Diseases of the gastrointestinal tract are common. There is increasing appreciation of the importance of the immune system in the pathogenesis of a number of these diseases. This book covers basic aspects of innate and adaptive immunity in the gastrointestinal tract, oral tolerance, and cellular and molecular mechanisms of acute and chronic inflammation. Specific disease covered include bacterial infections, human immunodeficiency virus (HIV) infection, coeliac disease, and inflammatory bowel disease. Other topics include mucosal immunisation and intestinal transplantation immunology. The readership of this book includes clinicians, scientists, and students interested in the gastrointestinal tract.

Basic research discusses the implication of pancreatic stress protein in acute pancreatitis and pancreatic cancer and their possible role as therapeutic targets. Also, very original results show the unexpected role of lipids as mediators during acute pancreatitis. Gene screening strategies allow the detection of the genes responsbile for gemcitabine resistance of pancreatic cancer cells. They lead to the selection of several target genes, in order to suppress the resistance of cells to gemcitabine treatment. The mechanism by which tetrahydrocannabinol is anti-tumoral in pancreatic cancer cells is presented and the use of THC as a promising new therapeutic agent is discussed.

Genetic data are shown concerning hundreds of families with hereditary chronic pancreatitis and their possible role in the pathogenesis of the disease. Another very original study addresses the prevention and treatment of pancreatic diseases with diat.

In clinical research, convincing data about the use of endoscopic sphicterotomy in the management of acute bilary pancreatitis is presented, based on the experience of a Center highly specialized in pancreatic diseases.

The aetiology of the chronic inflammatory bowel diseases - Crohn's disease and ulcerative colitis - is still enigmatic. The therapeutic approach has therefore traditionally focused on anti-inflammatory principles, including corticosteroids and aminosalicylates. Since a significant proportion of patients is steroid-dependent or refractory and because of the problematic side-effects of long-term systemic steroids, active immunosuppression has gained acceptance in the field. The classical immunosuppressants azathioprine and 6-mercaptopurine have long been evidence-based in IBD, but underused. Recently, methotrexate and cyclosporine have also been proven to be effective in certain situations. Newer drugs like tacrolimus, mycophenolate and others may be similarly useful but their potential is still unclear. Finally, the immune modifiers including IL-10 and TNF-antibodies have been successfully subjected to controlled trials. Other experimental drugs discussed in this book are on the horizon. This volume is the Proceedings of Falk Symposium 119 held in Freiburg-im-Breisgau, Germany, October 3-4, 2000, and covers systematically the field of immunosuppression in inflammatory bowel diseases. It is hoped that it will further the prudent use of these drugs in the proper clinical situations by increasing our understanding of both the mechanisms of action and the clinical benefit to the patient.

Beginning in 1970, the International Bile Acid Meeting has taken place every two years and each time new progress in our understanding of the complex role of bile acids in many metabolic processes of the liver and the intestine has been revealed by a selected group of leading scientists from all over the world. Although originally mainly physiological data on bile acid synthesis and transport were emphasized, and later on also the therapeutic benefit of bile acids in gallstone disease and cholestasis was discovered, we have come now to the molecular biology and genetic era with major discoveries in transport defects and related diseases. This book is the proceedings of Falk Symposium No. 120, held in The Hague, The Netherlands, on October 12-13, 2000 - the 16th International Bile Acid Meeting. One of the main discoveries recently has been the identification of nuclear receptors for bile acids, which gives them a much broader perspective than previously anticipated. It even suggests that bile acids can regulate their biosynthesis and enterohepatic circulation transcriptionally. It will therefore not be surprising that this topic, together with the molecular regulation of cholesterol 7alpha-hydroxylase and cholesterol homeostasis, has a dominant place in these proceedings. Another important topic is the progress in our molecular understanding of hepatic (both at the basolateral and canalicular sites), cholangiocytic and intestinal bile acid transport processes. Further insights into genetic defects causing cholestasis or intestinal malabsorption in animal models and in human diseases are also discussed by a number of well-known authors. Finally the last section deals with new findings on the role of bile acid therapy in cholestatic syndromes or chemoprevention and with the potential benefit of bile acid inhibitors. All contributors provide an update on the most recent developments in their field.

The pancreas is about the size and shape of the hand; the tail points to the spleen, and the head is nestled in a loop of the duodenum. Loss of the exocrine (digestive) func tions commonly leads to severe gastrointestinal disturbances, malabsorption, a cata bolic state, and weight loss in the face of an adequate diet. Loss of endocrine pancreatic function leads to a large spectrum of disorders associated with the loss of hormone secretions; the most common and most severe is diabetes mellitus. Loss of the entire pancreas owing to trauma, surgery, atherosclerosis, or other medical problems leaves the patient in a digestive and metabolic crisis. The correct diagnosis of pancreatic disorders remains a challenge given the multi faceted function of the pancreas. The clinical laboratory plays an important role, and other tools such as CAT scans, ultrasound, radiographs, biopsies, and even surgery are used to make a diagnosis. The emphasis of Clinical Pathology of Pancreatic Disorders is on the clinical laboratory definition of pancreatic pathology. Disorders of the endocrine pancreas can be highly complex, and sophisticated tests are needed to determine the nature of the disease, its prognosis, and its optimal treat ment. Diabetes is the most common of the endocrine diseases; it presents in many ways, and has varied etiologies. We now know that the diabetes of childhood is usually an autoimmune disease, and this has a major effect on the treatment of these individuals."

This book contains the proceedings of the XIIIth International Bile Acid Meeting (Falk Symposium 80), an official satellite meeting of the World Congress of Gastroenterology, held in San Diego, California, U.S.A., September 30--October 2, 1994. It begins with presentations of major advances in bile acid chemistry, biology and pharmacology. The new structure proposed for the mixed micelles present in bile is reviewed, as are the properties of new synthetic analogues of bile acids. The mechanisms by which bile acids interact with cell membranes are discussed in order to provide insight into the hepatotoxic effects of bile acids in cholestatic liver disease. The book further shows the exciting progress in the molecular biology of bile acid transport by the hepatocyte and enterocyte, and concludes with a consensus on the use of ursodeoxycholic acid in cholestatic liver disease and as an adjunct to immunosuppressive therapy after liver transplantation, and to interferon therapy in chronic viral hepatitis.

The Second International Symposium on Inflammatory Bowel Diseases was held in Jerusalem from September 8-11, 1985, under the auspices of the Israel Academy of Sciences, the Israel Gastroenterological Society and the Hebrew University-Hadassah Medical School. Five hundred physicians and researchers from 26 countries attended. The symposium was organized into six panels devoted to state of the art reviews and presentations of the latest findings and approaches on etiology, pathogenesis, medical and surgical management of IBD and clini cal assessment of disease. In addition, 89 abstracts were presented as posters during the symposium, all of which were published in the book of abstracts. The concluding panel outlined new directions for future re search on IBD. The organizing committee gratefully acknowledges all the contributors who presented their work in a clear and concise manner, and to all the participants whose active role in the discussions contributed to the suc cess of the meeting. In view of the great interest in the symposium and the tradition es tablished following the first, in 1981, it was decided to convene a third international symposium on IBD in Jerusalem in September 1989."

Hardly any other part of the human body is of such interdisciplinary interest as the anal, perianal and rectal region. Gastroenterologists, dermatologists, urologists, general practitioners and surgeons specialising in proctology, phlebology, and coloproctological surgery are involved in this region between the ectoderm, transitional zone, and entoderm. Diagnostic procedures, such as endoscopy, radiology, sonography, manometry, electromyography, and histopathology are even more diverse, in particular where the differential diagnosis of non-neoplastic conditions of the anorectal region is concerned. The Falk Symposium No. 118, held in Freiburg, Germany, on October 1-2, 2000, focused on the morphology and function of the pelvic floor and its dysfunction, radiation damage in proctology, haemorrhoidal complaints, and chronic inflammatory rectal diseases, as well as conditions of the anal and perianal region. These proceedings will be of interest to all research physicians and colleagues working in hospitals or in their own practice who are involved in the diagnosis and treatment of anorectal pathologies.

Clinical experts synthesize for the practicing physician all the important developments that have occurred recently in the diagnosis and treatment of acid-related diseases. They address the evaluation of patients suspected of harboring both peptic ulcers and ulcers from other causes, with emphasis on novel aspects of H. pylori infection. New information is also provided to assist clinicians in efficiently managing patients with dyspepsia and in the diagnosis and treatment of gastroesophageal reflux disease (GERD), including its extraesophageal manifestations and upper gastrointestinal bleeding. Authoritative and highly readable, Diseases of the Gastroesophageal Mucosa: The Acid-Related Disorders distills a wealth of cutting-edge clinical practice into one readable volume that will help every clinician manage patients with today's best diagnostic and treatment practice.

Chronic inflammatory bowel disease still represents a major gastroenterological challenge, in view of the unclear aetiology and unsatisfactory therapy. This book, the proceedings of a Falk Symposium held in L beck, Germany on 4--5 March 1994, will act as a vehicle for our current knowledge, and promote the dialogue between clinicians and those involved with the associated sciences. The book begins with international experts discussing the more recent theories concerning the aetiology and pathogenesis. Later on, the discussion turns to questions of diagnosis, and the conservative and surgical treatment of Crohn's disease and ulcerative colitis are dealt with in detail. This volume in the Falk Symposium both represents a forum of experts for discussion of the most recent findings, and provides clinical gastroenterologists with an opportunity to inform themselves of the state of the art in the field of inflammatory bowel disease.

This Trends in Inflammatory Bowel Disease Therapy Symposium was held in Vancouver, British Columbia, Canada, 27 29 August 1999. This is the seventh international symposium, sponsored by Axcan Pharma Canada Inc., since the first symposium in 1986. The Canadian Association of Gastroenterology has co-sponsored these symposia since 1990. Each symposium has been published, and reflects and updates the extensive research and education, and the understanding of the mechanisms and treatment of inflammatory bowel disease. From the beginning, Canadian and international experts have been involved, maintaining a consistently high quality, both in their presentations, during discussions, and the subsequent publication of their work. There have been major advances since the symposium held two years ago, and these are presented in this book. In keeping with modern educational practice, objectives are provided, and all presentations were subject to written independent evalu ation. All participants are asked to declare any conflicts of interest. MOCOMP and educational credits are available."

The discovery and concept that Helicobacter pylori is associated with gastric disease including gastric cancer which is one of the most common and frequently lethal forms of malignancy, heralded a new and rapidly expanding field recognizing the emergence of many new pathogens and disease syndromes in clinical medicine, as well as basic infectious disease research. There is now an extensive and widely known literature of how H. pylori is involved in a wide variety of disease syn dromes. As summarized in the introductory chapter of this volume, many major advances have been made in diagnosis, both serologic and endoscopic in time of the involvement of this organism in patients with upper GI ailments as well as its presence in those who are not clinically ill. The Introduction describes the rapid development of understanding the role of this organism in disease. The basic bacteriology of H. pylori is then described in the second chapter. Diagnostic tests for detecting H. pylori infection is then highlighted, as well as the role of such infection in gastric cancer. Current knowledge concerning risk factors and peptic ulcer pathology associated with H. pylori is then described. Newer information concerning therapy of H. pylori infection and colonization is described in a subsequent chapter as well as one concerning the effects of anti biotics on H. pylori infection. The extensive literature on natural substances with anti-H."

The gastrointestinal tract has a number of unique features. Its extensive surface is formed by a single layer of rapidly renewing cells, the intestinal epithelial cells. These cells are in contact with a number of other cell populations, including the largest part of the immune system, and with an excessive luminal antigen load, including vast numbers of bacteria. Furthermore two more organs, namely liver and pancreas, are part of the system. The rapid renewal of the epithelial layer, the interactions of different cell types, and the balance between cell proliferation and death, have been fascinating subjects of studies in recent years. Much has been learned, and cytokines have emerged as important mediators for all these interactions and homeostatic systems. This book, the proceedings of the Falk Symposium 113 on `Cytokines and Cell Homeostasis in the Gastrointestinal Tract', held in Regensburg, Germany, 16-18 September 1999, provides a forum for basic scientists and interested clinicians to exchange ideas, to discuss concepts and to plan further studies.

Because of the increasing burden of hepatitis C and fatty liver disease, there is an explosion in the prevalence of chronic liver failure and hence its complications. The onset of Hepatic Encephalopathy (HE) in these patients has a significant impact on the quality of life, morbidity and mortality. Unfortunately, the approach observed by most clinicians to this complex disorder is minimalistic. Hepatic Encephalopathy provides a comprehensive review on pathophysiology and clinically important aspects in HE. Topics in basic physiology, nitrogen metabolism, new insights into pathogenesis and brain edema are covered in great detail. The authors have made a special effort by simplifying the complex aspects of pathogenesis and diagnosis so that it can be easily understood and applied clinically. This volume also focuses on recent developments regarding diagnoses of subtle forms of HE, also known as minimal or covert HE as well as on new treatments. Hepatic Encephalopathy will be of great value to gastroenterologists, hepatologists, pathologists, medical residents, fellows, internists, and general practitioners who treat patients with hepatic encephalopathy.

Probiotic microorganisms have a long history of use, and their health benefits for hosts are well documented. This Microbiology Monographs volume provides an overview of the current knowledge and applications of probiotics. Reviews cover the biology and probiotic potential of the thoroughly studied prokaryotic genera Lactobacillus and Bifidobacterium, several eukaryotic microorganisms, probiotic strain characterization, and the analytical methods (such as FISH, microarray, and high throughput sequencing) required for their study. Further chapters describe the positive effects of probiotics on malabsorption disorders such as diarrhea and lactose intolerance, and document the clinical evidence of benefits in treating allergies and lung emphysema, and in dermatological applications. Also addresses are topics such as genetically engineered strains, new carriers for probiotics, protection techniques, challenges of health claims, safety aspects, and future market trends.

In recent years there have been a number of significant developments of natural products for the treatment of rheumatic diseases, pain and gastro-intestinal ulcers and inflammation. The volume covers some of these novel developments of natural products which are of current and future interest as therapies for the above-mentioned conditions. Most available volumes cover a wide range of biological and technicological aspects of natural products and their discovery, some involving synthesis and properties of chemical compounds. The difference in this volume is that the natural products have a focus on their therapeutic effects on pain, arthritic and gastrointestinal diseases. Some of the natural products covered are either at the experimental stage of development while others are well-established clinically-used products. Each has its own unique place in therapy.