The Leiden-Edinburgh Boerhaave Course on 'The Gastro-intestinal Tract', held in Leiden on October 29 and 30, 1969, resulted from the renewed co-operation between the Medical Faculties of Edinburgh and Leiden, based on very old ties. As one will know, the Edinburgh Faculty of Medi cine was founded in 1726 on the principles guiding the Leiden Faculty of Medicine at that time, on the instigation of John Monro I, who had studied medicine in Leiden under the famous Boerhaave. These old ties were revived some 8 years ago, first by students, later by the Faculties themselves, with the special purpose to facilitate and en large the exchange of medical knowledge between two medical centres. One of the results of this was that it was considered whether physicians from both countries could not profit from the knowledge gained specific ally in both these faculties by letting the investigators from both faculties tell about their work within the framework of courses for post-academic medical training, in Leiden called the 'Boerhaave Courses'."

Exciting major changes have occurred in the understanding and treatment of gallstone disease over the last two decades. In bygone years, books about gallstones were often based on postgraduate lectures which the author, usually a surgeon of distinction, had given. More recently, many books dealing with this subject have been based upon national or international conferences. The single-author text has the disadvantage that few authors today can authoritatively encompass a whole field: the reports of symposia, conferences or workshops often lack balance and auth ority. The merits of 'Gallstone disease and its Management' edited by Malcolm Bateson are clear. He has chosen 11 authors, all of whom write on topics relating to their own expertise, and the content of the book has been carefully planned to reflect the most modern ideas about the aetiology and management of cholesterol gallstones. It is worth repeating that we are experiencing rapid developments in the field of gallstone disease. Disappointingly the least progress has been made in identifying the cause (or causes) of the disease notwithstanding the many data implicating a variety of environmental factors. Most of these affect the chemistry of hepatic bile and the contribution of the gallbladder to lithogenesis remains uncertain and unstudied."

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."

The rapid growth of fibre-optic endoscopy in recent than 7,500 examinations has been accumulated. years has had two consequences for the radiology of In part I of this study the theoretical background the stomach and the duocienum. and the technique of examination proper are de- scribed. The basic principles of interpretation of DC 1. Radiology has lost its previously rather auton- studies are stated. omous position in this field. Part II deals with the results. Chapter 5 consists of 2. As a result of the constant feed-back from the general remarks on the results, and on the comple- endoscopist, which the radiologist can and should mentary role of radiological examination and endos- have, he is in an excellent position to re-evaluate copy. Chapter 6 deals with a quantative study of and improve his own technique of examination. standard biphasic-contrast examinations in patients The author believes that the radiological exam- over a period of 3 years. This study was restricted to ination retains its value as a screening technique and malignant lesions, because it is only in this group a complementary method to gastroscopy and biop- that the definite criterion, a histological diagnosis, is sy. Only a sophisticated radiological technique will obtained. The natural history of malignant lesions fulfil these requirements. In 1973 the author devel- also makes follow-up studies possible. Results of the oped a standard examination that was called "bi- diagnosis of Early Gastric Cancer (EGC) are phasic", because it combines the advantages of included.

Inflammatory bowel disease - i.e. ulcerative colitis and Crohn's disease - not only creates significant patient morbidity but also imposes a diagnostic and therapeutic challenge to the physician in charge of these patients. Since the development of sulphasalazine by Dr Nanna Svartz in Sweden half a century ago, important improvements in the prognosis of ulcerative colitis and Crohn's disease have been achieved. This book makes an attempt to present and discuss some of the most recent advances in diagnostic procedures and therapeutic approaches to inflammatory bowel disease with special respect to Crohn's disease. Although the fmal diagnosis of ulcerative colitis and Crohn's disease is generally based on endoscopic, histological or X-ray examinations, nuclear medicine and its imaging procedures have established their place in certain aspects of inflammatory bowel disease. One chapter of this book is dedicated accordingly to the indications of nuclear diagnostic procedures in the clinical setting. Sulphasalazine has been the mainstay of medical therapy in ulcerative colitis and Crohn's disease of the colon. Recently 5-aminosalicylic acid has been discovered to be its active compound and sulphapyridine was found to be the component responsible for most of the adverse effects of sulpha salazine. It is not surprising that many studies have investigated 5-amino salicylic acid as a single therapeutic agent in inflammatory bowel disease."

Grouping ulcerative colitis with Crohn's disease (Inflammatory Bowel Disease) in a teaching seminar has historical support. The medical literature includes descriptions of both diseases in the latter half of the 19th century; they share many symptoms; in some instances, differentiating them may be very difficult; and the cause of each remains unknown. Furthermore, one member of a family may suffer with Crohn's disease while another has ulcerative colitis. And both processes are prone to the late complications of carcinoma at a site of previous involvement. Finally, the investigators and students of one disease have usually also contributed to the understanding of the other disease. The incidence of Crohn's disease seems to be increasing rapidly. This has been sug gested by reports from Sweden, the Netherlands, England, Scotland, and South Africa as well as the United States. Though methods of recording data vary, the increase is further supported by cases of greater virulence, still younger ages of onset, and more cases in the elderly. This is remarkable when we consider that fifty years ago, when the classic description from Mt. Sinai Hospital was being prepared, the disease was rare. Since the cause remains elusive, we must try to cope with this entity as skillfully as we can, with consideration of indications, and timing of drug and surgical intervention. The choice of forms of management has been controversial, even among the most experi enced physicians."

Oral tolerance is a major immunological property of the gastrointestinal mucosa. It plays a critical role in immune defence by preventing inflammatory and allergic responses to dietary and non pathogenic microbial antigens. The interest in oral tolerance has been renewed in the recent years, due to novel insights on its cellular mechanisms and potential clinical applications in the treatment of autoimmune diseases. Oral Tolerance: Cellular and Molecular Basis, Clinical Aspects, and Therapeutic Potential, has been designed as a concise yet comprehensive overview of the newest fundamental and clinical advances in the field. Based on the outstanding contribution of world experts, this book will be helpful to students, clinicians, and researchers working in mucosal immunology and gastroenterology. The first part of this volume describes the structure and functions of the gastrointestinal mucosa and the fundamental features and mechanisms of oral tolerance, including the role of T cells, cytokines, IgA antibodies, and bacterial antigens. The second part explores the clinical implications of the disruption of oral tolerance in Inflammatory Bowel Diseases, food and milk allergies, and coeliac disease in particular. The final chapter focuses on the clinical potential of oral tolerance as a promising therapeutic tool.

This book presents detailed methods on a variety of aspects of Salmonella research, focusing on those which provide landmarks for future discovery. It is the first comprehensive volume of methods and protocols for studying Salmonella and will be indispensable to researchers engaged in the study of Salmonella, and enterobacteria in general. Each chapter provides a short overview of the topic, followed by detailed explanations of techniques.

The liver is an exceptionally complex and diverse organ that functions both as an exocrine and an endocrine gland. It secretes bile, which contains many con stituents in addition to bile salts, and it synthesizes and releases many substances in response to the body's demands, including prohormones, albumin, clotting factors, glucose, fatty acids, and various lipoproteins. It has a dual blood supply providing a rich mixture of nutrients and other absorbed substances via the portal vein and oxygen-rich blood via the hepatic artery. This functional heterogeneity is accompanied by cellular heterogeneity. The liver contains many cell types including hepatic parachymal cells, Kiipffer cells, Ito cells, and endothelial cells. The most abundant cell type, the parenchymal cells, are biochemically and structurally heterogeneous. The cells in the oxygen-rich areas of the portal triad appear more dependent on oxidative metabolism, whereas those around the central vein (pericentral, perivenous, or centrolobular areas) are more dependent upon an anaerobic mechanism. Throughout this volume the latter three terms are used synonymously by various authors to indicate the five to eight layers of cells radiating from the central vein. Structural and metabolic heterogeneity of hepatic parenchymal cells has been demonstrated by a variety of approaches, including histochemical, ultra structural, and ultramicrobiochemical studies. This microheterogeneity is linked to the physiological functions of the liver and its response to injurious substances."

Are you looking for concise, practical answers to those questions that are often left unanswered by traditional pediatric GI references? Are you seeking brief, evidence-based advice for complicated cases or controversial decisions? Curbside Consultation in Pediatric GI: 49 Clinical Questions provides quick answers to the tricky questions most commonly posed during a "curbside consultation" between pediatricians. Drs. Joel R. Rosh and Athos Bousvarous have designed this unique reference which offers expert advice, preferences, and opinions on tough clinical questions commonly associated with pediatric GI. The unique Q&A format provides quick access to current information related to pediatric GI with the simplicity of a conversation between two colleagues. Numerous images, diagrams, and references allow readers to browse large amounts of information in an expedited fashion. Some of the questions that are answered: * How is infantile colic diagnosed and treated? * How is GERD diagnosed in infants and what are the best treatments? * How can I optimize my treatment of childhood constipation and does this vary by age? * How can I effectively intervene in a child that is overweight or obese? * Celiac disease seems so much more common -- is this an epidemic? * Why have food allergies become so common and what are the most accurate means of diagnosis? Curbside Consultation in Pediatric GI: 49 Clinical Questions provides information basic enough for residents while also incorporating expert advice that even high-volume pediatricians will appreciate. Pediatricians, nurse practitioners, physician assistants, family practitioners and pediatric residents will benefit from the user-friendly, casual format and the expert advice contained within.

This book is unique for its comprehensive presentation of protease function in the stomach, colon, pancreas and liver under both physiological conditions and major diseases manifesting in these four organs. The individual chapters have been written by leaders in the field who outline in great detail the role of proteases in the pathogenesis, diagnosis and treatment of disease. Animal models and experimental data are discussed in the context of patient-derived data.

Pathology of the Stomach and Duodenum comprehensively surveys gastric and duodenal disease, including clinical findings, pathophysiology, and epidemiology, and emphasizing diagnostic gross and microscopic pathology. Topics discussed include anomalies, gastritis, peptic ulceration, hyperplasias and benign epithelial tumors, carcinoma of the stomach and duodenum, carcinoid tumors, reactive and neoplastic lymphoid lesions, gastric smooth muscle and nerve sheath tumors, and miscellaneous lesions and rare conditions reflecting gastroduodenal participation in systemic disease.

I am delighted to be able to write the foreword for this new book on Helicobacter pylori by three pioneers in the field, Vlf West blom, Steven Czinn and John Nedrud. Because of their long experience in both basic and clinical aspects of H. pylori, the editors have been able to produce a volume which is authoritative and up to date in the science of H. pylori, while still being concise and interesting for the practicing physician or H. pylori novice. To achieve this, they have collected a very distinguished group of authors from within the Vnited States and around the world. The chapters are sequenced in approximately the same order as developments in H. pylori science over the past 15 years. The first chapter on the discovery of H. pylori is by Cliodna McNulty, who was the first person to culture the organism in Europe. The epidemiology is then described followed by the main clinical as sociations, which are gastritis and dyspepsia, peptic ulcers, can cers and lymphoma. This naturally leads to discussion of the laboratory aspects of H. pylori, especially the microbiology, in cluding essential information on antibiotic resistance patterns. Next, virulence and pathogenicity of H. pylori are explained as defined in studies using animal models, then by discussion of the metabolism of the organism. Finally, the interaction of the bac terium with the host immune systems is dealt with, including the implications of these findings as they relate to the development of future vaccines."

This volume serves as a hands-on, practical reference in nutrition support for the clinical gastroenterologist and for other clinicians with similar interests. The book offers expert nutritional knowledge and management ideas. It also provides methodology for combating problems such as short bowel syndrome, inflammatory bowel disease, celiac disease and obesity.

In the past 30 years, gastroesophageal and reflux disease (GERD) has become an important area of clinical medicine. GERD has gradually become associated with other common but unexplained disorders. These conditions have been designated as the extraesophageal manifestations of GERD. Dr. Anthony J. DiMarino, Jr. and Dr. Sidney Cohen and their contributors have written Extraesophageal Manifestations of GERD with the purpose to identify associations with conditions like hoarseness, laryngeal cancer, sleep disorders, and dental caries, and to explore possible causation and mechanisms of disease or possible noncausal relationships. The extraesophageal disorders have become widely accepted in clinical practice. The evidence supporting the pathogenesis of these conditions falls into three major categories: guilt by association, observed mechanistic studies, and therapeutic response to treatment. Inside the pages of Extraesophageal Manifestations of GERD the reader will find recognition and balance in treating patients with common symptom-based disorders. Final resolution of some of the controversies inherent in these associations may require advanced diagnostic tools and advanced pharmacological therapies. With chapters written by experts in the fields of medicine, pediatrics, otolaryngology, and dentistry, Extraesophageal Manifestations of GERD will be a must have for gastroenterologists, internal medicine residents, surgeons, otolaryngologists, and pediatricians.

This textbook addresses the best way of evaluating patients with rectal prolapse, the underlying pathophysiology, the different surgical approaches, the expected functional results after surgery and the management of complex clinical conditions associated with this condition. It is an essential book that attempts to draw together material that could be of vital importance to surgeons around the world. The pathophysiology of rectal prolapse is still uncertain and its clinical and instrumental diagnostic assessment needs to be clarified.

Since a number of mucosal digestive tract cancer detected has increased in recent years with an advance of endoscopic instruments, endoscopic treatment of digestive tract cancer is widely spread in Japan but not in other countries. Minute cancers seem to have own characteristic mucosal signs compared with benign lesions. Therefore, strategies, those are different in Japan from other countries, of endoscopic diagnosis are very important.

The cancer institute hospital of JFCR (Japan foundation of cancer research) is one of the top institutions which do the best endoscopic treatment in Japan. This book is expected to be the first valuable atlas in which the abundant experiences of this hospital offer beautiful photographs of minute cancers without any scars of biopsies which change aspects of original lesions. This book also offer pictures of magnifying endoscopy using NBI (Narrow Band Imaging) and pathological findings.

Endomicroscopy is a newly developed diagnostic tool which enables in vivo microscopy with subcellular resolution during ongoing endoscopy in the upper and lower gastrointestinal tract. Thus, endomicroscopy is a revolutionary technology because it provides the endoscopists for the first time with information about living cells in humans. Endoscopy and pathology are no longer separate subjects and thus endomicroscopy leads to a close interaction between endoscopist and pathologist. This Atlas of Endomicroscopy is the first book dealing with the new insights of endomicroscopy and provides you an overview about the development, the requirements, the technique, current indications and further possibilities of endomicroscopy.

- With a dramatic increase in knowledge of anorectal physiology and imaging over the last five years, this book provides a comprehensive study of anorectal assessment.

- Explores all the lastest techniques and treatments in the field

- Organized into two, easy to manage, sections

- First book to pull a diverse area together and includes 3-D ultrasound, transperineal ultrasonography and dynamic MRI not found in other texts on anorectal disorders

Surgery of the Esophagus and Stomach provides an illustrative, instructive, and comprehensive review that depicts the rationale of basic operative principles essential to surgical therapy of the esophagus and stomach. The chapters provide pertinent and concise summaries of how to deal with various esophagus and stomach disorders, spanning benign and malignant problems and minimally invasive procedures. Stages of operative approaches with relevant technical considerations are outlined in an easily understandable manner. Complications are reviewed when appropriate for the organ system and problem. The text is illustrated throughout by line drawings and photographs that depict anatomic or technical principles. A concise, handbook-sized reference work, this book is a valuable resource for all general surgeons and residents in training.

This book addresses the contemporary multidisciplinary management of liver metastases. Throughout the text, experience from the paradigms of colorectal cancer metastases treatment strategies are used to point to new directions in the management of liver metastases from other cancers. The book will be invaluable for surgeons in general surgery, hepatobiliary surgery, upper GI surgery, colorectal surgery, medical and clinical oncologists with an interest in liver tumours, and radiologists with an interest in liver disease.

This is the first book to specifically deal with hidradenitis suppurativa, a common but overlooked disease that regularly causes significant problems for both patients and doctors. The first section of this book presents the best current knowledge about diagnosis, pathogenesis and complications. The second section offers comprehensive guidelines on diagnosis and therapy. The book will assist doctors in providing a broader range of treatments for their patients. To increase the practical usefulness of the book, a description of the patients' perspective and patient information is included.

The only book to deal specifically with constipation for specialists has been updated to include all the new advances since the first edition (1995). These advances include biofeedback, surgery for constipation, sacral nerve stimulation, the use of laparoscopy for rectal prolapse, treament and our understanding of some of the psychological problems of these patients. Innovations also include Professor Norman Williams Malone Procedure and the newer pharmacologic treatments such as nitric oxide and botulinum toxin injections.