abdel-Aal Mantawy",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ain Shams University",country:{name:"Egypt"}}}],filtersByRegion:[{group:"region",caption:"North America",value:1,count:5682},{group:"region",caption:"Middle and South America",value:2,count:5165},{group:"region",caption:"Africa",value:3,count:1682},{group:"region",caption:"Asia",value:4,count:10206},{group:"region",caption:"Australia and Oceania",value:5,count:886},{group:"region",caption:"Europe",value:6,count:15610}],offset:12,limit:12,total:1682},chapterEmbeded:{data:{}},editorApplication:{success:null,errors:{}},ofsBooks:{filterParams:{sort:"dateendthirdsteppublish"},books:[],filtersByTopic:[{group:"topic",caption:"Agricultural and Biological Sciences",value:5,count:9},{group:"topic",caption:"Biochemistry, Genetics and Molecular Biology",value:6,count:18},{group:"topic",caption:"Business, Management and Economics",value:7,count:2},{group:"topic",caption:"Chemistry",value:8,count:7},{group:"topic",caption:"Computer and Information Science",value:9,count:10},{group:"topic",caption:"Earth and Planetary Sciences",value:10,count:5},{group:"topic",caption:"Engineering",value:11,count:15},{group:"topic",caption:"Environmental Sciences",value:12,count:2},{group:"topic",caption:"Immunology and Microbiology",value:13,count:5},{group:"topic",caption:"Materials Science",value:14,count:4},{group:"topic",caption:"Mathematics",value:15,count:1},{group:"topic",caption:"Medicine",value:16,count:60},{group:"topic",caption:"Nanotechnology and Nanomaterials",value:17,count:1},{group:"topic",caption:"Neuroscience",value:18,count:1},{group:"topic",caption:"Pharmacology, Toxicology and Pharmaceutical Science",value:19,count:6},{group:"topic",caption:"Physics",value:20,count:2},{group:"topic",caption:"Psychology",value:21,count:3},{group:"topic",caption:"Robotics",value:22,count:1},{group:"topic",caption:"Social Sciences",value:23,count:3},{group:"topic",caption:"Technology",value:24,count:1},{group:"topic",caption:"Veterinary Medicine and Science",value:25,count:2}],offset:0,limit:12,total:null},popularBooks:{featuredBooks:[{type:"book",id:"9208",title:"Welding",subtitle:"Modern Topics",isOpenForSubmission:!1,hash:"7d6be076ccf3a3f8bd2ca52d86d4506b",slug:"welding-modern-topics",bookSignature:"Sadek Crisóstomo Absi Alfaro, Wojciech Borek and Błażej Tomiczek",coverURL:"https://cdn.intechopen.com/books/images_new/9208.jpg",editors:[{id:"65292",title:"Prof.",name:"Sadek Crisostomo Absi",middleName:"C. Absi",surname:"Alfaro",slug:"sadek-crisostomo-absi-alfaro",fullName:"Sadek Crisostomo Absi Alfaro"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9139",title:"Topics in Primary Care Medicine",subtitle:null,isOpenForSubmission:!1,hash:"ea774a4d4c1179da92a782e0ae9cde92",slug:"topics-in-primary-care-medicine",bookSignature:"Thomas F. Heston",coverURL:"https://cdn.intechopen.com/books/images_new/9139.jpg",editors:[{id:"217926",title:"Dr.",name:"Thomas F.",middleName:null,surname:"Heston",slug:"thomas-f.-heston",fullName:"Thomas F. Heston"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8697",title:"Virtual Reality and Its Application in Education",subtitle:null,isOpenForSubmission:!1,hash:"ee01b5e387ba0062c6b0d1e9227bda05",slug:"virtual-reality-and-its-application-in-education",bookSignature:"Dragan Cvetković",coverURL:"https://cdn.intechopen.com/books/images_new/8697.jpg",editors:[{id:"101330",title:"Dr.",name:"Dragan",middleName:"Mladen",surname:"Cvetković",slug:"dragan-cvetkovic",fullName:"Dragan Cvetković"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9785",title:"Endometriosis",subtitle:null,isOpenForSubmission:!1,hash:"f457ca61f29cf7e8bc191732c50bb0ce",slug:"endometriosis",bookSignature:"Courtney Marsh",coverURL:"https://cdn.intechopen.com/books/images_new/9785.jpg",editors:[{id:"255491",title:"Dr.",name:"Courtney",middleName:null,surname:"Marsh",slug:"courtney-marsh",fullName:"Courtney Marsh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9343",title:"Trace Metals in the Environment",subtitle:"New Approaches and Recent Advances",isOpenForSubmission:!1,hash:"ae07e345bc2ce1ebbda9f70c5cd12141",slug:"trace-metals-in-the-environment-new-approaches-and-recent-advances",bookSignature:"Mario Alfonso Murillo-Tovar, Hugo Saldarriaga-Noreña and Agnieszka Saeid",coverURL:"https://cdn.intechopen.com/books/images_new/9343.jpg",editors:[{id:"255959",title:"Dr.",name:"Mario Alfonso",middleName:null,surname:"Murillo-Tovar",slug:"mario-alfonso-murillo-tovar",fullName:"Mario Alfonso Murillo-Tovar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7831",title:"Sustainability in Urban Planning and Design",subtitle:null,isOpenForSubmission:!1,hash:"c924420492c8c2c9751e178d025f4066",slug:"sustainability-in-urban-planning-and-design",bookSignature:"Amjad Almusaed, Asaad Almssad and Linh Truong - Hong",coverURL:"https://cdn.intechopen.com/books/images_new/7831.jpg",editors:[{id:"110471",title:"Dr.",name:"Amjad",middleName:"Zaki",surname:"Almusaed",slug:"amjad-almusaed",fullName:"Amjad Almusaed"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8468",title:"Sheep Farming",subtitle:"An Approach to Feed, Growth and Sanity",isOpenForSubmission:!1,hash:"838f08594850bc04aa14ec873ed1b96f",slug:"sheep-farming-an-approach-to-feed-growth-and-sanity",bookSignature:"António Monteiro",coverURL:"https://cdn.intechopen.com/books/images_new/8468.jpg",editors:[{id:"190314",title:"Prof.",name:"António",middleName:"Cardoso",surname:"Monteiro",slug:"antonio-monteiro",fullName:"António Monteiro"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8816",title:"Financial Crises",subtitle:"A Selection of Readings",isOpenForSubmission:!1,hash:"6f2f49fb903656e4e54280c79fabd10c",slug:"financial-crises-a-selection-of-readings",bookSignature:"Stelios Markoulis",coverURL:"https://cdn.intechopen.com/books/images_new/8816.jpg",editors:[{id:"237863",title:"Dr.",name:"Stelios",middleName:null,surname:"Markoulis",slug:"stelios-markoulis",fullName:"Stelios Markoulis"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9376",title:"Contemporary Developments and Perspectives in International Health Security",subtitle:"Volume 1",isOpenForSubmission:!1,hash:"b9a00b84cd04aae458fb1d6c65795601",slug:"contemporary-developments-and-perspectives-in-international-health-security-volume-1",bookSignature:"Stanislaw P. Stawicki, Michael S. Firstenberg, Sagar C. Galwankar, Ricardo Izurieta and Thomas Papadimos",coverURL:"https://cdn.intechopen.com/books/images_new/9376.jpg",editors:[{id:"181694",title:"Dr.",name:"Stanislaw P.",middleName:null,surname:"Stawicki",slug:"stanislaw-p.-stawicki",fullName:"Stanislaw P. Stawicki"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7769",title:"Medical Isotopes",subtitle:null,isOpenForSubmission:!1,hash:"f8d3c5a6c9a42398e56b4e82264753f7",slug:"medical-isotopes",bookSignature:"Syed Ali Raza Naqvi and Muhammad Babar Imrani",coverURL:"https://cdn.intechopen.com/books/images_new/7769.jpg",editors:[{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9279",title:"Concepts, Applications and Emerging Opportunities in Industrial Engineering",subtitle:null,isOpenForSubmission:!1,hash:"9bfa87f9b627a5468b7c1e30b0eea07a",slug:"concepts-applications-and-emerging-opportunities-in-industrial-engineering",bookSignature:"Gary Moynihan",coverURL:"https://cdn.intechopen.com/books/images_new/9279.jpg",editors:[{id:"16974",title:"Dr.",name:"Gary",middleName:null,surname:"Moynihan",slug:"gary-moynihan",fullName:"Gary Moynihan"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7807",title:"A Closer Look at Organizational Culture in Action",subtitle:null,isOpenForSubmission:!1,hash:"05c608b9271cc2bc711f4b28748b247b",slug:"a-closer-look-at-organizational-culture-in-action",bookSignature:"Süleyman Davut Göker",coverURL:"https://cdn.intechopen.com/books/images_new/7807.jpg",editors:[{id:"190035",title:"Associate Prof.",name:"Süleyman Davut",middleName:null,surname:"Göker",slug:"suleyman-davut-goker",fullName:"Süleyman Davut Göker"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],offset:12,limit:12,total:5128},hotBookTopics:{hotBooks:[],offset:0,limit:12,total:null},publish:{},publishingProposal:{success:null,errors:{}},books:{featuredBooks:[{type:"book",id:"9208",title:"Welding",subtitle:"Modern Topics",isOpenForSubmission:!1,hash:"7d6be076ccf3a3f8bd2ca52d86d4506b",slug:"welding-modern-topics",bookSignature:"Sadek Crisóstomo Absi Alfaro, Wojciech Borek and Błażej Tomiczek",coverURL:"https://cdn.intechopen.com/books/images_new/9208.jpg",editors:[{id:"65292",title:"Prof.",name:"Sadek Crisostomo Absi",middleName:"C. Absi",surname:"Alfaro",slug:"sadek-crisostomo-absi-alfaro",fullName:"Sadek Crisostomo Absi Alfaro"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9139",title:"Topics in Primary Care Medicine",subtitle:null,isOpenForSubmission:!1,hash:"ea774a4d4c1179da92a782e0ae9cde92",slug:"topics-in-primary-care-medicine",bookSignature:"Thomas F. Heston",coverURL:"https://cdn.intechopen.com/books/images_new/9139.jpg",editors:[{id:"217926",title:"Dr.",name:"Thomas F.",middleName:null,surname:"Heston",slug:"thomas-f.-heston",fullName:"Thomas F. Heston"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8697",title:"Virtual Reality and Its Application in Education",subtitle:null,isOpenForSubmission:!1,hash:"ee01b5e387ba0062c6b0d1e9227bda05",slug:"virtual-reality-and-its-application-in-education",bookSignature:"Dragan Cvetković",coverURL:"https://cdn.intechopen.com/books/images_new/8697.jpg",editors:[{id:"101330",title:"Dr.",name:"Dragan",middleName:"Mladen",surname:"Cvetković",slug:"dragan-cvetkovic",fullName:"Dragan Cvetković"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9785",title:"Endometriosis",subtitle:null,isOpenForSubmission:!1,hash:"f457ca61f29cf7e8bc191732c50bb0ce",slug:"endometriosis",bookSignature:"Courtney Marsh",coverURL:"https://cdn.intechopen.com/books/images_new/9785.jpg",editors:[{id:"255491",title:"Dr.",name:"Courtney",middleName:null,surname:"Marsh",slug:"courtney-marsh",fullName:"Courtney Marsh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9343",title:"Trace Metals in the Environment",subtitle:"New Approaches and Recent Advances",isOpenForSubmission:!1,hash:"ae07e345bc2ce1ebbda9f70c5cd12141",slug:"trace-metals-in-the-environment-new-approaches-and-recent-advances",bookSignature:"Mario Alfonso Murillo-Tovar, Hugo Saldarriaga-Noreña and Agnieszka Saeid",coverURL:"https://cdn.intechopen.com/books/images_new/9343.jpg",editors:[{id:"255959",title:"Dr.",name:"Mario Alfonso",middleName:null,surname:"Murillo-Tovar",slug:"mario-alfonso-murillo-tovar",fullName:"Mario Alfonso Murillo-Tovar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8468",title:"Sheep Farming",subtitle:"An Approach to Feed, Growth and Sanity",isOpenForSubmission:!1,hash:"838f08594850bc04aa14ec873ed1b96f",slug:"sheep-farming-an-approach-to-feed-growth-and-sanity",bookSignature:"António Monteiro",coverURL:"https://cdn.intechopen.com/books/images_new/8468.jpg",editors:[{id:"190314",title:"Prof.",name:"António",middleName:"Cardoso",surname:"Monteiro",slug:"antonio-monteiro",fullName:"António Monteiro"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8816",title:"Financial Crises",subtitle:"A Selection of Readings",isOpenForSubmission:!1,hash:"6f2f49fb903656e4e54280c79fabd10c",slug:"financial-crises-a-selection-of-readings",bookSignature:"Stelios Markoulis",coverURL:"https://cdn.intechopen.com/books/images_new/8816.jpg",editors:[{id:"237863",title:"Dr.",name:"Stelios",middleName:null,surname:"Markoulis",slug:"stelios-markoulis",fullName:"Stelios Markoulis"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7831",title:"Sustainability in Urban Planning and Design",subtitle:null,isOpenForSubmission:!1,hash:"c924420492c8c2c9751e178d025f4066",slug:"sustainability-in-urban-planning-and-design",bookSignature:"Amjad Almusaed, Asaad Almssad and Linh Truong - Hong",coverURL:"https://cdn.intechopen.com/books/images_new/7831.jpg",editors:[{id:"110471",title:"Dr.",name:"Amjad",middleName:"Zaki",surname:"Almusaed",slug:"amjad-almusaed",fullName:"Amjad Almusaed"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9376",title:"Contemporary Developments and Perspectives in International Health Security",subtitle:"Volume 1",isOpenForSubmission:!1,hash:"b9a00b84cd04aae458fb1d6c65795601",slug:"contemporary-developments-and-perspectives-in-international-health-security-volume-1",bookSignature:"Stanislaw P. Stawicki, Michael S. Firstenberg, Sagar C. Galwankar, Ricardo Izurieta and Thomas Papadimos",coverURL:"https://cdn.intechopen.com/books/images_new/9376.jpg",editors:[{id:"181694",title:"Dr.",name:"Stanislaw P.",middleName:null,surname:"Stawicki",slug:"stanislaw-p.-stawicki",fullName:"Stanislaw P. Stawicki"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7769",title:"Medical Isotopes",subtitle:null,isOpenForSubmission:!1,hash:"f8d3c5a6c9a42398e56b4e82264753f7",slug:"medical-isotopes",bookSignature:"Syed Ali Raza Naqvi and Muhammad Babar Imrani",coverURL:"https://cdn.intechopen.com/books/images_new/7769.jpg",editors:[{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],latestBooks:[{type:"book",id:"8468",title:"Sheep Farming",subtitle:"An Approach to Feed, Growth and Health",isOpenForSubmission:!1,hash:"838f08594850bc04aa14ec873ed1b96f",slug:"sheep-farming-an-approach-to-feed-growth-and-health",bookSignature:"António Monteiro",coverURL:"https://cdn.intechopen.com/books/images_new/8468.jpg",editedByType:"Edited by",editors:[{id:"190314",title:"Prof.",name:"António",middleName:"Cardoso",surname:"Monteiro",slug:"antonio-monteiro",fullName:"António Monteiro"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9523",title:"Oral and Maxillofacial Surgery",subtitle:null,isOpenForSubmission:!1,hash:"5eb6ec2db961a6c8965d11180a58d5c1",slug:"oral-and-maxillofacial-surgery",bookSignature:"Gokul Sridharan",coverURL:"https://cdn.intechopen.com/books/images_new/9523.jpg",editedByType:"Edited by",editors:[{id:"82453",title:"Dr.",name:"Gokul",middleName:null,surname:"Sridharan",slug:"gokul-sridharan",fullName:"Gokul Sridharan"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9785",title:"Endometriosis",subtitle:null,isOpenForSubmission:!1,hash:"f457ca61f29cf7e8bc191732c50bb0ce",slug:"endometriosis",bookSignature:"Courtney Marsh",coverURL:"https://cdn.intechopen.com/books/images_new/9785.jpg",editedByType:"Edited by",editors:[{id:"255491",title:"Dr.",name:"Courtney",middleName:null,surname:"Marsh",slug:"courtney-marsh",fullName:"Courtney Marsh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9018",title:"Some RNA Viruses",subtitle:null,isOpenForSubmission:!1,hash:"a5cae846dbe3692495fc4add2f60fd84",slug:"some-rna-viruses",bookSignature:"Yogendra Shah and Eltayb Abuelzein",coverURL:"https://cdn.intechopen.com/books/images_new/9018.jpg",editedByType:"Edited by",editors:[{id:"278914",title:"Ph.D.",name:"Yogendra",middleName:null,surname:"Shah",slug:"yogendra-shah",fullName:"Yogendra Shah"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8816",title:"Financial Crises",subtitle:"A Selection of Readings",isOpenForSubmission:!1,hash:"6f2f49fb903656e4e54280c79fabd10c",slug:"financial-crises-a-selection-of-readings",bookSignature:"Stelios Markoulis",coverURL:"https://cdn.intechopen.com/books/images_new/8816.jpg",editedByType:"Edited by",editors:[{id:"237863",title:"Dr.",name:"Stelios",middleName:null,surname:"Markoulis",slug:"stelios-markoulis",fullName:"Stelios Markoulis"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9585",title:"Advances in Complex Valvular Disease",subtitle:null,isOpenForSubmission:!1,hash:"ef64f11e211621ecfe69c46e60e7ca3d",slug:"advances-in-complex-valvular-disease",bookSignature:"Michael S. Firstenberg and Imran Khan",coverURL:"https://cdn.intechopen.com/books/images_new/9585.jpg",editedByType:"Edited by",editors:[{id:"64343",title:null,name:"Michael S.",middleName:"S",surname:"Firstenberg",slug:"michael-s.-firstenberg",fullName:"Michael S. Firstenberg"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10150",title:"Smart Manufacturing",subtitle:"When Artificial Intelligence Meets the Internet of Things",isOpenForSubmission:!1,hash:"87004a19de13702d042f8ff96d454698",slug:"smart-manufacturing-when-artificial-intelligence-meets-the-internet-of-things",bookSignature:"Tan Yen Kheng",coverURL:"https://cdn.intechopen.com/books/images_new/10150.jpg",editedByType:"Edited by",editors:[{id:"78857",title:"Dr.",name:"Tan Yen",middleName:null,surname:"Kheng",slug:"tan-yen-kheng",fullName:"Tan Yen Kheng"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9386",title:"Direct Numerical Simulations",subtitle:"An Introduction and Applications",isOpenForSubmission:!1,hash:"158a3a0fdba295d21ff23326f5a072d5",slug:"direct-numerical-simulations-an-introduction-and-applications",bookSignature:"Srinivasa Rao",coverURL:"https://cdn.intechopen.com/books/images_new/9386.jpg",editedByType:"Edited by",editors:[{id:"6897",title:"Dr.",name:"Srinivasa",middleName:"P",surname:"Rao",slug:"srinivasa-rao",fullName:"Srinivasa Rao"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9139",title:"Topics in Primary Care Medicine",subtitle:null,isOpenForSubmission:!1,hash:"ea774a4d4c1179da92a782e0ae9cde92",slug:"topics-in-primary-care-medicine",bookSignature:"Thomas F. Heston",coverURL:"https://cdn.intechopen.com/books/images_new/9139.jpg",editedByType:"Edited by",editors:[{id:"217926",title:"Dr.",name:"Thomas F.",middleName:null,surname:"Heston",slug:"thomas-f.-heston",fullName:"Thomas F. Heston"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9208",title:"Welding",subtitle:"Modern Topics",isOpenForSubmission:!1,hash:"7d6be076ccf3a3f8bd2ca52d86d4506b",slug:"welding-modern-topics",bookSignature:"Sadek Crisóstomo Absi Alfaro, Wojciech Borek and Błażej Tomiczek",coverURL:"https://cdn.intechopen.com/books/images_new/9208.jpg",editedByType:"Edited by",editors:[{id:"65292",title:"Prof.",name:"Sadek Crisostomo Absi",middleName:"C. Absi",surname:"Alfaro",slug:"sadek-crisostomo-absi-alfaro",fullName:"Sadek Crisostomo Absi Alfaro"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"1221",title:"Biomechanics",slug:"optics-and-lasers-biomechanics",parent:{title:"Optics and Lasers",slug:"optics-and-lasers"},numberOfBooks:0,numberOfAuthorsAndEditors:0,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicSlug:"optics-and-lasers-biomechanics",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[],booksByTopicTotal:0,mostCitedChapters:[],mostDownloadedChaptersLast30Days:[],onlineFirstChaptersFilter:{topicSlug:"optics-and-lasers-biomechanics",limit:3,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[{type:"book",id:"10176",title:"Microgrids and Local Energy Systems",subtitle:null,isOpenForSubmission:!0,hash:"c32b4a5351a88f263074b0d0ca813a9c",slug:null,bookSignature:"Prof. Nick Jenkins",coverURL:"https://cdn.intechopen.com/books/images_new/10176.jpg",editedByType:null,editors:[{id:"55219",title:"Prof.",name:"Nick",middleName:null,surname:"Jenkins",slug:"nick-jenkins",fullName:"Nick Jenkins"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],offset:8,limit:8,total:1},route:{name:"profile.detail",path:"/profiles/104151/kenji-konashi",hash:"",query:{},params:{id:"104151",slug:"kenji-konashi"},fullPath:"/profiles/104151/kenji-konashi",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()