Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\n
We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\n
Throughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\n
We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
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From their direct and recent experience, the readers can achieve a wide vision on the new and ongoing potentialities of different synthetic and engineered biomaterials. Contributions were selected not based on a direct market or clinical interest, but based on results coming from very fundamental studies. This too will allow to gain a more general view of what and how the various biomaterials can do and work for, along with the methodologies necessary to design, develop and characterize them, without the restrictions necessarily imposed by industrial or profit concerns. The chapters have been arranged to give readers an organized view of this research area. In particular, this book contains 25 chapters related to recent researches on new and known materials, with a particular attention to their physical, mechanical and chemical characterization, along with biocompatibility and hystopathological studies. 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\r\n\tSince the discovery of toroidal oligosaccharide-based seminatural products so-called cyclodextrins around 130 years ago by Villiers, they seem to be the most studied macrocyclic hosts in supramolecular chemistry. Interestingly, cyclodextrins are produced hundreds-of-thousands of tons every year through environmentally benign techniques and methods. More importantly, their crucial properties can be altered significantly through their ability to form inclusion complexes and also utilize their functionalizations. Remarkably, their unique ‘molecular encapsulation feature’ had already been exploited in a myriad of industrial products, technologies, & analytical practices. And their fascination towards researchers & industrialists worldwide could be seen from their diverse vital applications in pharmacy, biomedicine, nanotechnology, environmental protection, wastewater treatment, solar cells, conducting polymer, catalysis, drug-carriers, agrochemistry & cosmetology, etc. In contrast to the earlier books on cyclodextrins, herewith we planned to showcase the new developments in this emerging area with an intention, Of where this wonderful field presently stands and where it might go in years to come. Hope this new package in cyclodextrin chemistry would be informative to the readers of both academia & industry in addition to the undergraduate and post-graduate students.
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He has 12 years of research experience, one spent at Sookmyung Women's University, South Korea, and is a holder of more than 45 original papers published in journals including Nature Chemistry, JACS, Chem. Commun., Green chemistry, and Coord. Chem. Rev. He has also published several book chapters and many more are on the way; he authored a book (currently under preparation) in Bentham Science entitled ‘Indicator Displacement Assays (IDAs): An Innovative Molecular Sensing Approach’. Besides having numerous collaborations worldwide he is also a reviewer for numerous international journals. 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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:"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:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],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:"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:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"872",title:"Organic Pollutants Ten Years After the Stockholm Convention",subtitle:"Environmental and Analytical Update",isOpenForSubmission:!1,hash:"f01dc7077e1d23f3d8f5454985cafa0a",slug:"organic-pollutants-ten-years-after-the-stockholm-convention-environmental-and-analytical-update",bookSignature:"Tomasz Puzyn and Aleksandra Mostrag-Szlichtyng",coverURL:"https://cdn.intechopen.com/books/images_new/872.jpg",editedByType:"Edited by",editors:[{id:"84887",title:"Dr.",name:"Tomasz",surname:"Puzyn",slug:"tomasz-puzyn",fullName:"Tomasz Puzyn"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"26182",title:"Acute Biliary Pancreatitis",doi:"10.5772/26272",slug:"acute-biliary-pancreatitis",body:'\n\t\t
\n\t\t\t
1. Introduction
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Acute pancreatitis is an inflammatory disease of the pancreas. The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide. It can be initiated by several factors, including gallstones, alcohol, trauma, infections and hereditary factors. About 75% of pancreatitis is caused by gallstones or alcohol. In this chapter we discuss the causes, diagnosis, imaging findings, therapy, and complications of acute biliary pancreatitis.
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2. Anatomy and physiology
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The pancreas is perhaps the most unforgiving organ in the human body, leading most surgeons to avoid even palpating it unless necessary. Situated deep in the center of the abdomen, the pancreas is surrounded by numerous important structures and major blood vessels. Surgeons that choose to undertake surgery on the pancreas require a thorough knowledge of its anatomy. However, knowledge of the relationships of the pancreas and surrounding structures is also critically important for all surgeons to ensure that pancreatic injury is avoided during surgery on other structures.
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The pancreas is a retroperitoneal organ that lies in an oblique position, sloping upward from the C-loop of the duodenum to the splenic hilum. In an adult, the pancreas weighs 75 to 100 g and is about 15 to 20 cm long. The fact that the pancreas is situated so deeply in the abdomen and is sealed in the retroperitoneum explains the poorly localized and sometimes ill-defined nature with which pancreatic pathology presents.
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Surgeons typically describe the location of pathology within the pancreas in relation to four regions: the head, neck, body, and tail. The head of the pancreas is nestled in the C-loop of the duodenum and is posterior to the transverse mesocolon.
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Most of the pancreas drains through the duct of Wirsung, or main pancreatic duct, into the common channel formed from the bile duct and pancreatic duct. (Figure 1) The length of the common channel is variable. In about one third of patients, the bile duct and pancreatic duct remain distinct to the end of the papilla, the two ducts merge at the end of the papilla in another one third, and in the remaining one third, a true common channel is present for a distance of several millimeters.
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The main pancreatic duct is usually only 2 to 3 mm in diameter and runs midway between the superior and inferior borders of the pancreas, usually closer to the posterior than to the anterior surface. Pressure inside the pancreatic duct is about twice that in the common bile duct, which is thought to prevent reflux of bile into the pancreatic duct. The main pancreatic duct joins with the common bile duct and empties at the ampulla of Vater or major papilla, which is located on the medial aspect of the second portion of the duodenum. The muscle fibers around the ampulla form the sphincter of Oddi, which controls the flow of pancreatic and biliary secretions into the duodenum. Contraction and relaxation of the sphincter is regulated by complex neural and hormonal factors.
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Figure 1.
Pancreas and biliary system anatomy
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The exocrine pancreas accounts for about 85% of the pancreatic mass; 10% of the gland is accounted for by extracellular matrix, and 4% by blood vessels and the major ducts, whereas only 2% of the gland is comprised of endocrine tissue.
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The pancreas secretes approximately 500 to 800 mL per day of colorless, odorless, alkaline, isosmotic pancreatic juice. Pancreatic juice is a combination of acinar cell and duct cell secretions. The acinar cells secrete amylase, proteases, and lipases, enzymes responsible for the digestion of all three food types: carbohydrate, protein, and fat. The acinar cells are pyramid-shaped, with their apices facing the lumen of the acinus. Near the apex of each cell are numerous enzyme-containing zymogen granules that fuse with the apical cell membrane.
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Pancreatic amylase is secreted in its active form and completes the digestive process already begun by salivary amylase. Amylase is the only pancreatic enzyme secreted in its active form, and it hydrolyzes starch and glycogen to glucose, maltose, maltotriose, and dextrins. These simple sugars are transported across the brush border of the intestinal epithelial cells by active transport mechanisms. Gastric hydrolysis of protein yields peptides that enter the intestine and stimulate intestinal endocrine cells to release cholecystokinin (CCK)-releasing peptide, CCK, and secretin, which then stimulate the pancreas to secrete enzymes and bicarbonate into the intestine.
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The proteolytic enzymes are secreted as proenzymes that require activation. Trypsinogen is converted to its active form, trypsin, by another enzyme, enterokinase, which is produced by the duodenal mucosal cells. Trypsin, in turn, activates the other proteolytic enzymes. Trypsinogen activation within the pancreas is prevented by the presence of inhibitors that are also secreted by the acinar cells. Chymotrypsinogen is activated to form chymotrypsin. Elastase, carboxypeptidase A and B, and phospholipase are also activated by trypsin. Trypsin, chymotrypsin, and elastase cleave bonds between amino acids within a target peptide chain, and carboxypeptidase A and B cleave amino acids at the end of peptide chains. Individual amino acids and small dipeptides are then actively transported into the intestinal epithelial cells. Pancreatic lipase hydrolyzes triglycerides to 2-monoglyceride and fatty acid. Pancreatic lipase is secreted in an active form. Colipase is also secreted by the pancreas and binds to lipase, changing its molecular configuration and increasing its activity. Phospholipase A2 is secreted by the pancreas as a proenzyme that becomes activated by trypsin. Phospholipase A2 hydrolyzes phospholipids and, as with all lipases, requires bile salts for its action. Carboxylic ester hydrolase and cholesterol esterase hydrolyze neutral lipid substrates like esters of cholesterol, fat-soluble vitamins, and triglycerides. The hydrolyzed fat is then packaged into micelles for transport into the intestinal epithelial cells, where the fatty acids are reassembled and packaged inside chylomicrons for transport through the lymphatic system into the bloodstream.
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The centroacinar and intercalated duct cells secrete the water and electrolytes present in the pancreatic juice. About 40 acinar cells are arranged into a spherical unit called an acinus. Centroacinar cells are located near the center of the acinus and are responsible for fluid and electrolyte secretion. These cells contain the enzyme carbonic anhydrase, which is needed for bicarbonate secretion.
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The acinar cells release pancreatic enzymes from their zymogen granules into the lumen of the acinus, and these proteins combine with the water and bicarbonate secretions of the centroacinar cells. The pancreatic juice then travels into small intercalated ducts. Several small intercalated ducts join to form an interlobular duct. Cells in the interlobular ducts continue to contribute fluid and electrolytes to adjust the final concentrations of the pancreatic fluid. Interlobular ducts then join to form about 20 secondary ducts that empty into the main pancreatic duct. Destruction of the branching ductal tree from recurrent inflammation, scarring, and deposition of stones eventually contributes to destruction of the exocrine pancreas and exocrine pancreatic insufficiency.
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There are nearly 1 million islets of Langerhans in the normal adult pancreas. Alpha cells that secrete glucagon, Beta cells that secrete insulin, Delta cells that secrete somatostatin, Epsilon cells that secrete ghrelin, and PP cells that secrete PP.[\n\t\t\t\t\t1\n\t\t\t\t]
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3. Incidence
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Acute pancreatitis is a relatively common disease that affects about 300,000 patients per annum in America with a mortality of about 7%. Acute pancreatitis is mild and resolves itself without serious complications in 80% of patients, but it has complications and a substantial mortality in up to 20% of patients despite the agressive intervention[\n\t\t\t\t\t1\n\t\t\t\t]. The incidence of alcoholic pancreatitis is higher in male, and the risk of developing acute pancreatitis in patients with gallstones is greater in male. However, more women develop this disorder since gallstones occur with increased frequency in women[\n\t\t\t\t\t2\n\t\t\t\t].
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4. Etiology and pathophysiology
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The pathogenesis of acute pancreatitis has not been fully understood. The general belief today is that pancreatitis begins with the activation of digestive enzymes inside acinar cells, which cause acinar cell injury. The Factors in Acute Pancreatitis can be classified as:
Of note, 10% to 20% of patients with acute pancreatitis have no known associated processes. Although this condition is currently termed idiopathic.
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The underlying reason of gallstone disease and other conditions causing acute pancreatitis is ductal hypertension resulting from ongoing exocrine secretion into an obstructed pancreatic duct. Elevated intraductal pressure, due to ongoing exocrine secretion, causes rupture of the smaller ductules and leakage of pancreatic juice into the parenchyma. Pancreatic tissue favors activation of proteases when transductal extravasation of fluid occurs.
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In the normal pancreas, the inactive digestive zymogens and the lysosomal hydrolases are found separately in discrete organelles. However, in response to ductal obstruction, hypersecretion, or a cellular insult, these two classes of substances become improperly colocalized in a vacuolar structure within the pancreatic acinar cell. Coalescence of zymogen granules with lysosome vacuoles resulting in intrapancreatic activation of proteolytic enzymes. Small amounts of trypsin can be countered by endogenous pancreatic trypsin inhibitor. However, large amounts of trypsin release can overwhelm the serological defense mechanism (α-1-antitrypsin and α-2-macroglobulin) and activate other enzymes resulting in destruction of acinar cells, local and systemic complications commonly seen in the course of the disease. Activation of the enzyme phospolipase A2 has important consequences like destruction of pulmonary surfactant that can result in ARDS and liberation of prostaglandins and leucotriens that may be important in the pathogenesis of the systemic inflammatory response which can lead to multi organ failure. More than that, inflammatory mediators may be used as predictors of disease severity in the near future. Also, trypsin activates and complements kinin, kallikrein, possibly playing a part in disseminated intravascular coagulation, shock, renal failure and vascular instability. [\n\t\t\t\t\t3\n\t\t\t\t], [\n\t\t\t\t\t4\n\t\t\t\t].
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5. Diagnosis
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A detailed history and careful physical examination are the first step towards making the diagnosis. The diagnosis of gallstone pancreatitis should be suspected if the patient has a prior history of biliary colic. (5], (6] Acute pancreatitis typically presents with severe upper abdominal pain which may radiate through to the back and be associated with nausea and vomiting.
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On physical examination, the patient may show tachycardia, tachypnea, hypotension, and hyperthermia. The temperature is usually only mildly elevated in uncomplicated pancreatitis. Voluntary and involuntary guarding can be seen over the epigastric region. The bowel sounds are decreased or absent. There are usually no palpable masses. The abdomen may be distended with intraperitoneal fluid. There may be pleural effusion, particularly on the left side. With increasing severity of disease, the intravascular fluid loss may become life-threatening as a result of sequestration of edematous fluid in the retroperitoneum.
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6. Biochemical markers
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Due to the destruction of acinar cells, the levels of the enzymes that they contain (e.g., amylase, lipase, trypsinogen, and elastase) are found elevated in the serum of most pancreatitis patients. Serum amylase concentration increases almost immediately with the onset of disease and peaks within several hours. It remains elevated for 3 to 5 days before returning to normal. There is no significant correlation between the magnitude of serum amylase elevation and severity of pancreatitis. [7,8]\n\t\t\t
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Lipase is more specific for pancreatitis. Serum lipase has a longer half life than amylase and therefore tends to remain elevated for longer.
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Urinary clearance of pancreatic enzymes from the circulation increases during pancreatitis; therefore, urinary levels may be more sensitive than serum levels.
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Several tests can help differentiate biliary pancreatitis from other causes of pancreatitis. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl Transpeptidase (GGT ), alkaline phosphatase and serum bilirubin are the so-called liver function tests; they should be reviewed before making a confident diagnosis.
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Several recent research studies have suggested additional markers that may have prognostic value, including C-reactive protein (CRP), alpha2-macroglobulin, polymorphonuclear neutrophil–elastase, alpha1-antitrypsin, and phospholipase A2. [9],[10] Although CRP measurement is commonly available, many of the others are not. Therefore, at this time, CRP seems to be the marker of choice in clinical settings. The measurement of IL-6 has recently been shown to distinguish patients with mild or severe forms of the disease. Another prognostic marker under evaluation is urinary–trypsinogen activation peptide (TAP). It has a good correlation between the severity of pancreatitis and concentrations of TAP in urine.
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Currently, these new markers have limited clinical availability, but there is significant interest in better understanding markers of immune response and pancreatic injury because these could be valuable tools for reliably predicting the severity of acute pancreatitis and supplementing imaging modalities. [10],[11],[12]\n\t\t\t
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7. Radiologic imaging
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Ultrasound: Abdominal ultrasound (US) examination is the best way to confirm the presence of gallstones in suspected biliary pancreatitis. It also can detect extrapancreatic ductal dilations and reveal pancreatic edema, swelling, and peripancreatic fluid collections. But abdominal ultrasonography seldom visualizes the pancreas in patients with acute pancreatitis due to air in the distended loops of the small bowel. [13] (Figure 2)
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Computed Tomography Scan (CT): A CT allows identification of pancreatic edema, fluid or cysts, and the severity of pancreatitis to be graded, detects complications including development of pseudocysts, abscess, necrosis, hemorrhage, and vascular occlusion. The finding of gallstones and dilatation of the extra-hepatic biliary tree on cross-sectional abdominal imaging further support to the diagnosis of gallstone pancreatitis. [14]\n\t\t\t
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Currently the best method to stage the acute pancreatitis is CT. Specific CT findings can be categorized into pancreatic and peripancreatic changes. Pancreatic changes include diffuse or focal parenchymal enlargement, edema, or necrosis with liquefaction. Peripancreatic involvement includes blurring or thickening of the surrounding tissue planes. An approximate correlation exists between the degree of CT abnormalities and the clinical course and severity of acute pancreatitis.
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An early discrimination between mild edematous and severe necrotizing forms of the disease is of the utmost importance to provide optimal care to the patient. CT has become the gold standard for detecting and assessing the severity of pancreatitis. Although clinically mild pancreatitis is usually associated with interstitial edema, severe pancreatitis is associated with necrosis. The presence of air bubbles on a CT scan is an indication of infected necrosis or pancreatic abscess. [\n\t\t\t\t\t15\n\t\t\t\t]
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Figure 2.
Ultrasound image of the gallbladder demonstrates multiple dependent gallstones (curved arrow) with acustic shadowing (straight arrows). The patient had elevated pancreatic enzyme levels and underwent cholecystectomy because of gallstone pancreatitis.
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Magnetic Resonance Cholangiopancreatography (MRCP): MRCP has been found to be as accurate as contrast-enhanced CT in predicting the severity of pancreatitis and identifying pancreatic necrosis but is less sensitive for detection of small stones.
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Endoscopic Ultrasonography: It is useful in obese patients and patients with ileus, and can help determine which patients with acute pancreatitis would benefit most from therapeutic ERCP. [16], [17]\n\t\t\t
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Figure 3.
Acute biliary pancreatitis with a thickened pancreas and an effusion around the pancreatic tail and around the spleen - CT scan
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Figure 4.
Sigmoid configuration of the main pancreatic duct with distal dilation of both main and dorsal ducts, suggesting the presence of an obstructive condition at the level of both major and minor papillae.
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ADMISSION
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INITIAL 48 HOURS
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Gallstone Pancreatitis
\n\t\t\t\t\t\t
\n\t\t\t\t\t
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\n\t\t\t\t\t\t
Age "/ 70 yr
\n\t\t\t\t\t\t
Hct fall "/10
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
WBC "/18,000/mm3\n\t\t\t\t\t\t
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BUN elevation "/2 mg/100 mL
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\n\t\t\t\t\t
\n\t\t\t\t\t\t
Glucose "/ 220 mg/100 mL
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Ca2+<8 mg/100 mL
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\n\t\t\t\t\t\t
LDH "/400 IU/L
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Base deficit "/5 mEq/L
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\n\t\t\t\t\t
\n\t\t\t\t\t\t
AST "/250U/100 mL
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Fluid sequestration "/4 L
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\n\t\t\t\t\t\t
Nongallstone Pancreatitis
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Age "/55 yr
\n\t\t\t\t\t\t
Hct fall "/10
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
WBC "/16,000/mm3
\n\t\t\t\t\t\t
BUN elevation "/5 mg/100 mL
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Glucose "/200 mg/100 mL
\n\t\t\t\t\t\t
Ca2+<8 mg/100 mL
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
LDH "/350 IU/L
\n\t\t\t\t\t\t
Pao2<55 mm Hg
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
AST "/250U/100 mL
\n\t\t\t\t\t\t
Base deficit "/4 mEq/L
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
Fluid sequestration "/6 L
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Table 1.
Adapted from Ranson JHC, Rifkind KM, Roses DF, et al: Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 139:69-81, 1974; and Ranson JHC: Etiological and prognostic factors in human acute pancreatitis: A review. Am J Gastroenterol 77:633, 1982. ( AST, aspartate transaminase; BUN, blood urea nitrogen; Ca2+, calcium; Hct, hematocrit; LDH, lactic dehydrogenase; Pao2, arterial oxygen; WBC, white blood cell count.)
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8. Scoring systems in acute pancreatitis
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A variety of scoring systems have been proposed for accurate assessment of the severity of acute pancreatitis. These include the clinical scoring scales as Ranson criteria, Glasgow scales, simplified acute physiology (SAP), score and acute physiology and chronic health evaluation II (APACHE II) score. The CT severity index (CTSI) derived by Balthazar grading of pancreatitis and the extent of pancreatic necrosis is now widely used in describing CT findings of acute pancreatitis and serves as the radiological scoring system. [18]\n\t\t\t
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Ranson identified a series of prognostic signs for early identification of patients with severe pancreatitis. Out of these 11 objective parameters, five are measured at the time of admission, whereas the remaining six are measured within 48 hours of admission. Morbidity and mortality of the disease are directly related to the number of signs present. It is important to realize that Ranson\'s prognostic signs are best used within the initial 48 hours of hospitalization and have not been validated for later time intervals.
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Another set of criteria often used to assess the severity of pancreatitis is the acute physiology and chronic health evaluation (APACHE-II) score. This grading system assesses severity on the basis of quantitative measures of abnormalities of multiple variables, including vital signs and specific laboratory parameters, coupled with the age and chronic health status of the patient. The main advantage of the APACHE-II scoring system is the immediate assessment of the severity of pancreatitis. A score of eight or more at admission is usually considered indicative of severe disease. APACHE II, although complicated, ensures the highest positive predictive value up to 69%. [19]\n\t\t\t
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The risk of severe acute pancreatitis is increased at Glasgow\'s or Ranson\'s score ≥3 in 48 hours, APACHE II on admission ≥8, Balthazar\'s score ≥4.
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In 1985, Balthazar and colleagues introduced a scoring system based on radiological findings by means of a 5- grade scale: the presence of pancreatic and peripancreatic inflammation and fluid accumulation. [\n\t\t\t\t\t20\n\t\t\t\t].
\n\t\t\t
Grade CT findings:
\n\t\t\t
Grade A Normal pancreas
\n\t\t\t
Grade B Pancreatic enlargement
\n\t\t\t
Grade C Pancreatic inflammation and/or peripancreatic fat
\n\t\t\t
Grade D Single peripancreatic fluid collection
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Grade E Two or more fluid collections and/or retroperitoneal air.
\n\t\t\t
A correlation was shown between the grade on CT performed within 10 days of admission and the clinical follow-up finding, morbidity, and mortality. Therefore, CT was appreciated as a useful prognostic indicator for outcome in Acute pancreatitis. The study showed a morbidity of only 4% and no mortality in patients with Acute pancreatitis and a CT grade of A, B, or C. In patients with CT grade D or E, the morbidity rate was 54% and the mortality 14%. The Balthazar radiological prognostic score was easy to assign without the need of contrast-enhanced CT. Unfortunately, this score did not assign any value to pancreatic necrosis as a prognostic parameter and did not make the distinction between Acute fluid collections and pseudocysts vs. post-necrotic fluid collections and walled-off pancreatic necrosis. With the introduction of newer CT-based scoring systems, some authors question the value of Balthazar’s score in predicting prognosis and severity in Acute Pancreatitis [\n\t\t\t\t\t21\n\t\t\t\t].
\n\t\t
\n\t\t
\n\t\t\t
9. Treatment
\n\t\t\t
Gallstones are the most common cause of acute pancreatitis worldwide. According to the physical examination, radiological findings and labarotory results the etiology of the acute pancreatitis is diagnosed as biliary or non-biliary. The most important initial treatment of biliary pancreatitis is conservative intensive care with the goals of oral food and fluid restriction, replacement of fluids and electrolytes parenterally as assessed by central venous pressure and urinary excretion, and control of pain. [22], [23]\n\t\t\t
\n\t\t\t
After stabilizing the patient, specific treatment and timing of the intervention have to be planned. The issue of when to intervene for clearance of gallstones is controversial. General consensus is either urgent intervention (cholecystectomy) within the first 48 to 72 hours of admission, or briefly delayed intervention (after 72 hours, but during the initial hospitalization) to give an inflamed pancreas time to recover. Cholecystectomy and common duct clearance is the best treatment of biliary acute pancreatitis. Patients who have persistent impacted stone in the distal common bile duct or ampulla should have confirmation by radiologic imaging (CT, magnetic resonance cholangiopancreatography, or endoscopic ultrasonography) before intervention. If common duct stone are diagnosed, stones are cleared and endoscopic sphincterotomy is done by ERCP and then laparoscopic cholecystectomy is performed.[24]\n\t\t\t
\n\t\t\t
Routine ERCP for examination of the bile duct is discouraged in cases of biliary pancreatitis, as the probability of finding residual stones is low, and the risk of ERCP-induced pancreatitis is significant. But in the case of acute biliary pancreatitis in which analytical studies suggest that the obstruction persists after 24 hours of observation, emergency ERCP has to be done to prevent biliary sepsis.
\n\t\t\t
Although ERCP with Endoscopic Sphincterotomy (ES) and stone extraction has been shown to be useful for early treatment of severe biliary pancreatitis, the incidence of bile duct stones at elective surgery is low and most of these ERCP are unnecessary. For this reason accurate predictors of common bile duct stones are required; studies have shown that the sensitivity of preoperative abdominal US for predicting common bile duct stones is 42% and specificity is 86% [25]. Furthermore, an endoscopic approach is unable to fully resolve the patient’s biliary pathology with one procedure and one anesthesia. This adds substantial risk of morbidity and even mortality. Concern remains also regarding the potential long-term risks of ES. Although the immediate complications of ES are well documented, the long-term effects are less defined. Stricture formation and stone recurrence account for nearly all longterm complications. Although most of the authors prefer the endoscopic to the surgical treatment of CBD stones, there is still some minor discussion on it[26].
\n\t\t\t
Timing of laparoscopic surgery in acute biliary pancreatitis depends upon the severity of the disease. In the case of mild pancreatitis it doesn’t matter when, within 1 week, laparoscopic cholecystectomy is performed. However, in patients with severe pancreatitis, laparoscopic cholecystectomy, when performed within the 1st week after the onset of symptoms, as other authors have observed [27], places patients at increased risk of operative morbidity and technical complications. In these patients, the management of complications of pancreatitis is strongly advisable before cholecystectomy.
\n\t\t\t
Delaying surgery for more than a week after hospitalization, in our experience, does not adversely affect technical difficulty. Delaying surgery for several weeks in severe acute pancreatitis allows acute inflammation to settle down and might allow stones in the common bile duct to clear spontaneously. However, studies showed that approximately one-quarter of patients have symptomatic recurrence within 6 weeks if gallstones are untreated, and it increases with time [28], [29]\n\t\t\t
\n\t\t\t
Cholangiogram of good quality during laparoscopic cholecystectomy, since the risk of common bile duct stones is 14–20%. [30] This strategy minimizes the need for common bile duct exploration and still achieves the goal of a limited hospital stay and the prevention of recurrence of pancreatitis. If common bile duct stones are found at cholangiogram they should be treated laparoscopically if at all possible. In most instances, it should be possible to retrieve the stones via the cystic duct, since acute pancreatitis is usually caused by the migration of small stones. If this is not feasible, one alternative is to perform a laparoscopic choledochotomy. These cases have a rather long hospital stay and delayed return to work, but their level of pain is diminished. Our current impression is that this procedure is possible though technically demanding. In case of failure, traditional exploration is mandatory.
\n\t\t\t
In severe acute pancreatitis, or when signs of infection are present, most experts recommend broad-spectrum antibiotics (e.g., imipenem) and careful surveillance for complications of the disease.
\n\t\t
\n\t\t
\n\t\t\t
10. Complications of acute pancreatitis
\n\t\t\t
Acute pancreatitis complications may be divided as systemic and local. Pancreatic phlegmon, pancreatic abscess, pancreatic pseudocyst, pancreatic ascites and involvement of adjacent organs, with hemorrhage, thrombosis, bowel infarction, obstructive jaundice, fistula formation, or mechanical obstruction are local complications. Systemic complications are classified as hematologic (Hemoconcentration, Disseminated intravascular coagulopathy), cardiovascular (Hypotension, Hypovolemia, Sudden death, Nonspecific ST-T wave changes, Pericardial effusion), pulmonary (Pneumonia, atelectasis, Acute respiratory distress syndrome, Pleural effusion), renal (Oliguria, Azotemia, renal artery/vein thrombosis), metabolic (Hyperglycemia, Hypocalcemia, Hypertriglyceridemia, Encephalopathy, Sudden blindness (Purtscher\'s retinopathy), central nervous system (Psychosis, Fat emboli, Alcohol withdrawal syndrome), gastro intestinal system (Peptic ulcer, Erosive gastritis, Portal vein or splenic vein thrombosis with varices)
\n\t\t
\n\t\n',keywords:null,chapterPDFUrl:"https://cdn.intechopen.com/pdfs/26182.pdf",chapterXML:"https://mts.intechopen.com/source/xml/26182.xml",downloadPdfUrl:"/chapter/pdf-download/26182",previewPdfUrl:"/chapter/pdf-preview/26182",totalDownloads:3878,totalViews:1866,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,impactScore:0,impactScorePercentile:18,impactScoreQuartile:1,hasAltmetrics:0,dateSubmitted:"February 6th 2011",dateReviewed:"July 4th 2011",datePrePublished:null,datePublished:"January 18th 2012",dateFinished:null,readingETA:"0",abstract:null,reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/26182",risUrl:"/chapter/ris/26182",book:{id:"932",slug:"acute-pancreatitis"},signatures:"Mehmet Ilhan and Halil Alıs",authors:[{id:"66078",title:"Dr.",name:"Mehmet",middleName:null,surname:"İlhan",fullName:"Mehmet İlhan",slug:"mehmet-ilhan",email:"milhan9786@yahoo.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi",institutionURL:null,country:{name:"Turkey"}}}],sections:[{id:"sec_1",title:"1. Introduction ",level:"1"},{id:"sec_2",title:"2. Anatomy and physiology",level:"1"},{id:"sec_3",title:"3. Incidence",level:"1"},{id:"sec_4",title:"4. Etiology and pathophysiology",level:"1"},{id:"sec_5",title:"5. Diagnosis",level:"1"},{id:"sec_6",title:"6. Biochemical markers",level:"1"},{id:"sec_7",title:"7. Radiologic imaging",level:"1"},{id:"sec_8",title:"8. Scoring systems in acute pancreatitis",level:"1"},{id:"sec_9",title:"9. Treatment",level:"1"},{id:"sec_10",title:"10. Complications of acute pancreatitis",level:"1"}],chapterReferences:[{id:"B1",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCharles\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBrunicardi\n\t\t\t\t\t\t\tD. K.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tAndersen\n\t\t\t\t\t\t\tTimothy. R.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBilliar\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tDunn\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHunter\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMatthews\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2005 Pollock Schwartz’s Principles of surgery,; 33\n\t\t\t\t\t1265\n\t\t\t\t\t73\n\t\t\t\t\n\t\t\t'},{id:"B2",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tEland\n\t\t\t\t\t\t\tI. A.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSturkenboom\n\t\t\t\t\t\t\tM. J.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tWilson\n\t\t\t\t\t\t\tJ. H.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tStricker\n\t\t\t\t\t\t\tB. H.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2000 Incidence and mortality of acute pancreatitis between 1985 and 1995". Scand J Gastroenterol;35\n\t\t\t\t\t1110\n\t\t\t\t\t6 .\n\t\t\t'},{id:"B3",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tReila\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tZeinthmeister\n\t\t\t\t\t\t\tA. R.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMilton\n\t\t\t\t\t\t\tLj.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1991 Etiology,incidence and survival of acute pancreatitis in olmested county, Minnosota. Gastroentrology. 100\n\t\t\t\t\tA269 .\n\t\t\t'},{id:"B4",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBanerjee\n\t\t\t\t\t\t\tA. K.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGalloway\n\t\t\t\t\t\t\tS. W.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKingsnorth\n\t\t\t\t\t\t\tA. N.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1994\n\t\t\t\t\tExperimental models of acute pancreatitis. Br J Surg;81\n\t\t\t\t\t1093\n\t\t\t\t\t106 .\n\t\t\t'},{id:"B5",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFormela\n\t\t\t\t\t\t\tL. J.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGalloway\n\t\t\t\t\t\t\tS. W.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKingsnorth\n\t\t\t\t\t\t\tA. N.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1995 Inflamatory mediators in acute pancreatitis. Br J Surg;82\n\t\t\t\t\t6\n\t\t\t\t\t13 .\n\t\t\t'},{id:"B6",body:'\n\t\t\t\t\n\t\t\t\t\tAcosta JM, Ledesma CL.\n\t\t\t\t\tGallstone migration as a cause of acute pancreatitis. N Engl J Med 290\n\t\t\t\t\t484\n\t\t\t\t\t7\n\t\t\t\t\t1974\n\t\t\t\t\n\t\t\t'},{id:"B7",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKelly\n\t\t\t\t\t\t\tT. R.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1980\n\t\t\t\t\tGallstone pancreatitis: the timing of surgery.\n\t\t\t\t\tKellyT. R. (1980). Gallstone pancreatitis: the timing of surgery. Surgery; . ;88\n\t\t\t\t\t345\n\t\t\t\t\t50 .\n\t\t\t'},{id:"B8",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMoody\n\t\t\t\t\t\t\tF. G.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSenninger\n\t\t\t\t\t\t\tN.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRunkel\n\t\t\t\t\t\t\tN.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1993Another challenge to the Opie’s theory. Gastroenterology;104\n\t\t\t\t\t927\n\t\t\t\t\t31 .\n\t\t\t'},{id:"B9",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCrunkel\n\t\t\t\t\t\t\tN.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMoody\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMueller\n\t\t\t\t\t\t\tW.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1992 Experimental evidence against Opie’s common channel bile reflux theory. Digestion;52\n\t\t\t\t\t67\n\t\t\t\t\t67 .\n\t\t\t'},{id:"B10",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSmotkin\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTenner\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2002\n\t\t\t\t\tLaboratory diagnostic tests in acute pancreatitis. 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G.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSlavin\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\tetal.\n\t\t\t\t\t\n\t\t\t\t\t2000\n\t\t\t\t\tEarly prediction of severity in acute pancreatitis by urinary trypsinogen activation peptide: a multicentre study.\n\t\t\t\t\tLancet;355\n\t\t\t\t\t1955\n\t\t\t\t\t60 .\n\t\t\t'},{id:"B13",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTenner\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2004 Initial management of acute pancreatitis: critical issues during the first 72 hours. Am J Gastroenterol;99\n\t\t\t\t\t2489\n\t\t\t\t\t94 .\n\t\t\t'},{id:"B14",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tChak\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHawes\n\t\t\t\t\t\t\tR. H.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCooper\n\t\t\t\t\t\t\tG. S.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHoffman\n\t\t\t\t\t\t\tB.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCatalano\n\t\t\t\t\t\t\tM. 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AJR Am J Roentgenol;140\n\t\t\t\t\t1173\n\t\t\t\t\t8 .\n\t\t\t'},{id:"B16",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKemppainen\n\t\t\t\t\t\t\tE.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSainio\n\t\t\t\t\t\t\tV.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHaapiainen\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKivisaari\n\t\t\t\t\t\t\tL.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKivilaakso\n\t\t\t\t\t\t\tE.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPuolakkainen\n\t\t\t\t\t\t\tP.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\tEarly localization of necrosis by contrast-enhanced computed tomography can predict outcome in severe pancreatitis. Br J Surg 83\n\t\t\t\t\t924\n\t\t\t\t\t9\n\t\t\t\t\t1996\n\t\t\t\t\n\t\t\t'},{id:"B17",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMakary\n\t\t\t\t\t\t\tM. A.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tDuncan\n\t\t\t\t\t\t\tM. D.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHarmon\n\t\t\t\t\t\t\tJ. W.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFreeswick\n\t\t\t\t\t\t\tP. D.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBender\n\t\t\t\t\t\t\tJ. S.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBohlman\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\tet al.\n\t\t\t\t\t\n\t\t\t\t\t2005 The role of magnetic resonance cholangiography in the management of patients with gallstone pancreatitis. Ann Surg;241\n\t\t\t\t\t119\n\t\t\t\t\t24\n\t\t\t\t\n\t\t\t'},{id:"B18",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tNorton\n\t\t\t\t\t\t\tS. A.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tAlderson\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2000\n\t\t\t\t\tEndoscopic ultrasonography in the evaluation of idiopathic acute pancreatitis. Br J Surg;87\n\t\t\t\t\t1650\n\t\t\t\t\t5 .\n\t\t\t'},{id:"B19",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tWahab\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKhan\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2010 2010. Imaging and clinical prognostic indicators of acute pancreatitis: a comparative insight. Sep;40\n\t\t\t\t\t3\n\t\t\t\t\t283\n\t\t\t\t\t7 .\n\t\t\t'},{id:"B20",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGravante\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGarcea\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tOng\n\t\t\t\t\t\t\tS. L.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMetcalfe\n\t\t\t\t\t\t\tM. S.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBerry\n\t\t\t\t\t\t\tD. P.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLloyd\n\t\t\t\t\t\t\tD. M.\n\t\t\t\t\t\t\n\t\t\t\t\t\tet al.\n\t\t\t\t\t\n\t\t\t\t\t2009 Prediction of mortality in acute pancreatitis: asystematic review of the published evidence. Pancreatology;9\n\t\t\t\t\t601\n\t\t\t\t\t614 .\n\t\t\t'},{id:"B21",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBalthazar\n\t\t\t\t\t\t\tE. J.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRanson\n\t\t\t\t\t\t\tJ. H. C.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tNaidich\n\t\t\t\t\t\t\tD. P.\n\t\t\t\t\t\t\n\t\t\t\t\t\tet al.\n\t\t\t\t\t\n\t\t\t\t\t1985\n\t\t\t\t\tAcute-pancreatitis-prognostic value of CT.\n\t\t\t\t\tRadiology\n\t\t\t\t\t3\n\t\t\t\t\t767\n\t\t\t\t\t772\n\t\t\t\t\n\t\t\t'},{id:"B22",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tJu\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tChen\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLiu\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tZheng\n\t\t\t\t\t\t\tK.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTeng\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2006\n\t\t\t\t\tValue of CT and clinical criteria in assessment of patients with acute pancreatitis. Eur J Radiol 1\n\t\t\t\t\t102\n\t\t\t\t\t107\n\t\t\t\t\n\t\t\t'},{id:"B23",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tNeoptolemos\n\t\t\t\t\t\t\tJ. P.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCarr-Locke\n\t\t\t\t\t\t\tD. L.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLondon\n\t\t\t\t\t\t\tN. J.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBailey\n\t\t\t\t\t\t\tI. A.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tJames\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFossard\n\t\t\t\t\t\t\tD. P.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1988\n\t\t\t\t\tControlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones.\n\t\t\t\t\tLancet;2\n\t\t\t\t\t979\n\t\t\t\t\t83 .\n\t\t\t'},{id:"B24",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCarroll\n\t\t\t\t\t\t\tB. J.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPhillips\n\t\t\t\t\t\t\tE. H.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1993 The early treatment of acute biliary pancreatitis [letter; comment]. N Engl J Med;329\n\t\t\t\t\t58\n\t\t\t\t\t9 .\n\t\t\t'},{id:"B25",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tUhl\n\t\t\t\t\t\t\tW.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMüller\n\t\t\t\t\t\t\tC. A.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKrδhenbühl\n\t\t\t\t\t\t\tL.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSchmid\n\t\t\t\t\t\t\tS. W.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSchφlzel\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBüchler\n\t\t\t\t\t\t\tM. W.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1999 Acute gallstone pancreatitis: timing of laparoscopic cholecystectomy in mild and severe disease.\n\t\t\t'},{id:"B26",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSoper\n\t\t\t\t\t\t\tN. J.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBrunt\n\t\t\t\t\t\t\tM. L.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCallery\n\t\t\t\t\t\t\tM. P.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tEdmundowicz\n\t\t\t\t\t\t\tS. A.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tAliperti\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1994 Role of laparoscopic cholecystectomy in the management of acute biliary pancreatitis. Am J Surg 167\n\t\t\t\t\t42\n\t\t\t\t\t51\n\t\t\t\t\n\t\t\t'},{id:"B27",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGraham\n\t\t\t\t\t\t\tS. M.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFlowers\n\t\t\t\t\t\t\tJ. L.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tScott\n\t\t\t\t\t\t\tT. R.\n\t\t\t\t\t\t\n\t\t\t\t\t\tet al.\n\t\t\t\t\t\n\t\t\t\t\t1993 Laparoscopic cholecystectomy and common bile duct stones. Ann Surg 218\n\t\t\t\t\t61\n\t\t\t\t\t67\n\t\t\t\t\n\t\t\t'},{id:"B28",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTang\n\t\t\t\t\t\t\tE.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tStain\n\t\t\t\t\t\t\tS. C.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTang\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFroes\n\t\t\t\t\t\t\tE.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBerne\n\t\t\t\t\t\t\tT. V.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1995 Timing of laparoscopic surger in gallstones pancreatitis. Arch Surg 130\n\t\t\t\t\t496\n\t\t\t\t\t500\n\t\t\t\t\n\t\t\t'},{id:"B29",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPatti\n\t\t\t\t\t\t\tM. G.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPellegrini\n\t\t\t\t\t\t\tC. A.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1990\n\t\t\t\t\tGallstone pancreatitis. Surg Clin North Am 70: 1277 EOF\n\t\t\t\t\t95 EOF\n\t\t\t\t\n\t\t\t'},{id:"B30",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPellegrini\n\t\t\t\t\t\t\tC. A.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1993\n\t\t\t\t\tSurgery for gallstone pancreatitis. Am J Surg 165\n\t\t\t\t\t515\n\t\t\t\t\t518\n\t\t\t\t\n\t\t\t'},{id:"B31",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tAcosta\n\t\t\t\t\t\t\tJ. M.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRossi\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGalli\n\t\t\t\t\t\t\tM. R.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPellegrini\n\t\t\t\t\t\t\tC. A.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSkinner\n\t\t\t\t\t\t\tD. B.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1978 Early surgery for acute gallstone pancreatitis: evaluation of a systemic approach. Surgery 83\n\t\t\t\t\t367\n\t\t\t\t\t370\n\t\t\t\t\n\t\t\t'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Mehmet Ilhan",address:null,affiliation:'
Ministry of Health Bakırkoy, Dr Sadi Konuk Training andResearch Hospital General Surgery, Istanbul,, Turkey
Ministry of Health Bakırkoy, Dr Sadi Konuk Training andResearch Hospital General Surgery, Istanbul,, Turkey
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1. History of veterinary anatomy and physiology
The anatomy of animals has long fascinated people, with mural paintings depicting the superficial anatomy of animals dating back to the Palaeolithic era [1]. However, evidence suggests that the earliest appearance of scientific anatomical study may have been in ancient Babylonia, although the tablets upon which this was recorded have perished and the remains indicate that Babylonian knowledge was in fact relatively limited [2].
As such, with early exploration of anatomy documented in the writing of various papyri, ancient Egyptian civilisation is believed to be the origin of the anatomist [3]. With content dating back to 3000 BCE, the Edwin Smith papyrus demonstrates a recognition of cerebrospinal fluid, meninges and surface anatomy of the brain, whilst the Ebers papyrus describes systemic function of the body including the heart and vasculature, gynaecology and tumours [4]. The Ebers papyrus dates back to around 1500 BCE; however, it is also thought to be based upon earlier texts. In the early third century, a school of anatomy was founded in Alexandria and became the first of its kind carrying out human dissection [5]. It was based on the Greek system, following Hippocratic teachings. Hippocrates (ca. 460–370 BCE) had described the human brain as being in two halves divided by a thin vertical membrane, as it was in other animals. The most renowned Alexandrian physicians were Herophilus and Erasistratus. Many graduates of this medical school travelled and practiced throughout the Mediterranean basin.
Many renowned Greek anatomists studied in Alexandria, but as Egypt entered a slow decline, developments in Greek philosophical and scientific culture began to surpass all current knowledge of anatomy and physiology [4]. The early scientist Alcmaeon of Croton, a Greek medic is widely credited for attributing the mind to the brain in around 500 BCE [6]. He also observed that the arteries and veins in his animal dissections appeared dissimilar to each other [7]. Herophilus progressed these theories around the brain and identified the organ as the centre of the nervous system [8]. Herophilus was born in 335 BCE, studied in Alexandria and remained there during the reigns of the first two Ptolemaios Pharaohs and is said to be the first anatomist to perform a systematic dissection of the human body. Erasistratus concentrated on physiology and mechanisms rather than the pure anatomy. This was not always a popular method of describing the body during either his life or later on.
Roman Marcus Aurelius (161–180 CE) highlighted that physicians were more likely to maim or kill their patients they were not aware of the anatomy required. He was famous for his mission to understand anatomy and physiology in a range of animals extending from monkeys and snakes to cattle and cats, in both adults and young. He even noted the similarities between macaques and humans. Ultimately it was the Greek Aristotle who became known as the father of comparative anatomy through his dissections performed on a variety of animals, including mammals, reptiles and insects [9].
Moving into the second century, the Greek anatomist Galen pioneered a number of anatomical and physiological theories, mainly through animal dissection [5]. Galen was responsible for the discovery of the recurrent laryngeal nerve [10], and had many advanced theories on wound healing [11]. His work remained influential in anatomical and physiological science for fifteen centuries and allowed significant advancements in medicine [12].
In the following years, until the twelfth century, much of the anatomical study that took place was therapeutically focussed and completed following the written works of early authors such as Galen [13]. The appearance of anatomist Mondino dei Luzzi in the thirteenth century induced progression in anatomical and physiological study based upon his work with human cadaver dissection [14]. Whilst Andreas Vesalius, an important figure in the Renaissance, pushed forward physiological study with accurate accounts of the mechanics of pulmonary ventilation, among many other revelations in his 1543 work entitled ‘De Humani Corporis Fabrica’ [15].
A number of years later, born in 1578 in England, William Harvey was the first to correctly describe the circulatory system, identifying the blood flow returning to the heart and the heart acting as a muscular pump [16]. Harvey also proposed the idea of capillary anastomoses joining the arterial and venous systems, although their existence was not proven until after his death by Marcello Malpighi in 1661 [16].
The eighteenth and nineteenth centuries saw dissection became a more prominent feature in anatomical study, when William Hunter encouraged students to carry out their own dissection on cadavers. This however led to ‘body-snatching’, and as a result, The Anatomy Act (1832) was enforced in order to regulate the acquisition of human cadaveric material [17]. This regulation favoured the anatomy schools based in hospitals and as such, the professionalisation of the science was observed [18].
At the present time, anatomy and physiology are unarguably fundamental aspects of medical education and can be taught in many ways including dissection, ‘self-directed learning’ and ‘problem based learning’ [19]. Recent developments in technology have allowed digital anatomical models to be implemented into university curricula, allowing wider access to the study of anatomy for the contemporary student [20].
2. Imaging technology within anatomy and physiology
In the days of the first anatomists and physiologists discussed above, fewer tools and techniques were available to allow visualisation of the body. Over the years many techniques have been developed by scientists that have been essential for veterinary and human anatomists and physiologists alike. Dissection and drawing were always essential skills and are still used today. As the first microscopes were developed the ability to see within the tissue and cell both anatomy and physiology were advanced, alongside medical practice. The first modern microscope developed by Hans and Zacharias Janssen in 1590 has certainly changed over the years [21]. There is also much evidence to suggest the use and theories on early microscopes and lens magnification from early China 4000 years ago and even the ancient Greeks and Romans. Hooke also designed a microscope and wrote the now famous ‘Micrographia’ and Antonie van Leeuwenhoek‑the Father of the Microscope developed this work and his publications to the Royal Society were validated by non-other than Hooke [21]. The modern microscope has advanced greatly with optical microscopy utilising a nonlinear optical phenomenon, electron microscopy, confocal microscopy and even hand held microscopes now available for the pursuit of anatomical, physiological and medical research and diagnosis.
Since the discovery of X-rays, developments in medical imaging have provided a powerful tool of investigation allowing visualisation of the body in detail never before seen [22]. The combination of postmortem cadaveric dissection and imaging techniques of live patients has proven to be an important technique in understanding the anatomy and physiology of the live animal [23].
1895 saw X-rays observed for the first time by German physicist Wilhelm Roentgen [24]. By imaging his wife’s hand, Roentgen deducted that bone and metal were opaque on radiographs and medical uses of the technology quickly followed [25]. Marie Curie used a portable X-ray unit to visualise skeletal trauma in soldiers on French battlefields [22]. Whilst, the use of X-ray crystallography was vital in understanding the genetic code, which in turn has had an enormous impact upon the understanding of physiology [24].
In later years, Godfrey Hounsfield expanded the use of X-rays by developing computer software that could integrate multiple radiographic images to give a three-dimensional view inside the body [26]. This was the discovery of computed tomography (CT) [27]. CT had a significant advantage over radiographs alone as it allowed the distinction of different soft tissue types to be visualised [28]. In 1971 the first CT scan of patient took place, successfully scanning the brain for a tumour in the frontal lobe [29]. The invention of CT had vital practical applications, and as a result, Hounsfield was awarded the Nobel Prize for Physiology or Medicine in 1979 [26].
The risks of using ionising radiation were acknowledged, particularly regarding imaging of the foetus, and as such, a reduction in use of X-rays was seen and replacement with ultrasonography and magnetic resonance imaging occurred [24]. Ian Donald pioneered the use of ultrasound in obstetrics and gynaecology in a paper published in 1958 [30]. Since this time, two-dimension ultrasound techniques have been significantly developed and three-dimension ultrasound can map and quantify blood flow [31]. Ultrasound has been a critical milestone for medical imaging and a fundamental method of non-invasive research [32].
However, the breakthrough of magnetic resonance imaging (MRI) has become a vital diagnostic and research tool in recent years [33]. Nuclear magnetic resonance was originally discovered by Felix Bloch and Edward Purcell in 1946 and formed a foundation for the development of modern day MRI. The use of NMR was developed by Paul Lauterbur when he applied gradients to magnetic fields to create a two-dimensional image and Sir Peter Mansfield developed methods of/slice selection and creating and interpreting images. These advance resulted in the development of MRI as we know it now [33] and the men shared the Nobel Prize in Medicine or Physiology in 2003. MRI is an important medical imaging tool, using no ionising radiation and providing a practical alternative to invasive procedures [34].
A recent development in imaging is that of imaging mass spectrometry that allows tissue samples to be visualised on a molecular level without labelling with chemicals or antibodies [35]. The mass spectrometry imaging technology was developed by a group of physicists, including Caprioli and the technique is particularly sensitive for use on proteins and peptides [36]. This technology however cannot map the transcriptome and a new technique, mass spectrometric imaging, has been developed as a result [37].
Moving forwards, it is predicted that radiography will progress to tomography based methods as opposed to projection based and molecular imaging may become more popular [38, 39]. It is also very likely that the field of imaging will continue to develop and give us deeper insights into anatomy and physiology [38]. Imaging is a key part of both anatomy and physiology but by no means the only tool used. We can see the advances made in imaging but many tools have either developed over the years or been discovered in more recent years. Genetics has revolutionised the worlds of anatomy and physiology for example. Understanding cellular and molecular biology alongside anatomy and physiology has become essential in the research we undertake today. Anatomy seeks to understand the structure, location and composition of the parts within organisms and their relationships with each other. Physiology seeks to understand the functions and processes of organisms, how they work and ultimately assist with understanding and treating diseases and disorders. Therefore whilst imaging is essential for both of these practices, the continued development and discovery of more tools are needed in order to further our research. Much of the work in this book uses these techniques, or a combination of them in the pursuit of advancing anatomical and physiological knowledge and understanding.
3. Women in veterinary medicine, anatomy and physiology
This book is part of the IntechOpen’s ‘Women in Sciences Book Collection’; therefore, it seems appropriate to discuss some of the women who have worked in anatomy and physiology, the history of women in veterinary medicine and the present day situation. As with most of the sciences, the majority of people already discussed in this introductory chapter are men. It is not that women were not making advances in science, rather that they were historically less likely to be working in these areas.
Claude Bourgelat founded the first veterinary school in Lyon 1762 [40]. The UK’s first veterinary school, The Veterinary College in London, was not opened until 1791 [41]. At that time, there were no regulations to study veterinary medicine and practitioners often had no formal training [42, 43]. Fifty years later the Royal Charter 1844 allowed the Royal College of Veterinary Surgeons to be created, giving the profession recognition [44, 45]. The Veterinary Surgeons Act 1881 distinguished qualified practitioners from those who were unqualified [45]. Veterinary work was originally centred around the horse, with many veterinarians employed in the army and public services [41, 46]. When engines evolved and horses less in demand, the number of equine veterinarians diminished so the profession then began to focus on farm animals and livestock [41, 46, 47]. During the mid-twentieth century the interest in companion animal care increased and the small animal sector grew [46].
The number of women in anatomy and physiology research has grown over the years. These women have a background either in veterinary medicine or in the basic sciences (biology, anatomy, animal science) or even transfer from human medicine and anatomy to veterinary research. The first UK female veterinary surgeon was Aleen Cust who completed her training in 1900 at Edinburgh Veterinary College. At this time, the Royal College of Veterinary Surgeons refused her membership and therefore Cust could not obtain a diploma from the RCVS [48]. It was not until 1922 when Cust obtained her full RCVS membership aided by The Sex Disqualification (Removal) Act of 1919, which forbade the discrimination of women [48].
Mary Brancker was the first woman president of the British Veterinary Association and a key founding member in the Society of Women Veterinary Surgeons [49, 50]. Brancker was incredibly influential and she obtained an OBE for her work during the foot and mouth disease outbreak in 1967–1968. Additionally she was awarded CBE for her contribution to animal health and welfare in 2000 [49. The influence of women in veterinary medicine continued to grow as Dame Olga Uvarov became the first woman president of the RCVS in 1976 [51].
In recent years, the veterinary profession has seen a substantial increase in the number of female veterinary surgeons, despite being a previously male-dominated occupation. Removal of gender discrimination, such as the Women’s Education Act of 1974 in the UK and similar movements and laws around the world, has been fundamental in allowing females to gain admission to veterinary colleges [52, 53]. In 2006, 51% of UK working veterinary surgeons were female [54] and by 2014, this number had increased to 57.6% [55]. Women now represent around 80% of veterinary medicine and science graduates in many countries including the United Kingdom, Slovenia and the United States of America however there is still thought to be a divide in the types of areas they later decide to work in [52]. The decrease in the number of men applying to veterinary colleges is thought to be due to declining salaries and pre-emptive flight—men are discouraged from entering the profession due to the increasing number of women [56, 57]. Although there are many historical reasons why fewer women entered the profession, it is clear that throughout the world the numbers of women entering the profession are increasing.
The demographic shift of the profession is not unique to the UK—it has occurred globally. In 1963 there were as few as 277 qualified female veterinary surgeons in the United States [58]. In 2017 females accounted for 55.7% of the total United States veterinary professionals [59]. Similarly, statistics in Canada showed that, in 2017, 55.8% of veterinary surgeons were women [60] and females now make up 80% of the Canadian veterinary student population [61]. In Australia 2010, 50% of registered veterinarians were female [44].
In other countries, feminisation of the veterinary profession has occurred at a slower rate. In Turkey, the proportion of female graduates was 26.2% between 2000 and 2005 compared to only 4.9% between 1975 and 1979 [62]. In Iran, women were previously banned from studying veterinary medicine. However since these restrictions were lifted the number of female veterinary students increased to 51.1% in 2003 [63].
In the past, many veterinary colleges stated they did not want female admissions—many believed women were not strong enough to handle large animals and were too sentimental to cope with the challenges of the work [43, 53]. Today sentimentality is considered vital in veterinary medicine, particularly when working with emotional clientele in companion animal practice [43]. The trend that more female than male graduates enter companion animal practice [43, 59, 60, 64] has posed the question whether the large animal industry will suffer [57]. However it has been highlighted the use of safer chemical restraints has eliminated the significance of physical strength, making the large animal sector more appealing to woman practitioners [53].
Despite increased numbers of female veterinary surgeons, practice ownership is still largely male dominated [46, 54, 65]. Only 6.5% of UK female veterinary surgeons held a director position in 2014 [66]. It is widely known that employees earn lower incomes in comparison to practice owners and directors [46, 65, 67]. The under-representation of women in practice ownership and increasingly low incomes of female employees could potentially stagnate the income of the entire profession [43, 46, 56, 57, 68]. Although, one study found that 73% of UK female veterinary students aspired to own a practice after graduating [69], indicating that women do wish to take on senior roles in a veterinary business; however may not get the opportunity. Therefore there is a significant wage gap between male and female veterinary surgeons but this also extends to starting wages. Full time starting salaries of male veterinarians were $56,433 compared to the female veterinarian mean full time starting salary of $48,722 in the United States [64]. One of our recent reviews also looked at women in academia in the sciences, including veterinary medicine and the basic sciences in order to show details such as reduced career progression, reduced income and other gender inequalities still present in academic institutions throughout the world [70].
At the beginning of this introductory chapter we listed just a few of the anatomists and physiologists from throughout history but documenting women in anatomy and physiology is sometimes more difficult. For many years women were not expected, allowed or encouraged to undertake education or the sciences in general. A quick look at Wikipedia (as of November 2018) showed just 10 pages for ‘women anatomists’ and 29 for ‘women physiologists’ [71]. It is difficult to correlate with the pages for men as these are not a subcategory in their own rights. Some of the anatomists and physiologists included on this site are international renowned, whilst others have made huge advances but are less well known. Italian Alessandra Giliani (1307–1326) was the first documented female anatomist although there is some debate around this matter, but she not only created prosections but was also a surgical assistant and is said to have undertaken research into the circulatory system [72]. In many ways the Italian universities really started a more modern revolution in that women were allowed to study and become academics. Anna Morandi Manzolini (1714–1774) worked as a professor at the University of Bologna as an anatomist, became a member of the Russian Royal Scientific Association and the British Royal Society [73]. Many years later Marion Bidder (1862–1932) an English physiologist became the first woman to do independent research at Cambridge University and also the first women to present her own work at the Royal Society [74]. Vera Mikhaĭlovna Danchakof (1879–1950) a Russian anatomist worked in the field and is often known as ‘the mother of stem cells’ [75]. At a similar time Katharine Julia Scott Bishop (1889–1975) born in the United States of America co-discovered vitamin E [76]. Around this time more women were able to work within universities worldwide. Ruth Bowden (1915–2001) from India became known for her work on striated muscle disease and leprosy [77] and Ruth Smith Lloyd (1917–1995) was the first African- American to achieve a PhD in anatomy working on fertility in both anatomical and physiological terms. Marian Diamond (1926–2017) born in the United States of America is often considered as one of the founders of modern neuroscience [78]. Mary Anne Frey (1945-present) was not only the chief scientist at NASA but also made real advances in the effects of gravity on the body [79]. Although it is not usual to source from Wikipedia, the aforementioned links may be useful for people interested in obtaining further information about these scientists.
Naturally over the last century a number of women have also won Nobel Prizes. These include Gerty Theresa Cori, Rosalyn Yalow, Barbara McClintock, Rita Levi-Montalcini, Gertrude B. Elion, Christiane Nüsslein-Volhard, Linda B. Buck, Françoise Barré-Sinoussi, Carol W. Greider, Elizabeth H. Blackburn, May-Britt Moser, and Youyou Tu [80]. Whilst not all of these scientists were specifically veterinary anatomists or physiologists, many did use these disciplines to help with their discoveries ranging from therapies against malaria, discovery of HIV, understanding chromosomes and DNA, understanding the olfactory system, early embryonic development, drug treatment discoveries, growth factors and countless other essential works throughout their lives.
The world is not filled with Nobel Prize winning scientists or pages on Wikipedia. It is difficult to ascertain the exact numbers of women in anatomy and physiology worldwide as this encompass both veterinary surgeons and scientists from the biological and biomedical fields. Many teach undergraduate and post graduate students, undertake research, work in industry and have other roles in educational establishments. International organisations such as the World, European, African and American Associations of Veterinary Anatomists and the international nomenclature committees all have female members, committee members and/or presidents and certainly other leading societies have similar situations [81, 82, 83, 84]. Looking at the International Union of Physiological Sciences, Federation of European Physiological Societies, American Physiology Society, Federation of the Asian and Oceanian Physiological Societies and the societies that they represent a similar pattern is observed [85, 86, 87, 88, 89].
Attending conferences, looking at the committee members, fellows, members, organising and scientific committees and looking at the literature being produced through books and peer reviewed papers it is clear that women now take substantial leading roles in the instruction of, and research into, veterinary physiology and anatomy. It has to be noted that many societies now also have equality officers (or equivalent) and even sub committees concentrating on women in science, for example the American Physiological Society has a ‘Women in Physiology’ committee to promote excellence in mentoring, to promote the visibility and success of women in physiology among many other aims [87]. Whilst specific committees, networks or similar activities are not always evident it is important to note that over the centuries and more recent decades the people involved in the sciences in general, and of course physiology and anatomy has changed. Grant funding bodies are starting to recognise that people may take career breaks including parental leave and undertaking blind reviewing of grants, more journals are trying to combat unconscious bias in all areas by conducting blind reviews of papers, many institutions across the world have, or are implementing equality charters.
Evidently, women may still face challenges with regards to unequal pay, gaining leadership roles, recognition within their fields and even in many parts of the world being able to achieve an education which allows them to succeed. A similar situation can be observed for many men of course. However, there has been considerable progression for women in the field of sciences since the 1900s so hopefully these issues will be overcome in future years.
This book contains anatomical and physiological reviews and original research from across the world. Perhaps one of the greatest strengths of veterinary anatomy and physiology is the diverse research which we see from all over the world. This book contains work in a variety of species including the horse, dog, cattle and chickens. It covers areas such as the heart, tendons, prostate gland, and the hoof. In addition it covers not only normal anatomy and physiology but also diseases, disorders and blends in information for those in the veterinary professions.
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Social Forces. 2010;88(5):1969-1998'},{id:"B57",body:'Lofstedt J. Gender and veterinary medicine. The Canadian Veterinary Journal = La revue veterinaire canadienne. 2003;44(7):533-535'},{id:"B58",body:'Drum S, Whiteley HE. Women in Veterinary Medicine: Profiles of Success. USA: Iowa State University Press; 1991'},{id:"B59",body:'AVMA. Market Research Statistics: U.S. Veterinarians 2017. 2017. Available from: https://www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-veterinarians.aspx. [Accessed 08/09/2018]'},{id:"B60",body:'CVMA. Veterinary Demographics (2017). 2017. Available from: https://www.canadianveterinarians.net/about/statistics. [Accessed 07/09/2018]'},{id:"B61",body:'Prescott JF, Bailey J, Hagele WC, Leung D, Lofstedt J, Radostits OM, et al. CVMA task force on education, licensing, and the expanding scope of veterinary practice. The Canadian Veterinary Journal. 2002;43(11):845-854'},{id:"B62",body:'Gul RT, Ozkul T, Akcay A, Ozen A. Historical profile of gender in Turkish veterinary education. Journal of veterinary medical education. 2008;35(2):305-309'},{id:"B63",body:'Rezai-Rashti G, Moghadam V. Women and higher education in Iran: What are the implications for employment and the "marriage market"? International Review of Education. 2011;57(3-4):419-441'},{id:"B64",body:'Shepherd AJ, Pikel L. Employment of female and male graduates of us veterinary medical colleges, 2013. Journal of the American Veterinary Medical Association. 2013;243(8):1122-1126'},{id:"B65",body:'Honey L. Women as veterinary leaders and entrepreneurs. Veterinary Record. 2014;175(23):578'},{id:"B66",body:'RCVS. The 2014 RCVS Survey of the Veterinary Profession. 2014. Available from: https://www.rcvs.org.uk/news-and-views/publications/rcvs-survey-of-the-veterinary-profession-2014/rcvs-survey-of-the-veterinary-profession-2014.pdf. [Accessed 07/08/2018]'},{id:"B67",body:'Heath TJ. Longitudinal study of veterinary students and veterinarians: The first 20 years. Australian Veterinary Journal. 2007;85(7):281-289'},{id:"B68",body:'Smith CA. The gender shift in veterinary medicine: Cause and effect. Veterinary clinics of North America. Small Animal Practice. 2006;36(2):329-339'},{id:"B69",body:'Castro SM, Armitage-Chan E. Career aspiration in UK veterinary students: The influences of gender, self-esteem and year of study. Veterinary Record. 2016;179(16):408'},{id:"B70",body:'Alibhai A, Saiger MM, Harding E, Rutland CS. Is your extra X chromosome holding you Back? An insight into female education and academic careers in STEMM. In: New Pedagogical Challenges in the 21st Century [Internet]. UK: IntechOpen; 2018. pp. 251-267. Available from: https://www.intechopen.com/books/new-pedagogical-challengesin-the-21st-century-contributionsof-research-in-education/is-your-extra-x-chromosome-holdingyou-back-an-insight-into-femaleeducation-and-academic-careers-in. DOI: 10.5772/intechopen.71898'},{id:"B71",body:'Wikipedia. Category: Women Anatomists. 2018. Available from: https://en.wikipedia.org/wiki/Category:Women_anatomists [cited: Nov 2, 2018]'},{id:"B72",body:'Wikipedia. Alessandra Giliani. 2018. Available from: https://en.wikipedia.org/wiki/Alessandra_Giliani [cited: Nov 1, 2018]'},{id:"B73",body:'Wikipedia. Anna Morandi Manzolini. 2018. Available from: https://en.wikipedia.org/wiki/Anna_Morandi_Manzolini'},{id:"B74",body:'Wikipedia. Marion Bidder. 2018. Available from: https://en.wikipedia.org/wiki/Marion_Bidder'},{id:"B75",body:'Wikipedia. Vera Danchakoff. 2018. Available from: https://en.wikipedia.org/wiki/Vera_Danchakoff [cited: Nov 2, 2018]'},{id:"B76",body:'Wikipedia. Katharine Bishop. 2018. Available from: https://en.wikipedia.org/wiki/Katharine_Bishop'},{id:"B77",body:'Wikipedia. Ruth Bowden. 2018. Available from: https://en.wikipedia.org/wiki/Ruth_Bowden [cited: Nov 2, 2018]'},{id:"B78",body:'Wikipedia. Marian Diamond. 2018. Available from: https://en.wikipedia.org/wiki/Marian_Diamond [cited: Nov 2, 2018]'},{id:"B79",body:'Wilkipedia. Mary Anne Frey. 2018. Available from: https://en.wikipedia.org/wiki/Mary_Anne_Frey [cited Oct 1 2018]'},{id:"B80",body:'NobelMediaAB. Nobel Prize Awarded Women. 2018. Available from: https://www.nobelprize.org/prizes/lists/nobel-prize-awarded-women-3/ [cited oct 2 2018]'},{id:"B81",body:'WAVA. World Association of Veterinary Anatomists. 2018. Available from: http://www.wava-amav.org/ [cited Nov 2 2018]'},{id:"B82",body:'EAVA. European Association of Veterinary Anatomists. 2018 Available from: http://www.eava.eu.com/ [cited nov 2 2018]'},{id:"B83",body:'AAVA. American Association of Veterinary Anatomists. 2018. Available from: https://vetanatomists.org/ [cited nov 2 2018]'},{id:"B84",body:'AfricanAVA. African Association of Veterinary Anatomists. 2018. Available from: http://www.vetanat.com/Association-Society.htm [cited nov 2 2018]'},{id:"B85",body:'IUSP. International Union of Physiological Sciences. 2018. Available from: http://www.iups.org/ [cited nov 2 2018]'},{id:"B86",body:'FEPS. Federation of European Physiological Societies. 2018. Available from: http://www.feps.org/index.php [cited: Nov 2, 2018]'},{id:"B87",body:'APS. American Physiology Society. 2018. Available from: http://www.the-aps.org/ [cited: Nov 2, 2018]'},{id:"B88",body:'AAPS. African Association of Physiological Sciences. 2018. Available from: https://aapsnet.org/'},{id:"B89",body:'FAOPS. Federation of the Asian and Oceanian Physiological Societies. 2018. Available from: http://faops.org.my/ [cited: Nov 2, 2018]'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Valentina Kubale",address:null,affiliation:'
Veterinary Faculty, University of Ljubljana, Slovenia
Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Alexandria University, Egypt
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He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. 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He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. 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Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Associate Prof.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329248",title:"Dr.",name:"Md. Faheem",middleName:null,surname:"Haider",slug:"md.-faheem-haider",fullName:"Md. Faheem Haider",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329248/images/system/329248.jpg",biography:"Dr. Md. Faheem Haider completed his BPharm in 2012 at Integral University, Lucknow, India. In 2014, he completed his MPharm with specialization in Pharmaceutics at Babasaheb Bhimrao Ambedkar University, Lucknow, India. He received his Ph.D. degree from Jamia Hamdard University, New Delhi, India, in 2018. He was selected for the GPAT six times and his best All India Rank was 34. Currently, he is an assistant professor at Integral University. Previously he was an assistant professor at IIMT University, Meerut, India. He has experience teaching DPharm, Pharm.D, BPharm, and MPharm students. He has more than five publications in reputed journals to his credit. Dr. Faheem’s research area is the development and characterization of nanoformulation for the delivery of drugs to various organs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/15648_n.jpg",biography:"Dr. Mohd Aftab Siddiqui is currently working as Assistant Professor in the Faculty of Pharmacy, Integral University, Lucknow for the last 6 years. He has completed his Doctor in Philosophy (Pharmacology) in 2020 from Integral University, Lucknow. He completed his Bachelor in Pharmacy in 2013 and Master in Pharmacy (Pharmacology) in 2015 from Integral University, Lucknow. He is the gold medalist in Bachelor and Master degree. He qualified GPAT -2013, GPAT -2014, and GPAT 2015. His area of research is Pharmacological screening of herbal drugs/ natural products in liver and cardiac diseases. He has guided many M. Pharm. research projects. He has many national and international publications.",institutionString:"Integral University",institution:null},{id:"333824",title:"Dr.",name:"Ahmad Farouk",middleName:null,surname:"Musa",slug:"ahmad-farouk-musa",fullName:"Ahmad Farouk Musa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333824/images/22684_n.jpg",biography:"Dato’ Dr Ahmad Farouk Musa\nMD, MMED (Surgery) (Mal), Fellowship in Cardiothoracic Surgery (Monash Health, Aust), Graduate Certificate in Higher Education (Aust), Academy of Medicine (Mal)\n\n\n\nDato’ Dr Ahmad Farouk Musa obtained his Doctor of Medicine from USM in 1992. He then obtained his Master of Medicine in Surgery from the same university in the year 2000 before subspecialising in Cardiothoracic Surgery at Institut Jantung Negara (IJN), Kuala Lumpur from 2002 until 2005. He then completed his Fellowship in Cardiothoracic Surgery at Monash Health, Melbourne, Australia in 2008. He has served in the Malaysian army as a Medical Officer with the rank of Captain upon completing his Internship before joining USM as a trainee lecturer. He is now serving as an academic and researcher at Monash University Malaysia. He is a life-member of the Malaysian Association of Thoracic & Cardiovascular Surgery (MATCVS) and a committee member of the MATCVS Database. He is also a life-member of the College of Surgeons, Academy of Medicine of Malaysia; a life-member of Malaysian Medical Association (MMA), and a life-member of Islamic Medical Association of Malaysia (IMAM). Recently he was appointed as an Interim Chairperson of Examination & Assessment Subcommittee of the UiTM-IJN Cardiothoracic Surgery Postgraduate Program. As an academic, he has published numerous research papers and book chapters. He has also been appointed to review many scientific manuscripts by established journals such as the British Medical Journal (BMJ). He has presented his research works at numerous local and international conferences such as the European Association for Cardiothoracic Surgery (EACTS) and the European Society of Cardiovascular Surgery (ESCVS), to name a few. He has also won many awards for his research presentations at meetings and conferences like the prestigious International Invention, Innovation & Technology Exhibition (ITEX); Design, Research and Innovation Exhibition, the National Conference on Medical Sciences and the Annual Scientific Meetings of the Malaysian Association for Thoracic and Cardiovascular Surgery. He was awarded the Darjah Setia Pangkuan Negeri (DSPN) by the Governor of Penang in July, 2015.",institutionString:null,institution:{name:"Monash University Malaysia",country:{name:"Malaysia"}}},{id:"30568",title:"Prof.",name:"Madhu",middleName:null,surname:"Khullar",slug:"madhu-khullar",fullName:"Madhu Khullar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/30568/images/system/30568.jpg",biography:"Dr. Madhu Khullar is a Professor of Experimental Medicine and Biotechnology at the Post Graduate Institute of Medical Education and Research, Chandigarh, India. She completed her Post Doctorate in hypertension research at the Henry Ford Hospital, Detroit, USA in 1985. She is an editor and reviewer of several international journals, and a fellow and member of several cardiovascular research societies. Dr. Khullar has a keen research interest in genetics of hypertension, and is currently studying pharmacogenetics of hypertension.",institutionString:"Post Graduate Institute of Medical Education and Research",institution:{name:"Post Graduate Institute of Medical Education and Research",country:{name:"India"}}},{id:"223233",title:"Prof.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/223233/images/system/223233.png",biography:"Xianquan Zhan received his MD and Ph.D. in Preventive Medicine at West China University of Medical Sciences. He received his post-doctoral training in oncology and cancer proteomics at the Central South University, China, and the University of Tennessee Health Science Center (UTHSC), USA. He worked at UTHSC and the Cleveland Clinic in 2001–2012 and achieved the rank of associate professor at UTHSC. Currently, he is a full professor at Central South University and Shandong First Medical University, and an advisor to MS/PhD students and postdoctoral fellows. He is also a fellow of the Royal Society of Medicine and European Association for Predictive Preventive Personalized Medicine (EPMA), a national representative of EPMA, and a member of the American Society of Clinical Oncology (ASCO) and the American Association for the Advancement of Sciences (AAAS). He is also the editor in chief of International Journal of Chronic Diseases & Therapy, an associate editor of EPMA Journal, Frontiers in Endocrinology, and BMC Medical Genomics, and a guest editor of Mass Spectrometry Reviews, Frontiers in Endocrinology, EPMA Journal, and Oxidative Medicine and Cellular Longevity. He has published more than 148 articles, 28 book chapters, 6 books, and 2 US patents in the field of clinical proteomics and biomarkers.",institutionString:"Shandong First Medical University",institution:{name:"Affiliated Hospital of Shandong Academy of Medical Sciences",country:{name:"China"}}},{id:"297507",title:"Dr.",name:"Charles",middleName:"Elias",surname:"Assmann",slug:"charles-assmann",fullName:"Charles Assmann",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/297507/images/system/297507.jpg",biography:"Charles Elias Assmann is a biologist from Federal University of Santa Maria (UFSM, Brazil), who spent some time abroad at the Ludwig-Maximilians-Universität München (LMU, Germany). He has Masters Degree in Biochemistry (UFSM), and is currently a PhD student at Biochemistry at the Department of Biochemistry and Molecular Biology of the UFSM. His areas of expertise include: Biochemistry, Molecular Biology, Enzymology, Genetics and Toxicology. He is currently working on the following subjects: Aluminium toxicity, Neuroinflammation, Oxidative stress and Purinergic system. Since 2011 he has presented more than 80 abstracts in scientific proceedings of national and international meetings. Since 2014, he has published more than 20 peer reviewed papers (including 4 reviews, 3 in Portuguese) and 2 book chapters. He has also been a reviewer of international journals and ad hoc reviewer of scientific committees from Brazilian Universities.",institutionString:"Universidade Federal de Santa Maria",institution:{name:"Universidade Federal de Santa Maria",country:{name:"Brazil"}}},{id:"217850",title:"Dr.",name:"Margarete Dulce",middleName:null,surname:"Bagatini",slug:"margarete-dulce-bagatini",fullName:"Margarete Dulce Bagatini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217850/images/system/217850.jpeg",biography:"Dr. Margarete Dulce Bagatini is an associate professor at the Federal University of Fronteira Sul/Brazil. She has a degree in Pharmacy and a PhD in Biological Sciences: Toxicological Biochemistry. She is a member of the UFFS Research Advisory Committee\nand a member of the Biovitta Research Institute. She is currently:\nthe leader of the research group: Biological and Clinical Studies\nin Human Pathologies, professor of postgraduate program in\nBiochemistry at UFSC and postgraduate program in Science and Food Technology at\nUFFS. She has experience in the area of pharmacy and clinical analysis, acting mainly\non the following topics: oxidative stress, the purinergic system and human pathologies, being a reviewer of several international journals and books.",institutionString:"Universidade Federal da Fronteira Sul",institution:{name:"Universidade Federal da Fronteira Sul",country:{name:"Brazil"}}}]}},subseries:{item:{id:"23",type:"subseries",title:"Computational Neuroscience",keywords:"Single-Neuron Modeling, Sensory Processing, Motor Control, Memory and Synaptic Pasticity, Attention, Identification, Categorization, Discrimination, Learning, Development, Axonal Patterning and Guidance, Neural Architecture, Behaviours and Dynamics of Networks, Cognition and the Neuroscientific Basis of Consciousness",scope:"Computational neuroscience focuses on biologically realistic abstractions and models validated and solved through computational simulations to understand principles for the development, structure, physiology, and ability of the nervous system. 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\r\n\tIn general, the harsher the environmental conditions in an ecosystem, the lower the biodiversity. Changes in the environment caused by human activity accelerate the impoverishment of biodiversity.
\r\n
\r\n\tBiodiversity refers to “the variability of living organisms from any source, including terrestrial, marine and other aquatic ecosystems and the ecological complexes of which they are part; it includes diversity within each species, between species, and that of ecosystems”.
\r\n
\r\n\tBiodiversity provides food security and constitutes a gene pool for biotechnology, especially in the field of agriculture and medicine, and promotes the development of ecotourism.
\r\n
\r\n\tCurrently, biologists admit that we are witnessing the first phases of the seventh mass extinction caused by human intervention. It is estimated that the current rate of extinction is between a hundred and a thousand times faster than it was when man first appeared. The disappearance of species is caused not only by an accelerated rate of extinction, but also by a decrease in the rate of emergence of new species as human activities degrade the natural environment. The conservation of biological diversity is "a common concern of humanity" and an integral part of the development process. Its objectives are “the conservation of biological diversity, the sustainable use of its components, and the fair and equitable sharing of the benefits resulting from the use of genetic resources”.
\r\n
\r\n\tThe following are the main causes of biodiversity loss:
\r\n
\r\n\t• The destruction of natural habitats to expand urban and agricultural areas and to obtain timber, minerals and other natural resources.
\r\n
\r\n\t• The introduction of alien species into a habitat, whether intentionally or unintentionally which has an impact on the fauna and flora of the area, and as a result, they are reduced or become extinct.
\r\n
\r\n\t• Pollution from industrial and agricultural products, which devastate the fauna and flora, especially those in fresh water.
\r\n
\r\n\t• Global warming, which is seen as a threat to biological diversity, and will become increasingly important in the future.
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\r\n\tThe environment is subject to severe anthropic effects. Among them are those associated with pollution, resource extraction and overexploitation, loss of biodiversity, soil degradation, disorderly land occupation and planning, and many others. These anthropic effects could potentially be caused by any inadequate management of the environment. However, ecosystems have a resilience that makes them react to disturbances which mitigate the negative effects. It is critical to understand how ecosystems, natural and anthropized, including urban environments, respond to actions that have a negative influence and how they are managed. It is also important to establish when the limits marked by the resilience and the breaking point are achieved and when no return is possible. The main focus for the chapters is to cover the subjects such as understanding how the environment resilience works, the mechanisms involved, and how to manage them in order to improve our interactions with the environment and promote the use of adequate management practices such as those outlined in the United Nations’ Sustainable Development Goals.
\r\n\tPollution is caused by a wide variety of human activities and occurs in diverse forms, for example biological, chemical, et cetera. In recent years, significant efforts have been made to ensure that the environment is clean, that rigorous rules are implemented, and old laws are updated to reduce the risks towards humans and ecosystems. However, rapid industrialization and the need for more cultivable sources or habitable lands, for an increasing population, as well as fewer alternatives for waste disposal, make the pollution control tasks more challenging. Therefore, this topic will focus on assessing and managing environmental pollution. It will cover various subjects, including risk assessment due to the pollution of ecosystems, transport and fate of pollutants, restoration or remediation of polluted matrices, and efforts towards sustainable solutions to minimize environmental pollution.
\r\n\tWater is not only a crucial substance needed for biological life on Earth, but it is also a basic requirement for the existence and development of the human society. Owing to the importance of water to life on Earth, early researchers conducted numerous studies and analyses on the liquid form of water from the perspectives of chemistry, physics, earth science, and biology, and concluded that Earth is a "water polo". Water covers approximately 71% of Earth's surface. However, 97.2% of this water is seawater, 21.5% is icebergs and glaciers, and only 0.65% is freshwater that can be used directly by humans. As a result, the amount of water reserves available for human consumption is limited. The development, utilization, and protection of freshwater resources has become the focus of water science research for the continued improvement of human livelihoods and society.
\r\n
\r\n\tWater exists as solid, liquid, and gas within Earth’s atmosphere, lithosphere, and biosphere. Liquid water is used for a variety of purposes besides drinking, including power generation, ecology, landscaping, and shipping. Because water is involved in various environmental hydrological processes as well as numerous aspects of the economy and human society, the study of various phenomena in the hydrosphere, the laws governing their occurrence and development, the relationship between the hydrosphere and other spheres of Earth, and the relationship between water and social development, are all part of water science. Knowledge systems for water science are improving continuously. Water science has become a specialized field concerned with the identification of its physical, chemical, and biological properties. In addition, it reveals the laws of water distribution, movement, and circulation, and proposes methods and tools for water development, utilization, planning, management, and protection. Currently, the field of water science covers research related to topics such as hydrology, water resources and water environment. It also includes research on water related issues such as safety, engineering, economy, law, culture, information, and education.
",coverUrl:"https://cdn.intechopen.com/series_topics/covers/41.jpg",keywords:"Water, Water resources, Freshwater, Hydrological processes, Utilization, Protection"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343",scope:"Biomedical Engineering is one of the fastest-growing interdisciplinary branches of science and industry. The combination of electronics and computer science with biology and medicine has improved patient diagnosis, reduced rehabilitation time, and helped to facilitate a better quality of life. Nowadays, all medical imaging devices, medical instruments, or new laboratory techniques result from the cooperation of specialists in various fields. The series of Biomedical Engineering books covers such areas of knowledge as chemistry, physics, electronics, medicine, and biology. 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Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},subseries:[{id:"7",title:"Bioinformatics and Medical Informatics",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine",scope:"Bioinformatics aims to help understand the functioning of the mechanisms of living organisms through the construction and use of quantitative tools. The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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