Primary and metastasizing malignant carcinoma of the liv er represent a challenge to both the diagnostician and the therapist. For this reason, it appears a worthwhile task to review the current status of knowledge about the treatment of primary and metastasizing tumors of the liver. The ques tion is whether modem diagnostic methods and new thera peutic concepts can help to improve the prospects of treat ment. Of particular interest is the role played by therapeu tic procedures directly involving the liver. Thus, it is equally important to discuss the pathophysiological and pharmacological bases for a modem therapy concept as it is to consider diagnostic issues and possible definitions of stages of progression. Therapeutic concepts comprise sys temic therapy and organ-related therapeutic methods, in cluding surgical resection, changes in the blood supply, re gional selective chemotherapy, and other localized or regional, highly specialized forms of therapy. This survey of the various possibilities in the field is meant too to stimulate further scientific research, given that methods of treatment are as yet by no means stan dardized, but are still in the stage of clinical research, where experimental models can find an application. The only well-established operative procedure is surgery on the isolated liver tumor. In this area, specialized techniques and various intraoperative procedures are discussed. There is a wealth of information available on all the top ics covered."

Parasitic Disease in Clinical Practice is the sixth monograph to appear in the now established and flourishing Bloomsbury Series in Clinical Science. Written by a distinguished authority in the field, the book gives a comprehensive and detailed description of parasitic infections and their clinical consequences. Such infections are no longer confined to tropical parts of the world and now have a widespread distribution. Rapid advances are being made in understanding their epidemiology and in diagnosing and treating particular infections. Current literature is largely directed to the parasites, their characteristics and their isolation; a clinical review is clearly needed. This has now been provided, for the author's stated objective is to "inculcate a greater awareness, understanding and appreciation of human parastic disease in the minds of all clinicians". London, March 1990 Jack Tinker Preface Homo sapiens has always existed in a finely balanced equilibrium with a great diversity of infective agents, almost all of them of great antiquity. Many must have exerted a profound effect on the evolution of the human genome. While the average physician is usually aware of potentially pathogenic viruses, bacteria (and rickettsia), and to a lesser extent fungi, hislher knowledge of protozoan and helminthic infections is frequently imperfect and often rudimentary.

In this book, precursors of gastric cancer are described histopathologically, especially about the precancerous conditons and precancerous lesions of the stomach. In addition to those precancerous changes stated in previous monographs and textbooks, some newly recognized gastric dysplasias are proposed. In order to be able to ovjectively evaluate the atypism of dysplasic changes, achievements of morphometric studies were presented.

The following papers were presented at an international symposium on the mechanisms and treatment of nausea and vomiting in man held in Oxford in 1984. I believe that this meeting was the first occasion on which representatives from such a wide variety of scientific and clinical specialities had come together to review and debate the spectrum of the vomiting phenomenon. An attempt was made to put before an invited international audience all the pertinent facts on the different facets of the topic and then to encourage extensive discussion of the contentious issues. The first day of the meeting was devoted to the basic science ap proach to the problem and the second day to the more clinical aspects. This format has been broadly retained in the layout of the book, with the addition of summary chapters reviewing each day's contributions and focusing upon areas of particular importance. Acknowledgement must here be made to the enormous input from the many participants who either spoke in the debate or rose and themselves gave small presenta tions in addition to those of the invited speakers. The meeting occurred at a time of increasing interest in the problem of nausea and vomiting, especially because of its importance in cancer chemotherapy and radiation therapy, and even in space travel."

It gives me great pleasure to have this opportunity to write a Foreword for this new book. In the past two decades we have witnessed very significant advances in the management of the very ill patient. The great success in this field of medical endeavour is largely due to the establishment of intensive care units, but a great deal of progress can also be attributed to the major developments in technology, which affect patient management and care as well as the many sophisticated techniques of diagnosis and patient monitoring. Imaging and Labelling Techniques in the Critically III covers this new important and difficult field of diagnosis and visual monitoring. By establishing the criteria and algorhythms for the choice of the different methods available for this purpose, defining the diagnostic signs on images and resolving some of the mis conceptions and pitfalls, this book will go a long way to help the reader, particularly those involved in the care of patients in the intensive care units. This book brings together many different methods of investigation and discusses the advantages and limitations of these techniques in different clinical circumstances. Some of the techniques are well established and their usefulness in the intensive care unit is in no doubt. Some of the newer techniques such as PET scanning or NMR imaging have not yet found a defined position of usage in the critically ill patient. There is, however, little doubt that in due course this situation will change.

Campy/o/meler pylori was described for the first time in 1983. Up to now more than 100 papers have been published dealing with its microbiological properties and its clinical implications. The lime has come to survey the field, to evaluate the hith erto accumulated information, and 10 discuss the questions thai should be answered in the ruture. It was for these purposes that the First International Symposium on Campy/abaeter pylori was held. bringing together specialists from a variety of discipl ines, including basic scientists as well as clinicians. This book is based on papers given at the symposium. We are very grateful 10 Rohm-Pharma for undertaking to sponsor this meeting, and to Mrs. C. 1. Klein and her starr for the impeccable organisation which permillcd us to work in such a pleasant environment, In the interest of rapidity of publication, we have reduced the amount of editing to a minimum and have not, in any sense, "re fereed" the discussions, which were written by the contributors at the time of the question-and-answer session. They were also veiled by their authors at the proof stage, and we have done our best to retain their original spontaneous flavour. We hope, in this way. 10 have produced a satisfactory record of the events and an up-Io-dale overview of research on Campylobacrer pylori."

Covering all aspects of gastrointestinal pathology, this award-winning volume in the Diagnostic Pathology series is an excellent point-of-care resource for pathologists at all levels of experience and training-both as a quick reference and as an efficient review to improve knowledge and skills. This updated third edition is an easy-to-use, one-stop reference for the entire GI system, offering a templated, highly formatted design; concise, bulleted text; and superior color images throughout, enabling you to arrive at the correct diagnosis and prepare actionable, useful reports. Provides comprehensive coverage with the necessary tools to make a comprehensive diagnostic workup Incorporates significant changes in the AJCC cancer staging of gastrointestinal tumors Provides details on PD-L1 (immune checkpoint inhibitor) therapy, new types of colitis, and molecular biology of GI tract tumors as it relates to precision medicine and targeted therapy Discusses timely topics such as GAPP, a newly described form of gastric polyposis that leads to cancer; the increasing complexity of large B-cell lymphomas and which immunostains and molecular tests to order for proper classification and therapy; Immune Modulator therapy effect, which can closely mimic IBD; and newly described polyposis syndromes, such as mixed and serrated polyposis Features more than 2,500 annotated images throughout, including gross pathology, a wide range of stains, and detailed medical illustrations, depicting virtually any GI specimen you're likely to see 2015 BMA Medical Book Awards 1st Prize Award Winner in Pathology Category (previous edition) Enhanced eBook version included with purchase, which allows you to access all of the text, figures, and references from the book on a variety of devices

Helieobaeter pylori has recently been recognized as a new genus according to specific taxonomic criteria; the "popular" name Campylobaeter pylori has been corrected by scientific progress. Following the discovery of the spiral microorgan ism in gastric mucosa by Marshall and Warren in 1982, it took only a few years for H. pylori to become established as a factor in the pathogenesis of gastritis and peptic ulcer disease. Interest in different aspects of H. pylori has grown continuously and has attracted scientists from various medical and biological disciplines such as gastroenterology, microbiology, pathology, immunology, and pharmacology. Indeed H. pylori provides an excellent model for interdisciplinary interaction and cooperation. To promote this concept of interdisciplinary research and exchange of knowledge, a European Campylobacter (Helicobacter) Pylori Study Group was founded in 1987 in Copenhagen. The second meeting of this expanding group was held from October 12-14,1989 in Ulm, FRG. The fact that more than 500 participants attended the conference and that 187 original contributions from all five continents were presented clearly confirmed that H. pylori has "scientifically infected" the whole world. Our understanding of the microbiological and pathogenetic aspects of H. pylori is continuously being challenged as new results follow swifthy from different research areas. This book includes an update and progress report on the various aspects of H. pylori presented and discussed in special workshops held during the meeting in Ulm.

Technical improvements over the past twenty years have made endos copy the procedure of choice for examination of the hollow organs of the genitourinary and gastrointestinal tracts. The development of electro surgical techniques, laser technology, injection therapy, and a wide variety of other modalities now allow the endoscopist to treat many problems that in the past required open surgery. The simultaneous development of transcutaneous abdominal sonography has had an equally dramatic impact on the practice of gastrointestinal and geni tourinary surgery. The marriage of these proven technologies, known as endoscopic sonography, provides an exciting new modality that promises to further revolutionize the diagnosis and management of many intraabdominal diseases. Endoscopic sonography opens new frontiers by overcoming the primary limitations of its parent technologies. Fiberoptic endoscopy is limited by the inability to see beyond the luminal surface, this is particularly important when considering neoplastic disease because depth of wall invasion is a key factor in determining treatment. The limiting factor in transcutaneous sonography is the distance between the transducer and the target organ. With endoscopic sonography, the transducer is placed in close proximity to the target organ. This allows the use of high frequency waves (greater than 5 MHz), which provide better tissue resolution and eliminates the image distortion caused by overlying structures.

The development and the widespread clinical application of various di agnostic imaging modalities, such as diagnostic ultrasonography, X-ray computed tomography, single photon emission computed tomography, and magnetic resonance imaging, have been beyond all expectation. In particular, ultrasonography and X-ray computed tomography have be come major diagnostic tools for diseases of the liver, the biliary tract, and the pancreas. They often have virtually replaced other conventional imag ing modalities including invasive angiography and percutaneous trans he patic cholangiography. One modality may complement or conflict with another or other modalities. Each modality should be carefully selected with due regard for its diagnostic efficacy. In this book, the first section contains nine chapters dealing with current techniques of each diagnostic modality applicable to the liver, the biliary tract, and the pancreas. The second section deals with diseases of the liver, the biliary tract, and the pancreas and takes the form of case presentation with discussion of the significance of diagnostic imagings and diagnostic procedure. Preparation of the manuscript was made possible by the help of Dr. S. Fujita, who prepared the photographs, and Mrs. Sobajima, who typed the original manuscript. Dr. S. Miura and Miss Y. Shimizu under took the labor of translating our manuscript from Japanese into English. I would like to express my deep appreciation to all these persons, as well as to the contributors to this book, and also to the publishers, Shujunsha, Japan and Springer-Verlag.

Since the beginnings of diagnostic ultrasound in the 1950s, each decade has seen significant advances in this technology. Commer cialization of ultrasound occurred during the 1960s with the introduction of many of the clinical uses that are in existence today. The 1970s showed the most dramatic changes with the commercial introduction of gray-scale and real-time ultrasound. In the 1980s many new advances were introduced, including color Doppler, as well as a wide variety of endoluminal approaches, including endorectal, endovaginal and transesophageal. The decade of the 1990s promises even more significant advances with further transducer miniaturization, three-dimensional ultra sound, and the introduction of a variety of ultrasound contrast agents. With such rapid changes occurring, it becomes important to disseminate knowledge in as rapid a fashion as possible, thus it was quite appropriate that a meeting such as this be held to provide an in-depth review of the many new areas of ultrasound imaging that show promise for the future. Emphasis was on the new uses of ultrasound in gastrointestinal diseases. Many of these advances will, of course, also have applications in many other areas of the body. It is hoped that those in attendance will acquire a much broader understanding of where ultrasound is now and where it is headed in the not too distant future.

The first portion of this work is devoted to a consideration of the practical aspects of the proctoscopic examination and thus presents the indications for performing a proctologic evaluation, the information that may be obtained from the patient's medical history, an example of a preprinted data form for use in the recording of the physician's findings, the preparation and positioning of the patient, and the preliminary examination of the anus including the digital rectal examination. The instruments needed to perform proctoscopy are uncomplicated, and the basic tools are inexpensive. The instruments currently available do not really differ from each other except in minor details. In the text, therefore, we have only described the prototype instruments, and details about the pro posed advantages of any particular instrument can be obtained from its manufac turer. The concluding portion of the text describes how the proctoscopic and colonoscopic examinations are performed. The atlas itself is a topographical stratification of the various diseases that may involve the perianal region, the anus, and the adjacent portions of the large bowel as well as their classification according to morphologic criteria, for example, inflammatory bowel diseases and tumors. Since many pathologic findings in the rectum and sigmoid colon are comparable to those in the upper portions of the large bowel, a duplication of these proctoscopic and colonoscopic illustrations has been avoided.

There has long been disagreement about various aspects of the structure and function of the "gatekeeper" (Greek pyloros, from pyle = gate and ouros = guard). In recent years the problem has often been mentioned in anatomy, physiology, gastroenterology, radiology and even in nuclear medicine. For instance, while referring to manometric and gastric emptying studies, Schu- urkes and van Nuenten (1984 ) pointed out that there was considerable contro- versy as to whether a true pyloric sphincter existed in most species, and espe- cially in man. According to Reeve (1981) many functional aspects of sphincters are poorly understood; the exact mechanism of control of the transfer of chyme from stomach to duodenum through the pylorus is still not clear. Malagelada (1983) states that controversy surrounds the motor activity and function of the antro- duodenal junction; there is disagreement as to whether the pylorus functions as or as an integral part of the distal antrum. Ehrlein et al. (1984) a separate unit reiterate that pyloric motility is poorly understood, and according to Funch- Jensen (1987) there are many unsolved questions. Malagelada (1990) states that the stomach performs multiple functions with a deceivingly simple anat- omy; this is regarded as the key to the investigator's frustration when trying to uncover its secrets. One source of the many controversies surrounding the pylorus may be species differences, according to Schulze-Delrieu et al. (1984).

Major advances have been made in the understanding of the molecular mechanisms of atherosclerosis, the disease that still affects more than 50 percent of the population in the highly industrialized countries. This volume covers the most recent advances in the treatment of hyperlipidemia. It represents a necessary update because molecular mechanisms of atherogenesis have been discovered in the past few years and their molecular mechanisms of action identified. Extensively treated are the molecular mechanisms of disease etiology of arteriosclerosis in relation to the major risk factor "hyperlipidemia," rationale for more effective treatment of this disease by dietary means, the treatment of associated or causing diseases, and the treatment using hypolipidemic drugs.

Basic and clinical research have in recent years contributed towards clarifying certain aspects ofthe epidemiology, pathogenesis, prevention, and treatment of liver diseases. New diagnostic techniques have, moreover, facilitated observations on the evolution of such diseases. Nevertheless, a numberofquestions still remain, especially in the assess- ment and management ofliver patients. The hope that such questions can be answered justifies publications like the present one, which provide experts an opportunity to pre- sent the results oftheir research. The papers collected in this volume cover all aspects of the assessment and man- agement of hepatobiliary disease. The focal points are three summaries ofthe state of the art. The first deals with the highly topical problem of liver transplants from the point ofview ofpatient selection. Roger Williams in fact stresses the urgent need to ex- ercise caution in the selection ofsuitable candidates. This is especially true at the pre- sent time when cyclosporin A, a new immunosuppressive drug now available on the market, has significantly changed the natural history ofsurvival after liver transplanta- tion.

GI and Liver Disease During Pregnancy: A Practical Approach by Drs. Kim Isaacs and Millie D. Long is a unique handbook focusing on common gastrointestinal symptoms and diseases seen in pregnant patients. Each chapter addresses the diseases or symptoms and focuses on key questions to ask the patient and key points regarding diagnosis and management. This handbook is organized to have each chapter focus on a common complaint or discrete disease, making it easy to find exact information in a ready reference. Also provided are tables of drug safety during pregnancy and breast feeding. Unique features also include a section on alternative therapies and a chapter on care in post bariatric surgery patients. Each Chapter Covers: * Epidemiology * Pathology * Presentation and Evaluation * Management * Summary * Key Points Pocket-sized and easy to read, GI and Liver Disease During Pregnancy: A Practical Approach is a convenient and accessible reference for gastroenterology fellows, OB/GYN fellows and residents, and practicing gastroenterologists.

The last decade has seen tremendous developments in many fields of gastroenterology and hepatology. The aim of this series is to highlight some of these topics that deserve particular interest. Research in the field of viral hepatitis has been very intense and successful in recent years. The hepatitis B virus is one of the best explored at the current level of virology. Not only the nucleotid sequence of the viral DNA can be decoded, but also the amino acid compounds of its genetic products are known today. Since the techniques of molecular biology have increasingly found access to clinical laboratory use, hepatitis B virus infection can serve as an example for the importance of molecular biology in clinical hepa tology. Another example for the interdependence of basic science and clini cal medicine represents the research on bile acid metabolism. The investigation of bile acids has revealed new diagnostic approaches to hepatic and intestinal disorders. Commercial kits for the routine measurement of serum bile acids in clinical laboratories by enzymatic or radioimmunologic techniques are now available. The diagnostic value of these measurements in gastroenterology and hepatology shall be defined. Another aspect of bile acid research leads to new per spectives in the treatment of gallstone disease. The dissolution of cholesterol gallstones by chenodeoxycholic acid (therapy) may be quoted as the best example for the development of new phar macotherapeutic principles derived from basic bile acid research."

A fine team of state-of-the-art researcher/clinicians who know their fields, have contributed to the advancement of knowledge, and are in a position to judge what is truly important have here pooled their thoughts in a series of chapters on the cutting edges of gastroenterology. Four attributes render this volume superior to other update-oriented publications. The first striking feature, which is immediately evident upon scanning the table of contents, is the imaginative choice of subjects, ranging from trav eler's diarrhea and sexually transmitted GI infections through TPN and interventional endoscopy to geriatrics and iatrogenic disease. A second outstanding feature of this volume is its success in balanc ing basic pathophysiology with practical considerations of clinical man agement. This is achieved in the discussions of such diverse topics as acid-peptic diseases, infectious and other diarrheal syndromes, and hep atitis immunization. Throughout the book we are led smoothly from basic science principles to specific recommendations for diagnosis and therapy. This practical emphasis appears repeatedly and sometimes pro duces a delightful surprise, such as a chapter on radiology that is not tech nology-based but instead problem-oriented."

Hepatocellular carcinoma (HCC) is common in the Far East and South Africa, but is rare in the United States and Europe. The vast experience of the East, which has led to marked improvement in the prognosis of patients with HCC, is made available to researchers worldwide in this monograph. The book is based on an enormous amount of data that has been collected and analyzed by the Liver Cancer Study Group of Japan. The data stems from a survey on HCC in Japan since 1965 and contains information from more than 30,000 patients with regard to age distribution, past medical history, diagnostic procedures, frequency of HBV-associated antigens and antibodies, surgical and conservative treatments, gross anatomical and histological features of the tumors, pathology of the noncancerous portions, distant metastasis, and survival rate. This data is a tremendous contribution to our understanding of the epidemiology, pathology, and the latest developments of the molecular biology and clinical problems of primary liver cancer.

The last few years have witnessed major developments in molecular biology which have had a significant impact on biomedical knowledge. As a result new concepts in cell biology have emerged, new etiologic agents have been discovered, and new drugs have become available. Furthermore, the world of mediators, cytokines, and humoral factors has enlarged considerably in a relatively short period and this has modified our views of diverse physio pathologic processes as well as opened up new therapeutic prospects. In addition, recent technologic advances have revolutionized our diagnostic methodology and have greatly enhanced the power of our therapeutic resources. All these factors have contributed to a substantial remodeling of both liver science and clinical hepatology, and these changes have generated the motivation for the production of the present book, which attempts to give an account of well-known clinical facts in the light of current thinking. It is the fruit of the coordinated work of experts from different countries in three continents. In a sense, it is a manifestation of the fact that inter national cooperation is becoming increasingly important not only in the expansion of science but also in its exposition. We hope that Hepatobiliary Diseases will be useful to both students and clinicians and that internists, gastroenterologists, and general practitioners will find in its contents a satifactory coverage of their field of interest."

Bei der Entstehung von Magengeschw}ren ist in den letzten Jahren die Bedeutung einer Ausl|sung durch Campylobacter pylori bekannt geworden. Neue systematische Untersuchungen f}hrten zu einer Namens{nderung: Helicobacter. Der Band gibt eine Obersicht }ber den derzeitigen Wissensstand.

A clinician's guideline for intra-abdominal infections written by experts in the field.

- A manual to help physicians to quickly recognize and better understand the pathogenesis of intra-abdominal
infections
- Includes several high-quality black and white and color photographs from real-life clinical cases
- Adheres to a simple format to serve as essential and quick reference guide for all non-surgical residents and physicians

This book has its roots in a monograph on cancer of the esophagus and gastric cardia edited by us in 1965 and published in Chinese on ly. Along with a number of colleagues in various fields, we summa rized our work in the epidemiology, pathology, diagnosis, radiother apy, and surgery of carcinoma of the esophagus and gastric cardia, carried out chiefly at Peking Union Medical College Hospital, Fu wai Hospital, and the Cancer Institute of the Chinese Academy of Medical Sciences during the 25 years from 1939 to 1964. In the 18 years since the publication of that monograph, further progress has been made in China in various aspects of research and surgical treatment. Abundant material has been accumulated on the long term results of surgery, and a number of newer principles and meth ods for diagnosis and management have been evolved. In order to meet the need for the exchange of scientific and technical informa tion, both domestically and internationally, we have invited a group of our current colleagues working on the different aspects of carci noma of the esophagus and gastric cardia to contribute to the pre sent volume, which is being printed in both Chinese and English. The Chinese edition, like the original monograph, is being publish ed by Shanghai Science and Technology Publishers. Through the kind invitation of Dr. Heinz Gotze, the English text is being publish ed for international circulation by Springer-Verlag.

Boston University School of Medicine has established a series of Medical Education Programs in Nutrition held each summer since 1975. These deal with controversies in human clinical nutrition. The subjects have covered various topics, including those dealing with the relation ships between diet and heart disease, diet and cancer, breast. versus bottle-feeding, and dietary fiber and disease. Other noncontroversial topics were also covered at these conferences; they were discussed simply to bring to the attention of the health professional new happenings in nutritional research. These topics dealt with the relationships of nutrition to immune function, to neurotransmitters, to infection, to obesity, and to chemotherapy. This text is a compilation of selected manuscripts of interest to the health professional in the area of human clinical nutrition. Whatever success this text enjoys is in no small way due to the ad ministrative and editorial efforts of our administrative assistant, Mrs Geraldine Rankin - our sincere thanks."

This book is a unique work devoted to the subject of disordered defaecation. It contains chapters written by experts in the field of ano-rectal physiology and management of disordered defaecation. The various contributions present personal views and special clinical experience of individuals. There are some personal views which we felt should be commented upon and a few areas where the experience of others has been included into the text. For the sake of completeness of each chapter, a slight overlap in some cases was inevitable. We hope the book will serve as a useful collection of opinions on a subject which until recently has been largely ignored by the medical profession. The editors Major contributors H. O. ten Cate Hoedemaker Department of Surgery, University Hospital, Rijnsburgerweg 10,2333 AA Leiden, The Netherlands G. Coremans Department ofInternal Medicine, University Hospital Gasthuisberg, Here- straat 49, 3000 Leuven, Belgium S. Fasth Department of Surgery II, Sahlgrenska Hospital, S-413 45 G6teborg, Swe- den H. G. Gooszen Department of Surgery, University Hospital, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands J. A. Gruwez Department of General Surgery, University Hospitals KU, Brusselsestraat 63,3000 Leuven, Belgium M. M. Henry Department of Gastroenterology, Central Middlesex Hospital, Acton Lane, London NWlO 7NS, United Kingdom M. R. B. Keighley Department of Surgery, The General Hospital, Steelhouse Lane, Bir- mingham B4 6NH, United Kingdom J. H. C. Kuypers Department of Surgery, University Hospital St. Radboud, Geert Groote- plein Zuid 14,6500 HB Nijmegen, The Netherlands Ph. B.