The Yale Swallow Protocol is an evidence-based protocol that is the only screening instrument that both identifies aspiration risk and, when passed, is able to recommend specific oral diets without the need for further instrumental dysphagia testing. Based upon research by Drs. Steven B. Leder and Debra M. Suiter, an easily administered, reliable and validated swallow screening protocol was developed and can be used by speech-language pathologists, nurses, otolaryngologists, oncologists, neurologists, intensivists and physicians assistants. In addition, the protocol can be used in a variety of environments, including acute care, rehabilitation and nursing homes. The Yale Swallow Protocol meets all of the criteria necessary for a successful screening test, including being simple to administer, cross-disciplinary, cost effective, acceptable to patients and able to identify the target attribute by giving a positive finding when aspiration risk is present and a negative finding when aspiration risk is absent. Additionally, early and accurate identification of aspiration risk can significantly reduce health-care costs associated with recognized prandial aspiration.

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."

The Third International Symposium on Inflammatory Bowel Diseases was held in Jerusalem during September 10-13, 1989. Four hundred physicians and scientists from 25 countries attended the meeting. The symposium was organized into five panels devoted to state of the art reviews of the latest findings and approaches on the etiology, pathogenesis, metabolic implications, clinical assessment of disease activity and the medical management of IBD. Several issues were discussed in debate form. The last panel was dedicated to discussion of three patients with computer assisted active participation of all the attendants. In addition, 03 abstracts were presented as posters, all of which were published in the Book of Abstracts. The organizing committee gratefully acknowledges the contributors who presented their work in clear and concise manner and the participants, whose active part in the discussions contributed to the success of the meeting. The Jerusalem International symposium on Inflammatory Bowel Diseases has become a tradition that will continue with the Fourth Symposium to be convened in September 1993. Joseph Zimmerman, M.D. Daniel Rachmi1ewitz, M.D. LIST OF FIRST AUTHORS Theodore M. Bayless, Michael J. Langman, Johns Hopkins University Department of Medicine, School of Medicine, Queen Elizabeth Hospital, Baltimore, Maryland. Birmingham, England. Michael D. Blackstone, J.E. Lennard-Jones, University of Chicago, St. Mark's Hospital, Chicago, Illinois. City Road, London, England. Charles O. Elson, Division of Gastroenterology, James Lee Madara, The University of Alabama Department of Pathology, at Birmingham, Brigham and Women's Hospital, Birmingham, Alabama. Boston, Massachusetts.

This is a carefully illustrated volume of surgical procedures. Well-known standard as well as alternative procedures in surgery of the stomach and the proximal duodenum are depicted with anatomical exactness. Possible complications, errors, and dangers and how to avoid them are discussed in detail. Each operative step is illustrated superbly and accompanied by a short, precise text. Both illustrations and text stem from the practical experience in the operating theater of the many renowned surgeons who have contributed to this volume. The book serves as an indispensable reference for surgeons; likewise, gastroenterologists, radiologists, pathologists, and anatomists will find this volume of immeasurable value in their daily work.

The gastrointestinal track provides one of the distinct systems where multiple malignancies, including adenocarcinoma of the pancreas, esophagus and colon are each associated with obesity. This unique association is covered in this volume of Energy Balance and Cancer from the epidemiologic, biologic and potential etiologic viewpoint. The focus on possible dietary contribution as well as the role of exercise in prevention and therapy is presented in both animal model and patient based studies. Special focus is provided also on the role of genetic mutations and inflammatory pathways as drivers of these obesity related gastrointestinal malignancies. Overall, this volume on Energy Balance and Gastrointestinal Malignancies should be valuable to Epidemiologists, Gastroenterologists and Oncologists, as well as to students and researchers from multiple disciplines interested in understanding and disrupting the association between obesity and cancer.

Whereas during the past decade endoscopy has become established as the leading means of diagnosis and management of diseases affecting the esophagus, starnach and large bowel, radiology has retained its pre-eminence for the clinical study and evaluation of the small bowel. This book provides unique coverage of all current radiological techniques used to study the small bowel, including not only barium studies and angiography but also cross-sectional methods such as uhrasound and computer tomography as well as nuclear medicine. Ernerging techniques such as magnetic resonance imaging are given close consideration, and interventional procedures are dealt with fully. Following an introduction on anatomy, physiology, and pathology pertinent to radiol ogy, the book describes in great detail common and less common congenital and development anomalies, trauma, infectious and infl.ammatory conditions, and tumors. The radiological accounts are illustrated by unique color photographs of pathological specimens. It is important for all professionals involved in the management of patients with small-bowel disease tobe critically informed about the specific advantages as well as the limitations of the various modern imaging techniques now employed for the in vivo morphological evaluation of the small bowel. This comprehensive book provides a timely update of our knowledge in this field and is a welcome addition to our series "Medical Radiology;' which aims to provide exhaustive coverage of modern diagnostic radiology. It will be of great interest for general and abdominal radiologists, gastroen terologists, and abdominal surgeons.

Primary liver cancer is a rather unusual malignancy in that the incidence varies tremendously from one geographical area to another. While relatively uncom mon in Western countries, it is the most prevalent malignant neoplasm in Southeast Asia, South Africa, and many other regions; in all, the countries in which primary liver cancer is very prevalent account for more than two-thirds of the world's population. In China alone, approximately 100 000 people die every year from primary liver cancer, mostly hepatocellular carcinoma. The incidence is rising in some countries, especially Japan, where it has doubled among males in the past 15 years or so, a staggering and puzzling trend. Since the demonstration of an etiological relationship between hepatitis B virus infection and hepatocellular carcinoma, intensive research has been con ducted in an effort to elucidate the role of the virus in hepatocarcinogenesis. Though much progress has been made, a full understanding of the molecular events leading to malignant transformation of the hepatocyte will probably require many more years of rigorous investigation. Chemical carcinogens and several industrial pollutants may also be involved in the etiopathogenesis of neoplastic liver disease."

The percentage of the population which is elderly has been increasing steadily in many countries in the world; and as this tendency continues, the question of how to treat the elderly rises in importance. The problem of how to manage hypertension in the elderly has become one of the most important issues in the prevention and treatment of cardiovascular disease. However, not many of the cIinical studies performed so far to evaluate the effects of antihypertensive drug treatment have incIuded the elderly. Many important problems remain unsolved. How much bene- ficial effect can be expected from active antihypertensive drug treatment in the elderly? How can isolated systolic hypertension, which is fre- quently encountered in the elderly, have better prognosis when treated? When is drug treatment indicated, to what level should blood pressure be reduced and maintained in the e1derly, and how should drugs be selected? The elderly also frequently bear other medical problems, either re- cognized or unrecognized, such as mental depression, respiratory problems, infection, malignant neoplasms, and water and electrolyte im- balances. The body's ability to eliminate drugs also decreases with age and necessitates modified dosage. The 12th Scientific Meeting of the International Society of Hyperten- sion held in Kyoto, Japan on May 22-26, 1988 incIuded the satelIite symposium. "How Should Elderly Hypertensive Patients Be Treated?" wh ich focused on the pathophysiology and outcome of elderly hyperten- sive patients.

Modern Management of Cancer of the Rectum is intended to provide a comprehensive overview of all aspects of rectal neoplasms. It addresses epidemiology, biology, screening and chemoprevention, the role of imaging in diagnosis, staging and prognosis, radiation therapy, medical and surgical treatment, as well as new modalities of therapy, including laparoscopy, and transanal endoscopic surgery. A greater understanding of prognostic factors, patterns of spread and natural history has occurred during the past decade; together with new diagnostic modalities this has led to significant changes in the management of patients with rectal cancer. This book will be invaluable for all those who treat rectal cancer.

This book will incorporate a multimodality approach toward inflammatory bowel diseases. Up to date imaging methodologies will be described along with their strengths and weaknesses that will help in providing a rational diagnostic strategy for clinical, surgical and support teams working with these patients. Advances in medical and surgical treatment would be detailed and these would be useful to readers and professionals keen to implement these techniques in their own clinical practice.

This book provides an overview on the critical role of diagnostic imaging in the assessment of patients with suspected alimentary tract perforation, an emergent condition that requires prompt surgery. With the aid of numerous high-quality images, it is described how different imaging modalities, including plain film X-ray, ultrasonography and multidetector row computed tomography (MDCT), permit correct diagnosis of the presence and cause of the perforation and of associated pathologies. Particular attention is paid to MDCT, with full description of its role in a range of scenarios at various levels of the alimentary tract. Imaging of GI tract perforation in different patient groups, such as pediatric patients, the elderly and oncologic patients, is also addressed. This volume will greatly assist residents in radiology, radiologists and physicians who are daily involved in the management of patients with clinically suspected alimentary tract perforation.

This book provides the reader with a multidisciplinary approach that is state of the art and reflects input from the European Neuroendocrine Tumor Society and the North American Neuroendocrine Tumor Society. In particular, the text focuses on the pathophysiology of neuroendocrine tumors and includes a comprehensive review of the most recent developments in understanding the complex hormone and receptor signaling that is important for the future development of potent pharmacological treatments. The volume reviews the pathological grading and staging systems providing useful clinical information for the treating clinician as well as a useful reference for pathologists. The clinical management of neuroendocrine tumors is reviewed enabling the treating physician to understand the diagnostic approaches to differentiating the various types of neuroendocrine tumors. In addition, the treatments are reviewed in great detail and include novel radiological, surgical, and chemotherapeutic approaches. The reader will utilize this book as both a comprehensive and quick reference guide through the use of diagnostic and treatment algorithms. Written by international experts in their particular field of study, Management of Pancreatic Neuroendocrine Tumors will be of great value to medical oncologists, endocrinologists, gastroenterologists, pathologists, surgeons, and diagnostic and interventional radiologists.

Gastroparesis is an increasingly recognized disorder. Treatment can be difficult due to the several mechanisms for symptom production. Gastroparesis: Pathophysiology, Presentation and Treatment serves as a concise reference on this disorder that allows clinicians to quickly access and evaluate the necessary information for treating and managing patients with gastroparesis. Each chapter is written byexperts in their respective area. The volume will enable the reader to better understand all aspects of this disorder. The book presents current concepts in a variety of areas opening with the epidemiology, clinical presentation and pathophysiology of gastroparesis. The natural history of patients is explored as well as evaluation of patients with suspected gastroparesis. This section includes chapters on Wireless Capsule Motility, Electrogastrography and Antroduodenal Manometry. This important resource concludes with a full section on treatment including dietary, prokinetic, antiemetic, sensory, electric stimulation, and surgical methods. New developments include the use of gastric electric stimulation for treatment, the use of SmartPill for diagnosis, and a number of new agents in development for this disorder. Gastroparesis: Pathophysiology, Presentation and Treatment is the ideal reference for gastroenterologists, and also for surgeons, endocrinologists, primary care physicians and nutritionists looking to keep pace with the latest information treatment options for their patients. "

Over past several decades, an increasing number of cases of diverticulitis of colon have been reported making it a major health problem particularly in western countries. The distribution of the disease varies geographically with western population having prevalence rates of 5-45% and Asian population having prevalence rates of 13-25%. Although elderly people are more likely to develop diverticulitis, younger patients may also develop diverticular disease. In fact, it has been reported that disease in younger patients is more aggressive with higher rates of complication and recurrence. According to latest statistical reports acute diverticulitis accounts to nearly 200000 hospital admissions putting a burden of 2.7 billion dollars on healthcare system in America. Diverticular disease can cause significant symptoms, impair quality of life and can prove fatal if left untreated and is considered as the fifth most costly gastrointestinal disorder in the Western world. The book entitled, Diverticulitis; Diagnosis and Treatment, presents an up to date review of the medical and surgical management of diverticulitis. The book comprises of various topics discussing the background, epidemiology, etiology, pathogenesis, presentation, treatment both medical and surgical, and recent advances in the management of diverticulitis. The book will be academic interest for surgeons, physicians, gastroenterologists and Coloproctologists. The book can be used as a reference book by teachers, professionals and students. The main benefit of reading this book is that since this disease entity is common all over the world and its incidence is increasing and is a significant contributor of health care costs, all the relevant and latest information regarding this disease has been published in a comprehensive form which will be helpful to the students, academicians, researchers and professionals dealing with medical healthcare.

Autoimmune Liver Diseases summarizes the recent high-impact research and clinical findings obtained in Japan in the study and treatment of autoimmune liver diseases. Although these disorders are relatively rare, they are recognized as an important group of refractory liver diseases, the most common of which are autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC). The book therefore comprises two major sections, one dealing with AIH, the other with PBC. AIH in Japanese patients creates a unique disease population, as its clinical features are different from those of Western patients resulting from the different genetic background of the two patient populations. Also, mouse models of neonatal thymectomy-PD-1 knockout mice, clinical analyses of acute hepatitis-like manifestations, and research findings on IgG4-related autoimmune hepatitis have been reported in Japan and are included in this book. A disease-susceptibility gene specific to Japanese PBC patients has also recently been discovered. Because of the relatively homogeneous population of Japan, analyses conducted with Japanese PBC patients have yielded findings that are highly relevant to the pathogenesis of the disease. Furthermore, new pathological staging criteria, anti-gp210 antibodies and the basis they provide for improved accuracy of prognosis, treatment with bezafibrate, and the outcomes of living-donor liver transplantation are also presented here. This volume therefore serves as a useful resource not only for hepatologists, but also for researchers, clinical residents, and medical students both in Japan and in other countries.

Dietary fibre is now recognized as a vital component of good daily nutrition, yet its properties and specific role in the digestive system are still being investigated. The involvement of government agencies, the food industry and health professionals - as well as public interest - make this global overview, Dietary Fibre - A Component of Food, an important contribution to the literature on the subject. The cooperation of experts from different research centers and their peer review of each other's papers enhance the value of the book, since it presents consolidated views and objective assessments on such key issues as fibre analysis and mineral bioavailability. The seventeen chapters are grouped into three sections. The background papers deal with biochemical and analytical characteristics: e.g. the physico-chemical properties of food polysaccharides and bacterial fermentation in the colon. The papers on physiological effects deal with the physiological function of dietary fibre throughout the gastrointestinal tract: its influence on protein, lipid and carbohydrate digestion and absorption and its role in bile acid metabolism and faecal bulking. The third section of papers focuses on the prevention and treatment of disease: gastrointestinal disorders, obesity, diabetes mellitus, and hyperlipidemias.

This Recent Results in Cancer Research volume provides an up-to-date overview of the multidisciplinary management of locally confined rectal cancer as well as colorectal cancer with synchronous resectable liver metastases. The contents comprise the majority of the invited contributions from the Second St. Gallen EORTC Gastrointestinal Cancer Conference, held on 6-8 March 2014 in St. Gallen, Switzerland. Written by some of the world s leading experts in the imaging, endoscopy, pathology, molecular biology, surgery, radiotherapy and medical oncology of rectal cancer and liver metastases, the chapters offer a comprehensive view on the latest recommendations in diagnosis and multidisciplinary treatment. Every clinician involved in the care of patients with rectal cancer will find this book interesting and helpful."

The Clinician's Guide to Swallowing Fluoroscopy is a comprehensive resource for all dysphagia clinicians. This beautifully-illustrated text is intended for SLP, ENT, radiology, GI, and rehabilitation specialists interested in swallowing and addresses the need for an up-to-date, all-inclusive reference. Topics covered include radiation safety and protection, fluoroscopic oral, pharygeal, and esophageal phase protocols and abnormalities, and objective measures of timing and displacement.

A volume on the biliary system appeared in 1965, based on a symposium of the NATO Advanced Institute held in September, 1963, in Newcastle upon Tyne in England. It soon became an authorita tive text on the problems of the biliary tract and, for instance, the discussion on the biliary secretion of organic anions, organic cations and inorganic ions were classic references. The worn pages of the volume in many libraries, including my own, bespeak its usefulness over ten long years. The initiative and energy of the Director of the first Institute have to be admired, even more so since he was able to assemble a Second Institute in Aalborg, Denmark, in 1975. His wisdom is reflected in the selection of the subjects discussed. The comparison between the two volumes tells something about the advancement in the time interval in knowledge about liver and biliary tract diseases, about the turnover of researchers interested in the liver and its diseases, and also about the present philosophy in biologic science. For this com parison, this volume is particularly suited because, in contrast to many other recent conferences, the more leisurely pace of the NATO Institutes permits more comprehensive but still scholarly reviews of the problems. The foreword of the first volume, written by my colleague, the late Harry Sobotka, expresses his, now dated, astonishment about the progress of knowledge of biology of the bile, so much less accessible to study than urine."

Since the publication of the first edition, there have been advances in both the diagnosis and the management of many of the cholestatic liver diseases. Cholestatic Liver Disease, Second Edition thoroughly updates the topics previously addressed, such as primary biliary cirrhosis, primary sclerosing cholangitis, and cholestatic variants of drug hepatotoxicity and viral disease. New treatments, such as the development of the farnesoid X receptor agonists for the treatment of PBC, are highlighted. Current guidelines and areas of uncertainty are also covered. Additionally, new chapters have been added to reflect the changing landscape of cholestatic liver disease. Cholestatic Liver Disease, Second Edition is a concise yet comprehensive summary of the current status of the field and is of value to clinicians and researchers interested in patients with cholestatic liver disease provide that will help to guide patient management and stimulate investigative efforts.

- Unlike previous atlases that deal with overall surgical techniques, this book goes into greater detail and focuses on individual cases.

- Lavishally illustrated with 534 illustrations, 133 of which are in color.

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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.

Experts from Europe, Japan and the United States have contributed to this in-depth volume on digestive disease pathology. Each chapter contains numerous electron micrographs, often supplemented byline drawings, and extensive references to the literature.The clear illustrations and text are an excellent aid for the diagnosis of pathological entities in the gastrointestinal tract.

Few human illnesses today are so challenging, medically, scientifically, and socio-economically, as the "nonspecific" inflammatory bowel diseases (IBD): ulcerative colitis and Crohn's disease. Originating several centuries ago but essentially diseases of the 20th century, often attacking children and young adults, involving all bodily systems as well as the gastrointestinal tract, ulcerative colitis and Crohn's disease have emerged in recent decades as among the more "glamorous" unsolved diseases, presenting unusual opportunities for insightful clinical and investigative study. Many of the prevailing concepts originated during the early and mid 20th century. The purpose of Origins and Directions of Inflammatory Bowel Disease is to review these earlier studies and their evolution "from the mystical to the molecular," and guide investigators and physicians through the challenging clinical and scientific maze of IBD.