This book is the proceedings of the Falk Symposium No.156 on ?Genetics in Liver Disease?, part of the XIII International Liver Week 2006 held in Freiburg, Germany, 7 October 2006. The first section covers the basic aspects of genetic diagnosis, pharmacogenetics, micro-arrays and their relevance for liver diseases, including viral hepatitis, hepatocellular carcinoma, and gallstone diseases. In the second section, the most important hereditary liver diseases are discussed, including haemchromatosis, Wilson disease, alpha-1-antitrypsin deficiency, porphyrias and cystic fibrosis. In the third section, the genetics of cholestatic and metabolic liver diseases as well as the current status of experimental and clinical studies of gene therapy for liver diseases and stem cell transplantation are presented. Each section starts with a State-of-the-Art Lecture which introduces the topic. In the tradition of the Falk Symposia, this book provides an exciting overview of the current developments in the field of genetics of liver diseases, their diagnosis, treatment and prevention, presented by an international array of outstanding scientists and clinicians.

Pregnancy is the main determinant of some liver diseases in humans: acute fatty liver of pregnancy, cholestasis of pregnancy, and acute liver failure in toxaemia of pregnancy. Pregnancy also modifies the natural history of other more common hepatobiliary diseases, such as cholesterol gallstones. Sex hormones (mainly oestrogens, progesterone and/or some of its metabolites) and prolactin are considered responsible for these pathological consequences and they also appear to be influential in the outcome of several other hepatobiliary disorders, in both sexes and all ages. Although these disorders and their hormonal interrelations have been clinically well characterized, their pathogenesis remains obscure from the biomolecular point of view. In recent years, novel approaches using new technologies have improved our understanding of hormone actions and metabolism, hormone receptors, metabolic pathways and their interrelations with closely related molecules, such as bile acids. This book, the proceedings of the 89th Falk Symposium, held in Santiago, Chile, 10-11 November, 1995, will help research scientists and clinicians to review basic and clinical aspects of these interactions, in order to stimulate biomedical research in a relevant and exciting area.

During the last decade, knowledge about cholestatic liver disease and concomitant diseases, such as ulcerative colitis, cholangio- and hepatocellular carcinoma, pancreas and colon cancer, has increased considerably. Studies on ursodeoxycholic acid treatment alone or in combination with immunosuppressive compounds and their positive effects on biliary liver disease as well as on so-called overlap syndromes or intestinal tumors are published in increasing numbers, and stimulate discussion on whether or not ursodeoxycholic acid is able to improve the general condition and/or life expectancy of patients. On the other hand, genetics, aetiological and pathogenetic aspects are still difficult to comprehend, but are the absolute prerequisite for the development of better treatment options. This book is the proceedings of Falk Symposium No. 136 (Part I of the XII Falk Liver Week, held in Freiburg, Germany, on October 15-16, 2003), and contains stimulating, exciting and controversial papers on clinical and also basic research at the highest scientific level.

The scope of the book is very broad, covering a wide range of areas in HBV/HDV and HCV research, including both basic and clinical science. The selected topics range from epidemiology, immunology, molecular virology and oncology, to clinical therapy.Chronic Hepatitis B and C consists of 14 chapters, each being a review of a special topic on HBV or HCV. While review articles on a special topic can be found in periodical journals, they tend to be more restricted in presentation. Therefore, this book will provide more in-depth coverage of what are presented as "unpublished results" and "data not shown" in journal articles. Furthermore, several authors in this book do not write review articles regularly. Some authors wrote reviews on a specific topic regularly, but they tried a new topic in this book (e.g., Dr. YF Liaw on "natural course," Dr. Shih on "virion release," Dr. Michael Lai on "lymphotropism of HCV," etc. ). Overall, the book will offer useful information at the cutting age.Sample Chapter(s)

Recent advances in gastroenterology and hepatology as well as new findings in biliary and pancreatic diseases are presented in the proceedings of the 86th annual congress of the Japanese Society of Gastroenterology. From the hundreds of papers delivered at the congress, 70 were selected for inclusion here. Opening with special lectures on gastroenterology in the new millennium, ulcerative colitis-pathophysiology and therapy, and life style-related diseases and gastroenterology, the volume is divided into sections reflecting the major concerns of researchers in the science of digestive diseases in Japan today: apoptosis in digestive organs, nitric oxide, transcription factors in digestive organs, antigen-presenting cells, pathology of inflammatory bowel disease, NSAID-induced gastric lesions, microcirculation in digestive diseases, hepatic regeneration, and hepatic fibrosis.

Hepatitis delta virus which causes severe acute and chronic liver disease was discovered following the detection of a novel antigen-antibody system in hepatitis B virus carriers. Currently, HDV is classified as a subviral satellite of hepatitis B virus. However, unlike other satellite viruses, the dependence of HDV on HBV is limited solely to the provision of an envelope of hepatitis B surface antigen for virus assembly. Research into the molecular virology of the HDV life cycle has revealed a fascinating collection of biology. These insights are now beginning to be translated into new potential treatment strategies. There are currently still an estimated 15 million HDV carriers worldwide.

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An easy to follow step-by-step guide to the most useful surgical skills from knot tying to simple procedures. Illustrated with colour photographs and video clips to demonstrate techniques, this book makes these practical skills as clear and easy to follow as possible. Including coverage of surgical instruments, wound management and suturing, and minor surgical procedures, it also explains how to use these essential surgical skills to make the most of a surgical placement. Healthcare students or junior professionals undertaking a placement in surgery or emergency medicine will feel confident and capable, and will be able to take an active role in surgical placements. Learning basic surgical skills is important for such placements, as well as for undertaking exams such as the Membership of the Royal College of Surgeons (MRCS).

In recent years there has been an increasing need for transplantation, but the number of donor livers available has increased only slightly, despite intensive public relations activities. New concepts in the field of transplantation, for instance the transplantation of living donor organs or the splitting of organs, are urgently required, to safeguard the treatment of patients with severe liver disease. The development and clinical application of cell therapy for patients with liver disease could soon present a significant enhancement of the therapeutic options. The aim of such cell therapy is to repair or improve the biological function of the chronically and acutely damaged liver. Even though systematic trials are not available, individual case reports and small series already show promising clinical results.

Present concepts of cell therapy for liver diseases based on the use of primary hepatocytes have recently been considerably extended through new data on the biology of stem cells. The adult haematopoetic stem cell as a pool for hepatocyte grafts - what would be the perspectives for the clinical application?

This book is the proceedings of the Falk Symposium No. 126 on Hepatocyte Transplantation' (Progress in Gastroenterology and Hepatology Part III) held in Hannover, Germany, October 2-3, 2001, and is a forum for basic research, but also for questions concerning clinical applications in the field of hepatocyte transplantation.

Bile acid research has attracted increasing attention from both basic scientists and clinical hepatologists over the last decade. Experimental studies have expanded our knowledge of the role of bile acids in liver disease, and well-designed clinical trials have documented beneficial effects of bile acid treatment for a number of hepatobiliary diseases. Bile Acids in Liver Diseases, the proceedings of an International Falk Workshop held in Munich, January 1995, provides insights into current concepts in bile acid chemistry, bile acid synthesis and metabolism, and transport of bile acids across the hepatocyte. The role of bile acids in bile formation, cholestasis and hepatotoxicity are discussed. Finally, the book addresses experimental studies and hypotheses about the putative mechanisms of action of ursodeoxycholic acid in cholestatic liver diseases, and summarizes the clinical applications of bile acid treatment on the basis of controlled clinical trials.

The advent of molecular biology and recombinant DNA technology has profoundly changed contemporary medicine. These new scientific tools have made it possible to identify and understand pathological mechanisms at cellular, subcellular and molecular levels which has added previously unimaginable novel dimensions to the diagnosis, therapy and prevention of a rapidly increasing number of diseases of the liver and biliary system. The title of this book - Acute and Chronic Liver Diseases: Molecular Biology and Clinics - expresses this epochal progress in hepatology. A series of acute or chronic diseases of the liver has been chosen whose modern clinical management most eloquently reflects the impact of the new scientific insight gained from molecular biology. The book, the proceedings of the 87th Falk Symposium (X International Congress of Liver Diseases: Part II of the Basel Liver Week 1995) held in Basel, Switzerland, October 19-21, 1995, first presents an overview of the molecular pathology of the chosen disease, followed by discussions of the clinical inference which this new scientific information entails for diagnosis, management and therapy. This approach is expected to ease the readers' endeavour to connect basic to clinical science and to facilitate appreciation of the enormous progress but also the inherent limitations and arising questions which modern molecular biology has brought to clinical medicine.

There has been a tremendous amount of scientific progress in our understanding of the molecular mechanisms of transport processes in the liver within the last few years. Cloning of various members of organic anion and cation transporters has provided the necessary tools to study their regulation under physiological and pathophysiological conditions and has advanced our knowledge about bile formation. Mutations of various hepatic organic anion transporters have been identified in humans as hereditary defects leading to the heterogenous syndrome of progressive familial intrahepatic cholestasis (PFIC). Various mouse models including knockout animals have given us the opportunity to gain insight into lipid transport by the liver and the genetics of cholesterol gallstone formation. The physiology of bile duct cells and the molecular mechanisms leading to various cholangiopathies have been a main scientific focus in hepatology in recent years. Drug targeting to the liver by hepatic organic anion transporters represents an attractive way of selective delivery of pharmaceutical agents in humans. Ursodeoxycholic acid is successfully used in the treatment of patients with chronic cholestatic liver disease and major advances have been made in understanding its mode of action in liver and bile duct cells. This book, the proceedings of the Falk Workshop held in Aachen, Germany, on 25-26 January 2001, contains chapters on all important aspects of biliary transport by well-known experts in this field. It is an essential resource for new developments in the field of biliary transport, both in basic science and clinical medicine.

Highly illustrated and conveniently templated for quick reference, Atlas of Liver Pathology, 4th Edition, is a useful Atlas and text for every practicing pathologist or trainee who assesses liver biopsy specimens. From cover to cover, it contains all the information needed to identify histologic features and correlate them with clinical findings, offering a clearer understanding of the clinical implications of the disease as it relates to treatment. More than 1,200 high-quality, full-color images and illustrations provide you with a complete visual guide to the vast majority of liver diseases and assist in the diagnoses of biopsy and resected liver specimens. Provides clear, templated information for each disease: Major Morphologic Features; Special Stains; Differential Diagnoses; Clinical and Biologic Behavior; and Treatment and Prognosis.  Incorporates relevant data from ancillary techniques (immunohistochemistry, cytology, cytogenetics and molecular genetics), giving you the necessary tools required to master the latest breakthroughs in diagnostic technology.  Incorporates the latest diagnostic biomarkers and their utility in differential diagnoses, newly described variants, and new histologic entities.  Contains two new chapters on liver biopsy interpretation and autoimmune hepatitis.  Features concise, bulleted text and abundant tables that cover common as well as rare diseases, differential diagnoses, and more.  An eBook version is included with purchase. The eBook allows you to access all of the text, tables, figures and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud. 

Hepatitis C virus (HCV), a major causative agent of chronic liver disease, is spread throughout the world and around 170 million people are persistently infected. In this volume, world-leading experts in the field of HCV research have compiled the most recent scientific advances to provide a comprehensive and very timely overview of the various facets of HCV. The book starts with a discussion of the possible origin of HCV and its spread among the human population. The focus of the subsequent chapters is on available cell culture and in vivo models before shifting to the molecular and cellular principles underlying the viral replication cycle. These chapters are complemented by insightful descriptions of the innate and adaptive immune responses to HCV as well as the virus-associated pathogenesis. Finally, the development of antiviral therapies, which is closely linked with progress in basic research, and the implementation of those therapies into present and future daily clinical practice are highlighted.

Inflammation and cancer are two major disorders that cause huge concerns in our society. However, what one may not know is that both diseases are closely associated and, in particular, both occur in the gastrointestinal tract and liver. This book describes the mechanics of how inflammation can progress to cancer in these organs. The authors in this book comprehensively discuss the different biomarkers for early diagnosis, and current therapeutic treatments for these diseases. All of these would allow us to better understand the pathogenesis of both diseases. As such, this book provides comprehensive information concerning the interrelationship between inflammation and cancer in a cohesive manner, and the information derived would benefit not only basic scientists but also clinicians who are working in these fields.

Cellular therapy with liver stem cells and their progeny, including bone marrow cells, is a promising new approach that will contribute significantly to the treatment of liver diseases. The existence of the liver stem cell had long been debated, but it is now generally accepted that the liver contains cells with stem-like properties and that these cells can be activated to proliferate and differentiate into mature hepatocytes under certain conditions. There is also a substantial body of evidence to suggest that oval cells are involved in liver regeneration as they differentiate into hepatocytes and biliary cells. This book is a collection of work on stem cell and liver regeneration, initially delivered at the 14th Yamaguchi (Japan) Symposium on Liver Disease. Its nine chapters present the most recent data about basic and clinical research in hepatology in Japan and other countries, providing a valuable resource for researchers and practitioners alike.

In 1992, the Falk Symposium No. 70 dealt with the topic Immunology and Liver'. At that time basic mechanisms of immunology as well as immunopathogenetic mechanisms in viral and autoimmune liver diseases were discussed. Now, 7 years later, the Falk Symposium No. 114, held in Basel, Switzerland, October 20-21 1999 (Part I of the Basel Liver Week 1999), focused on immunology in autoimmune liver diseases. In the first section basic mechanisms of autoimmunity are presented, including the relevance of superantigens and the role of apoptosis. A further topic is the latest developments concerning animal models for autoimmune diseases. Recently the International Autoimmune Hepatitis Group newly defined and reclassified the syndrome of autoimmune hepatitis. Autoimmune hepatitis is now identified and studied in all parts of the world, including Asia and South America. A special variant of autoimmune hepatitis was identified as one organ manifestation of the autoimmune polyendocrine syndrome type 1, a genetic disease caused by mutations in a single transcription factor. Drug- and hepatitis-virus induced immune mediated liver diseases may serve as models for nonhepatic immune mediated disorders. DNA technology has increased our knowledge of the immunogenetic background of autoimmune liver diseases. Among the cholestatic immune mediated liver diseases, significant progress has been made concerning primary biliary cirrhosis, in particular regarding the identification of mitochondrial antigens and the characterisation of the immune reactions directed at them. The involvement of infectious agents in PBC as well as the definition of overlap syndromes is a particular focus for basic and clinical research in this area. Concerning the therapy of autoimmune liver diseases, corticosteroids and azathioprin remain the state of the art for autoimmune hepatitis, while bile acids have become well established in treatment of primary biliary cirrhosis as well as primary sclerosing cholangitis. New drugs in the future will include topical steroids such as budesonide and new immunosuppressive agents like mofetil/mycophenolate. Liver transplantation is the treatment of choice for end stage liver diseases; all autoimmune liver diseases are among the best candidates for liver transplantation. Hopefully, new therapeutic strategies based on the results obtained from experimental models will become everyday clinical practice in the next decade. Therefore this symposium concludes with a discussion.

This volume contains the proceedings of the Falk Workshop on Bile Acids in Hepatobiliary Disease, which took place at the Royal Society of Medicine (RSM) in London, UK, on 29-30 March 1999, and was held in association with the Section of Measurement in Medicine at the RSM. The main interest in bile acid therapy has been recently in cholestatic liver disease. The proceedings of the workshop not only discusses this, but moves on to examine its possible use in alcoholic liver disease, and moves back to re-examine its role in biliary disease. Leading world experts attempt to define its mechanism of action, and the current role of other non-surgical treatments in biliary disease. The physiology and pathogenesis of cholestatic and alcoholic liver disease and cholesterol gallstone disease is also examined.

Whereas other textbooks mix a clinical approach with large amounts of the basic science of gastroenterology, this book concentrates on providing practicing gastroenterologists with 100% clinically focused, evidence-based chapters on how to correctly diagnosis and treat all disorders of the digestive tract. Once again, the book is divided into 4 clear parts: Symptoms, Syndromes and Scenarios; Diseases of the Gut and Liver; Primer of Diagnostic Methods; and Primer of Treatments. An accompanying website contains more than 85 high-definition surgical videos of diagnostic and therapeutic endoscopic procedures, 300 MCQs written to mirror the American College of Gastroenterology postgraduate course exams, more than 35 management protocol charts for different diseases, and 850+ illustrations for use in scientific presentations.

Laparoscopic cholecystectomy is a straightforward abdominal surgery performed worldwide, which can occasionally be mired with life-threatening complications when the safety principles are flouted. The tips and tricks of safety given in this book provide a complete insight into the variability of biliary anatomy, the nuances, and the technique of addressing the safety issues during routine and complicated procedures. Additionally, the book also explores the reasons for complications in real-life situations and suggests means for their avoidance. Using high-resolution video grabs, appropriately edited, an attempt has been made to explain all critical issues during laparoscopic cholecystectomy. Key Features Explains the Do's & Don'ts of laparoscopic cholecystectomy in a concise and focused atlas form. Serves as an illustrated reference to perform a safe uncomplicated cholecystectomy for postgraduate students in general surgery, surgeons practicing minimally invasive surgery and hepatobiliary surgeons. Uses high quality operative videos to provide a detailed understanding of real-life situations and means to comply with safety measures.

Laparoscopic cholecystectomy is a straightforward abdominal surgery performed worldwide, which can occasionally be mired with life-threatening complications when the safety principles are flouted. The tips and tricks of safety given in this book provide a complete insight into the variability of biliary anatomy, the nuances, and the technique of addressing the safety issues during routine and complicated procedures. Additionally, the book also explores the reasons for complications in real-life situations and suggests means for their avoidance. Using high-resolution video grabs, appropriately edited, an attempt has been made to explain all critical issues during laparoscopic cholecystectomy. Key Features Explains the Do's & Don'ts of laparoscopic cholecystectomy in a concise and focused atlas form. Serves as an illustrated reference to perform a safe uncomplicated cholecystectomy for postgraduate students in general surgery, surgeons practicing minimally invasive surgery and hepatobiliary surgeons. Uses high quality operative videos to provide a detailed understanding of real-life situations and means to comply with safety measures.

The regenerative capacity of the liver has been recognized for centuries, but when it is overwhelmed by insulting stimuli or is chronically damaged, its regenerative capability is substantially reduced or lost. Researchers have been working to find solutions to cure failing human liver function. Given the ability of stem cells to self- renew and differentiate into specialized cell liver types, they represent an attractive strategy to replace lost liver function. This book begins by outlining the complex nature of human liver disease and proceeds to examine the potential that stem cell-based approaches have to offer.

Primary sclerosing cholangitis is a chronic disease of the intra- and extrahepatic bile ducts leading to obstructions and dilatations followed by liver cirrhosis and in some cases cholangiocarcinoma. In 50% of cases primary sclerosing cholangitis is associated with inflammatory bowel disease. The cause of the disease is unknown and many questions concerning the pathogenesis still remain open. In recent years our knowledge of the natural course, the risk of cholangiocarcinoma and the possibility of medical, endoscopic and surgical treatment has increased. Ursodeoxycholic acid, endoscopic treatment and liver transplantation have become standard therapeutic procedures. This book is the proceedings of the Falk Workshop held on October 3, 1997, in Freiburg, Germany (Part II of the Liver Week Freiburg 1997), and covers the most important aspects of this fascinating disease.

This text provides a comprehensive review of ERCP and EUS and the clinical conditions for which they are employed. Presented in a case-based format with accompanying videos, it will serve as a valuable practical clinical resource for gastroenterologists with an interest in ERCP and EUS. The text highlights major techniques involved in ERCP, reviews complications and recent data on preventing post-ERCP pancreatitis, and discusses important issues in training in ERCP including use of endoscopic simulators and assessment of competency as emphasized in the new ACGME guidelines. For biliary diseases, new techniques for managing biliary stones, novel technologies for diagnosing indeterminate biliary strictures, and new devices for treating benign and malignant strictures are also highlighted. For pancreatic diseases, advances in minimally invasive endoscopic techniques for pancreatic stones and strictures, and management of the complications of pancreatitis are reviewed. Furthermore, ERCP is not limited by age, pregnancy or history of abdominal surgeries and special considerations particular to these patient populations are also discussed. The EUS chapters review the breadth of equipment available for performing EUS and EUS-FNA, detail the technique of performing EUS-FNA, and explore pertinent issues with training and assessing competency analogous to ERCP training. Valuable insights on the basics of cytopathology relevant to the endosonographer are summarized. The classic indication for EUS of staging luminal cancers is examined in detail while pancreaticobiliary indications are discussed highlighting newer adjunctive technologies including elastography and contrast-enhanced EUS. Although in its infancy, the brave new world of therapeutic EUS is explored with a focus on endoscopic necrosectomy, EUS-guided biliary and pancreatic access as well as the exciting possibilities of EUS-guided radiofrequency ablation and injection of anti-tumor agents. ERCP and EUS: A Case Based Approach will serve as a very useful resource for physicians who perform or refer patients for ERCP and EUS. It provides a concise yet comprehensive summary of the current status of ERCP and EUS that will help guide patient management and stimulate clinical research.

First published in 1995: Clinically Applied Microcirculation Research combines state-of-the-art microcirculation technology with present and potential applications in clinical medicine. This comprehensive guide unites the expertise of clinicians and basic researchers from around the world. Many of the chapters are authored by scientist/physician teams. The book provides a broad overview of how microcirculation is involved in clinical research. This is also a valuable reference source for both the history of and latest developments in microcirculation research.

Hepatocytes account for approximately 80% of the liver mass and play a significant role in various aspects of liver physiopathology, exhibiting unrivaled complexity and diversity of functions. In Hepatocytes: Methods and Protocols, expert researchers provide the reader with methods, technical protocols, and review chapters focusing on selected areas of hepatocyte biology including isolation, culture, differentiation and stem cells, and hepatocyte use in clinical, basic, and applied research. With a specific emphasis on human hepatocytes, the volume presents chapters covering subjects including hepatocyte culture models, cryopreservation methods, differentiation assessment, liver ontogenesis, production of hepatocytes from stem cells, drug/xenobiotic metabolism, toxicity and transport, bile acid and blood coagulation factor production, infection by HBV and HCV, humanized animals, biortificial liver devices, hepatocyte transplantation. As a volume in the highly successful Methods in Molecular Biology (TM) series, protocol chapters include brief introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and notes on troubleshooting and avoiding known pitfalls. Comprehensive and cutting-edge, Hepatocytes: Methods and Protocols will be useful to all those who are currently using or planning to use human, or animal, hepatocytes to investigate any aspect of liver physiopathology or who are interested in liver development or liver stem cells and liver biotherapy.