The immunology of mucosal surfaces is one of the most exciting and relevant areas of medical veterinary and dental research since it applies basic research to tissues in volved in everyday defence against microbes and against environmental and food antigens. This book is based on the contributions presented at the International Con gress of Mucosal Immunology, held in London in July 1989 and organised by the Mu cosal Immunology Affinity Group of the British Society for Immunology. The meet ing was attended by over 500 delegates from 27 countries, including virtually all of the leading investigators in the field. The contents give comprehensive and up-to date information on such topics as antigen presentation and processing in the gut, mucosal vaccines in man and animals, HIV infection in the gut, the role of yo T cells in the gut epithelium, recent advances in inflammatory bowel disease and coeliac dis ease, the role of cytokines in the regulation of the IgA response, mucosal mast cells and cell migration. The contributions reflect the rapid pace of research in mucosal immunology, and the great strides which are taking place in the understanding of the immunology, molecular biology and biochemistry of host response at mucosal sur faces."

The scientific main programmes of these series of symposia changed from time to time following the international scientific trends. The main programmes of the First Symposium were: 1. Gastric and intestinal cytoprotection; 2. Hepatoprotection; 3. Pancreatic protection. For the second one: 1. Gastrointestinal mucosal 'cytoprotection'; 2. Liver 'cytoprotection'; 3. Pancreatic 'cytoprotection'; 4. Free radicals and scavangers; 5. Computer approach to cytoprotec tion. For the third one: 1. Basic, central, peripheral and cellular mechanisms of gastrointestinaol cytoprotection; 2. Esophagal protection; 3. Gastric protection; 4. Small intestinal injury and protection; 5. Large bowel injury and protection; 6. Liver injury and protection; 7. Pancreas injury and protection. The main scientific programmes of the Fourth International Symposium on 'Cell Injury and Protection in the Gastrointestinal Tract' are: 1. General mechanisms of gastrointestinal injury and protection; 2. Cell injury and protection in the stomach; 3. Cell injury and protection in the small intestine and in the large bowel; 4. Cell injury and protection in the liver and pancreas; 5. Cell injury and protection of the premalignant status and malignant diseases in the gastrointestinal tract. The presented papers are published in this book. The abstracts of this meeting were published in Digestive Diseases and Sciences, and we record appreciation of the Editor ofthatjoumal for their publication. Some of the papers published here have appeared in Inflammopharmacology 1996;4:331-398."

Quick Reference Dictionary for GI and Hepatology is a unique, pocket-sized reference designed specifically to provide a magnitude of terms and their definitions, guidelines, and references essential to the gastroenterology profession. Led by Dr. Jonathan Fenkel and his contributors, this compact, concise, and informative reference contains over 1000 commonly used GI and hepatology terms and definitions. Additionally, Quick Reference Dictionary for GI and Hepatology offers more than 20 quick reference appendices related to common GI and liver diseases. Some appendices include: * Causes of acute liver failure * Approach to elevated liver enzyme tests * Peptic ulcer disease: therapy and re-bleeding rates * Colorectal cancer surveillance guidelines * Scoring of acute pancreatitis * Types of gallstones Quick Reference Dictionary for GI and Hepatology provides an at- your-fingertips guide for anyone who works in the gastroenterology profession, including gastroenterologists, medical students, residents, fellows, nurse practitioners, physician assistants, office staff, and industry sales representatives.

Core Concepts in Colonoscopy covers all aspects of diagnostic and therapeutic colonoscopy, emphasizing overarching concepts that gastroenterology fellows and physicians must know to achieve success in both the technical and cognitive aspects of the procedure. In this comprehensive resource, Dr. Douglas G. Adler and his contributors provides a straightforward and practical review of colonoscopy. Core Concepts in Colonoscopy aims to address and convey the core concepts of colonoscopy: from the structure and function of the colonoscope itself, to insertion techniques, loop formation and reduction, polypectomy techniques for any situation, the avoidance and management of perforations and other adverse events, as well as advanced techniques including (but not limited to) endoscopic mucosal resection and colonic stenting. Each chapter inside Core Concepts in Colonoscopy is lavishly illustrated with multiple key images to accentuate and enhance the written text, as well as a plethora of tips, tricks, and accumulated points of wisdom in each chapter on all facets of colonoscopy. Additional Website Component! Core Concepts in Colonoscopy is accompanied by a video website with specific videos connected to individual chapters that will illustrate basic and advanced colonoscopic techniques from many leading experts and will further enhance the learning process. The addition of the video website allows for a more robust learning experience and allows the reader to watch, listen, view repeatedly, and reinforces the techniques presented in the written text. GI fellows, junior gastroenterologists, and even advanced physicians will appreciate Core Concepts in Colonoscopy because of the user-friendly and efficient structure that allows for the material to be quickly read, as well as easily absorb the wealth of key practical knowledge found inside.

Causes and Control of Colorectal Cancer: A Model for Cancer Prevention is a ground- breaking monograph which takes a global, multidisciplinary approach to the causes, carcinogenesis and control of colorectal cancer. Over 1000 key studies were analyzed on colorectal cancer cause, carcinogenesis, primary prevention, early detection using modern screening techniques, and surveillance after tumor excision. All major research results are included up to the date of publication. The key chapters include those on morphology, molecular biology and evolution of tumors, etiology chapters on heredity, diet, alcohol, smoking, physical activity, life stress and others, while major chapters in the area of colorectal cancer control are on primary prevention, early detection by screening and surveillance, and post-tumor excision surveillance. Important recommendations on primary prevention, screening and surveillance of colorectal tumors are made in keeping with the most current research data. Causes and Control of Colorectal Cancer: A Model for Cancer Prevention takes colorectal cancer control into the 21st century, and suggests this to be the first cancer in which control will be largely achieved within the next generation, as a result of the unprecedented multidisciplinary research into causation, primary prevention, screening and surveillance over the past 30 years. The book also serves as a model for the control of other common malignancies, particularly cancers of the breast and prostate, the causes and prevention of which are less well understood.

More than a century ago, Cripps successfully employed the direct and complete division of the anal sphincters as a means of approaching the lower rectum and anal canal, and reported on a series of 36 patients who had been treated in that fashion. Cripps was pleasantly surprised to find good fecal continence in over two-thirds of the patients during later follow-ups, despite the fact that the divided sphincters had not been repaired. The transsphincteric procedure was largely forgotten in subsequent years, however, and only the parasacral proctotomy of Kraske, which spared the anal sphincters, can be said to have gained an established place in the" surgical armamentarium. " It remained for York Mason to redirect the attention of the surgical community to the great potential of the trans sphincteric approach and the excellent continence that can be achieved through adequate repair of the divided sphincters. Having recognized the outstanding practical value of this procedure, we felt it necessary to define more precisely the anatomical prerequisites that would ensure minimum operative bleeding, and to bring the procedure more in line with current knowledge of normal continence and defecation. Dr. A. Huber, in consultation with the director of the Institute for Clinical Anatomy of our surgical department, Prof. A. von Hochstetter, did many months of dissection work on fresh anatomic preparations in an effort to explore and refine the various aspects of the trans sphincteric ap proach."

In the rapidly evolving field of Helicobacter infection new data on pathogenetic and pathophysiological mechanism have appeared. New methods which will be more sensitive and specific in the diagnosis of the infection are being developed and in this proceedings the first attempt using PCR technology is published. From the clinical point of view, a challenging aspect that needs clarification, is the observation which suggests an appearance of a correlation between the presence of the bacteria and abdominal pain and other symptoms in children whereas in old age no such correlation is evident. The relationship of H. pylori and gastric cancer is studied with histopathological data and epidemiological approaches. On the treatment side schemes using short courses and new antibiotic combinations are being investigated and preliminary data are reported.

The larvae of Anisakis, whose adult form lives on sea mammals such as whales, seals, and dolphins, are parasitic upon many species of salt-water fish. When the final host animals eat paratenic hosts, the larvae grow to adulthood in the hosts' stomach. However, when hu mans eat these infested fish, the larvae die instead, causing a disease called anisakiasis. In 1960, in the Netherlands, van Thiel et al. found a worm in the intestinal wall of a patient who had eaten raw herring and had suffered symptoms of acute abdomen. The impact of this report was tremendous among Japanese parasitologists because of the Japanese habit of eating raw fish. In 1964, the Special Research Group from the Ministry of Education was established to investigate the disease, stimulating progress in the study of anisakiasis. Three types of worm, Anisakis simplex larva (previously known as Anisakis larva type I), Anisakis physeteris larva (Anisakis larva type II), and Pseudoterranova decipiens larva type A, are believed to cause anisakiasis. As many as 165 kinds of fish and squid in the seas near Japan are hosts to Anisakis simplex, and 9 species are hosts to Pseudoterranova decipiens larvae. Contra caecum has experimentally been observed to invade the gastrointestinal tract, but no infection by this larva has been reported in humans. A case of infection by Pseudoterranova decipiens type B has been described. In Japan, the name Terranova decipiens (Shiraki 1974) has been adopted instead of Phocanema decipiens (Mozgovoi 1953)."

Biopsy of the gastrointestinal tract has been revolution less busy) teaching hospital. These sort of techniques, which I confess interest me greatly because of the ized by the introduction of fibreoptics; the proximal additional information which they can yield when rightly reaches, as far as the second part of the duodenum, and chosen, are naturally linked with improved methods of the whole large bowel back to the caecum can now be tissue preservation in general, bearing in mind that the sampled under direct vision and multiple small biopsies need for special techniques often becomes apparent can be obtained. Only in the jejunum and ileum are there only when the biopsy has been conventionally still limitations on the sampling of localized as opposed to generalized conditions. The sheer volume of gastro processed and examined. However, I have firmly intestinal material passing through our own laboratories stabled this hobbyhorse and have included little that has risen steeply over the last years to form some 25% cannot be done in a district general hospital and nothing that I am not prepared to do myself. I have tried to of the total current work load and the rise continues; stress, particularly, common lesions which can cause nearly all of it is in biopsy form rather than as resected specimens."

The literature of medicine continues to expand at a remarkable pace. The number of papers and monographs published has increased dramatically in the past five years. Nowhere has this increase been as dramatic as in the field of acute and chronic hepatitis. Why then should there be still another book? Despite the sheer volume of words published, it is still difficult to find in anyone volume a compilation of all of the most significant work. Most mono graphs have considered either chronic or acute hepatitis, not both. Few works have addressed both the clinician and the basic scientist. This book addresses both of these audiences and considers both of these diseases. It was designed to provide an authoritative but concise assessment of our changing concepts of acute and chronic hepatitis. It covers what is currently known and, based on the most convincing research, believed about these diseases. To fulfill this ambitious goal, only authors with international reputations in their fields of expertise were invited to contribute. In the evolution of our current thoughts on the pathogenesis and manage ment of acute and chronic hepatitis, our ideas have changed several times. This book presents the facts as they are known today and, in areas where all the facts are not established, presents the well-founded opinions of those considered to be authorities. The authors present established and usually confirmed data and do not deal extensively with areas of speculation or unconfirmed material."

A physician with a broad consultative practice, Dr. Floch combines his clinical experience with a zeal for exploring what has been written by others. Chief of Medicine at the Norwalk Hospital for the past decade and still an active consult ing gastroenterologist, Dr. Floch has given us a volume which every clinician dealing with digestive disorders will want to have at his or her desk. Not everyone will agree with all that Dr. Floch has prescribed in the way of detailed dietary help for the common afflictions of mankind's gut, but in this book the reader can get at the background of the controversy. All clinicians have had problems in assessing when to use elemental diets, how to apply advances in peripheral and intravenous alimentation, and in many other matters which are discussed in detail in this fine volume. Dr. Floch displays what is available in dietary therapy, evaluates the nutritional inadequacies surrounding most diges tive disturbances, and calmly evaluates competing claims. He gives a brief overview of gastrointestinal physiology pertaining to an understanding of nutri tional complications as well as the genesis of the major gastrointestinal dis orders. In this sense his book can be read as a mini-physiological text. I am delighted to have this book in our gastrointestinal series and I hope that the reader will profit from it as much as I have."

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.

This study assembles current and new information on the mechanisms involved in intracellular calcium regulation and their actual or potential relationship to cellular calcium transport. Topics discussed in detail are calcium channels, cellular calcium extrusion, sodium/calcium exchange, calcium-binding proteins with special reference to the vitamin D-induced calbindin, calcium transport and disorders thereof. Each topic is introduced with an overview followed by research papers dealing with relevant topics in each category. New information deals with calcium channels which are not voltage-sensitive, the structure and function of the plasma membrane Ca ATPase, the role of the Na/Ca exchanger in intracellular Na and proton regulation, a comprehensive overview of calcium transport with quantitative analysis of the role of the intestinal and renal calcium-binding proteins, description of the structure and function of the calbindin genes, and identification of calcium transport defects in diabetes and hypertension. Readers will be brought up-to-date on current knowledge and concepts in this rapidly expanding field and be directed to the relevant primary and secondary literature.

This book aims to be a synthesis of our current knowledge about the normal and pathological esophagus. Although a number of excellent monographs on limited aspects of esophageal pathology are available, a recent handbook treating the whole of esophageal physiology and pathology is lacking. We attempted to present the collected material in such a way that even the neophyte in the field would not get lost in the wealth of data. For this reason we have included a number of illustrations such as classical radiological and endoscopic images, manometric tracings and uncomplicated graphs, which may seem superfluous for specialists but will be helpful to the reader who wants to be initiated in the subject. At the same time we tried to be fairly complete so as to make available to the esophageal specialist a book of references, to which he can readily turn when faced with rare diseases or unusual physiological or pathophysiological pheno mena. In order to achieve both aims the authors often give their own point of view when faced with controversal topics, while classical as well as more recent features and concepts are mentioned and diverging opinions discussed."

Inflammatory dieseases of the pancreas occur with increasing incidence in western industrialized countries. This volume deals with all aspects of CHRONIC PANCREATITIS including epidemiology, etiology, morphology and pathophysiology, dia- gnostic imaging as well as conservative and operative treat- ment. Very recent data based on experimental and clinical research projects are presented. The contributions have all been written by a team of internationally well recognized authorities in the various fields involved. Topics of parti- cular interest include feed-back regulation, new aspects of conservative and interventional treatment as well as modern surgical approaches including organ-preserving procedures.

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.

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.

Provides findings on acute pancreatitis in the fields of morphology, epidemiology, pathophysiology, enzymatic and in- strumental diagnosis, clinical aspects and pharmacological and surgical treatment. Emphasis on clinical implications on the local release and vasoactice and toxic substances, the high rate of bacterial infection in the necroses, and the causes of impairment of cardiocirculatory, pulmonary and re- nal organs.

Attempts to influence survival of patients with colorectal cancer (CRC) by adjuvant chemotherapy are limited by the variability of survival in different prognostic groups [4] and the paucity of drugs that have shown activity in the advanced disease [10]. Of the few drugs which are active in the advanced disease, only 5-fluorouracil (5-FU) and razoxane "+/-1,2-bis(3,4-dioxopiperazin-1-yl)propane) are suitable for long-term adjuvant treatment [2, 9]. 5-FU has been widely and intensively studied as adjuvant chemotherapy in CRC [7], but there is no unanimity that it has even the marginal influence on survival that has been claimed [3, 10]. Razoxane has not previously been tested for adjuvant or maintenance treatment in CRC. It has however a number of biological activities which might be thought useful in the treatment of residual or minimal tumours [1] and which might therefore make it useful as an adjuvant. Thus it specifically prevents tumour dissemination and metastases in some tumours and normalizes the neovasculature which the tumours induce [6, 8, 11]. The drug is not cytotoxic in the usual sense, does not affect non-dividing cells, and only blocks cell division during a brief period of the cell cycle in late G and/or early mitosis [12]. It does so non-selectively and most cells capable of 2 division examined so far have been affected by the drug. Even affected cells however are not destroyed immediately, but may increase in size and become multinucleate [5].

For the first time four crucial aspects of gastrointestinal endoscopy are combined in a single text. Drugs for sedation and monitoring of the patient are addressed with particular reference to safety issues and comfort and acceptability for the patient. Resource management and health economic techniques are applied to endoscopy to determine quality and outcome. Problems of negligence and informed consent form the basis of a medico-legal examination of endoscopic practices.

Investigation of anorectal disorders has become a very wide field reaching from case history and simple plain radiography to advanced techniques such as defecography, nuclear medicine, endosonography, computed tomography, and magnetic resonance imaging. The place and value of defecography, thedynamic demonstration of bowel evacuation, have not previously been clearly defined. In this highly illustrated volume, radiologists experienced in thisfield describe techniques, radiation risks, and the interpretation of normal and abnormal findings using the aforementioned techniques of investigation. Anorectal surgeons and gastro- enterologists also participatein the discussion of indications and the influence of abnormal findings on patient management. This book will be helpful as a practical guide tothe choice, performance, and interpretation of the appropriate investigationfor a patient with functional anorectal disorders. As such it represents an excellent addition to the library of every physician and specialist withan interest in anorectal disease.

Since the small bowel except the duodenum and (1961), Pygott et al. (1960), Gianturco (1967) terminal ileum is largely inaccessible during en- and Bilbao et al. (1967). doscopic examination, radiology of the small Sellink, however, was really responsible for bowel attains special significance as a diagnostic the widespread recognition of enteroclysis method. Owing to the length and position of (1971, 1974, 1976). In spite of the increasing this organ, good images are difficult to obtain. popularity of this method, the necessity for sub- Furthermore, the considerable variation oftran- stituting this apparently viable method for the sit time, unpredictable response of the contrast peroral examination is still equivocal (Rabe medium, and superimposition with the filled etal. 1981; Fried etal. 1981; Maglinte etal. loops make small bowel radiology difficult. As 1982; Ott et al. 1985). Comparisons of both methods, however, (Fleckenstein and Pedersen a result, few radiologists specialize in this field. With the exception of Crohn's disease, disorders 1975; Sanders and Ho 1976; Ekberg 1977; Val- lance 1980) have confirmed the superiority of of the small bowel are relatively rare. Thus, not many clinicians and radiologists are interested enteroclysis. It achieves a high accuracy (Antes in the small intestine. and Lissner 1983).

Imaging of Gastrointestinal Tract Tumors describes current imaging practice for the most commonly encountered benign and malignant digestive tract tumors and gives a review of the literature for less frequent tumors. General features (anatomic data, frequency, clinical and biologic signs, treatment) are discussed for all pathologies prior to description of imaging techniques, which include barium studies, ultrasonography and angiography, and above all CT. MRI appears particularly indicated for esophageal carcinoma and pelvic recurrences of colorectal cancers. The book is divided into three main section - benign tumors, malignant tumors, and tumors with an indeterminate prognosis - reflecting the value of different imaging strategies as a function of a tumor's natural history. The thorough analysis of literature for both frequent and less common tumors allows global evaluation of the diagnostic possibilities of imaging techniques, making Imaging of Gastrointestinal Tract Tumors a reference work for all specialists concerned with digestive tract pathologies.

Only a few years ago, most treatises on sonography covered all the diagnostic applications of ultrasound, de scribing organs from the brain down to the placenta. Dr. Bruneton and his associates must be thanked for pre senting this book devoted to the spleen. It probably offers the most complete presentation of details and the richest images available in its field. This book will thus become the ultimate reference in most libraries of books on son ography. March 1988 F. Weill The authors wish to thank Christine Rostagni, Fran ise Fein, and Bernard Fontaine for their assistance in the preparation of this book. Contents 1 Sonographic Anatomy of the Normal Spleen, Normal Anatomic Variants, and Pitfalls B. Senecail . . . . . . . . . . . . . . . . . . . . . . 1 1. 1 Anatomy of the Spleen. . . . . . . . . . . . . . . . 1 1. 1. 1 Morphology and Structure . . . . . . . . . . . . . 1 1. 1. 2 Location and Relations of the Spleen. . . . . . . . 3 1. 1. 3 Average Dimensions of the Cadaver Spleen . . . . 5 1. 1. 4 Congenital Anomalies and Normal Variants. . . . 5 1. 1. 4. 1 Fissured Spleen. . . . . . . . . . . . . . . . . . . . 5 1. 1. 4. 2 Lobulated Spleen. . . . . . . . . . . . . . . . . . . 5 1. 1. 4. 3 Spleen with Two Hili. . . . . . . . . . . . . . . . . 5 1. 1. 4. 4 Wandering or Ectopic Spleen . . . . . . . . . . . . 6 1. 1. 4. 5 Numeric Anomalies . . . . . . . . . . . . . . . . . 6 Ultrasonography of the Spleen . . . . . . . . . . . 1. 2 6 1. 2. 1 Equipment . . . . . . . . . . . . . . . . . . . . . . 6 1. 2. 2 Patient Examination . . . . . . . . . . . . . . . . . 7 1. 2. 3 Scanning Technique . . . . . . . . . . . . . . . . . 7 1. 3 Sonographic Features of the Normal Spleen. . . . 7 1. 3. 1 Splenic Contour . . . . . . . . . . . . . . . . . . . 7 1. 3. 2 Echo Pattern of the Splenic Parenchyma. . . . . ."

The aim of this symposium was to provide a framework for fruitful discussion on intestinal transport, not only for advanced scientists but also for younger people starting in this field of research. Invited lectures, communications and poster presentations were focused on four central themes, all treating the prop erties of the sole intestinal epithelium, deliberately leaving aside problems dealing with more integrative functions of the whole intestine. The importance of motility or blood circulation, for instance, is certainly capital in the overall intestinal function, but these aspects by themselves deserve another meeting. This volume has compiled the manuscripts of the invited lectures which sub stantially comprised the four sessions of the Symposium. Part 1 is designed to emphasize actual knowledge of the transport of water, inorganic as well as organic ions and molecules across the isolated intestinal epithelium. An enormous wave of investigations has emerged from studies per formed with "Ussing chambers," which roused interest in studies on absorption mechanisms and subsequently on secretory processes. This has triggered off a trend to research on isolated cells as absorption and secretion are the main func tion of the different cell types constituting the intestinal epithelium. In this first session not only the importance of the parallel arrangement of these different cellular entities is stressed, but also the role played by the paracellular route."