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.

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.

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."

As the population ages, clinicians are facing an increasing number of elderly patients with colorectal cancer. These patients pose unique challenges as they have more comorbidities and lower functional reserves. In addition, the treatment goals may differ from those in younger patients. This book discusses in depth the different aspects of management of colorectal cancer in the elderly. After the provision of pertinent background information on the normal physiology of aging, screening and diagnosis are discussed. Subsequent chapters focus on a range of issues associated with the surgical and perioperative care of these patients and with adjuvant treatment and palliative care. Each chapter provides helpful take-home messages in bullet point form, and numerous informative figures and tables are also included. The authors are surgeons, physicians, anesthetists, geriatricians, oncologists, and allied health professionals with extensive experience in the field.

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. "

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.

General Section. Progress in laparoscopy (new instruments, technical innovations, integration between laparoscopy and sonography). Special Section. Traditional and present indications for laparoscopy. Laparoscopy inliver diseases. Oncological lapaoscopy (diagnosis, staging and follow-up for malignant tumors). Emergency laparoscopy.

- 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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****VERKAUFSKATEGORIE*** 0 e

Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening as well as increasing patient participation is presentedd. For the subspecialist, information regarding the latest imaging techniques as well as flat adenomas and chromoendoscopy are covered. The section on the molecular changes in CRC will appeal to both groups. The text includes up to date information about colorectal screening that encompasses the entire spectrum of the topic and features photographs of polyps as well as diagrams of the morphology of polyps as well as photographs of CT colonography images. Algorithms are presented for all the suggested guidelines. Chapters are devoted to patient participation in screening and risk factors as well as new imaging technology. This useful volume explains the rationale behind screening for CRC. In addition, it covers the different screening options as well as the performance characteristics, when available in the literature, for each test. This volume will be used by the sub specialists who perform screening tests as well as primary care practitioners who refer patients to be screened for colorectal cancer.

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.

This volume provides a history of Eosinophilic Esophagitis (EoE), a basic understanding of the physiology of the eosinophil, and a current understanding of the pathophysiology and genetics of EoE. The emphasis is on clinical applications including presenting symptoms, diagnosis and treatment options for patients with EoE. Written by both pediatric and adult experts in the fields of gastroenterology, allergy and pathology, this volume includes the most up to date information. Providing practical information useful in the treatment of patients, this book will be of great value to gastroenterologists, allergists, pathologists, medical residents, fellows, internists, and general practitioners who treat patients with eosinophilic esophagitis.

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.

Gastric secretions contain hydrogen ions at a concentration that is more than one million times higher than their intracellular concentration. This phenomenal gradient as well as the demonstrated ability of gastric juice to digest tissues has motivated clinicians and investigators alike to emphasize acid secretion and acid ablation in studying the pathogenesis and therapy of peptic ulcer disease. Conse quently, over the past 150 years, we have made considerable progress in under standing the mechanisms and regulation of acid secretion by the stomach. Not surprisingly, therapy for both peptic disease and mucosal injury has also been predominantly directed at either neutralizing acid or suppressing its production. During the past 10 years, attention has been focused on factors other than acid in the genesis and therapy of ulcer disease. Work done worldwide demon strated that acid hypersecretion is not a common event in peptic ulcer disease. Therefore, we began realizing that factors other than acid secretion may be important in the genesis of ulcer disease or in gastroduodenal mucosal damage. In addition, new physiological information has established that the gas troduodenal mucosa is normally protected by a complex series of events includ ing mucus and bicarbonate secretion, cell renewal, surface mucosal restitution, and preservation of the microvasculature and mucosal proliferative zone.

By 1977 it was clear that the thermophilic campylobacters were a major cause of acute bacterial enteritis. In response to that observation an international workshop was convened in Reading, England, and attracted over 130 participants. Many of these individuals resolutely returned for the eighth in the series of biennial international workshops, this time held in Win chester, England, in July 1995. All were surprised at the continued, and even expanding, re search effort in this narrow microbiological field. Such a lasting interest is undoubtedly a reflection of a consistent rise in the incidence of infection, the growing number of closely re lated organisms and disease associations, and an ever-increasing awareness by the public and government agencies of public health and food safety issues. The second workshop in Brussels in 1983 was a forum that demonstrated the growing awareness in the campylobacter community of the existence of campylobacter-like organisms and provided the platform for presentations describing the association of these organisms, now classified in the genus Helicobacter. with gastroduodenal disease. The clinical aspects of the research into helicobacters is now thoroughly covered in several other meetings, and the remit of the international workshop has been expanded to provide a forum for the presentation of the basic microbiological research carried out on these bacteria. In a continuation of this ap proach the remit of the workshop has been further extended to other related organisms, reflect ing that there are many other campylobacter-like organisms still to identify and characterize."

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 intestinal protozoan Giardia was first described over 300 years ago in 1681 by Leeuwenhoek, from his own stools. In his description of Giardia, he noted the size, movement, and morphology of the organism, and associated its presence with the diarrheic nature of his stools and his dietary habits. This truly remarkable account contains the first description of Giardia in morphologic, pathogenic, and epidemiologic terms. Our knowledge of the organisms in the genus Giardia has advanced tremendously in the past two decades. With the advent of new tech nologies, including techniques in electron microscopy, biochemistry, immunochemistry, tissue culture, and physiology, a tidal wave of information has appeared on the organization and function of this parasitic protozoan and its interaction with its host. The purpose of this book is to celebrate the tricentennial discovery of Giardia by Leeuwenhoek by presenting the above-mentioned advances in our knowledge of Giardia and giardiasis. In the first section of this book, the dominant theme is the biology of the organism and the correlation of structure-function relationships."

In the past 15 years much evidence has accumulated which indicates the paramount importance of sensory nerves in reg ulating functions of the gastrointestinal tract. In parallel, the attention of researchers in this field has been increas ingly attracted to the role played by neuropeptides in the normal and diseased gut. Basic research on the peculiar properties of capsaicin, the pungent ingredient from plants of the genus Capsicum, has allowed the gap between these two areas of research to be bridged. Sincethen, the study of gut afferents and neuropeptides has become more and more interconnected and recognized as a major avenue to understand ing the pathophysiology of various human diseases. It is widely recognized that a certain subset of primary afferents synthesize, store and release neuropeptides (such as tachykin nins and calcitonin gene-related peptide) from their central and peripheral endings, the latter being widely distributed in the alimentary canal and related organs (liver, pancreas). The First International Meeting on Sensory Nerves and Neuropeptides in Gastroenterology, held in Florence from December 4-5, 1989, sponsored and organized by Fondazione Internazionale Menarini, aimed to focus the current status of research in this field. The contributions presented at the meeting and in this book delineate a suggestive scenario in which sensory nerves of the gut, and the multiple messages they carry through the release of neuropeptides, are to be considered as a major target for the development of new drugs potentially useful in a number of diseases of the gastro intestinal tract."

"Contemporary Coloproctology" covers colorectal surgery, as practiced today, in an easily accessible format with emphasis on bringing key facts rapidly into focus. It is ideal reading both for the medical trainee and the practicing colorectal surgeon.

As well as a succinct presentation of the current colorectal knowledge base, each chapter contains practical advice and pearls of wisdom from established practicing clinicians. A unique feature of the format is the identification of key references and questions and scenarios that present real life decisions in colorectal surgery.

Edited and authored by outstanding surgeons in their fields, this book brings the reader expertise in surgery and management across the various conditions encountered in coloproctology.""

It is with much pleasure that I introduce this first volume in a series of Topics in Gastroenterology aimed at the intelligent clinician. Dr. Peter Banks is first and foremost a clinician and teacher and therefore an ideal lead-off author. His very helpful review of pancreatitis is based not only on a thorough assimilation of clinical and experimental evidence but also on his long clinical practice in university hospitals and in private practice. Dr. Banks understands what we clinicians need to know about the patho physiology of this challenging disorder. I found much practical informa tion in this volume to help me in thinking about my own patients, and I recommend it with enthusiasm. Howard M. Spiro, M.D. vii Preface In the preparation of this book, I have made a special effort to provide detailed clinical information on the care of the patient with pancreatitis. The usefulness of newer diagnostic tests such as amylase/creatinine clearance ratio, ERCP, diagnostic ultrasound, and C-T scan has been carefully evaluated. Particular attention has been devoted to the manage ment of the more difficult therapeutic problems such as severe protracted pancreatitis, pancreatitis of unknown etiology, pancreatic pseudocyst, and pancreatic insufficiency. Points of controversy regarding medical and surgical alternatives in the treatment of acute and chronic pancreatitis have been reviewed with specific recommendations for therapy. In all discussions, emphasis has been placed on basic physiological principles that govern treatment. A comprehensive and current bibliography accom panies each chapter."

Systems Biology is a fast moving field. This accessible book uses the example of regulated exocytosis in pancreatic ss-cells, and its relevance to diabetes, to illustrate the major concepts of systems biology, its methods and applications.

As in the first edition of Inflammatory Bowel Diseases this new edition continues to provide readers with a concise, yet in-depth review of many of the important areas in the history, epidemiology, pathogenesis, diagnosis, and treatment of the inflammatory bowel diseases (ulcerative colitis and Crohn's disease), as well as associated issues: extraintestinal manifestations, ostomy care, women's issues, economics, etc. This Second Edition provides the reders with up-to-date, state-of-the art approaches to these disease states, with expansion into the newer topics that have emerged in the past few years which include the expansion of biological agents for treatment, new studies in the epidemiology of IBD, the changing economics of IBD, breakthroughs in new endoscopic evaluations, major advances in novel radiographic techniques, the detection of colorectal cancer in patients with IBD and new findings in the genetics of IBD. New Trend / Developments (* These all emerged since our last edition) The most critical trend that has arisen over the past few years has been the introduction and expansion of biological agents in the treatment of inflammatory diseases worldwide. While only one agent, infliximab (Remicade), existed at the time of publication of my first edition, there have been multiple other agents either approved or pending approval for the treatments of these diseases, or in the upper-stages of development. The impact is not only upon the patients, but also on the health-care providers, policy makers, researchers, biotech and pharmacompanies, and the business community. Major changes worldwide in the epidemiology of IBD has spurred new studies in the demographics of who is getting these diseases and why. Previously characterized as diseases primarily affected Caucasians in industrialized countries, there has been an explosion of growth amongst the African American and Hispanic populations in the United States, and well as in pockets of these and other ethnic groups worldwide. The economics of IBD has been changing greatly, given the issues raised above, as well as major changes in the United States Medicare program, and other insurance changes. The growing proportion of the GNP that healthcare costs are consuming in the US and worldwide has shifted attention to decreasing utilization of health care services, and other cost-savings measures. Again, up to this point this has been an exclusive part of our IBD book. New findings in the genetics of IBD have been recently published. Our first edition had the finding of the first Crohn's disease gene inserted just before going to press; so much has been published about the phenotypes and other genotypes that have emerged. Breakthroughs in new endoscopic evaluations of the bowel (ie. Capsule endoscopy, double-balloon enteroscopy, endoscopic ultrasound) and their use in the inflammatory bowel diseases will be a key highlight of this new book. Major advances in novel radiographic techniques employed in patients with inflammatory bowel disease (ie. CT enterography, MR enterography, advanced ultrasounds, etc.) will also an important component of our work. There have been numerous areas related to the development and detection of colorectal cancer in patients with IBD that have emerged in the past few years. Techniques of better detection (ie. Narrow band imaging; special mucosal staining; endoscopic histological evaluations) as well as research in the putative role of mesalamine and other agents for colorectal cancer prevention are all hot topics that will attract much interest from a variety of interest groups I described above. Identification of additional disease states that probably belong in the IBD family, such as microscopic colitis (including lymphocytic colitis), and collagenous colitis add to the diseases that will be discussed in this new edition.