\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"506",leadTitle:null,fullTitle:"Advanced Biomedical Engineering",title:"Advanced Biomedical Engineering",subtitle:null,reviewType:"peer-reviewed",abstract:"This book presents a collection of recent and extended academic works in selected topics of biomedical signal processing, bio-imaging and biomedical ethics and legislation. 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The nutrient nitrogen is an essential element required by all life forms including the plants due to the presence in essential molecules such as proteins, amino acids, and enzymes. Although, this nutrient is in a large amount in the atmosphere, a small group of microorganisms is able to fix it becoming them available to plants.
The biological and physical processes in an ecosystem convert the nitrogen into multiple chemical forms and the phenomenon is called as nitrogen cycle. Biological nitrogen fixation accounts for about 70% of the atmospheric nitrogen. The four steps involved in a nitrogen cycle, namely nitrogen fixation, ammonification, nitrifications, and denitrification are described in Figure 1.
The nitrogen cycle.
This process of nitrogen fixation is influenced by several aspects of biotic and abiotic variables. In this chapter, the effects of various factors especially the pesticide applications, temperature, and light as well as acidity, alkalinity, salinity, phosphorus, and water content status of the soils on the nitrogen fixation have been discussed briefly.
This chapter has addressed each environmental variable and discussed the effect of each one on the nitrogen fixation process and brings information related to it, for example, regarding the use of pesticides in an indiscriminate way. Usually, when the pesticides are used in the recommended dose, it does not harm the soil microbiota, but when the pesticides are overused, it may affect the physiological and growth characteristics of both rhizobia and legume plants. They also inhibit more or less the symbiotic nitrogen fixation by blocking biochemical communication and dialogues between the legumes and rhizobial symbionts.
In the current scenario of modern agriculture, agrochemicals play a key role in improving plant protection and production of food crops. Chemical pesticides are extensively used against a range of pests infesting agricultural crops worldwide. Due to the indiscriminate use of pesticides, the issue of the impact of these chemicals on the environment and soil has gained attention. Only about 0.1% of the total applied pesticides reach the target site/organism, while the remaining bulk contaminates the soil environment [1]. Consequently, sizable amounts of pesticides reach soil directly and indirectly, which affects the composition of soil microflora [2].
One of the most important and potentially limiting factors to biological nitrogen fixation is the use of chemical pesticides. Recommended doses of pesticides, in general, do not have any harmful effect on nitrogen fixation.
At higher doses, various chemical pesticides affect the physiological and growth characteristics of both rhizobia and legume plants. They also inhibit more or less the symbiotic nitrogen fixation by blocking biochemical communication and dialogues between the legumes and rhizobial symbionts [3].
Herbicides applied to leguminous crops constitute a potential hazard to the establishment and performance of the N2-fixing root nodules. Soil and foliar application of herbicide at the recommended rates altered the morphology of root hairs and reduced nodule numbers and nitrogenase activity [4]. Some rhizobium strains also shown resistance towards herbicides when isolated and grown in laboratory media.
Legume seeds are inoculated with specific rhizobium to increase yield and at the same time they are also treated with fungicides to disinfect and guard it against seed and soil-borne pathogens. It is imperative to know the effect of seed disinfectants on the efficacy of rhizobia. Earlier studies show fungicidal seed treatment is safe as far as nitrogen fixation by rhizobium in symbiosis with legumes is concerned. Contradictory, Osman et al. reported a very strong negative effect of the dose of the thiram on
Temperature has a significant influence on survival and persistence of N-fixing microbes in soils [6]. Elevated temperatures may delay nodule initiation and development, and interfere with nodule structure and functioning in temperate legumes. Whereas in tropical legumes, competitive ability and N fixation efficiency of legume symbionts are mainly affected. Similarly, low temperatures reduce nodule formation and nitrogen fixation in temperate legumes.
In the extreme environment (−40 to −68°C) of the high arctic, native legumes can nodulate and fix nitrogen at rates comparable to those observed with legumes in temperate climates [7]. This indicates that both the plants and their rhizobia have successfully adapted to arctic conditions.
At constant temperature (20°C) under long photoperiod (14 hours), plants may not show a significant decrease in N fixation in terms of fixation per plant or per unit nodule mass [8]. However, under a short photoperiod (6 hours) at the same temperature, plants show a significant decrease in N fixation. Under short photoperiod, plants compensate for reduced photosynthesis by maintaining only half the root nodule mass and N fixation activity as that of long photoperiod. However, similar rates of N2 fixation per unit mass of nodule may be observed in some plants under both the long and short photoperiods. This is because the shoot reserves for sustaining nitrogenase activity may compensate for reduced N fixation ability of plants.
A major problem associated with many acidic soils is metal toxicity. Highly acidic soils (pH < 4.0) frequently have low levels of phosphorus, calcium, and molybdenum and high levels of aluminium and manganese which are often toxic for both plants and symbiotic N-fixing bacteria [7]. Nodulation by this N-fixing bacteria is more affected than the normal growth of the host-plants in such conditions. It is a well-known fact that most leguminous plants grow less favourably in acidic conditions than in neutral or slightly alkaline conditions [9]. This is mainly due to a reduced nitrogen fixation as may be concluded from the improved growth at low pH upon the addition of combined nitrogen.
Highly alkaline soils (pH > 8.0) tend to be high in sodium chloride, bicarbonate, and borate, and are often associated with high salinity which reduces symbiotic nitrogen fixation [4]. However, the symbiotic N-fixing rhizobia, showing significantly higher salt tolerance, have been isolated from alkaline soils [10]. This suggests that the possession of high salt tolerance trait might be of some evolutionary significance for the survival of rhizobia in alkaline soils. Phosphate solubilising, alkaline tolerant rhizobia have also been isolated from wild legumes grown in dune systems of the southwest coast of India [11]. The stress tolerance traits of these rhizobia are of potential value in strain improvement of symbiotic bacteria for efficient N-fixing ability.
Soil salinity, which extremely increases in the protected cultivation, may occur when there are irregular irrigation schedules, inadequate drainage systems, wrong fertiliser applications, etc. [12]. The specific sensitivity of leguminous crops, where the N fixation is predominated by symbiotic bacteria, to soil salinity is well documented for initiation, development, and function of nodules [13]. An increase in salinity decreases the nodule permeability in these crops. This decrease is associated with a contraction of nodule inner-cortex cells and an increase in abscisic acid content of the nodule [14]. This phenomenon may lead to less survival of the symbiotic N-fixing bacteria associated with these crops. Even if the bacteria are survived, they may be less viable with decreased N-fixing ability. However, survival of the viable
Phosphorus deficiency in soils affects nodule functioning; however, it does not inhibit the other aspects of plant growth and metabolism. There exists an interaction between the plant’s growth and N fixation in response to increasing P supply [15]. This interaction may be positive, zero, or negative. A negative interaction suggests a greater need for P by N2-fixing plants; a zero interaction indicates that the plants have the same P requirement for growth and N fixation, while a positive interaction indicates that higher P supply may be inhibitory to N2 fixation (Figure 2).
Effects of phosphorus (P) status of soil on nitrogen fixation.
Legume tissues do not appear to have higher P content than those of other plants. Therefore a positive interaction exists between legume’s growth and N fixation in response to P supply (Figure 2). For example, in both soybean and lucerne (alfalfa), nodules from plants grown under P deficiency may have a higher concentration of P than those grown with sufficient P and may fix more N2 per unit of P [16].
Water influences the growth of soil micro-organisms through processes of diffusion, mass flow, and nutrient concentration [17]. Soil water retention is related to soil pore space, and soils containing larger pores and pore spaces retain less water. Thus, soil aggregates having smaller internal pore spaces offers more favourable environments for the growth of N-fixing microbes.
There is a high degree of correlation between soil water content and N-fixing activity [16]. Maximum N fixation occurs at about field capacity of soil and above this, the N-fixing activity may be reduced due to water logging. Slow natural drying of soil over a 6 week period may result in a progressive reduction of N-fixing activity, which can be restored by irrigation. This indicates that soil water availability is the major environmental factor affecting nitrogen fixation. It is plausible that water stress directly affects nodule activity. This effect may further be aggravated by reduced supplies of photosynthate due to wilted plant leaves [18].
Environmental variables such as pesticides, temperature, and light as well as acidity, alkalinity, salinity, phosphorus, and water content status of the soils have a significant impact on nitrogen fixation. Despite many decades of progress and the acquisition of ample information, the physiological and molecular bases of the effects of these environmental variables on the symbiotic and non-symbiotic N2 fixation systems remains largely unknown and empirical in nature. Although understanding these processes was originally thought to be straightforward and tractable, we now have learned that the flavonoid nod-gene inducers are specific for a particular N2 fixation system [19]. Needless to say that, the production of these inducers is influenced by environmental variables. Therefore, more work needs to be done to understand the underlying molecular bases for tolerance to environmental variables in both N2 fixation systems. Further, the genomics and proteomics tools need to be combined with traditional plant breeding and microbial selection studies in order to rapidly define and utilise their genetic loci involved in tolerance to environmental stresses.
We would like to thank all colleagues who have done work on nitrogen fixation and related fields. We apologise to colleagues whose work in this rapidly changing field was not directly cited in this review due to space limitations and timing. We would also like to thank anonymous reviewers for helpful comments.
All the vessels that drain blood out of the heart are called artery, and those that drain blood into the heart are called vein. Pulmonary veins, literally, are the vessels that transport oxygenated blood from the lungs back to the left atrium. The information of those veins is hardly found in veterinary textbooks. First of all, this chapter is focus on the development of those veins in fetus. If something wrongs during the process, different type of the abnormality leads to different results. The diagnosis, treatment and prognosis in human medicines are introduced simply in this chapter. In addition, pulmonary venous abnormalities in the veterinary medicines are reported in several species. Those case reports will also be briefly reviewed in this chapter.
The development of the cardiovascular system is complicated because it involves the process from before the folding of heart tube and extend to the later stage of vascular growth. In the vertebrate embryo, most discussion start from the Carnegie stage 12, which approximately equals to 28-30 days in human [1] and 2 days in chicken [2]. At this moment, the primitive pulmonary vein originates from the venous plexus of splanchnic mesoderm. The staining characteristic of the pulmonary vein orifices in the developing heart can prove that the pulmonary vein is not part of the heart tube: it has no atrial natriuretic factor and has connexin 40 (a transmembrane protein that responsible for electrical coupling mostly found in the nodal tissue) [3]. In addition, an observation study of chicken embryo using image analysis and three-dimensional reconstruction technique also revealed that the pulmonary vein is developing from the splanchnic plexus [4]. The venous plexus of splanchnic mesoderm is a great capillary network that spread from the heart to the liver, connecting cardinal and umbilicovitelline veins. In other words, the pulmonary vein is communicating with systemic venous system in the beginning. In the subsequent developmental process, this communication will degenerate, therefore separating the systemic and pulmonary venous systems (Figure 1) [5].
The normal pulmonary venous development. A, the lung buds are surrounded the splanchnic plexus that communicates umbilical veins and cardinal veins. B, Common pulmonary vein is formed and connected with the sinoatrial part of the heart. C, the connection between pulmonary and splanchnic venous plexus is disappearing. D, the common pulmonary vein develops to four distinct pulmonary veins that incorporates separately with the left atrium. LA, left atrium; LCCV, left common cardinal vein; LLB, left lung bud; RA, right atrium; RCCV, right common cardinal vein; RLB, right lung bud; UV, umbilical vein.
This common pulmonary vein connects the lung buds to the dorsal heart tube, where would develop to left atrium after the outgrowth of intertrial septum. At the level of left atrium, the common pulmonary vein would usually divide into four branches and incorporate with left atrium, forming the smooth part of the left atrium wall [6]. In a study using 26 normal human embryos, the initial process of formation of the human pulmonary vein is very similar to that seen in animal models; marked temporal and morphological difference between the development process of right- and left-side pulmonary veins was found: a much longer tributary being formed on the left than on the right [7].
Various congenital abnormalities of pulmonary veins can occur if anything is wrong during these developmental processes. The cor triatriatum sinister (CTS), a condition that left atrium is separated into two chambers by a membranous tissue, is thought to be the consequence of the inappropriate incorporation of pulmonary veins with the left atrium [7]. In addition, if the atrophy of connection between pulmonary veins and systemic venous system is fail, total or partial anomalous pulmonary venous connection (TAPVC or PAPVC) occurs, depending on the degree of remanent communication between systemic and pulmonary venous system [8].
The pulmonary veins, in contrast to systemic veins that collect deoxygenated blood from all organs except lungs, deliver oxygen-rich blood from the lungs to the left atrium. Generally, there are four tributaries of pulmonary vein that would form four ostia on the left atrial wall, two from the right cranial and caudal pulmonary vein and the other two from the left cranial and caudal pulmonary vein (Figure 2). The right cranial pulmonary vein collects blood from the right cranial and middle lung lobe, and the right caudal pulmonary vein receives blood from the right caudal and accessory lung lobe. The rest pulmonary veins serve for the corresponded lung lobs that they are named after [9].
Normal anatomy of pulmonary veins. The blue (deoxygenated) marks pulmonary arteries, and the red (oxygenated) marks the pulmonary veins.
In atypical but not rare situations in human, pulmonary veins that both originate from right (4%) or left (17.8%) may fuse into a common trunk before entering the left atrium [10]. Additional pulmonary veins derive from individual lung lobes can also happen. Generally, these variations of the number of pulmonary veins are not always problematic, but it may interfere with clinical decisions especially in surgical procedures.
In the species that have two atriums, two ventricles, and execute oxygen exchange via the lungs, the oxygenated blood is pumped from the aorta and sent into tissues. The oxygen, nutrients and metabolic products diffuse and exchange in the capillaries that converge and form the vein. Vena cava collect all the venous blood and return to right atrium, right ventricle and lungs. After oxygenation in the lung, these fresh, oxygen-rich blood is returned into left atrium via pulmonary veins, therefore complete the cycle of blood circulation.
Before we go deeper into more understanding of the pulmonary veins, there is an important concept that should be explained first. The cardiovascular system has several functions that are all indispensable to keep the body works normally. Maintaining the systemic arterial pressure is the first priority of the cardiovascular system, it means that the systemic arterial pressure is the last one that the decompensation occurs. The second one is to keep the cardiac output at an adequate level that can provide enough blood flow to the peripheral tissues. Maintaining the normal capillary pressure is the last priority, and therefore it is the reason that the first sign of heart failure is commonly those that associate with congestion [11]. In the cases of pulmonary vein abnormalities, although the pathophysiological mechanisms are different among diagnosis, the loss of normal capillary and venous pressure is often the end result of the developmental disorders. Patient is commonly presented to the clinic because of signs related to congestion. Therefore, we will discuss the pulmonary venous pressure in the next paragraph.
In the fetus, the pressure of the pulmonary system is higher compared to after birth because of very high pulmonary vascular resistance and resultant low pulmonary blood flow (only account for 10 to 15% of right heart stroke volume). The pulmonary vascular resistance falls after birth, and the pressure of pulmonary system drops to a lower level than the systemic circulation in normal setting [12]. In an experiment that studying normal dogs with light sedation, the mean pulmonary venous pressure (17.1 ± 6.5 mm Hg) is consistently slightly higher than mean left atrial pressure (13.4 ± 6.3 mm Hg), which is almost the same with mean pulmonary wedge pressure (13.3 ± 6.2 mm Hg). Considering that the lungs are a large organ that occupy the thorax cavity, the pulmonary venous pressure between locations that differ from altitude (distance from left atrium) is vary [13]. Generally, the pulmonary veins share the similar intravascular pressure with left atrium because there is no valve between them.
During ventricular systole and early diastole, the blood in the pulmonary veins flow into left atrium, and part of blood in the left atrium would regurgitates back into pulmonary veins when the atrial active pumping that corresponds to the ventricular late filling phase. The changes of pulmonary venous profile among different cardiac cycle can be record by the echocardiographic Doppler examination [14]. It is therefore reasonable that any reason that elevates pressure of the left atrium has the potential to increase the pulmonary venous pressure, because of the higher impedance of draining blood forward and larger regurgitated volume from the high-pressured left atrium.
Another important characteristic of vessel that we cannot forget when we are discussing the hemodynamic is the vascular distensibility and compliance. Distensibility is an ability of vessel whose volume can increase or decrease for every increase or decrease intravascular pressure, and the compliance is equal to distensibility times the volume of blood in the given portion of the circulation. Because of the different wall constitution between veins and arteries, the distensibility of veins is about eight times larger than that of arteries. That is, the venous system can conserve more blood and only has slightly elevation of the intravascular pressure [15]. The pulmonary veins have similar distensibility to the systemic veins, meaning that the pulmonary venous pressure would not exceed the normal range before large amount of blood is congested in the pulmonary capillary and veins.
Various congenital and acquired cardiovascular diseases that affecting pulmonary veins themselves and the left atrium could lead to the congestion of pulmonary veins. They can be simply classified into conditions that cause obstruction or pulmonary overcirculation. Occlusions of one or more pulmonary veins, and the divided left atrium (like the CTS) are examples that pulmonary venous blood flow has difficulties to get through obstacles in its normal pathway and therefore causing high pressure to the rest part of pulmonary veins. In addition, pulmonary overcirculation caused by intra- or extra-cardiac left to right shunting (atrial and ventricular septal defects, patent foramen ovale, patent ductus arteriosus, and anomalous pulmonary venous connection and so on) also has the potential to causes pulmonary congestion because of larger than normal volume that circulates the pulmonary vasculature. Among them, CTS, TAPVC and PAPVC are three of the good examples that is closely related to the development of pulmonary veins. We will discuss these diseases in the following sections.
The CTS is a relatively rare congenital cardiovascular disease that has been first reported in 1868 [16]. In an autopsy research, it was accounted for 0.1% to 0.4% in human patients with congenital heart disease [17]. In veterinary medicine, the true prevalence is hard to know because this abnormality is not always producing heart murmur and develops clinical signs that can be observed by the owner and the veterinarian at the general practice. By reviewing case reports, naturally-occurred CTS is identified more frequently in cats [18, 19, 20, 21, 22, 23] than in dogs [24, 25, 26].
The embryonic cause of CTS is still controversial, but the theory of pulmonary venous abnormality is the most popular. In the development of pulmonary veins, they should incorporate with left atrium and form four ostia on the smooth part of the dorsal left atrial wall. If certain degree of failure in this process occurs, the left atrium could be separated by the remains of the pulmonary veins, most of the time is a fibromuscular membrane. The left atrium is therefore divided to a proximal chamber that locates between the atriopulmonary junction and the fibromuscular membrane, and a distal chamber that extends from the fibromuscular membrane to the mitral valve annulus. The molecular cause of CTS was first reported in experimental mice without hyaluronidase 2, which is an enzyme required for the degradation of hyaluronan that is the major extracellular matrix component of the heart [27]. Later, the similar result was obtained by genetic studies in affected human families and mice [28].
Anatomic variation of the membrane exists and whether or how much of the blood flow would be impeded depends on the three-dimensional relative position between the membrane and left atrium. This intra-atrial septum can be complete, incomplete or fenestrated, and its size, shape, thickness and location can be varied among affected patients. Types of diaphragmatic, hourglass and tubular has been used to describe the variations [29]. In a retrospective study, the histopathology of the membranous tissue was investigated. Elastin fibers were found to be presence in the top and bottom side and was absent in the middle layer of the diaphragm. Cardiomyocytes with positive staining of cardiac troponin C were located in the peripheral region, more on the side that near the diaphragm and atrial septum than on the side that near the diaphragm and the atrial free wall. The remanent area was mostly made up by the fibrous collagen and other mesenchymal cells. These specimens were collected from human patients that undergo surgical repair of the Cor triatriatum sinister, without surgical death in this cohort [30].
Impendence of the blood flow in the left atrium could cause turbulence, but the pressure gradient between two chambers may be not large enough for the heart murmur to be heard. Elevated pressure in the proximal chamber of the left atrium could raise the intravascular pressure of the pulmonary veins, and signs of left-side congestive heart failure may occur. However, the natural progression of the CTS in human patients is generally stable, with more than half patients were diagnosed in adulthood. In patients that need surgical correction using cardiopulmonary bypass, the surgery is safe and effective [31].
Transthoracic echocardiography is usually helpful in making diagnosis [32]. Except for detecting Cor triatriatum sinister, the echocardiography can also identify concurrent lesions. High proportion (58%) of affected human patients had associated abnormalities, and atrial septal defect and anomalous pulmonary venous connection were the most common and should be always keep in mind [30, 31, 33]. Two feline cases had been published that one kitten had CTS combined with persistent left cranial vena cava [20], and the other was diagnosed CTS with incomplete atrioventricular septal defect [21]. Some conditions can mimic the CTS under two-dimensional imaging mode, including supramitral ring or pulmonary stenosis [34]. In cases that the echocardiographic result alone is controversial or is suspicious of having multiple cardiovascular developmental diseases, additional imaging tools should be considered. A special case that was diagnosed as CTS with TAPVC by echocardiography combined with saline contrast technique was report in 2020 [35]. In some conditions especially when our target area is located near the heart base, the transesophageal echocardiography can provide better image resolution and details than the transthoracic echocardiography. Cardiac catheterization angiography has its advantages that it can measure the true intra-lumen pressure, which is always an estimated value if only echocardiography is performed. However, its clinical utility is limited in the veterinary field because deep sedation to generalized anesthesia is usually required in veterinary patients. Other imaging tools like computed tomography angiography and magnetic resonance imaging can provide multiplaner image reconstruction and assist with the diagnosis process [29].
Early in the 1998, a kitten presented signs of respiratory distress and diagnosed with CTS was successfully surgically managed. The membrane was torn by a dilator introduced from an opened left atrium [18]. Procedure that combining thoracotomy and cardiac catheter guided cutting balloon was performed in a cat that signs of congestive heart failure resolved completely after the hybrid technique [22]. Surgical correction under cardiopulmonary bypass was also feasible in feline patient with appropriate body size and weight [23]. In canine, the first case was published in 2012, and the patient was doing well only by internal medical treatment for the congestive heart failure [25]. A poodle case was presented with acute dyspnea and cyanosis, and was unfortunately made its definite diagnosis in postmortem examination [26]. Recently, Toaldo et al. reported a 6-year-old intact male French bulldog was accidentally diagnosed as CTS [24].
By reviewing veterinary literature, we can find that cats are more frequently presented, and their age at diagnosis is generally younger (8 weeks old to 4 years old, mostly <1 year old) than dogs (3, 5 and 6 years old). Although most of affected cats had congestive heart failure at admission (this result can be biased in veterinary patients), the surgery is usually tolerable and the patient can be free of heart failure after procedure. Medicine for controlling congestive heart failure is an alternative option if surgery is not performed. Weather the surgery is also benefit and recommended in patient without heart failure is not conclusive.
Another important developmental abnormality of pulmonary vein is the anomalous pulmonary venous connection. In human medicine, the TAPVC was comprised of 1–5% congenital heart diseases cases [36] and 0.6 to 1.2 per 10,000 live births [37]. The PAPVC was found 0.4% to 0.7% in the routine autopsies [38, 39]. A retrospective study that reviewed 290 dogs with cardiovascular malformations from 1953 to 1965 revealed that only 1 case was diagnosed PAPVC with secundum atrial septal defect [40]. For the published case reports, there are only 3 dogs [41, 42, 43] and each 1 of chicken [44] and foal [45] that are diagnosed as TAPVC; only 4 dogs [46, 47, 48] and 2 cats [49, 50] are PAPVC. One canine case reported in 1975 did not describe its detail (TAPVC or PAPVC) [51].
As previous discussed, the primitive pulmonary veins from the lung buds develop from the splanchnic plexus, which communicates with the systemic venous system, and connects to the left atrium. As development proceeds, the connection between pulmonary veins and the systemic venous system disappears. If the communication between pulmonary veins and the systemic venous system persists, TAPVC or PAPVC would be diagnosed depending on the degree of persistent connections [8].
The TAPVC is that all pulmonary veins being abnormally connected to the systemic venous circulation, that is, the right atrium would receive both systemic and pulmonary venous return. Researchers had described four types of TAPVC depending on the connection level (Figure 3). Type I, or supra-cardiac type, is the most common type that consist 40–55% of cases. The pulmonary veins empty through left innominate vein, superior vena cava or azygos veins. Type II, or cardiac type, is the second common type that consist 15–30% of cases. The pulmonary veins drain into the right atrium through the coronary sinus or in the posterior wall of the right atrium. Type III, or infra-cardiac type, is accounting approximately 15–26% of cases. The pulmonary veins run to the portal venous system or inferior vena cava. And type IV, or mixed type, is representing 2–10% cases that there are at least two different drainage sites [52, 53].
The classification of TAPVR. Type I, the Supra-cardiac type; Type II, the cardiac type; Type III, the infra-cardiac type, and the Type IV, the mixed type. CaVC, caudal vena cava; CrVC, cranial vena cava; PA, pulmonary artery; PV, pulmonary vein; RA, right atrium.
In the setting of TAPVC, a right-to left shunt via an atrial septal defect (ASD), patent foramen ovale (PFO) or to a lesser extent of patent ductus arteriosus is required for completing circulation and maintaining life [54]. The presence of right (pulmonary) to left (systemic) shunting permits mixture of oxygenated and deoxygenated blood to enter the systemic circulation. Signs of dyspnea with exertion, cyanosis and exercise intolerance could be observed, and the patient is at risk of developing to pulmonary hypertension and congestive heart failure. Three veterinary cases were found to have concurrent ASD (secundum type in 1 dog [41] and 1 chicken [44]; sinus venous type in another dog [42]) and the case of foal [45] had concurrent PFO. A special child case had been recognized recently that all of his pulmonary veins were anatomically connected to the left atrium but the blood inside actually was drained into superior vena cava via an innominate vein, therefore corresponded to the definition of supra-cardiac type of anomaly [35].
Thoracic radiography is commonly the first imaging exam, it can be normal or some classic changes may exist depending on the types of abnormal connections. A snowman sign has been described in patients with supra-cardiac TAPVC. The head is formed by superior vena cava, vertical vein (common vein that formed by the four anomalous pulmonary veins) and innominate vein, and the body is formed by enlarged right atrium. Another famous radiographic characteristic is the scimitar signs in the PAPVC. It describes the anomalous pulmonary veins like a sword with a curved blade that mostly affect the right-side lung lobes [5, 55].
In addition, the clinical utility of echocardiography in diagnosing abnormalities of pulmonary venous connection is somewhat difficult because of limited echo window, but it can provide the information of the concurrent congenital cardiac anomalies and hemodynamic consequences like the dilated right heart or possible pulmonary hypertension. Transesophageal echocardiography has the advantage that it can access from the heart base aspect, therefore providing more clear images of the structures near the heart base. Right heart catherization can opacify the right heart chambers and venous vasculature but is limited that some small accessory and anomalous vessels may be missed.
For obtaining the full picture of abnormal development of pulmonary veins, multidetector computed tomography and magnetic resonance imaging both can provide good images. The importance of advanced imaging modules in diagnosing these complex cardiovascular developmental diseases had been emphasized in these years [49, 50]. Both of multidetector computed tomography and magnetic resonance imaging are non-invasive, and they can offer multiplanar and three-dimensional reconstructive model. Small lesions and details can be further illustrated by contrast median. Lack of ionizing radiation is the advantage of magnetic resonance imaging, but this procedure needs longer time and sedation which may be risky in some patients [53].
Generally, surgical repair is recommended at the time that TAPVC is diagnosed [56]. The surgical outcome is acceptable with the 6.6% of intraoperative and late death and 15% of recurrent pulmonary venous obstruction in the survivors. Risk factors for both undesired consequences including preoperative pulmonary venous obstruction, infra-cardiac type and mixed type [57]. This result emphasizes the importance of pre- and intra-operative assessment.
Partial anomalous pulmonary venous connection refers to equal to or more than 1, but not all, pulmonary veins being connected to the systemic venous circulation rather than the left atrium. Affected animals can exhibit no clinical signs or have symptoms associates with congestive heart failure and pulmonary hypertension. In the total of 6 veterinary cases, half of them were asymptomatic (2 miniature schnauzers [46] and 1 Devon Rex cat [49]) and the other half were presented with signs of decompensation (exercise intolerance in 1 Belgian Malinois dog [47], pulmonary edema in 1 toy poodle [48] and 1 American shorthair kitten [50]). The severity of symptoms depends on the number of affected pulmonary veins, that is, the degree of left-to-right shunt. A ratio of pulmonary to systemic blood flow (Qp:Qs) can be used to estimate the magnitude of left-to-right shunt, and the ratio greater than 1.5 to 2 is generally considered hemodynamic significant because the patient is at risk of pulmonary hypertension and heart failure, and surgical treatment is usually recommended in these cases [58].
According to the affected pulmonary veins, as many as 27 different anatomic variations had been proposed [59]. The characteristic of partial APVR in pediatric and adult populations varies significantly. In a prospective survey of pediatric patients, mostly (90%) were right-sided and in association of sinus venosus atrial septal defect [60]. In other two retrospective study that focused on adult (>18 years old), abnormal development of pulmonary vein from the left upper lobe was the most (ranging from 47–79%), followed by the right upper pulmonary vein (ranging from 17–38%) [61, 62]. The human patients that were diagnosed in childhood were mostly symptomatic, and those that diagnosed until adulthood were usually an incidental finding. Related signs including dyspnea, orthopnea, fatigue, chest pain, palpitations, tachycardia, and peripheral edema [53].
Surgical repair of the PAPVC with different strategies (intracardiac baffle, pulmonary vein implantation, or superior vena cava division with reimplantation on the right atrial appendage) in children showed excellent outcomes [60]. In a case series that only contain adult patients (20 to 66 years old), conservative management with close monitoring is recommended in asymptomatic patients, and the surgical outcomes in symptomatic patients are usually excellent with low complication rate [63]. Sinus node dysfunction and postoperative venous stenosis are the possible consequences followed surgery [64]. In a recent canine case, his PAPVC and sinus venosus ASD were successfully repaired by single-patch method under cardiopulmonary bypass. The patient remained stable and free of clinical signs in the following one year, suggesting that this is a valid treatment option for other similar case [48].
We can find that the terms of “connection”, “drainage” and “return” are all used in the literature to describe the abnormality. The “connection” indicates an anomalous venoatrial connection, whereas the word “drainage” or “return” describe the concept of abnormal pulmonary venous return despite normal anatomical connection [65]. Appropriate wording should be applied depending on the individual case. By reviewing veterinary literature, the clinical manifestation of TAPVC or PAPVC can vary depending on the individual. Owing to the scarcity of these diseases, we still know little about them. Future reports, including studies before and after death, treatment options and related outcome, are warrant.
In this chapter, we describe the embryology, physiological function and congenital diseases associated with pulmonary veins. The developmental process of the cardiovascular system is complicated, and every step is crucial. The CTS, TAPVC and PAPVC are rare congenital cardiovascular diseases in human and other animals, and can be asymptomatic or life-threatening. The improvement of advance imaging modules helps in diagnosing these abnormalities, particularly those have multiple concurrent developmental diseases. Knowledges regarding to the treatment intervention in the veterinary medicine is much less than the human medicine, further studies are welcome to provide more information.
We really appreciate of Dong-Hua, Liu, who provided these wonderful drawings for our chapter.
The authors declare no conflict of interest.
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His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,annualVolume:11421,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. 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She is also a UNESCO-trained International Bioethics Facilitator.",institutionString:"University of the Witwatersrand",institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"419588",title:"Ph.D.",name:"Sergio",middleName:"Alexandre",surname:"Gehrke",slug:"sergio-gehrke",fullName:"Sergio Gehrke",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038WgMKQA0/Profile_Picture_2022-06-02T11:44:20.jpg",biography:"Dr. Sergio Alexandre Gehrke is a doctorate holder in two fields. The first is a Ph.D. in Cellular and Molecular Biology from the Pontificia Catholic University, Porto Alegre, Brazil, in 2010 and the other is an International Ph.D. in Bioengineering from the Universidad Miguel Hernandez, Elche/Alicante, Spain, obtained in 2020. In 2018, he completed a postdoctoral fellowship in Materials Engineering in the NUCLEMAT of the Pontificia Catholic University, Porto Alegre, Brazil. He is currently the Director of the Postgraduate Program in Implantology of the Bioface/UCAM/PgO (Montevideo, Uruguay), Director of the Cathedra of Biotechnology of the Catholic University of Murcia (Murcia, Spain), an Extraordinary Full Professor of the Catholic University of Murcia (Murcia, Spain) as well as the Director of the private center of research Biotecnos – Technology and Science (Montevideo, Uruguay). Applied biomaterials, cellular and molecular biology, and dental implants are among his research interests. He has published several original papers in renowned journals. In addition, he is also a Collaborating Professor in several Postgraduate programs at different universities all over the world.",institutionString:null,institution:{name:"Universidad Católica San Antonio de Murcia",country:{name:"Spain"}}},{id:"342152",title:"Dr.",name:"Santo",middleName:null,surname:"Grace Umesh",slug:"santo-grace-umesh",fullName:"Santo Grace Umesh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/342152/images/16311_n.jpg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"333647",title:"Dr.",name:"Shreya",middleName:null,surname:"Kishore",slug:"shreya-kishore",fullName:"Shreya Kishore",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333647/images/14701_n.jpg",biography:"Dr. Shreya Kishore completed her Bachelor in Dental Surgery in Chettinad Dental College and Research Institute, Chennai, and her Master of Dental Surgery (Orthodontics) in Saveetha Dental College, Chennai. She is also Invisalign certified. She’s working as a Senior Lecturer in the Department of Orthodontics, SRM Dental College since November 2019. She is actively involved in teaching orthodontics to the undergraduates and the postgraduates. Her clinical research topics include new orthodontic brackets, fixed appliances and TADs. She’s published 4 articles in well renowned indexed journals and has a published patency of her own. Her private practice is currently limited to orthodontics and works as a consultant in various clinics.",institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"323731",title:"Prof.",name:"Deepak M.",middleName:"Macchindra",surname:"Vikhe",slug:"deepak-m.-vikhe",fullName:"Deepak M. Vikhe",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/323731/images/13613_n.jpg",biography:"Dr Deepak M.Vikhe .\n\n\t\n\tDr Deepak M.Vikhe , completed his Masters & PhD in Prosthodontics from Rural Dental College, Loni securing third rank in the Pravara Institute of Medical Sciences Deemed University. He was awarded Dr.G.C.DAS Memorial Award for Research on Implants at 39th IPS conference Dubai (U A E).He has two patents under his name. He has received Dr.Saraswati medal award for best research for implant study in 2017.He has received Fully funded scholarship to Spain ,university of Santiago de Compostela. He has completed fellowship in Implantlogy from Noble Biocare. \nHe has attended various conferences and CDE programmes and has national publications to his credit. His field of interest is in Implant supported prosthesis. Presently he is working as a associate professor in the Dept of Prosthodontics, Rural Dental College, Loni and maintains a successful private practice specialising in Implantology at Rahata.\n\nEmail: drdeepak_mvikhe@yahoo.com..................",institutionString:null,institution:{name:"Pravara Institute of Medical Sciences",country:{name:"India"}}},{id:"204110",title:"Dr.",name:"Ahmed A.",middleName:null,surname:"Madfa",slug:"ahmed-a.-madfa",fullName:"Ahmed A. Madfa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204110/images/system/204110.jpg",biography:"Dr. Madfa is currently Associate Professor of Endodontics at Thamar University and a visiting lecturer at Sana'a University and University of Sciences and Technology. He has more than 6 years of experience in teaching. His research interests include root canal morphology, functionally graded concept, dental biomaterials, epidemiology and dental education, biomimetic restoration, finite element analysis and endodontic regeneration. Dr. Madfa has numerous international publications, full articles, two patents, a book and a book chapter. Furthermore, he won 14 international scientific awards. Furthermore, he is involved in many academic activities ranging from editorial board member, reviewer for many international journals and postgraduate students' supervisor. Besides, I deliver many courses and training workshops at various scientific events. Dr. Madfa also regularly attends international conferences and holds administrative positions (Deputy Dean of the Faculty for Students’ & Academic Affairs and Deputy Head of Research Unit).",institutionString:"Thamar University",institution:null},{id:"210472",title:"Dr.",name:"Nermin",middleName:"Mohammed Ahmed",surname:"Yussif",slug:"nermin-yussif",fullName:"Nermin Yussif",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210472/images/system/210472.jpg",biography:"Dr. Nermin Mohammed Ahmed Yussif is working at the Faculty of dentistry, University for October university for modern sciences and arts (MSA). Her areas of expertise include: periodontology, dental laserology, oral implantology, periodontal plastic surgeries, oral mesotherapy, nutrition, dental pharmacology. She is an editor and reviewer in numerous international journals.",institutionString:"MSA University",institution:null},{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",biography:"Dr. Serdar Gözler has completed his undergraduate studies at the Marmara University Faculty of Dentistry in 1978, followed by an assistantship in the Prosthesis Department of Dicle University Faculty of Dentistry. Starting his PhD work on non-resilient overdentures with Assoc. Prof. Hüsnü Yavuzyılmaz, he continued his studies with Prof. Dr. Gürbüz Öztürk of Istanbul University Faculty of Dentistry Department of Prosthodontics, this time on Gnatology. He attended training programs on occlusion, neurology, neurophysiology, EMG, radiology and biostatistics. In 1982, he presented his PhD thesis \\Gerber and Lauritzen Occlusion Analysis Techniques: Diagnosis Values,\\ at Istanbul University School of Dentistry, Department of Prosthodontics. As he was also working with Prof. Senih Çalıkkocaoğlu on The Physiology of Chewing at the same time, Gözler has written a chapter in Çalıkkocaoğlu\\'s book \\Complete Prostheses\\ entitled \\The Place of Neuromuscular Mechanism in Prosthetic Dentistry.\\ The book was published five times since by the Istanbul University Publications. Having presented in various conferences about occlusion analysis until 1998, Dr. Gözler has also decided to use the T-Scan II occlusion analysis method. Having been personally trained by Dr. Robert Kerstein on this method, Dr. Gözler has been lecturing on the T-Scan Occlusion Analysis Method in conferences both in Turkey and abroad. Dr. Gözler has various articles and presentations on Digital Occlusion Analysis methods. He is now Head of the TMD Clinic at Prosthodontic Department of Faculty of Dentistry , Istanbul Aydın University , Turkey.",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",biography:"Dr. Al Ostwani Alaa Eddin Omar received his Master in dentistry from Damascus University in 2010, and his Ph.D. in Pediatric Dentistry from Damascus University in 2014. Dr. Al Ostwani is an assistant professor and faculty member at IUST University since 2014. \nDuring his academic experience, he has received several awards including the scientific research award from the Union of Arab Universities, the Syrian gold medal and the international gold medal for invention and creativity. Dr. Al Ostwani is a Member of the International Association of Dental Traumatology and the Syrian Society for Research and Preventive Dentistry since 2017. He is also a Member of the Reviewer Board of International Journal of Dental Medicine (IJDM), and the Indian Journal of Conservative and Endodontics since 2016.",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",country:{name:"India"}}},{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",biography:"Dr. Belma IşIk Aslan was born in 1976 in Ankara-TURKEY. After graduating from TED Ankara College in 1994, she attended to Gazi University, Faculty of Dentistry in Ankara. She completed her PhD in orthodontic education at Gazi University between 1999-2005. Dr. Işık Aslan stayed at the Providence Hospital Craniofacial Institude and Reconstructive Surgery in Michigan, USA for three months as an observer. She worked as a specialist doctor at Gazi University, Dentistry Faculty, Department of Orthodontics between 2005-2014. She was appointed as associate professor in January, 2014 and as professor in 2021. Dr. Işık Aslan still works as an instructor at the same faculty. She has published a total of 35 articles, 10 book chapters, 39 conference proceedings both internationally and nationally. Also she was the academic editor of the international book 'Current Advances in Orthodontics'. She is a member of the Turkish Orthodontic Society and Turkish Cleft Lip and Palate Society. She is married and has 2 children. Her knowledge of English is at an advanced level.",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null},{id:"178412",title:"Associate Prof.",name:"Guhan",middleName:null,surname:"Dergin",slug:"guhan-dergin",fullName:"Guhan Dergin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178412/images/6954_n.jpg",biography:"Assoc. Prof. Dr. Gühan Dergin was born in 1973 in Izmit. He graduated from Marmara University Faculty of Dentistry in 1999. He completed his specialty of OMFS surgery in Marmara University Faculty of Dentistry and obtained his PhD degree in 2006. In 2005, he was invited as a visiting doctor in the Oral and Maxillofacial Surgery Department of the University of North Carolina, USA, where he went on a scholarship. Dr. Dergin still continues his academic career as an associate professor in Marmara University Faculty of Dentistry. He has many articles in international and national scientific journals and chapters in books.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178414",title:"Prof.",name:"Yusuf",middleName:null,surname:"Emes",slug:"yusuf-emes",fullName:"Yusuf Emes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178414/images/6953_n.jpg",biography:"Born in Istanbul in 1974, Dr. Emes graduated from Istanbul University Faculty of Dentistry in 1997 and completed his PhD degree in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery in 2005. He has papers published in international and national scientific journals, including research articles on implantology, oroantral fistulas, odontogenic cysts, and temporomandibular disorders. Dr. Emes is currently working as a full-time academic staff in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery.",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"192229",title:"Ph.D.",name:"Ana Luiza",middleName:null,surname:"De Carvalho Felippini",slug:"ana-luiza-de-carvalho-felippini",fullName:"Ana Luiza De Carvalho Felippini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192229/images/system/192229.jpg",biography:null,institutionString:"University of São Paulo",institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"256851",title:"Prof.",name:"Ayşe",middleName:null,surname:"Gülşen",slug:"ayse-gulsen",fullName:"Ayşe Gülşen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256851/images/9696_n.jpg",biography:"Dr. Ayşe Gülşen graduated in 1990 from Faculty of Dentistry, University of Ankara and did a postgraduate program at University of Gazi. \nShe worked as an observer and research assistant in Craniofacial Surgery Departments in New York, Providence Hospital in Michigan and Chang Gung Memorial Hospital in Taiwan. \nShe works as Craniofacial Orthodontist in Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi, Ankara Turkey since 2004.",institutionString:"Univeristy of Gazi",institution:null},{id:"255366",title:"Prof.",name:"Tosun",middleName:null,surname:"Tosun",slug:"tosun-tosun",fullName:"Tosun Tosun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255366/images/7347_n.jpg",biography:"Graduated at the Faculty of Dentistry, University of Istanbul, Turkey in 1989;\nVisitor Assistant at the University of Padua, Italy and Branemark Osseointegration Center of Treviso, Italy between 1993-94;\nPhD thesis on oral implantology in University of Istanbul and was awarded the academic title “Dr.med.dent.”, 1997;\nHe was awarded the academic title “Doç.Dr.” (Associated Professor) in 2003;\nProficiency in Botulinum Toxin Applications, Reading-UK in 2009;\nMastership, RWTH Certificate in Laser Therapy in Dentistry, AALZ-Aachen University, Germany 2009-11;\nMaster of Science (MSc) in Laser Dentistry, University of Genoa, Italy 2013-14.\n\nDr.Tosun worked as Research Assistant in the Department of Oral Implantology, Faculty of Dentistry, University of Istanbul between 1990-2002. \nHe worked part-time as Consultant surgeon in Harvard Medical International Hospitals and John Hopkins Medicine, Istanbul between years 2007-09.\u2028He was contract Professor in the Department of Surgical and Diagnostic Sciences (DI.S.C.), Medical School, University of Genova, Italy between years 2011-16. \nSince 2015 he is visiting Professor at Medical School, University of Plovdiv, Bulgaria. \nCurrently he is Associated Prof.Dr. at the Dental School, Oral Surgery Dept., Istanbul Aydin University and since 2003 he works in his own private clinic in Istanbul, Turkey.\u2028\nDr.Tosun is reviewer in journal ‘Laser in Medical Sciences’, reviewer in journal ‘Folia Medica\\', a Fellow of the International Team for Implantology, Clinical Lecturer of DGZI German Association of Oral Implantology, Expert Lecturer of Laser&Health Academy, Country Representative of World Federation for Laser Dentistry, member of European Federation of Periodontology, member of Academy of Laser Dentistry. Dr.Tosun presents papers in international and national congresses and has scientific publications in international and national journals. He speaks english, spanish, italian and french.",institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",biography:"Zühre Akarslan was born in 1977 in Cyprus. She graduated from Gazi University Faculty of Dentistry, Ankara, Turkey in 2000. \r\nLater she received her Ph.D. degree from the Oral Diagnosis and Radiology Department; which was recently renamed as Oral and Dentomaxillofacial Radiology, from the same university. \r\nShe is working as a full-time Associate Professor and is a lecturer and an academic researcher. \r\nHer expertise areas are dental caries, cancer, dental fear and anxiety, gag reflex in dentistry, oral medicine, and dentomaxillofacial radiology.",institutionString:"Gazi University",institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"256417",title:"Associate Prof.",name:"Sanaz",middleName:null,surname:"Sadry",slug:"sanaz-sadry",fullName:"Sanaz Sadry",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256417/images/8106_n.jpg",biography:null,institutionString:null,institution:null},{id:"272237",title:"Dr.",name:"Pinar",middleName:"Kiymet",surname:"Karataban",slug:"pinar-karataban",fullName:"Pinar Karataban",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272237/images/8911_n.png",biography:"Assist.Prof.Dr.Pınar Kıymet Karataban, DDS PhD \n\nDr.Pınar Kıymet Karataban was born in Istanbul in 1975. After her graduation from Marmara University Faculty of Dentistry in 1998 she started her PhD in Paediatric Dentistry focused on children with special needs; mainly children with Cerebral Palsy. She finished her pHD thesis entitled \\'Investigation of occlusion via cast analysis and evaluation of dental caries prevalance, periodontal status and muscle dysfunctions in children with cerebral palsy” in 2008. She got her Assist. Proffessor degree in Istanbul Aydın University Paediatric Dentistry Department in 2015-2018. ın 2019 she started her new career in Bahcesehir University, Istanbul as Head of Department of Pediatric Dentistry. In 2020 she was accepted to BAU International University, Batumi as Professor of Pediatric Dentistry. She’s a lecturer in the same university meanwhile working part-time in private practice in Ege Dental Studio (https://www.egedisklinigi.com/) a multidisciplinary dental clinic in Istanbul. Her main interests are paleodontology, ancient and contemporary dentistry, oral microbiology, cerebral palsy and special care dentistry. She has national and international publications, scientific reports and is a member of IAPO (International Association for Paleodontology), IADH (International Association of Disability and Oral Health) and EAPD (European Association of Pediatric Dentistry).",institutionString:null,institution:null},{id:"202198",title:"Dr.",name:"Buket",middleName:null,surname:"Aybar",slug:"buket-aybar",fullName:"Buket Aybar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202198/images/6955_n.jpg",biography:"Buket Aybar, DDS, PhD, was born in 1971. She graduated from Istanbul University, Faculty of Dentistry, in 1992 and completed her PhD degree on Oral and Maxillofacial Surgery in Istanbul University in 1997.\nDr. Aybar is currently a full-time professor in Istanbul University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery. She has teaching responsibilities in graduate and postgraduate programs. Her clinical practice includes mainly dentoalveolar surgery.\nHer topics of interest are biomaterials science and cell culture studies. She has many articles in international and national scientific journals and chapters in books; she also has participated in several scientific projects supported by Istanbul University Research fund.",institutionString:null,institution:null},{id:"260116",title:"Dr.",name:"Mehmet",middleName:null,surname:"Yaltirik",slug:"mehmet-yaltirik",fullName:"Mehmet Yaltirik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/260116/images/7413_n.jpg",biography:"Birth Date 25.09.1965\r\nBirth Place Adana- Turkey\r\nSex Male\r\nMarrial Status Bachelor\r\nDriving License Acquired\r\nMother Tongue Turkish\r\n\r\nAddress:\r\nWork:University of Istanbul,Faculty of Dentistry, Department of Oral Surgery and Oral Medicine 34093 Capa,Istanbul- TURKIYE",institutionString:null,institution:null},{id:"172009",title:"Dr.",name:"Fatma Deniz",middleName:null,surname:"Uzuner",slug:"fatma-deniz-uzuner",fullName:"Fatma Deniz Uzuner",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/172009/images/7122_n.jpg",biography:"Dr. Deniz Uzuner was born in 1969 in Kocaeli-TURKEY. After graduating from TED Ankara College in 1986, she attended the Hacettepe University, Faculty of Dentistry in Ankara. \nIn 1993 she attended the Gazi University, Faculty of Dentistry, Department of Orthodontics for her PhD education. After finishing the PhD education, she worked as orthodontist in Ankara Dental Hospital under the Turkish Government, Ministry of Health and in a special Orthodontic Clinic till 2011. Between 2011 and 2016, Dr. Deniz Uzuner worked as a specialist in the Department of Orthodontics, Faculty of Dentistry, Gazi University in Ankara/Turkey. In 2016, she was appointed associate professor. Dr. Deniz Uzuner has authored 23 Journal Papers, 3 Book Chapters and has had 39 oral/poster presentations. She is a member of the Turkish Orthodontic Society. Her knowledge of English is at an advanced level.",institutionString:null,institution:null},{id:"332914",title:"Dr.",name:"Muhammad Saad",middleName:null,surname:"Shaikh",slug:"muhammad-saad-shaikh",fullName:"Muhammad Saad Shaikh",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jinnah Sindh Medical University",country:{name:"Pakistan"}}},{id:"315775",title:"Dr.",name:"Feng",middleName:null,surname:"Luo",slug:"feng-luo",fullName:"Feng Luo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Sichuan University",country:{name:"China"}}},{id:"423519",title:"Dr.",name:"Sizakele",middleName:null,surname:"Ngwenya",slug:"sizakele-ngwenya",fullName:"Sizakele Ngwenya",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"419270",title:"Dr.",name:"Ann",middleName:null,surname:"Chianchitlert",slug:"ann-chianchitlert",fullName:"Ann Chianchitlert",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419271",title:"Dr.",name:"Diane",middleName:null,surname:"Selvido",slug:"diane-selvido",fullName:"Diane Selvido",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419272",title:"Dr.",name:"Irin",middleName:null,surname:"Sirisoontorn",slug:"irin-sirisoontorn",fullName:"Irin Sirisoontorn",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"355660",title:"Dr.",name:"Anitha",middleName:null,surname:"Mani",slug:"anitha-mani",fullName:"Anitha Mani",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"355612",title:"Dr.",name:"Janani",middleName:null,surname:"Karthikeyan",slug:"janani-karthikeyan",fullName:"Janani Karthikeyan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"334400",title:"Dr.",name:"Suvetha",middleName:null,surname:"Siva",slug:"suvetha-siva",fullName:"Suvetha Siva",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}}]}},subseries:{item:{id:"1",type:"subseries",title:"Oral Health",keywords:"Oral health, Dental care, Diagnosis, Diagnostic imaging, Early diagnosis, Oral cancer, Conservative treatment, Epidemiology, Comprehensive dental care, Complementary therapies, Holistic health",scope:"
\r\n This topic aims to provide a comprehensive overview of the latest trends in Oral Health based on recent scientific evidence. Subjects will include an overview of oral diseases and infections, systemic diseases affecting the oral cavity, prevention, diagnosis, treatment, epidemiology, as well as current clinical recommendations for the management of oral, dental, and periodontal diseases.
",coverUrl:"https://cdn.intechopen.com/series_topics/covers/1.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11397,editor:{id:"173955",title:"Prof.",name:"Sandra",middleName:null,surname:"Marinho",slug:"sandra-marinho",fullName:"Sandra Marinho",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRGYMQA4/Profile_Picture_2022-06-01T13:22:41.png",biography:"Dr. Sandra A. Marinho is an Associate Professor and Brazilian researcher at the State University of Paraíba (Universidade Estadual da Paraíba- UEPB), Campus VIII, located in Araruna, state of Paraíba since 2011. She holds a degree in Dentistry from the Federal University of Alfenas (UNIFAL), while her specialization and professional improvement in Stomatology took place at Hospital Heliopolis (São Paulo, SP). Her qualifications are: a specialist in Dental Imaging and Radiology, Master in Dentistry (Periodontics) from the University of São Paulo (FORP-USP, Ribeirão Preto, SP), and Doctor (Ph.D.) in Dentistry (Stomatology Clinic) from Hospital São Lucas of the Pontifical Catholic University of Rio Grande do Sul (HSL-PUCRS, Porto Alegre, RS). She held a postdoctoral internship at the Federal University from Jequitinhonha and Mucuri Valleys (UFVJM, Diamantina, MG). She is currently a member of the Brazilian Society for Dental Research (SBPqO) and the Brazilian Society of Stomatology and Pathology (SOBEP). Dr. Marinho's experience in Dentistry mainly covers the following subjects: oral diagnosis, oral radiology; oral medicine; lesions and oral infections; oral pathology, laser therapy and epidemiological studies.",institutionString:null,institution:{name:"State University of Paraíba",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,series:{id:"3",title:"Dentistry",doi:"10.5772/intechopen.71199",issn:"2631-6218"},editorialBoard:[{id:"267724",title:"Dr.",name:"Febronia",middleName:null,surname:"Kahabuka",slug:"febronia-kahabuka",fullName:"Febronia Kahabuka",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRZpJQAW/Profile_Picture_2022-06-27T12:00:42.JPG",institutionString:null,institution:null}]},onlineFirstChapters:{paginationCount:1,paginationItems:[{id:"82310",title:"Knowledge of Intergenerational Contact to Combat Ageism towards Older People",doi:"10.5772/intechopen.105592",signatures:"Alice Nga Lai Kwong",slug:"knowledge-of-intergenerational-contact-to-combat-ageism-towards-older-people",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Social Aspects of Ageing - 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